Blood flow characteristics in the ascending aorta after TAVI compared to surgical aortic valve replacement

Abstract Ascending aortic blood flow characteristics are altered after aortic valve surgery, but the effect of transcatheter aortic valve implantation (TAVI) is unknown. Abnormal flow may be associated with aortic and cardiac remodeling. We analyzed blood flow characteristics in the ascending aorta after TAVI in comparison to conventional stented aortic bioprostheses (AVR) and healthy subjects using time-resolved three-dimensional flow-sensitive cardiovascular magnetic resonance imaging (4D-flow MRI). Seventeen patients with TAVI (Edwards Sapien XT), 12 with AVR and 9 healthy controls underwent 4D-flow MRI of the ascending aorta. Target parameters were: severity of vortical and helical flow pattern (semiquantitative grading from 0 = none to 3 = severe) and the local distribution of systolic wall shear stress (WSSsystole). AVR revealed significantly more extensive vortical and helical flow pattern than TAVI (p = 0.042 and p = 0.002) and controls (p 
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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ConclusionBoth TTR ‐ and AL‐CA can accompany severe AS. Parameters solely based on ECG and echocardiography allow for the identification of the majority of CA‐AS. In the present cohort, CA did not significantly worsen prognosis 15.3 months after TAVR.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
CONCLUSIONS: Patients with aortic root disease and bicuspid aortic valve may be treated with Sleeve technique with excellent midterm results. However, a longer follow-up is required before drawing any solid conclusion. PMID: 31985188 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
ConclusionComplex congenital aortic arch repairs can change aortic hemodynamics. Associated cardiac defects can further alter findings. Studies are warranted to investigate clinical implications in larger cohorts.
Source: Pediatric Radiology - Category: Radiology Source Type: research
Transcatheter aortic valve implantation (TAVI) is an alternative to surgical aortic valve replacement in selected patients with severe symptomatic aortic stenosis (AS) and high surgical risk. The planning and follow-up of TAVI requires an array of imaging techniques, each has advantages and limitations. Echocardiography and multidetector computer tomography (MDCT) have established applications in patient selection and procedure guidance, but are limited in some patients. TAVI applications of cardiovascular magnetic resonance imaging (CMRI) are emerging.
Source: Clinical Radiology - Category: Radiology Authors: Tags: Review Source Type: research
DiscussionShould it be shown that our cognitive training can improve postoperative cognitive deficits and quality of life, one possibility could be to integrate this intervention into early rehabilitation. Furthermore, we hope that the investigation of perioperative ischemia by diffusion-weighted magnetic resonance imaging will improve our understanding of neurobiological factors influencing the course of postoperative cognitive plasticity.Trial registrationGerman Clinical Trials Register (DRKS),DRKS00015512. Retrospectively registered on 21 September 2018.
Source: Trials - Category: Research Source Type: clinical trials
ConclusionsSingle modality 3D echocardiography ‐based modeling allows for a quantitative description of the aortic valve and root geometry. This technique together with novel indices will improve our understanding of normal and pathologic geometry in the BAV population and may help to identify geometric predictors of adverse remodeling and gui de tailored surgical therapy.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
AbstractPurpose of ReviewAortic stenosis is the most prevalent valvular heart disease. The purpose of this paper is to review the epidemiology, pathophysiology, and diagnosis of aortic valve stenosis.Recent FindingsThe diagnosis of aortic stenosis has evolved over time. Originally diagnosed with cardiac catheterization and echocardiography, more advance imaging techniques including computed tomography, magnetic resonance imaging, and 3D printing have improved our understanding of the physiology and hemodynamic effects of aortic stenosis.SummaryValvular heart disease affects a broad patient population, and the most common f...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research
Abstract Infective endocarditis (IE) is a complex disease with cardiac involvement and multiorgan complications. Its prognosis depends on prompt diagnosis that leads to an aggressive therapeutic management combining antibiotic therapy and early cardiac surgery when indicated. However, IE diagnosis always poses a challenge, and echocardiography remains diagnostically imperfect in cases of prosthetic valve IE or cardiac implantable electronic device infection. In recent years, other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) have experienced significant technical improvemen...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Publication date: February 2020Source: IJC Heart &Vasculature, Volume 26Author(s): Alexander C. Egbe, Keerthana Banala, Rahul Vojjini, Karim Osman, Arslan Afzal, Vaibhav Jain, Sahith Thotamgari, Naser M. AmmashAbstractCardiac magnetic resonance imaging derived right ventricular (RV) volumes are often necessary for optimal timing of pulmonary valve replacement in patients with tetralogy of Fallot (TOF). This practice is based on previous studies that reported preoperative RV volumetric thresholds that predicted postoperative RV remodeling. As a result, pulmonary valve replacements are being performed even in asymptomati...
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
AbstractPurpose of reviewAs the number of surgical and transcatheter valve replacements continue to increase in the aging population, so does the incidence of paravalvular leak (PVL). Given its impact on morbidity and mortality, this article will focus on the epidemiology, clinical presentation, diagnostic assessment, and available treatments for PVL.Recent findingsDespite being performed on inoperable and typically higher risk patients, short-term complication rates of transcatheter PVL closure appear relatively low (
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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