Low gradient severe aortic stenosis with preserved ejection fraction: reclassification of severity by fusion of Doppler and computed tomographic data

Aims Low gradient severe aortic stenosis (AS) with preserved left ventricular ejection fraction (LVEF) may be attributed to aortic valve area index (AVAi) underestimation due to the assumption of a circular shape of the left ventricular outflow tract (LVOT) with 2-dimensional echocardiography. The current study evaluated whether fusing Doppler and multidetector computed tomography (MDCT) data to calculate AVAi results in significant reclassification of inconsistently graded severe AS. Methods and results In total, 191 patients with AVAi
Source: European Heart Journal - Category: Cardiology Authors: Tags: Valvular heart disease Source Type: research

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Publication date: Available online 21 November 2019Source: Canadian Journal of CardiologyAuthor(s): Gabriele Crimi, Claudio Montalto, Luca Angelo Ferri, Luigi Piatti, Irene Bossi, Nuccia Morici, Alessandro Mandurino-Mirizzi, Daniele Grosseto, Giovanni Tortorella, Stefano Savonitto, Stefano De Servi, Elderly-ACS 2 InvestigatorsABSTRACTBackgroundElderlies are underrepresented in clinical trials and registries and a gap of evidence exists for clinical decision making in the setting of acute coronary syndromes (ACS). We aimed to assess the prevalence and independent prognostic impact of valvular heart disease (VHD) diagnosed d...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
AbstractBackgroundUntreated symptomatic high-grade aortic stenosis remains a lethal disease requiring individually adapted valve replacement. High-risk surgical patients benefit from transcatheter aortic valve replacement (TAVR), but there is no uniform standard for patient selection and valve sizing and it is still unclear whether transthoracic (TTE) or transesophageal (TEE) echocardiography is superior in preprocedural aortic annulus sizing. As preprocedural sizing of the native aortic annulus diameter is crucial to outcome and survival, we report the results of a direct comparison between preprocedural sizing with TTE a...
Source: Journal of Echocardiography - Category: Cardiology Source Type: research
Abstract Valvular heart diseases are one of the most frequent causes for heart failure. Degenerative diseases of the aortic and mitral valve as well as a dysfunctional tricuspid valve disease result in a worse clinical outcome if severe. Minimal-invasive, surgical and/or catheter-based structural heart disease (SHD) interventions have recently seen a dramatic increase. Transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) is a disruptive technology, and next generation devices and careful patient selection will minimize limitations of TAVI such as paravalvular leak, conductance disturbance...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Purpose of review Transcatheter aortic valve replacement (TAVR) has become the cornerstone for aortic valve intervention since the first implantation in 2002. Recent advances with novel devices and introduction into lower risk cohorts have been successful. In this review, we discuss the ongoing limitations to transcatheter aortic valve therapy and whether it will replace surgical aortic valve replacement in the foreseeable future. Recent findings A better understanding of valve durability, high-grade heart block, and stroke post TAVR has led to practice changes that improve patient outcome. Summary Although there h...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research
This study investigated the relationship between VO2, SVi and AS severity in patients with AS to examine the association between reduced VO2 and PLFLPG AS. In 59 patients (24 men, mean age 78±7 years) with severe AS, SVi, AS severity and type were evaluated by echocardiography, and VO2 was measured by the fraction of O2 in expired gases. The SVi and VO2 were significantly decreased in 20 patients with PLFLPG AS compared to those in 39 patients with non-PLFLPG AS (30±4 vs 41±7 ml/m2 and 2.4±0.5 vs 3.0±0.5 ml/min/kg, p
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research
BOSTON (CBS) – There aren’t many people who run their age in miles every year. Dave McGillivray does. From the time he was a boy, he’s celebrated his good health and love of running with a personal challenge that obviously gets more challenging with age. His last “full” birthday run was last year: 63 miles. This year, by necessity, he split the effort into 32 miles of running and 32 miles of biking. A feat, to be sure. But this year, he is facing a challenge for which there is no training. McGillivray, arguably one of the most fit people on the planet, has coronary artery disease and is prepa...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Health Seen On WBZ-TV Syndicated Local Watch Listen Dave McGillivray Lisa Hughes Mass General Hospital Source Type: news
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: ECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation. PMID: 30236527 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
FW Abstract The Old-Age Heart Abstract. Knowledge of cardiovascular changes in old age and their therapeutic options is important. Old age can lead to hypertrophy of the left ventricle, diastolic dysfunction, heart valve changes and pulmonary hypertension. Patients often develop arterial hypertension. Valvular changes are common in people over 100 years of age (aortic stenosis and mitral insufficiency). The risk of coronary heart disease is 35 % for men and 24 % for women. In old age, sinus node dysfunction and atrial fibrillation are common. 25 % of all strokes are cardiac embolisms in atrial fibrillation. Cardi...
Source: Praxis - Category: General Medicine Authors: Tags: Praxis (Bern 1994) Source Type: research
AbstractWith the advent of transcatheter aortic valve replacement (TAVR), appropriately selected intermediate-, high-, and extreme-risk patients with severe aortic stenosis (AS) are now offered a less invasive option compared to conventional surgery. In contemporary practice, TAVR is performed predominantly via a transfemoral arterial approach, whereby a transcatheter heart valve (THV) is delivered in a retrograde fashion through the iliofemoral arterial system and thoraco-abdominal aorta, into the native aortic valve annulus. While the majority of patients possess suitable anatomy for transfemoral arterial access, there i...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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