scholarly journals Apical Aortic Valve Implantation in a Patient With a Mechanical Valve Prosthesis in Mitral Position

2008 ◽  
Vol 1 (3) ◽  
pp. 233-233 ◽  
Author(s):  
Josep Rodés-Cabau ◽  
Eric Dumont ◽  
Santiago Miró ◽  
Daniel Doyle ◽  
Robert De Larochellière ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mechanical Valve ◽  
Valve Prosthesis ◽  
Mitral Position ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Image-Guided Transapical Aortic Valve Implantation Sensorless Tracking of Stenotic Valve Landmarks in Live Fluoroscopic Images

2011 ◽  
Vol 6 (4) ◽  
pp. 231-236 ◽  
Author(s):  
Denis R. Merk ◽  
Mohamed Esmail Karar ◽  
Claire Chalopin ◽  
David Holzhey ◽  
Volkmar Falk ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Contrast Agent ◽  
Image Sequences ◽  
Invasive Technique ◽  
Valve Prosthesis ◽  
Tracking Method ◽  
Fluoroscopic Image ◽  
Aortic Valve Implantation ◽  
Valve Implantation ◽  
Contrast Image

Objective Aortic valve stenosis is one of the most frequently acquired valvular heart diseases, accounting for almost 70% of valvular cardiac surgery. Transapical transcatheter aortic valve implantation has recently become a suitable minimally invasive technique for high-risk and elderly patients with severe aortic stenosis. In this article, we aim to automatically define a target area of valve implantation, namely, the area between the coronary ostia and the lowest points of two aortic valve cusps. Therefore, we present a new image-based tracking method of these aortic landmarks to assist in the placement of aortic valve prosthesis under live 2D fluoroscopy guidance. Methods We propose a rigid intensity-based image registration technique for tracking valve landmarks in 2D fluoroscopic image sequences, based on a real-time alignment of a contrast image including the initialized manual valve landmarks to each image of sequence. The contrast image is automatically detected to visualize aortic valve features when the aortic root is filled with a contrast agent. Results Our registration-based tracking method has been retrospectively applied to 10 fluoroscopic image sequences from routine transapical aortic valve implantation procedures. Most of all tested fluoroscopic images showed a successful tracking of valve landmarks, especially for the images without contrast agent injections. Conclusions A new intraoperative image-based method has been developed for tracking aortic valve landmarks in live 2D fluoroscopic images to assist transapical aortic valve implantations and to increase the overall safety of surgery as well.

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.

Outcome of Patients Treated with Engager Transapical Aortic Valve Implantation

2013 ◽  
Vol 8 (5) ◽  
pp. 332-336 ◽  
Author(s):  
Simon H. Sündermann ◽  
Jürg Grünenfelder ◽  
Roberto Corti ◽  
Ardawan J. Rastan ◽  
Axel Linke ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Delivery System ◽  
Multiorgan Failure ◽  
Academic Research ◽  
Heart Association ◽  
Valve Prosthesis ◽  
Short Term ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Objective The aim of this study was to investigate the short-term and midterm outcome of the Engager transcatheter aortic valve implantation (TAVI) system, a transapical self-expanding valve device with anatomic orientation. Methods Transapical aortic valve implantation with the Engager valve prosthesis was performed in 10 patients. Endpoints were defined according to the Valve Academic Research Consortium recommendations for reporting outcomes of TAVI in clinical trials. Follow-up has been completed after 30 days and 1 year. Results All patients underwent the implantation procedure successfully. No device-related or delivery system–related complications were observed. One patient died of non–device-related reasons at postoperative day 23 in multiorgan failure. At 30-day follow-up, no more than mild transvalvular and paravalvular aortic regurgitation were seen. After 1 year, no transvalvular regurgitation was observed as assessed by transthoracic echocardiography. None of the patients had more than mild paravalvular leakage. The mean ± SD gradient was 15.3 ± 4.2 mm Hg. New York Heart Association class decreased one degree in mean and sustained until 1-year follow-up. No more patients died until 1-year follow-up. Conclusions Application of the Engager TAVI system is safe and reliable. Prosthesis deployment in an anatomically correct position was facilitated by the design of the valve prosthesis and successful in all patients. No device-related or delivery system–related complications occurred. Procedural, short-term, and midterm results up to 1 year concerning the aortic valve performance are promising, with stable mean gradients and low rates of even mild regurgitation.

scholarly journals Features of echocardiographic assessment on transcatheter aortic valve implantation multiple stages

2021 ◽  
Vol 28 (1) ◽  
pp. 43-51
Author(s):  
G. I. Yemets ◽  
O. V. Telehuzova ◽  
G. B. Mankovsky ◽  
A. V. Maksymenko ◽  
Ye. Yu. Marushko ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
Full Range ◽  
Valve Prosthesis ◽  
Novel Device ◽  
Transcatheter Aortic Valve ◽  
Echocardiographic Parameters ◽  
Aortic Valve Implantation ◽  
Valve Implantation

The aim – to systematize information on key features of echocardiographic evaluation of transcatheter aortic valve implantation (TAVI) procedure stages and their effectiveness in cardiac surgery, in patients with severe aortic valve stenosis.Materials and methods. We initiated a single-center clinical study to evaluate the XPand device and initial analysis of the primary results was performed. Patients met the inclusion criteria underwent a full range of examinations and TAVI procedures using the XPand device. The key parameters for echocardiographic examination in TAVI, which influence the formation of further procedure strategy, have been determined for the cardiac surgeon.Results and discussion. Based on the determined echocardiographic parameters, we obtained the primary outcomes of TAVI XPand in patients (n=7), the result of implantation was good. Minimal paravalvular insufficiency absence was found in 71.5 % of patients and minimal insufficiency in 14,5 %. In one patient to moderate insufficiency was observed. There was a statistically significant improvement in the ejection fraction (p<0.05) and a decrease in the mean gradient at the aortic valve (p<0.01).Conclusions. Echocardiographic parameters at all TAVI stages in patients over 75 years allow to control the implementation of the procedure and to improve the immediate post procedural outcome. The first experience of using the novel device for transcatheter implantation of the XPand aortic valve prosthesis confirms its effectiveness and safety in elderly patients with severe aortic stenosis.

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