Transaortic Access Using Vascular Graft for Transcatheter Aortic Valve Implantation.

Transaortic Access Using Vascular Graft for Transcatheter Aortic Valve Implantation. Int Heart J. 2019 Jun 14;: Authors: Kakizaki R, Meguro K, Kitamura T, Hashimoto T, Ako J Abstract A 92-year-old man with acute heart failure due to severe aortic stenosis underwent transcatheter aortic valve implantation (TAVI). Computed tomography demonstrated severe stenosis of the right common iliac artery, occlusion of the left external iliac artery, and stenosis of the left subclavian artery. Severe calcification was observed in the sinotubular junction, which was considered a risk factor for aortic dissection with transapical TAVI using a balloon-expanding bioprosthetic valve. Therefore, transaortic (TAo) access was the only option for this high-risk surgical patient. As the maximum distance from the aortic valve annulus to the sheath insertion point was less than 60 mm, TAVI was performed transaortically using a vascular graft that extended this distance, in order to avoid sheath dislocation. Our experience demonstrates that vascular graft application is a viable option in patients with an inadequate distance between the aortic valve annulus and the puncture site in TAo-TAVI. PMID: 31204375 [PubMed - as supplied by publisher]
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research

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Publication date: Available online 16 April 2019Source: Canadian Journal of CardiologyAuthor(s): Luca Baldetti, Francesco Giannini, Nicolas Van Mieghem, Nahid El Faquir, Didier Tchétché, Chiara De Biase, Anna Sonia Petronio, Cristina Giannini, Giuseppe Tarantini, Chiara Fraccaro, Ariel Finkelstein, Amit Segev, Israel Barbash, Giuseppe Bruschi, Corrado Tamburino, Marco Barbanti, Scott Lim, Ivandito Kuntjoro, Mohamed Abdel-Wahab, Antonio ColomboAbstractBackgroundTranscatheter aortic valve replacement (TAVR) is the gold-standard for severe valvular aortic stenosis in patients at high/prohibitive surgical risk. T...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
A 41-YEAR-OLD male with a complex history including a bicuspid aortic valve with aortic stenosis, a background of inherited cardiomyopathy, and an implantable cardiac defibrillator for prevention of malignant arrhythmias presented to the cardiology department of our hospital with signs and symptoms of congestive heart failure. He previously had undergone a full workup for transcatheter aortic valve implantation (TAVI), including multidetector computed tomography for annular sizing. A transthoracic echocardiogram performed on this patient showed a left ventricular ejection fraction of 15% to 20% with low-flow/low-gradient s...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Authors: Pineda AM, Gowani SA, Mihos CG, Beohar N, Santana O Abstract In this heart failure patient, TEE images confirm the presence of the persistent left SVC with a dilated coronary sinus, severe mitral regurgitation, and aortic stenosis. Computed tomography reveals an isolated persistent left SVC and rules out anomalous pulmonary vein drainage or additional congenital disease. PMID: 29715168 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
An 81-year-old woman was hospitalized for heart failure (HF) with severe aortic stenosis (AS). She had a history of liver transplantation under immunosuppressive therapy and multiple comorbidities. Our heart team considered her as a candidate for transcatheter aortic valve implantation (TAVI). Pre-screening multidetector computed tomography revealed the presence of a bulky calcification on the aortic root (Panel A). Therefore, a self-expandable transcatheter heart valve [THV; 26-mm CoreValve Evolut-R (Medtronic, USA)] was implanted via the femoral artery after balloon pre-dilatation (Panels B andC). Haemodynamic measuremen...
Source: European Heart Journal - Category: Cardiology Source Type: research
This report concerns an 83‐year‐old woman with aortic stenosis (AS) who had a history of repetitive hospitalization due to decompensated heart failure. Although her clinical history was compatible with significant AS, findings for aortic valve area, hemodynamics, and valvular calcium burden were discrepant. Multiplanar reconstruction images revealed the membranous structures attached to a subcommissural lesion, which resulted in severe stenosis. The patient had a favorable clinical course after transcatheter aortic valve replacement. This is the first reported case of severe AS due to the subcommissural adhesions, whic...
Source: Echocardiography - Category: Cardiology Authors: Tags: CT ROUNDS Source Type: research
We present a case of aortic root rupture caused by unusually fragile aortic wall during TAVI and the lesson from the autopsy results.>
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
An 87year-old female with symptomatic severe aortic stenosis underwent transcatheter valve replacement (TAVR) via the transfemoral approach with a 29mm self-expanding device. Moderate to severe paravalvular regurgitation led to the development of congestive heart failure and hospital readmission one month following TAVR. A second 29mm valve was placed to abolish the paravalvular regurgitation. Routine follow-up computed tomography (CT) imaging demonstrated leaflet thickening and decreased leaflet mobility suggesting valve thrombosis, despite adherence to Factor Xa inhibitor.
Source: Cardiovascular Revascularization Medicine - Category: Cardiology Authors: Source Type: research
An 86-year-old woman was hospitalized for rapidly progressive dyspnoea, severe sepsis, and initial echocardiographic signs of biventricular cardiac decompensation. The patient had a history of transcatheter aortic valve replacement (TAVR) 1.5 years ago due to severe aortic stenosis (26  mm CoreValve Evolut R, Medtronic, Minneapolis, Minnesota, USA). For further evaluation, a contrast-enhanced multidetector computed tomography (MDCT) scan of the chest was performed. Multidetector computed tomography revealed a massive, free-floating thrombus in the ascending aorta arising from th e TAVR (Panel A andB). On cross-secti...
Source: European Heart Journal - Category: Cardiology Source Type: research
Conclusions High TACS was associated with increased LVMI among patients with severe AS. Further, high TACS usefully predicted less regression of LVMI and poor clinical outcomes after AVR. TACS may serve as a useful proxy for predicting LV remodeling and adverse prognosis in patients with severe AS undergoing AVR.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
This study examined whether the thoracic aorta calcium score (TACS) is related to LV hypertrophy and whether it leads to an adverse prognosis in patients with severe aortic stenosis (AS) after aortic valve replacement (AVR). METHODS: We retrospectively reviewed 47 patients (mean age, 64 ± 11 years) with isolated severe AS who underwent noncontrast computed tomography of the entire thoracic aorta and who received AVR. TACS was quantified using the volume method with values becoming log transformed (log[TACS+1]). Transthoracic echocardiography was performed before and 1 year after the operation. RESULTS: Pre...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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