Transfemoral transcatheter aortic valve implantation in the presence of a mechanical mitral valve prosthesis using a dedicated TAVI guidewire: utility of a patient-specific three-dimensional heart model

2016 ◽  
Vol 32 (3) ◽  
pp. 308-311 ◽  
Author(s):  
Takanari Fujita ◽  
Naritatsu Saito ◽  
Kenji Minakata ◽  
Masao Imai ◽  
Kazuhiro Yamazaki ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Three Dimensional ◽  
Patient Specific ◽  
Valve Prosthesis ◽  
Heart Model ◽  
Transcatheter Aortic Valve ◽  
Mitral Valve Prosthesis ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Antithrombotic treatment in patients undergoing transcatheter aortic valve implantation (TAVI)

2015 ◽  
Vol 113 (04) ◽  
pp. 674-685 ◽  
Author(s):  
Vincent J. Nijenhuis ◽  
Naoual Bennaghmouch ◽  
Jan-Peter van Kuijk ◽  
Davide Capodanno ◽  
Jurriën M. ten Berg
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Bleeding Complications ◽  
Valve Prosthesis ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Mitral Valve Prosthesis ◽  
Ischemic Complications ◽  
Aortic Valve Implantation ◽  
Valve Implantation

SummaryTranscatheter aortic valve implantation (TAVI) is an established treatment option for symptomatic patients with severe aortic valvular disease who are not suitable for conventional surgical aortic valve replacement. Despite improving experience and techniques, ischaemic and bleeding complications after TAVI remain prevalent and impair survival in this generally old and comorbid-rich population. Due to changing aetiology of complications over time, antiplatelet and anticoagulant therapy after TAVI should be carefully balanced. Empirically, a dual antiplatelet strategy is generally used after TAVI for patients without an indication for oral anticoagulation (OAC; e. g. atrial fibrillation, mechanical mitral valve prosthesis), including aspirin and a thienopyridine. For patients on OAC, a combination of OAC and aspirin or thienopyridine is generally used. This review shows that current registries are unfit to directly compare antithrombotic regimens. Small exploring studies suggest that additional clopidogrel after TAVI only affects bleeding and not ischemic complications. However, these studies are lack in quality in terms of Cochrane criteria. Currently, three randomised controlled trials are recruiting to gather more knowledge about the effects of clopidogrel after TAVI.

scholarly journals Simulated Prosthesis Overlay for Patient-Specific Planning of Transcatheter Aortic Valve Implantation Procedures

2015 ◽  
Vol 10 (5) ◽  
pp. 314-322 ◽  
Author(s):  
Simon H. Sündermann ◽  
Michael Gessat ◽  
Willibald Maier ◽  
Jörg Kempfert ◽  
Thomas Frauenfelder ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Pacemaker Implantation ◽  
Three Dimensional ◽  
Patient Data ◽  
Equal Size ◽  
Patient Specific ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Objective We tested the hypothesis that simulated three-dimensional prosthesis overlay procedure planning may support valve selection in transcatheter aortic valve implantation (TAVI) procedures. Methods Preoperative multidimensional computed tomography (MDCT) data sets from 81 consecutive TAVI patients were included in the study. A planning tool was developed, which semiautomatically creates a three-dimensional model of the aortic root from these data. Three-dimensional templates of the commonly used TAVI implants are spatially registered with the patient data and presented as graphic overlay. Fourteen physicians used the tool to perform retrospective planning of TAVI procedures. Results of prosthesis sizing were compared with the prosthesis size used in the actually performed procedure, and the patients were accordingly divided into three groups: those with equal size (concordance with retrospective planning), oversizing (retrospective planning of a smaller prosthesis), and undersizing (retrospective planning of a larger prosthesis). Results In the oversizing group, 85% of the patients had new pacemaker implantation. In the undersizing group, in 66%, at least mild paravalvular leakage was observed (greater than grade 1 in one third of the cases). In 46% of the patients in the equal-size group, neither of these complications was observed. Conclusions Three-dimensional prosthesis overlay in MDCT-derived patient data for patient-specific planning of TAVI procedures is feasible. It may improve valve selection compared with two-dimensional MDCT planning and thus yield better outcomes.

scholarly journals Transfemoral aortic valve implantation in severe aortic stenosis patients with prior mitral valve prosthesis

2015 ◽  
Vol 4 ◽  
pp. 304-311 ◽  
Author(s):  
Cenk Sari ◽  
Serdal Baştuğ ◽  
Hüseyin Ayhan ◽  
Hacı Ahmet Kasapkara ◽  
Tahir Durmaz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Severe Aortic Stenosis ◽  
Valve Prosthesis ◽  
Mitral Valve Prosthesis ◽  
Aortic Valve Implantation ◽  
Valve Implantation

scholarly journals Transseptal transcatheter valve-in-valve implantation for failed surgical mitral bioprosthesis: the first clinical experience

2020 ◽  
Vol 24 (1) ◽  
pp. 94
Author(s):  
V. I. Ganyukov ◽  
E. A. Shloido ◽  
R. S. Tarasov ◽  
N. V. Rogulina ◽  
I. K. Khalivopulo ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Conflict Of Interest ◽  
Clinical Status ◽  
Clinical Aspects ◽  
Valve Prosthesis ◽  
Transcatheter Aortic Valve ◽  
Mitral Valve Prosthesis ◽  
Transcatheter Valve ◽  
Valve Implantation

