Patient-Specific Computer Simulation of Transcatheter Aortic Valve Replacement in Bicuspid Aortic Valve Morphology.

Background: A patient-specific computer simulation of transcatheter aortic valve replacement (TAVR) in tricuspid aortic valve has been developed, which can predict paravalvular regurgitation and conduction disturbance. We wished to validate a patient-specific computer simulation of TAVR in bicuspid aortic valve and to determine whether patient-specific transcatheter heart valve (THV) sizing and positioning might improve clinical outcomes.

Methods: A retrospective study was performed on TAVR in bicuspid aortic valve patients that had both pre- and postprocedural computed tomography imaging.

Clinical outcomes of the Lotus Valve in patients with bicuspid aortic valve stenosis: An analysis from the RESPOND study.

Aims: Patients with bicuspid valves represent a challenging anatomical subgroup for transcatheter aortic valve implantation (TAVI). This analysis evaluated the clinical outcomes of the fully repositionable and retrievable Lotus Valve System in patients with bicuspid aortic valves enrolled in the RESPOND post-market registry.

Methods And Results: The prospective, open-label RESPOND study enrolled 1,014 patients at 41 centers in Europe, New Zealand, and Latin America, 31 (3.

Transcatheter valve-in-valve implantation in a degenerated very small Mitroflow prosthesis.

Objectives: To assess the feasibility and results of 'valve-in-valve' implantation using the 23-mm CoreValve for the treatment of degenerated 19-mm and 21-mm Mitroflow bioprostheses.

Methods: We retrospectively analysed all consecutive patients who underwent transcatheter aortic valve implantation for 19-mm and 21-mm Mitroflow bioprostheses. The height of implantation with respect to the ring of the Mitroflow prosthesis was targeted at -6 mm for the first 3 cases.

Matched Comparison of Self-Expanding Transcatheter Heart Valves for the Treatment of Failed Aortic Surgical Bioprosthesis: Insights From the Valve-in-Valve International Data Registry (VIVID).

Background: Transcatheter valve-in-valve implantation is an established therapy for high-risk patients with failed surgical aortic bioprosthesis. There are limited data comparing outcomes of valve-in-valve implantation using different transcatheter heart valves (THV).

Methods And Results: Patients included in the Valve-in-Valve International Data registry (VIVID) and treated with self-expanding THV devices were analyzed using centralized core laboratory blinded to clinical events.

Initial Experience of a Second-Generation Self-Expanding Transcatheter Aortic Valve: The UK & Ireland Evolut R Implanters' Registry.

Objectives: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve.

Background: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications.

Methods: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland.

Treatment and clinical outcomes of transcatheter heart valve thrombosis.

Background: Valve thrombosis has yet to be fully evaluated after transcatheter aortic valve implantation. This study aimed to report the prevalence, timing, and treatment of transcatheter heart valve (THV) thrombosis.

Methods And Results: THV thrombosis was defined as follows (1) THV dysfunction secondary to thrombosis diagnosed based on response to anticoagulation therapy, imaging modality or histopathology findings, or (2) mobile mass detected on THV suspicious of thrombus, irrespective of dysfunction and in absence of infection.

Transcatheter aortic valve implantation in failed bioprosthetic surgical valves.

Importance: Owing to a considerable shift toward bioprosthesis implantation rather than mechanical valves, it is expected that patients will increasingly present with degenerated bioprostheses in the next few years. Transcatheter aortic valve-in-valve implantation is a less invasive approach for patients with structural valve deterioration; however, a comprehensive evaluation of survival after the procedure has not yet been performed.

Objective: To determine the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves.

Transcatheter aortic valve implantation for severe autograft regurgitation after Ross operation.

The Ross operation is the procedure of choice for aortic valve disease in paediatric patients, because of the potential for growth of the pulmonary autograft and because anticoagulation is not required. However, early and late autograft dilatation and severe aortic regurgitation may occur. Transcatheter aortic valve implantation (TAVI) is an effective procedure for treatment of severe degenerative aortic stenosis in patients deemed inoperable or high surgical risk.

Distortion of the CoreValve during transcatheter aortic valve-in-valve implantation due to valve dislocation.

Nowadays transcatheter aortic valve implantation (TAVI) is an accepted alternative to surgical aortic valve replacement for high-risk patients (pts). Successful TAVI procedures for failed aortic surgical bioprosthesis (TAV-in-SAV) have already been reported. In the presented two cases of TAV-in-SAV implantation a strut distortion of the stent was revealed on angiographic imaging and confirmed on control CT scan.

