scholarly journals Pregnancy after Prosthetic Aortic Valve Replacement: How Do We Monitor Prosthetic Valvular Function during Pregnancy?

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Nicole Sahasrabudhe ◽  
Nickolas Teigen ◽  
Diana S. Wolfe ◽  
Cynthia Taub
Keyword(s):  
Aortic Valve ◽  
Prenatal Care ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Modern Medicine ◽  
Multidisciplinary Management ◽  
Prosthetic Aortic Valve ◽  
Echocardiographic Parameters ◽  
Valvular Function ◽  
In Pregnancy

Background. With modern medicine, many women after structural heart repair are deciding to experience pregnancy. There is a need for further study to identify normal echocardiographic parameters to better assess prosthetic valvular function in pregnancy. In addition, a multidisciplinary approach is essential in managing pregnant patients with complex cardiac conditions.Case. A 22-year-old nulliparous woman with an aortic valve replacement 18 months prior to her pregnancy presented to prenatal care at 20-week gestation. During her prenatal care, serial echocardiography showed a significant increase in the mean gradient across the prosthetic aortic valve. Multidisciplinary management and a serial echocardiography played an integral role in her care that resulted in a successful spontaneous vaginal delivery without complications.Conclusion. Further characterization of the normal echocardiographic parameters in pregnant patients with prosthetic valves is critical to optimize prenatal care for this patient population. This case report is novel in that serial echocardiograms were obtained throughout prenatal care, which showed significant changes across the prosthetic aortic valve.Teaching Points.(1)Further study is needed to identify normal echocardiographic parameters to best assess prosthetic valvular function in pregnancy.(2)Multidisciplinary management is encouraged to optimize prenatal care for women with prosthetic aortic valve replacements.

scholarly journals Transcatheter Aortic Valve Replacement for Bioprosthetic Aortic Stenosis in Pregnancy

2018 ◽  
Vol 11 (19) ◽  
pp. e161-e162 ◽  
Author(s):  
Natalia Berry ◽  
Neal Sawlani ◽  
Katherine Economy ◽  
Douglas Shook ◽  
Charles Nyman ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
In Pregnancy

scholarly journals P757 Left atrial contractile function improves shortly after transcatheter aortic valve replacement. A speckle tracking echocardiography study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Calin ◽  
D Cadil ◽  
C Parasca ◽  
A Mateescu ◽  
M Rosca ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Strain Rate ◽  
Valve Replacement ◽  
Speckle Tracking Echocardiography ◽  
Contractile Function ◽  
Transcatheter Aortic Valve ◽  
Lv Mass ◽  
Echocardiographic Parameters ◽  
The Mean

Abstract Background Transcatheter aortic valve replacement (TAVR) reverses LV remodeling and improves overall cardiac function, but data regarding its effect on left atrial (LA) function is scarce. Our aim was to evaluate the short-term effect of TAVR on LA myocardial deformation parameters and the relationship between the improvement of LA function and baseline echocardiographic parameters. Methods Fourty-eight consecutive pts (75 ± 6 yrs, 28 men) considered to be at increased risk for surgical aortic valve replacement were enrolled and examined before and 30 days after TAVR. All pts underwent a comprehensive echocardiogram, including speckle tracking echocardiography (STE) for deformation analysis. Longitudinal LA strain parameters were assessed from the apical 4-chamber view. Peak values of global longitudinal LA strain (LAε) and LA systolic strain rate (SSr, reservoir function) and early diastolic strain rate (ESr, conduit function) were measured in all. Contractile LA function (late diastolic strain rate, ASr) was assessed in patients in sinus rhythm (39 pts). Results Compared with baseline, the mean indexed LV mass was significantly reduced after TAVR (141 ± 26 vs 160 ± 37 g/m2, p = 0.009) but the mean increase in LVEF was not statistically significant (51 ± 14% vs 47 ± 15%, p = 0.2). There was a significant reduction in systolic pulmonary pressure after TAVR (34 ± 12 vs 42 ± 13, p = 0.004). Although there was no significant decrease in indexed LA volume (51 ± 22 vs 56 ± 20 ml/m2, p = 0.3), the contractile LA function significantly improved 30-days after TAVR (mean ASr, -1.1 ± 0.5 vs -0.8 ± 0.4 %, p = 0.02). There was a tendency of improvement in global longitudinal LA strain (15 ± 7 vs 12 ± 6%, p = 0.06) and global longitudinal LV strain (-13 ± 4 vs -11 ± 5%, p = 0.06) as well. Parameters of LV diastolic function, including TDI derived e’ and E/e’ ratios were not significantly improved 30 days after TAVI. While LA volumes and function parameters were not significantly different between genders at baseline, the improvement of LA function was more frequently found in male pts (p = 0.05). There were no significant correlations between the improvement of LA function parameters and baseline echocardiographic parameters in our study group. The only predictor of LA booster function improvement was the baseline value of ASr (p = 0.01). Conclusions TAVR is associated with a significant recovery of LA function as assessed by STE, suggesting a reverse cavity remodeling. This was accompanied by a significant reduction in LV mass and systolic pulmonary pressure. Men seem to show a more significant improvement in LA contractile function, suggesting a gender-related LA response to chronic afterload reduction.

scholarly journals Predictors of the Size of Prosthetic Aortic Valve and In-Hospital Mortality in Aortic Valve Replacement

2014 ◽  
Vol 6 (4) ◽  
Author(s):  
Muhammad Shahzeb Khan ◽  
Faizan Imran Bawany ◽  
Mudassir Iqbal Dar ◽  
Muhammad Umer Ahmed ◽  
Mehwish Hussain ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Mortality ◽  
Valve Replacement ◽  
Prosthetic Aortic Valve

Case 7.27

2014 ◽  
pp. 357-358
Author(s):  
Christine U. Lee ◽  
James F. Glockner
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Cardiac Failure ◽  
Aortic Root ◽  
Aortic Root Replacement ◽  
Prosthetic Aortic Valve

72-year-old man with aortic dissection who underwent aortic root replacement and prosthetic aortic valve replacement 14 years ago; the patient has had worsening periprosthetic regurgitation and cardiac failure and has required multiple transfusions Two axial GRE images from a BOLD acquisition (Figure 7.27.1...

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