<p>A clinical case of endovascular correction of a biological mitral valve prosthesis dysfunction by implantation of a transcatheter aortic valve into the mitral position is described. Considering the clinical status of the patient, the condition was determined to be inoperable. Subsequently, based on vital fluoroscopy and echocardiography findings, the patient was implanted with a transcatheter aortic valve in the mitral valve bioprosthesis position. The technical and clinical aspects of the intervention and its results were analysed during the hospital period and for 5 months after implantation. The selected method of treatment was found to be appropriate.</p><p>Received 10 January 2020. Revised 18 March 2020. Accepted 19 March 2020.</p><p><strong>Funding</strong>: The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Drafting the article: N.V. Rogulina, I.V. Ganyukov, A.M. Kochergina, V.I. Ganyukov, R.S. Tarasov, I.K. Khalivopulo, I.N. Sizova <br />Literature review: V.I. Ganyukov, R.S. Tarasov, N.V. Rogulina, I.K. Khalivopulo, I.V. Ganyukov, A.M. Kochergina <br />Illustrations: I.V. Ganyukov, I.N. Sizova, N.V. Rogulina <br />Critical revision of the article: V.I. Ganyukov, R.S. Tarasov, E.A. Shloido, L.S. Barbarash <br />Surgical treatment: E.A. Shloido, V.I. Ganyukov, R.S. Tarasov<br />Final approval of the version to be published: V.I. Ganyukov, E.A. Shloido, R.S. Tarasov, N.V. Rogulina, I.K. Khalivopulo, I.V. Ganyukov, A.M. Kochergina, I.N. Sizova, L.S. Barbarash</p>

scholarly journals Simulation of Transcatheter Aortic Valve Implantation Procedure

2019 ◽  
Vol 14 (1) ◽  
pp. 204-219
Author(s):  
K.Yu. Klyshnikov ◽  
V.I. Ganyukov ◽  
A.V. Batranin ◽  
D.V. Nushtaev ◽  
E.A. Ovcharenko
Keyword(s):  
Aortic Valve ◽  
Delivery System ◽  
Transcatheter Aortic Valve Implantation ◽  
Research Work ◽  
Clinical Results ◽  
Patient Specific ◽  
Valve Prosthesis ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

The study is devoted to numerical modeling of transcatheter aortic valve implantation (TAVI) from the position of prognostic value in comparison with clinical data. The finite element method implemented in the Abaqus/CAE software and the reconstruction of three-dimensional models based on the computer microtomography of the CoreValve bioprosthesis of a size of 29 mm and the patient-specific data of functional studies (multispiral tomography) were used in the work. The study included three variations in the modeling of the aortic valve prosthesis procedure, which determine the level of detalization of the numerical experiment. All stages of the TAVI process were reproduced: the crimp of the prosthesis, the movement of the delivery system, the interaction of the guide - guidewire with the elements of the “prosthesis-root” of the aorta system, implantation itself. In silico experiment demonstrated significant quantitative and qualitative agreement with the data of intraoperative fluorography and computed tomography after the TAVI procedure. It is shown that the inclusion of additional elements – the guidewire and catheter of the delivery system into the “aortic root” has a positive effect on the convergence of the data with the clinical results. The analysis of the stress-strain state of the elements interacting in the experiment demonstrated a significant contribution to the analyzed parameters of the prosthetic motion stage along the guidewire as part of the delivery system catheter. Nevertheless, a comparison with the results of the clinical evaluation of the TAVI procedure revealed a number of differences in the response of the model of the bioprosthesis at the later stages of modeling, which requires further researches of a level of detalization. The approach is extremely promising both for practitioners and for research work of prosthetic designers, it can be applied in further R&D tasks.

scholarly journals Mitral valve replacement after transcatheter aortic valve implantation in a patient with rheumatic heart disease and prior Ross procedure: a case report

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Khaled D. Algarni ◽  
Amr A. Arafat
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Ross Procedure ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Reoperations are required frequently after the Ross procedure in rheumatic patients. The use of transcatheter aortic valve implantation (TAVI) in those patients could decrease the risk of future open procedure; however, the outcome may be affected by the concomitant mitral valve disease, and subsequent mitral reoperation may distort the implanted aortic valve. Case presentation We present a female patient who had a beating mitral valve replacement after valve-in-valve TAVI in a patient with prior Ross procedure. Weaning from cardiopulmonary bypass was difficult, and the patient needed extra-cardiac membrane oxygenation (ECMO) and intra-aortic balloon pump because of right ventricular dysfunction. The right ventricular dysfunction could be due to the concomitant coronary artery disease or air embolism during the beating mitral valve surgery. Recovery was gradual, and the patient was discharged after 33 days. Pre-discharge echocardiography showed a maximum gradient of 9 mmHg on the aortic valve and mild paravalvular leak. Conclusions Mitral valve replacement in a patient with prior TAVI and the Ross procedure was feasible; it decreased the operative risk and did not distort the implanted aortic valve.

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