Anatomical angulation between the long axis of the left ventricle and left ventricular outflow tract as possible predictor of postprocedural complications in patients undergoing transapical aortic valve implantation

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
B Foldyna ◽  
D Holzhey ◽  
M Haensig ◽  
C Luecke ◽  
MA Borger ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Ventricular Outflow ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Echocardiographic assessment of the aortic valve and left ventricular outflow tract

2005 ◽  
Vol 15 (S1) ◽  
pp. 27-36 ◽  
Author(s):  
Alfred Asante-Korang ◽  
Robert H. Anderson
Keyword(s):  
Aortic Valve ◽  
Left Ventricle ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Left Heart ◽  
Transesophageal Echocardiogram ◽  
Left Ventricular Outflow ◽  
Echocardiographic Assessment

The previous reviews in this section of our Supplement1,2 have summarized the anatomic components of the ventriculo-arterial junctions, and then assessed the echocardiographic approach to the ventriculo-arterial junction or junctions as seen in the morphologically right ventricle. In this complementary review, we discuss the echocardiographic assessment of the comparable components found in the morphologically left ventricle, specifically the outflow tract and the arterial root. We will address the echocardiographic anatomy of the aortic valvar complex, and we will review the causes of congenital arterial valvar stenosis, using the aortic valve as our example. We will also review the various lesions that, in the outflow of the morphologically left ventricle, can produce subvalvar and supravalvar stenosis. We will then consider the salient features of the left ventricular outflow tract in patients with discordant ventriculo-arterial connections, and double outlet ventricles. To conclude the review, we will briefly address some rarer anomalies that involve the left ventricular outflow tract, showing how the transesophageal echocardiogram is used to assist the surgeon preparing for repair. The essence of the approach will be to consider the malformations as seen at valvar, subvalvar, or supravalvar levels,1 but we should not lose sight of the fact that aortic coarctation or interruption, hypoplasia of the left heart, and malformations of the mitral valve are all part of the spectrum of lesions associated with obstruction to the left ventricular outflow tract. These additional malformations, however, are beyond the scope of this review.

scholarly journals Recurrence of Left Ventricular Outflow Tract Obstruction Requiring Alcohol Septal Ablation after Transcatheter Aortic Valve Implantation

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Hideki Kitahara ◽  
Kaoru Mastuura ◽  
Atsushi Sugiura ◽  
Akiko Yoshimura ◽  
Takahiro Muramatsu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Alcohol Septal Ablation ◽  
Transcatheter Aortic Valve ◽  
Left Ventricular Outflow ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Left ventricular outflow tract (LVOT) obstruction is sometimes observed in patients with severe aortic stenosis (AS). It is still controversial how to manage the remaining severe AS, when LVOT obstruction is well-controlled by medical therapy. We report a case with acute recurrence of LVOT obstruction requiring emergent alcohol septal ablation (ASA) after transcatheter aortic valve implantation (TAVI), even in a stable state on beta-blockers. For the ASA procedure, transesophageal echocardiography was useful to clearly observe the perfusion area of the target septal branch by injecting microbubble contrast. Since it took some time to cause the recurrence of LVOT obstruction in this case, careful evaluation should be done after TAVI in high-risk patients for LVOT obstruction before terminating the TAVI procedure.

scholarly journals Treatment of severe aortic stenosis and left ventricular outflow tract mass with transcutaneous aortic valve implantation: a case report

2019 ◽  
Author(s):  
Hesham A Naeim ◽  
Waleed Saeed ◽  
Ibraheem Alharbi ◽  
Reda Abuelatta
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Left Ventricular Outflow Tract ◽  
Severe Aortic Stenosis ◽  
Transoesophageal Echocardiography ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Ventricular Outflow ◽  
Aortic Valve Implantation ◽  
Valve Implantation

AbstractBackgroundPercutaneous implantation of aortic valve for severe aortic stenosis (AS) in the presence of pedunculated mobile left ventricular outflow tract (LVOT) mass not reported before. In this case report, we address the feasibility of this procedure.Case summaryAn 80-year-old patient who presented with presyncope, transthoracic echocardiogram (TTE), and transoesophageal echocardiography (TOE) revealed severe calcific AS and LVOT mass measuring 2.1*1.5 cm. The patient was turned down for surgery. It was decided that transcatheter aortic valve implantation (TAVI) be performed because the valve compresses the mass against the proximal part of the interventricular septum. The mass peduncle was 1.4 cm, and it was 4 mm away from the annulus. This meant the valve was needed to be deployed 18 mm below the annulus to cover the mass completely. Gentle manipulation and direct valve deployment without preballoon dilation to decrease the possibility of fragment embolization were necessary. Self-expandable core valve deployed as low as possible, after initial deployment, the distance of LVOT covered by the valve measured by TOE 1.66 cm, the whole mass was covered, then the valve was fully deployed. The patient was extubated in the catheterization room; there was no clinical evidence of embolization. The patient was discharged home after 2 days. A follow-up TTE after 6 months showed a well-functioning valve and the LVOT mass then disappeared.DiscussionPedunculated LVOT mass should be resected surgically. In high-risk surgical patients, direct TAVI to compress the mass is feasible in experienced canters. The safety issues need more research and more cases to judge. Transoesophageal echocardiography during the procedure is mandatory to guide the valve position.

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