Transcatheter aortic valve replacement 24 years after cardiac transplantation

AbstractAs patient survival after cardiac transplantation has improved over the course of the last several decades, clinicians are now faced with late complications. This includes aortic stenosis which, traditionally, has been treated with reoperative sternotomy and aortic valve replacement. Transcather aortic valve replacement (TAVR) offers a minimally invasive alternative in this high ‐risk population. A small but growing number of cases of TAVR after heart transplantation in high‐risk patients have been reported in the last 10 years; we now present a case of aortic valve replacement via a transcatheter approach 24 years after cardiac transplantation.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research

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CONCLUSION: With the improved survival of these patients, we think it is time to look into pathophysiology of valvular disease in transplant heart recipients. Some other unanswered questions include, underlying donor and recipient risk factors for valvular diseases in heart transplant recipients. PMID: 31523399 [PubMed]
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
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 an...
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research
AbstractFor the year 2017, more than 21,000 published references can be found in PubMed when entering the search term “cardiac surgery”. This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventio...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Left ventricular assist devices (LVADs) revolutionized the management of patients with end stage heart failure (ESHF). Approximately 30% of patients develop aortic insufficiency (AI) after one year of LVAD support. AI is progressive and is associated with increased morbidity and mortality. Transcatheter aortic valve replacement (TAVR) is approved for treating symptomatic high surgical risk patients with severe aortic stenosis. TAVR is not studied in symptomatic AI in LVAD patients.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Source Type: research
In conclusion, senescence of vascular cells promotes the development of age-related disorders, including heart failure, diabetes, and atherosclerotic diseases, while suppression of vascular cell senescence ameliorates phenotypic features of aging in various models. Recent findings have indicated that specific depletion of senescent cells reverses age-related changes. Although the biological networks contributing to maintenance of homeostasis are extremely complex, it seems reasonable to explore senolytic agents that can act on specific cellular components or tissues. Several clinical trials of senolytic agents are currentl...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, CAVD is highly prevalent. Long understood as a passive process, it is now known to be complex and one which involves pathophysiological mechanisms similar to those of atherosclerosis. Understanding these mechanisms could help to establish new therapeutic targets that might allow us to halt or at least slow down the progression of the disease. Early Steps in the Tissue Engineering of Intervertebral Discs In this paper, researchers report on progress towards the manufacture of interver...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
OBJECTIVES To evaluate the efficacy and safety of Edwards SAPIEN-XT or SAPIEN-3 transcatheter heart valves via transaortic (TAo) access. METHODS A total of 100 consecutive patients with severe symptomatic aortic stenosis undergoing TAo-transcatheter aortic valve implantation (TAVI) were included in this observational registry (November 2012–December 2014). Periprocedural and post-procedural outcomes were assessed. RESULTS Of these 100 patients, 1 received a Medtronic CoreValve. Therefore, this patient was subsequently removed from the analysis. Ninety-nine consecutive TAo-TAVI patients received a balloon-expandable...
Source: Interactive CardioVascular and Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: History, Transplantation - heart, Basic research vascular ADULT CARDIAC Source Type: research
Although bicuspid aortic valves (BAV) affect only 1 to 2% of the general population (1), up to 50% of adults with severe, symptomatic aortic stenosis undergoing surgical aortic valve replacement (AVR) may have BAV [1]. Given this frequency and the increasing survival for patients after orthotopic heart transplantation (OHT), it is important for clinicians to recognize the potential for aortic stenosis due to BAV in this population. There have been case reports of open AVR after cardiac transplant for BAV [2,3].
Source: Cardiovascular Revascularization Medicine - Category: Cardiology Authors: Source Type: research
OBJECTIVES Aortic valve replacement (AVR) via minimally invasive surgery (MIS) may provide clinical benefits in patients with aortic valve disease. A new class of bioprosthetic valves that enable rapid deployment AVR (RDAVR) may facilitate MIS. We here report the 1-year results of a randomized, multicentre trial comparing the outcomes for MIS-RDAVR with those for conventional AVR via full sternotomy (FS) with a commercially available stented aortic bioprosthesis. METHODS A total of 100 patients with aortic stenosis were enrolled in a prospective, multicentre, randomized comparison trial (CADENCE-MIS). Key exclusion criter...
Source: European Journal of Cardio-Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Transplantation - heart, Basic research vascular ADULT CARDIAC Source Type: research
We examined the engraftment and differentiation of alkaline phosphatase-positive NSCs expanded from the postnatal subventricular zone (SVZ), 3 months after grafting into the intact young or aged rat hippocampus. Graft-derived cells engrafted robustly into both young and aged hippocampi. Although most graft-derived cells pervasively migrated into different hippocampal layers, the graft cores endured and contained graft-derived neurons. The results demonstrate that advanced age of the host at the time of grafting has no major adverse effects on engraftment, migration, and differentiation of grafted subventricular zone...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
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