Transcatheter aortic valve implantation for pure severe native aortic valve regurgitation.

Objectives: This study sought to collect data and evaluate the anecdotal use of transcatheter aortic valve implantation (TAVI) in pure native aortic valve regurgitation (NAVR) for patients who were deemed surgically inoperable

Background: Data and experience with TAVI in the treatment of patients with pure severe NAVR are limited.

Methods: Data on baseline patient characteristics, device and procedure parameters, echocardiographic parameters, and outcomes up to July 2012 were collected retrospectively from 14 centers that have performed TAVI for NAVR.

Results: A total of 43 patients underwent TAVI with the CoreValve prosthesis (Medtronic, Minneapolis, Minnesota) at 14 centers (mean age, 75.

First-in-man assessment of a dedicated guidewire for transcatheter aortic valve implantation.

Aims: The aim of this study was to evaluate the safety and performance of a specifically designed, dedicated TAVI guidewire.

Methods And Results: From May 2011 to August 2012, 39 consecutive patients referred for TAVI were prospectively enrolled in a first-in-man, open label, non-randomised feasibility study to evaluate the safety and performance of a specifically designed, dedicated TAVI guidewire in our institution (mean age 80.4±5.

Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry.

Background: Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry.

Methods And Results: The Global Valve-in-Valve Registry included 202 patients with degenerated bioprosthetic valves (aged 77.

Complications at the time of transcatheter aortic valve implantation.

Transcatheter aortic valve implantation (TAVI) improves the prognosis of patients with severe aortic stenosis who are deemed too high risk for surgical valve replacement. However, this evolving technology is associated with a wide range of potential complications--some specific to TAVI, some often fatal. Prevention, early recognition, and effective treatment of these complications will significantly improve the outcome of this procedure and are essential prerequisites before the therapy is extended to lower-risk patient subsets.

Transcatheter aortic valve implantation for severe, non-calcified aortic regurgitation and narrow aortic root: description from a case report of a new approach to potentially avoid coronary artery obstruction.

Transcatheter aortic valve implantation is a possible, although off-label, alternative to conventional aortic valve replacement for high-surgical-risk patients with severe, non-calcified aortic regurgitation (AR). To date, feasibility has only been demonstrated with the Medtronic CoreValve prosthesis (MCV). This prosthesis needs the aortic sinuses to have enough width to avoid coronary obstruction.

Comparison of magnetic resonance imaging of aortic valve stenosis and aortic root to multimodality imaging for selection of transcatheter aortic valve implantation candidates.

The purpose of the present study was to compare the aortic valve area, aortic valve annulus, and aortic root dimensions measured using magnetic resonance imaging (MRI) with catheterization, transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). An optimal prosthesis--aortic root match is an essential goal when evaluating patients for transcatheter aortic valve implantation. Comparisons between MRI and the other imaging techniques are rare and need validation.

Incidence and treatment of procedural cardiovascular complications associated with trans-arterial and trans-apical interventional aortic valve implantation in 412 consecutive patients.

Objective: Trans-catheter aortic valve implantation (TAVI) technology is rapidly evolving, with 412 procedures having been performed at our institution. Herein, we report a complete, prospective analysis of complications occurring during transvascular and trans-apical implantations with two different prostheses.

Methods: Between June 2007 and June 2010, 412 patients (258 female, mean age 80.

Outcome of patients with aortic stenosis referred to a multidisciplinary meeting for transcatheter valve.

Background: Until recently, many elderly patients with symptomatic aortic stenosis and multiple risk factors were untreated due to perceived risks of surgery. With the advent of transcatheter aortic valve implantation there has been a surge in referral for treatment. We present the outcome of patients referred to a multidisciplinary meeting.

Predictors for permanent pacing after transcatheter aortic valve implantation.

Background: Transcatheter aortic valve implantation (TAVI) is a new treatment strategy for patients with symptomatic aortic stenosis who are high risk for traditional surgical aortic valve replacement. The incidence of conduction system abnormalities after the procedure is significant. We examine our experience with CoreValve TAVI focusing on electrocardiographic changes found pre-, peri-, and postintervention.

A novel 14F endograft for abdominal aortic aneurysm: first in man.

Objective: This study evaluated the feasibility of percutaneous endovascular treatment of infra-renal abdominal aortic aneurysm (AAA) using the novel low profile modular Tripelay system (Tripelay, France).

Background: Endovascular aortic aneurysm treatment (EVAR) has become more widely used as early mortality has been significantly reduced. Also, percutaneous access has become possible with the introduction of vascular closure devices and with the initial reduction in size of delivery catheters.