Doppler‐Detected Valve Movement in Aortic Stenosis: A Predictor of Adverse Outcome

Abstract BackgroundThe absence of auscultatory aortic valve closure sound is associated with severe aortic stenosis. The absence of Doppler‐derived aortic opening (Aop) or closing (Acl) may be a sign of advanced severe aortic stenosis. HypothesisAbsent Doppler‐detected Aop or Acl transient is indicative of very severe aortic stenosis and is associated with adverse outcome. MethodsA total of 118 consecutive patients with moderate (n = 63) or severe aortic stenosis (n = 55) were included. Aop and Acl signals were identified in a blinded fashion by continuous‐wave Doppler. Patients with and without Aop and Acl were compared using χ2 test for dichotomous variables and analysis of variance for continuous variables. The associations of Aop and Acl with aortic valve replacement were determined. ResultsAop or Acl were absent in 22 of 118 patients. The absence of Aop or Acl was associated with echocardiographic parameters of severe aortic stenosis. The absence of Aop or Acl was associated with incident aortic valve replacement (36.4% vs 7.3%, respectively, P
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: Clinical Investigations Source Type: research

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ConclusionBoth TTR ‐ and AL‐CA can accompany severe AS. Parameters solely based on ECG and echocardiography allow for the identification of the majority of CA‐AS. In the present cohort, CA did not significantly worsen prognosis 15.3 months after TAVR.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for severe symptomatic aortic stenosis. Despite advances in device technology and procedural techniques, periprocedural stroke remains a severe complication of TAVR, affecting 2% of patients. The embolization of calcific debris from the degenerated aortic valve and atherosclerotic plaque from the aorta, both of which are manipulated during TAVR, is the likely mechanism of periprocedural stroke. Accordingly, cerebral embolic protection devices (EPDs) have been designed to prevent stroke by sequestering embolic debris during TAVR.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research
My understanding of the legality and propriety of hospital"advertising" in social media was rather vague but an article on this topic cleared away the cobwebs (see:Hospital Advertising). Below is an excerpt from it. It turns out to be legal but later in the post I will discuss why I think it's beneficial for healthcare consumers.While advertising by doctors and hospitals has been legal for 30 years, until recently, professional taboos discouraged the practice. Increasing economic pressures and changing cultural norms have led, however, to the demise of these informal proscriptions, and advertisements pro...
Source: Lab Soft News - Category: Laboratory Medicine Authors: Tags: Healthcare Business Healthcare Innovations Medical Consumerism Quality of Care Social Media Source Type: blogs
The objective of this study was to assess imaging predictors of mitral regurgitation (MR) improvement and to evaluate the impact of MR regression on long-term outcome in patients undergoing transcatheter aortic valve replacement (TAVR).BackgroundConcomitant MR is a frequent finding in patients with severe aortic stenosis but usually left untreated at the time of TAVR.MethodsMitral regurgitation was graded by transthoracic echocardiography before and after TAVR in 677 consecutive patients with severe aortic stenosis. 2-year mortality was related to the degree of baseline and discharge MR. Morphological echo analysis was per...
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
Publication date: April 2020Source: IJC Heart &Vasculature, Volume 27Author(s): Paola Angela Maria Purita, Luisa Salido Tahoces, Chiara Fraccaro, Luca Nai Fovino, Won-Keun Kim, Cláudio Espada-Guerreiro, Ole De Backer, Morritz Seiffert, Luis Nombela-Franco, Raul Moreno Gomez, Antonio Mangieri, Anna Franzone, Francesco Bedogni, Fausto Castriota, Tiziana Attisano, Lars Søndergaard, Rosana Hernandez Antolin, Giuseppe TarantiniAbstractBackgroundTranscatheter aortic valve replacement (TAVR) has been validated for the treatment of severe symptomatic aortic stenosis in patients at high and intermediate surgical r...
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
Publication date: Available online 12 February 2020Source: The Annals of Thoracic SurgeryAuthor(s): Fausto Biancari., Antti Valtola, Tatu Juvonen, Annastiina Husso, Sebastian Dahlbacka, Teemu Laakso, Maina P. Jalava, Tuomas Tauriainen, Tuomas Ahvenvaara, Eeva-Maija Kinnunen, Matti Niemelä, Timo Mäkikallio, Markku Eskola, Marko P.O. Virtanen, Pasi Maaranen, Stefano Rosato, Vesa Anttila, Antti Vento, Juhani Airaksinen, Peter RaivioAbstractBackgroundRecent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability.MethodsThis is a comparative analysis of the outcome...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
To examine the role and outcomes of all interventions for aortic stenosis in children, with focus on freedom from reintervention and the aim to minimise prosthetic aortic valve replacement (pAVR) during childhood. Retrospective analysis of 194 consecutive children who underwent any aortic valve intervention for a biventricular repair strategy at a single institution between 1995-2017. Data were obtained from hospital records and follow-up was 100% complete. Over a 22-year period, 194 children underwent total 313 aortic valve procedures: Primary interventions were surgical valvotomy (SV)/surgical repair (SR) in 94 (48.5%), ...
Source: Seminars in Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CONGENITAL – Original Submission Source Type: research
aivio P Abstract BACKGROUND: Recent surgical bovine pericardial prostheses are widely used in spite of limited data on their long-term durability. METHODS: This is a comparative analysis of the outcome of the Trifecta and Perimount Magna Ease bioprostheses from the FinnValve registry, a Finnish nationwide database including patients with aortic stenosis who underwent transcatheter or surgical aortic valve replacement with a bioprosthesis between 2008 and 2017. RESULTS: Overall 2216 patients (mean age, 74.1±6.7 years; age
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Transcatheter aortic valve implantation (TAVI) via total percutaneous transfemoral approach is an increasingly common technique for aortic stenosis treatment. It is primarily indicated in elderly with serious ...
Source: BMC Surgery - Category: Surgery Authors: Tags: Case report Source Type: research
Abstract Transcatheter aortic valve replacement (TAVR) has emerged as the treatment of choice for patients with severe aortic stenosis deemed at high or intermediate risk for cardiac surgery. In light of the latest literature advances, TAVR will undoubtedly concern a growing number of patients because of the progressive extension of its indications. Whereas significant efforts have been made to reduce the burden of periprocedural complications, TAVR still exposes patients to a sizeable number of adverse outcomes, including thrombotic and bleeding events. Although contradictory, these two phenomena are closely rela...
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
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