Search results for "valve"
showing 10 items of 576 documents
MitraClip Implantation in Holography.
2021
Transcatheter edge-to-edge repair for tricuspid regurgitation in Barlow-type tricuspid valve prolapse
2020
Update on tricuspid regurgitation
2014
Although commonly detected by transthoracic echocardiography, tricuspid regurgitation (TR) has been somehow neglected, and recent data have emerged on the need for careful examination of the tricuspid valve. Functional or secondary TR is the most frequent etiology of tricuspid valve pathology in western countries and is related to tricuspid annular dilation and leaflet tethering. The prognostic role of TR associated with organic left-sided valvular heart disease is well known. However, the value of functional TR in outcome stratification of patients with advanced left ventricular dysfunction is less clear. Surgical tricuspid repair has been avoided for years, because of the misconception th…
Numerical simulation of transcatheter mitral valve replacement: The dynamic implication of LVOT obstruction in the valve-in-ring case.
2022
Transcatheter mitral valve replacement (TMVR) has been used for “off-label” treatment when annuloplasty band ring for mitral repair fails. However, the complex anatomy and function of the mitral valve may lead to fatal complications as a result of the left ventricular outflow tract (LVOT) obstruction in TMVR. We report the structural and hemodynamic response of LVOT obstruction resulting from TMVR with the Edwards SAPIEN 3 Ultra (S3) device. We modified the original Living Heart Human Model (LHHM) to account for a failed mitral valve with an annuloplasty band ring and simulated the cardiac beating condition in the setting of S3 device implantation. Findings demonstrated a high dynamic behav…
Early symptomatic benefit indicates long-term prognosis after transcatheter mitral valve edge-to-edge repair in functional and degenerative etiology
2021
Mitral regurgitation (MR) is common in patients with heart failure and constitutes an independent risk factor for adverse prognosis besides NYHA-class. The predictive value of dyspnea reduction after transcatheter mitral valve repair (TMVr) on outcome has not been investigated up to now.We enrolled 627 consecutive patients (47.0% female, 57.4% functional MR; median follow-up 486 days[IQR 157/961]; survival status available in 96.8%; symptoms assessed in n = 556 at baseline / n = 406 at 1 month) treated with isolated percutaneous mitral valve edge-to-edge repair in our center from 06/2010-03/2018 (exclusion of combined forms of TMVr) in a monocentric retrospective analysis. Survival was 97.6…
Impact of Prosthesis-Patient Mismatch after Mitral Valve Replacement
2016
Background and aim of the study: The study aim was to determine the impact of prosthesis-patient mismatch (PPM) on early and late clinical outcomes, left atrial and ventricular remodeling, late tricuspid valve regurgitation and pulmonary hypertension (PH) in patients after mitral valve replacement (MVR). Methods: A total of 46 patients (mean age 66 ± 9.3 years) with mitral valve diseases and undergoing isolated MVR was enrolled in the study. The mitral valve effective orifice area (EOA) was determined using the continuity equation and indexed for the patient’s body surface area (EOAi). PPM was defined as EOAi ≤1.2 cm2/m2. PH was defined as a systolic pulmonary artery pressure (sPAP) >40 mmH…
Preoperative evaluation before MitraClip®: present and future perspective.
2014
ABSTRACT Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion. Among these techniques, the perc…
SIMPLE, SAFE AND EASY TECHNIQUE TO ENSURE THE CORRECT LENGTH OF ARTIFICIAL CHORDAE IN MITRAL VALVE REPAIR.
2007
Replacement of diseased chordae with Gore-Tex sutures (W. L. Gore & Assoc, Flagstaff, AZ) in patients with degenerative mitral valve insufficiency has become a standard technique used by surgeons in mitral valve repair with good long-term results. Nevertheless, determining the correct length of the artificial chordae has remained problematic. Although various procedures have been previously published, in this article we describe our approach used to achieve an accurate chordal height adjustment.
Transgastric imaging-The key to successful periprocedural TEE guiding for edge-to-edge repair of the tricuspid valve.
2021
Intraprocedural transesophageal echocardiography (TEE) guidance plays an essential role in transcatheter repair therapy of the tricuspid valve (TV). So far, several different imaging concepts are in use. We propose an imaging protocol that fully addresses the morphological complexity of the TV and further offers efficacious workarounds for the frequently occurring restrictions of TV imaging in edge-to-edge repair of the TV. As a tertiary referral center with a large experience of more than 250 cases of transcatheter edge-to-edge repair (TEER) of the TV performed at the Heart Valve Center in Mainz/Germany, we have constantly adapted our peri-interventional echocardiographic approach to accom…
Fabrication of elastomeric scaffolds with curvilinear fibrous structures for heart valve leaflet engineering
2014
Native semi-lunar heart valves are composed of a dense fibrous network that generally follows a curvilinear path along the width of the leaflet. Recent models of engineered valve leaflets have predicted that such curvilinear fiber orientations would homogenize the strain field and reduce stress concentrations at the commissure. In the present work, a method was developed to reproduce this curvilinear fiber alignment in electrospun scaffolds by varying the geometry of the collecting mandrel. Elastomeric poly(ester urethane)urea was electrospun onto rotating conical mandrels of varying angles to produce fibrous scaffolds where the angle of fiber alignment varied linearly over scaffold length.…