Characterization of Aortic Root Compliance at Different Heights

2008 ◽  
Author(s):  
Eric M. Sirois ◽  
Tsuicheng Chiu ◽  
Martin Fox ◽  
Wei Sun
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Significant Risk ◽  
Access Site ◽  
Serious Adverse Events

Aortic valve stenosis is a significant cause of morbidity and mortality [1]. Currently, the preferred treatment of severe aortic stenosis is aortic valve replacement, which carries a significant risk for patients with comorbidities [2]. Recently, percutaneous aortic valve (PHV) replacement represents an endovascular alternative to conventional open heart surgery without the need for sternotomy, aortotomy, or cardiopulmonary bypass [3]. However, there are significant serious adverse events associated with the percutaneous procedure, such as myocardial infarction, peripheral embolism, injury to the aorta, perivalvular leak and access site injury [3–5]. Furthermore, long-term durability and safety of these valves need to be evaluated and studied carefully. We hypothesize that the device (dys)function could be more accurately predicted if a better understanding of the biomechanical interaction between the native aortic valve/root and the PHV were available. In this study, our objective is to characterize the mechanical properties of the aortic root such that its interaction with the PHV device can be quantified.

Short and Long-term Results of Open Heart Surgery in Aortic Valve Disease

1998 ◽  
Vol 28 (9) ◽  
pp. 1509 ◽  
Author(s):  
Hyun-Sook Kim ◽  
Jae-Kwan Song ◽  
Jae-Hwan Lee ◽  
Young-Hak Kim ◽  
Min-Kyu Kim ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Valve Disease ◽  
Long Term Results ◽  
Open Heart ◽  
Short And Long Term

scholarly journals Prosthetic Valve Endocarditis with Valvular Obstruction after Transcatheter Aortic Valve Replacement

2015 ◽  
Vol 42 (2) ◽  
pp. 172-174 ◽  
Author(s):  
Christine Pabilona ◽  
Bernard Gitler ◽  
Jeffrey A. Lederman ◽  
Donald Miller ◽  
Theodore N. Keltz
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Prosthetic Valve Endocarditis ◽  
Transcatheter Aortic Valve

Patients with severe aortic stenosis who are at high risk for open-heart surgery might be candidates for transcatheter aortic valve replacement (TAVR). To our knowledge, this is the first report of Streptococcus viridans endocarditis that caused prosthetic valve obstruction after TAVR. A 77-year-old man who had undergone TAVR 17 months earlier was admitted because of evidence of prosthetic valve endocarditis. A transthoracic echocardiogram revealed a substantial increase in the transvalvular peak gradient and mean gradient in comparison with an echocardiogram of 7 months earlier. A transesophageal echocardiogram showed a 1.5-cm vegetation obstructing the valve. Blood cultures yielded penicillin-sensitive S. viridans. The patient was hemodynamically stable and was initially treated with vancomycin because of his previous penicillin allergy. Subsequent therapy with levofloxacin, oral penicillin (after a negative penicillin skin test), and intravenous penicillin eliminated the symptoms of the infection. Transcatheter aortic valve replacement is a relatively new procedure, and sequelae are still being discovered. We recommend that physicians consider obstructive endocarditis as one of these.

scholarly journals Transcatheter Aortic Valve Implantation (TAVI): Is It Time for this Intervention to be Applied in a Lower Risk Population?

2014 ◽  
Vol 8 ◽  
pp. CMC.S19217 ◽  
Author(s):  
Loannis M. Panayiotides ◽  
Evagoras Nikolaides
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Transcatheter Aortic Valve Implantation ◽  
Lower Risk ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Patients with severe aortic stenosis are sometimes not candidates for conventional open heart surgery because of severe deconditioning, excessive risk factors, and multiple comorbidities. Transcatheter aortic valve implantation (TAVI) is a relatively recent intervention, which was initially addressed to individuals with severe symptomatic aortic stenosis at substantial or prohibitive surgical risk. Despite the documented beneficial effects of this therapeutic intervention in certain carefully selected individuals, it has not yet been applied to lower risk patients. This is a review of the current literature and accumulated clinical data of this rapidly evolving invasive procedure in an attempt to resolve whether it can now be applied to a wider portion of patients with aortic stenosis.

scholarly journals Characterization of Turbulent Flow Behind a Transcatheter Aortic Valve in Different Implantation Positions

2022 ◽  
Vol 8 ◽  
Author(s):  
Leonardo Pietrasanta ◽  
Shaokai Zheng ◽  
Dario De Marinis ◽  
David Hasler ◽  
Dominik Obrist
Keyword(s):  
Aortic Valve ◽  
Flow Field ◽  
Turbulent Flow ◽  
Aortic Root ◽  
Flow Topology ◽  
Transcatheter Aortic Valve ◽  
Long Term Performance ◽  
Term Performance

The development of turbulence after transcatheter aortic valve (TAV) implantation may have detrimental effects on the long-term performance and durability of the valves. The characterization of turbulent flow generated after TAV implantation can provide fundamental insights to enhance implantation techniques. A self-expandable TAV was tested in a pulse replicator and the three-dimensional flow field was extracted by means of tomographic particle image velocimetry. The valve was fixed inside a silicone phantom mimicking the aortic root and the flow field was studied for two different supra-annular axial positions at peak systole. Fluctuating velocities and turbulent kinetic energy were compared between the two implantations. Velocity spectra were derived at different spatial positions in the turbulent wakes to characterize the turbulent flow. The valve presented similar overall flow topology but approximately 8% higher turbulent intensity in the lower implantation. In this configuration, axial views of the valve revealed smaller opening area and more corrugated leaflets during systole, as well as more accentuated pinwheeling during diastole. The difference arose from a lower degree of expansion of the TAV's stent inside the aortic lumen. These results suggest that the degree of expansion of the TAV in-situ is related to the onset of turbulence and that a smaller and less regular opening area might introduce flow instabilities that could be detrimental for the long-term performance of the valve. The present study highlights how implantation mismatches may affect the structure and intensity of the turbulent flow in the aortic root.

scholarly journals Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report

2019 ◽  
Author(s):  
Ahmet Korkmaz ◽  
Havva Tuğba Gürsoy ◽  
Mehmet İleri ◽  
Özgül Uçar Elalmış ◽  
Ümit Güray
Keyword(s):  
Case Report ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Surgery ◽  
Severe Aortic Stenosis ◽  
Open Heart Surgery ◽  
Mitral Valve Surgery ◽  
Transcatheter Aortic Valve

Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or who are unsuitable candidates for open-heart surgery. However, concerns exist over treating patients who have undergone previous mitral valve surgery due to the potential interference between the mitral prosthetic valve or ring and the TAVI device. In this case report, we present a case in which a patient with symptomatic severe aortic stenosis and previous mechanical mitral valve replacement was successfully treated with TAVI using a Portico valve, which is under-researched.   J Teh Univ Heart Ctr 2019;14(2):85-89   This paper should be cited as: Korkmaz A, Gürsoy HT, İleri M, Uçar Elalmış Ö, Güray Ü. Transcatheter Self-expandable Aortic Valve (Portico) Implantation in a Patient with Previous Mitral Valve Replacement: A Case Report. J Teh Univ Heart Ctr 2019;14(2):85-89.

scholarly journals Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lytfi Krasniqi ◽  
Mads P. Kronby ◽  
Lars P. S. Riber
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Risk ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Long Term Survival ◽  
All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

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