Valve in Valve in Valve Trans-Catheter Aortic Valve Replacement Followed by LVAD Deactivation in the Setting of Recovered Systolic Function.

We present a 46 year old patient who had LV systolic function recovery while on LVAD. However, he had a severely stenotic aortic valve bioprosthesis with leaflet fusion that had to be corrected before deactivating his LVAD. Due to high surgical risk, we performed valve-in-valve TAVR with an Evolut CoreValve , however, the patient had significant aortic regurgitation secondary to deployment above the bioprosthetic valve ring. We successfully deployed a second Evolut CoreValve inside the ring with excellent results. This was followed by a successful LVAD deactivation next day. His LV systolic function continued to recover and he had no heart failure symptoms at 3 month follow up. In the right settings, TAVR in recovered LVAD patients with aortic stenosis as bridge to LVAD deactivation is viable option, especially for patients who fall in the high risk group. To the best of our knowledge, this is the first reported case of a valve-in-valve TAVR followed by successful LVAD deactivation in the setting of recovered LV systolic function. PMID: 31072295 [PubMed - as supplied by publisher]
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research

Related Links:

All eyes will be on ISCHEMIA in Philadelphia, but a study on asymptomatic aortic stenosis as well as trials in heart failure and cardiogenic shock also piqued Dr John Mandrola's interest.theheart.org on Medscape
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Cardiology Commentary Source Type: news
We describe the case of a 64-year-old man who came to the emergency room due to acute heart failure and intermittent gastrointestinal bleeding. Treatment involves initial correction of anemia and heart failure followed by aortic valve replacement. The prosthesis used depends on the characteristics of each patient and valve replacement allows the resolution of bleeding in most cases. Gastrointestinal bleeding in patients with aortic stenosis is associated with severity of the valve obstruction. A mechanical prosthesis was used with no recurrent bleeding even with the need for lifelong anticoagulation therapy.
Source: Revista Brasileira de Cirurgia Cardiovascular - Category: Cardiovascular & Thoracic Surgery Source Type: research
The development of aortic valve stenosis is strongly associated with older adults. Patients who undergo transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) frequently have heart failure (HF). We investigated the predictors of mortality after TAVI according to the presence of HF, and specifically HF with preserved ejection fraction (HFpEF) versus HF with reduced ejection fraction (HFrEF). Patients were identified from the Nationwide Inpatient Sample registry from January 2011 to September 2015  using the ICD-9 codes. Patients with HF who underwent TAVI were classified according to whethe...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Diastolic dysfunction (DD) is a common finding in severe aortic stenosis (AS) patients.1 Myocardial remodeling eventually affects left ventricular (LV) relaxation, therefore impairing LV diastolic function with an increase in left atrial (LA) pressure, ultimately causing pulmonary congestion and symptoms of heart failure.2,3 Relief of stenosis through transcatheter aortic valve implantation (TAVI) results in reverse remodeling of the left ventricle, regression of LV hypertrophy, and improvement of LV systolic function.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Abstract Despite mounting evidence implicating inflammation in cardiovascular diseases, attempts at clinical translation have shown mixed results. Recent preclinical studies have reenergized this field and provided new insights into how to favorably modulate cardiac macrophage function in the context of acute myocardial injury and chronic disease. In this review, we discuss the origins and roles of cardiac macrophage populations in the steady-state and diseased heart, focusing on the human heart and mouse models of ischemia, hypertensive heart disease, and aortic stenosis. Specific attention is given to delineatin...
Source: Annual Review of Physiology - Category: Physiology Authors: Tags: Annu Rev Physiol Source Type: research
inkás A, Varga A Abstract Stress echocardiography is a safe, low-cost, widely available, radiation-free versatile imaging modality that is becoming increasingly recognized as a valuable tool in the assessment of coronary heart disease. In recent years, there has also been an increasing use of stress echocardiography in the assessment of non-ischaemic cardiac disease given its unique ability for simultaneous assessment of both functional performance and exercise-related noninvasive hemodynamic changes which can help guide treatment and inform about the prognosis of the patients. Today in the echocardiography...
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
Last month, Medtronic announced receipt of U.S. Food and Drug Administration (FDA) approval for and launch of the Evolut Pro+ TAVR (Transcatheter Aortic Valve Replacement) System to treat patients with symptomatic severe aortic stenosis. Aortic steno...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiac Surgery Cardiology Exclusive Source Type: blogs
Risk factors for adverse clinical outcomes in patients with moderate aortic stenosis are not well defined. Previous studies have suggested that certain patients with moderate AS may be at an increased risk of heart failure or death. All patients with moderate AS seen in our institution during the study period (6/1/2014 to 6/30/2017) with a minimum 1-year follow-up were included. Clinical and echocardiographic data were collected retrospectively. Endpoints were defined as heart failure (HF) hospitalization, aortic valve replacement (AVR) or death.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
CONCLUSIONS: NFLG-AS was the most prevalent form of LG severe AS and was associated with adequate left ventricular compensation and good prognosis. On the other hand, CLFLG-AS represents the heart-failure with reduced ejection fraction (HFrEF) form of AS and was associated with the worst prognosis, whereas PLFLG-AS represents the heart-failure with preserved ejection fraction (HFpEF) form of AS with intermediary prognosis. Both groups showed early hemodynamic reverse response after TAVR. PMID: 31566569 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Publication date: Available online 27 September 2019Source: The LancetAuthor(s): Jonas Lanz, Won-Keun Kim, Thomas Walther, Christof Burgdorf, Helge Möllmann, Axel Linke, Simon Redwood, Christian Thilo, Michael Hilker, Michael Joner, Holger Thiele, Lars Conzelmann, Lenard Conradi, Sebastian Kerber, Gerhard Schymik, Bernard Prendergast, Oliver Husser, Stefan Stortecky, Dik Heg, Peter JüniSummaryBackgroundTranscatheter aortic valve replacement (TAVR) is the preferred treatment option for older patients with symptomatic severe aortic stenosis. Differences in the properties of available TAVR systems can affect clinica...
Source: The Lancet - Category: General Medicine Source Type: research
More News: Aortic Stenosis | Cardiology | Heart | Heart Failure | Heart Transplant | Heart Valve Surgery | Transplant Surgery | Transplants