Early detection of transcatheter heart valve dysfunction.

Early detection of transcatheter heart valve dysfunction. Expert Rev Cardiovasc Ther. 2019 Dec 13;:1-10 Authors: Valvo R, Criscione E, Reddavid C, Barbanti M Abstract Introduction: Transcatheter aortic valve implantation therapy is spreading rapidly, representing the standard of care in inoperable and high-risk patients, and a valid alternative in intermediate- and low-risk patients with severe symptomatic aortic stenosis. In this subset, the development and validation of noninvasive, quantitative, in vivo imaging modality, to monitor possible valve dysfunction is mandatory, in order to plan timely therapeutic interventions before the onset of symptoms.Areas covered: The implantation of transcatheter heart valves (THV) is increasing rapidly. As a consequence, THV dysfunction will become a major cause of cardiovascular morbidity after TAVI. Emergency repeat aortic valve replacement surgery is associated with a high rate of mortality compared with elective repeat surgery. In this context, early detection of THV dysfunction is therefore highly desirable. The review aims to examine the different diagnostic method to early detect THV dysfunction.Expert opinion: Most promising innovations in the diagnosis of early detection of THV dysfunction are evaluated, and the future outlook is explored. Waiting for upcoming evidence about the utility of CT, CMR, and PET on early detection of THV dysfunction, tailoring echocardiogram follow-up based on patients' characteri...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research

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Publication date: November 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 6Author(s): Vincent M. Brandenburg, Alexander Schuh, Rafael KramannAccelerated and premature cardiovascular calcification is a hallmark of patients with chronic kidney disease (CKD) or end-stage renal disease (ESRD). The presence and the amount of cardiovascular calcification are among the driving forces of increased morbidity and mortality in renal patients. Cardiovascular calcification occurs at different sites, including the cardiac valves—a location that is of particular importance for both the patient and the treating phy...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research
This article presents the evolution and current status of TAVR, with respect to the different types of devices and procedures as well as its outcomes.
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
ConclusionsMIAMVS can be performed via a right mini ‐thoracotomy, with acceptable early and midterm results expected. This may be a feasible alternative to the standard median sternotomy approach.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Calcific aortic valve stenosis is the commonest form of heart valve disease in high-income countries and set to become a major health care burden. Currently, there are no medical therapies that have proved to slow down or halt disease progression. The only available treatment is aortic valve replacement, of which the optimal timing is unknown and to which not all patients are suited. This review discusses the pathophysiology of aortic stenosis, how noninvasive imaging techniques have improved our understanding of the underlying biology, and how these emerging insights might translate into potential novel treatments targeti...
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
Increasing life expectancy, the emergence of transcatheter aortic valve replacement (TAVR) therapy in intermediate- and high-risk surgical patients with aortic stenosis, and more frequent use of biologic surgical prostheses has resulted in increasingly large populations facing bioprosthetic structural valve degeneration (SVD). Greater understanding of the risk factors and pathogenic mechanisms underlying SVD is critical to improving the durability of any individual prosthesis. Despite the increasing incidence of both native and bioprosthetic heart valve disease, however, there remains a paucity of knowledge regarding the p...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Invited Expert Opinion 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
Publication date: Available online 4 October 2019Source: Journal of Cardiology CasesAuthor(s): Toru Yoshizaki, Toru Naganuma, Sunao NakamuraAbstractA 69-year-old female Jehovah’s Witness was diagnosed with symptomatic severe aortic stenosis (AS). Because the patient, who refused blood transfusion for religious reasons, had multiple comorbidities, such as thrombocytopenia due to liver cirrhosis, esophageal varices, and an old cerebral infarction, a decision to perform transcatheter aortic valve implantation (TAVI) was made. Preprocedural computed tomography showed a small aortic root and severe leaflet calcification, ...
Source: Journal of Cardiology Cases - Category: Cardiology 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
AbstractConcern for early degeneration limits the use of bioprosthetic heart valves. A 77 ‐year‐old man who underwent surgical aortic valve replacement at age 70 for severe aortic stenosis (AoS) presented with premature bioprosthesis degeneration and AoS recurrence. Transthoracic echocardiography demonstrated severe AoS and aortic regurgitation, a 30% ejection fraction, and pulmonary hypertension. Transesophageal echocardiography revealed that the aortic regurgitation was due to a 5‐mm paravalvular leak (PVL). A high EuroScoreII excluded surgical treatment. Simultaneous transcatheter aortic valve replacement and PVL ...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
The transcatheter aortic valve replacement market received one of the biggest jolts of the year when FDA expanded indications of both Edwards Lifesciences and Medtronic’s valves. FDA’s measure would open up the valves to be used in younger and low-risk patients. The agency said these transcatheter valves – Edwards’ Sapien 3, and Sapien 3 Ultra, with Medtronic’s CoreValve Evolut R and CoreValve Evolut PRO – were previously indicated only for patients at intermediate or higher risk for death or major complications duri...
Source: MDDI - Category: Medical Devices Authors: Tags: Cardiovascular Regulatory and Compliance Source Type: news
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