Treatment of a failing aortic bioprosthesis by transcatheter valve-in-valve (ViV) therapy has become an alternative to redo surgery. However, the ViV technique may be less effective in small surgical valves because of patient/prosthesis mismatch (PPM). Here we will discuss the bioprosthetic valve fracture/remodelling (BVF) procedure and the most important issues regarding this promising new technique.
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http://dx.doi.org/10.4244/AIJ-D-18-00058 | DOI Listing |
Gen Thorac Cardiovasc Surg Cases
December 2024
Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Osaka, 564-8565, Japan.
Background: With the rapid expansion of transcatheter aortic valve replacement (TAVR), TAVR valve explantation is also increasing. Nevertheless, previous reports on Lotus Edge valve explantation are limited to only two reports, none of which include intraoperative videos. Therefore, we report the case of an older adult who underwent a 2-year-old Lotus Edge valve explantation, after developing prosthetic valve endocarditis (PVE) and aortic annular abscess, with a strong indication for a TAVR explantation and surgical aortic valve replacement (AVR).
View Article and Find Full Text PDFTrials
December 2024
Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Background: The American College of Cardiology, American Heart Association, and Centers for Medicare and Medicaid Services recommend shared decision-making (SDM) for patients with severe aortic stenosis choosing between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). Although tools such as patient decision aids (DAs) and training in SDM have been shown to improve SDM, implementation of SDM and DAs is limited. The IMproving treatment decisions for Patients with AortiC stenosis Through Shared Decision Making (IMPACT SDM) study aims to (1) determine the effectiveness of the interventions (a DA and clinician SDM training) in achieving SDM (primary outcome) and improving the quality of decisions about aortic valve replacement, (2) determine the reach of the DAs and adoption of training, and (3) explore potential mechanisms of effectiveness and implementation at the patient-, clinician-, and clinic-level.
View Article and Find Full Text PDFEur Heart J Cardiovasc Imaging
December 2024
Medizinische Klinik und Poliklinik I, LMU Klinikum, Munich, Germany.
Aims: Data on the prognostic value of left and right atrial strain after transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) are limited. Aim of this study was to evaluate outcomes of patients undergoing TAVR stratified by left and right atrial strain.
Methods And Results: Using data from a high-volume academic center, left and right atrial reservoir strain (LASr and RASr) was obtained in patients who underwent TAVR for severe AS from 2018 until 2021.
J Am Coll Cardiol
November 2024
British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Background: Current guidelines recommend a strategy of clinical surveillance (CS) for patients with asymptomatic severe aortic stenosis (AS) and a normal left ventricular ejection fraction.
Objectives: The aim of this study was to conduct a study-level meta-analysis of randomized controlled trials (RCTs) evaluating the effect of early aortic valve replacement (AVR) compared with CS in patients with asymptomatic severe AS.
Methods: Studies were quantitatively assessed in a meta-analysis using random-effects modeling.
J Soc Cardiovasc Angiogr Interv
September 2024
Division of Cardiovascular Medicine, Department of Medicine, University of Washington, Seattle, Washington.
Background: We aimed to develop a transcatheter aortic valve replacement (TAVR) sizing algorithm and implantation method to facilitate safe and effective TAVR without contrast use in patients with severe chronic kidney disease (CKD) who do not yet require renal replacement therapy. Patients with CKD are a challenging patient subset to treat using standard TAVR care pathways which most usually require the use of iodinated contrast media both during gated computed tomography (CT) angiography sizing, and valve deployment. Iodinated contrast exposure may worsen kidney function in a dose-dependent fashion, and may result in a need for renal replacement therapy.
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