Could a Biomarker Take AVR to the New Aortic Stenosis Frontier? Could a Biomarker Take AVR to the New Aortic Stenosis Frontier?

Mortality climbs for patients with severe aortic stenosis who don't get a valve replacement because they are asymptomatic, especially if their natriuretic peptides are elevated, an analysis suggests.Medscape Medical News
Source: Medscape Cardiology Headlines - Category: Cardiology Tags: Cardiology News Source Type: news

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AbstractBoth transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) have been proven to effectively correct von Willebrand Factor (vWF) pathologies, however there is limited data simultaneously comparing outcomes of both approaches. We prospectively enrolled patients with severe aortic stenosis referred for TAVI (n  = 52) or SAVR (n = 48). In each case, vWF antigen (vWF:Ag), vWF activity (vWF:Ac) and activity-to-antigen (vWF:Ac/Ag) ratio were assessed at baseline, 24 h and 72 h after procedure. VWF abnormalities were defined as reduced vWF:Ac/Ag ratio (
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology 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
FOR PATIENTS with severe aortic valve stenosis (AS) and significant comorbid conditions who are determined to be at a high or prohibitive surgical risk, transcatheter aortic valve replacement (TAVR) represents a viable and durable treatment option. The anesthetic management of these cases is often complex because the procedure may be complicated by hemodynamic instability or circulatory collapse. In particular, TAVR in patients with severely reduced left ventricular ejection fraction (LVEF) poses significant challenges, and optimal treatment strategies are not established fully.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
We report a case of an 84-year-old Japanese female patient with transcatheter valve embolization treated with thoracic endovascular stenting. She was diagnosed with severe aortic stenosis and referred to our hospital. Transapical transcatheter aortic valve implantation (TA-TAVI) was selected because she had multiple comorbidities and peripheral vascular disease. During TA-TAVI, the transcatheter valve (TV) came loose and lodged in the distal aortic arch. The TV was floating and unstable, thereby affecting her hemodynamics. After a second TV was placed in the appropriate position with no trouble, we tried fixing the TV usin...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSION: Mortality in CS patients due to decompensated severe AS is high, regardless of interventional treatment strategy. Both eBAV and eTAVR seem feasible. As eTAVR is associated with better initial improvements in hemodynamics and simultaneously avoids sequential interventions, it might be favorable to eBAV in select patients. If eTAVR is not available, eBAV might serve as a "bridge" to elective TAVR. PMID: 31611428 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol 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
Authors: Hsieh WC, Aboud A, Henry BM, Omara M, Lindner J, Pirk J Abstract Transcatheter aortic valve replacement is becoming a more common therapeutic option for the treatment of aortic stenosis in patients at high risk for invasive surgery, but detecting which patients will benefit clinically can be challenging. Hypoalbuminemia is a useful prognostic marker for chronic inflammation in this population. We carried out a systematic review and meta-analysis of studies evaluating the prognostic value of serum albumin level in patients undergoing transcatheter aortic valve replacement. A literature search of PubMed, Emb...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
Bicuspid aortic valve (BAV) disease is the most common congenital cardiac anomaly and is a prominent risk factor for premature aortic valve disease, most commonly aortic stenosis [1]. BAV has historically been detected using 2-dimensional echocardiography; however, compared with pathologic analysis of BAV removed at the time of surgery, echocardiography detects only congenital BAV morphology in 58 –66% of cases [2,3]. Therefore, the use of three-dimensional imaging, mainly ECG-gated computed tomography (CT), is fundamentally required in the diagnosis and definition of the complex [4] and variable BAV anatomy (Fig.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Trans-catheter aortic valve implantation (TAVI) is currently becoming an alternative to surgical valve replacement for patients at low risk, a population that is likely to experience an increase in the radiation-induced cancer risk following TAVI. We aimed to evaluate the overall exposure to ionizing radiation in patients undergoing trans-femoral TAVI, including the procedure itself as well as the procedures performed in the pre-intervention work-up and the post-TAVI interventions. All patients who underwent trans-femoral TAVI for symptomatic aortic stenosis in our centre over a 26 months period were included.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
We report a patient with severe aortic stenosis with an extremely high calcium score who underwent a transfemoral transcatheter aortic valve replacement with an Evolut R (Medtronic, Minneapolis, MN) and needed a valve-in-valve approach with a SAPIEN 3 (Edwards Lifesciences, Irvine, CA) to treat significant paravalvular leak. Interestingly, the closure time with adenosine diphosphate, assessed using the Platelet Function Analyzer 100 (Siemens Healthcare Diagnostics, Los Angeles, CA), measured after each important step of this complex procedure, correlated very well with the severity of the paravalvular leak.Résum&eac...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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