Aortic Valve Stenosis: A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.Heart Valve Prosthesis Implantation: Surgical insertion of synthetic material to repair injured or diseased heart valves.Aortic Valve Insufficiency: Pathological condition characterized by the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to regurgitation. It is caused by diseases of the AORTIC VALVE or its surrounding tissue (aortic root).Pulmonary Valve Stenosis: The pathologic narrowing of the orifice of the PULMONARY VALVE. This lesion restricts blood outflow from the RIGHT VENTRICLE to the PULMONARY ARTERY. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete.Heart Valve Prosthesis: A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.Heart Valve Diseases: Pathological conditions involving any of the various HEART VALVES and the associated structures (PAPILLARY MUSCLES and CHORDAE TENDINEAE).Calcinosis: Pathologic deposition of calcium salts in tissues.Mitral Valve: The valve between the left atrium and left ventricle of the heart.Mitral Valve Stenosis: Narrowing of the passage through the MITRAL VALVE due to FIBROSIS, and CALCINOSIS in the leaflets and chordal areas. This elevates the left atrial pressure which, in turn, raises pulmonary venous and capillary pressure leading to bouts of DYSPNEA and TACHYCARDIA during physical exertion. RHEUMATIC FEVER is its primary cause.Tricuspid Valve Stenosis: The pathologic narrowing of the orifice of the TRICUSPID VALVE. This hinders the emptying of RIGHT ATRIUM leading to elevated right atrial pressure and systemic venous congestion. Tricuspid valve stenosis is almost always due to RHEUMATIC FEVER.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Bioprosthesis: Prosthesis, usually heart valve, composed of biological material and whose durability depends upon the stability of the material after pretreatment, rather than regeneration by host cell ingrowth. Durability is achieved 1, mechanically by the interposition of a cloth, usually polytetrafluoroethylene, between the host and the graft, and 2, chemically by stabilization of the tissue by intermolecular linking, usually with glutaraldehyde, after removal of antigenic components, or the use of reconstituted and restructured biopolymers.Catheterization: Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Pulmonary Valve: A valve situated at the entrance to the pulmonary trunk from the right ventricle.Echocardiography, Doppler: Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Prosthesis Design: The plan and delineation of prostheses in general or a specific prosthesis.Bloodless Medical and Surgical Procedures: The treatment of patients without the use of allogeneic BLOOD TRANSFUSIONS or blood products.Carotid Stenosis: Narrowing or stricture of any part of the CAROTID ARTERIES, most often due to atherosclerotic plaque formation. Ulcerations may form in atherosclerotic plaques and induce THROMBUS formation. Platelet or cholesterol emboli may arise from stenotic carotid lesions and induce a TRANSIENT ISCHEMIC ATTACK; CEREBROVASCULAR ACCIDENT; or temporary blindness (AMAUROSIS FUGAX). (From Adams et al., Principles of Neurology, 6th ed, pp 822-3)Hypoplastic Left Heart Syndrome: A condition caused by underdevelopment of the whole left half of the heart. It is characterized by hypoplasia of the left cardiac chambers (HEART ATRIUM; HEART VENTRICLE), the AORTA, the AORTIC VALVE, and the MITRAL VALVE. Severe symptoms appear in early infancy when DUCTUS ARTERIOSUS closes.Balloon Valvuloplasty: Widening of a stenosed HEART VALVE by the insertion of a balloon CATHETER into the valve and inflation of the balloon.Echocardiography, Transesophageal: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues using a transducer placed in the esophagus.Angiodysplasia: Acquired degenerative dilation or expansion (ectasia) of normal BLOOD VESSELS, often associated with aging. They are isolated, tortuous, thin-walled vessels and sources of bleeding. They occur most often in mucosal capillaries of the GASTROINTESTINAL TRACT leading to GASTROINTESTINAL HEMORRHAGE and ANEMIA.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Tricuspid Valve: The valve consisting of three cusps situated between the right atrium and right ventricle of the heart.Echocardiography, Doppler, Color: Echocardiography applying the Doppler effect, with the superposition of flow information as colors on a gray scale in a real-time image.Coronary Stenosis: Narrowing or constriction of a coronary artery.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Ventricular Function, Left: The hemodynamic and electrophysiological action of the left HEART VENTRICLE. Its measurement is an important aspect of the clinical evaluation of patients with heart disease to determine the effects of the disease on cardiac performance.Ventricular Outflow Obstruction: Occlusion of the outflow tract in either the LEFT VENTRICLE or the RIGHT VENTRICLE of the heart. This may result from CONGENITAL HEART DEFECTS, predisposing heart diseases, complications of surgery, or HEART NEOPLASMS.Spinal Stenosis: Narrowing of the spinal canal.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Mitral Valve Insufficiency: Backflow of blood from the LEFT VENTRICLE into the LEFT ATRIUM due to imperfect closure of the MITRAL VALVE. This can lead to mitral valve regurgitation.Heart Ventricles: The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.Tracheal StenosisTime Factors: Elements of limited time intervals, contributing to particular results or situations.Aorta: The main trunk of the systemic arteries.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Aortic Valve Prolapse: The downward displacement of the cuspal or pointed end of the trileaflet AORTIC VALVE causing misalignment of the cusps. Severe valve distortion can cause leakage and allow the backflow of blood from the ASCENDING AORTA back into the LEFT VENTRICLE, leading to aortic regurgitation.Ventricular Dysfunction, Left: A condition in which the LEFT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE; MYOCARDIAL INFARCTION; and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the left ventricular wall.Stroke Volume: The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Heart Defects, Congenital: Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.Observer Variation: The failure by the observer to measure or identify a phenomenon accurately, which results in an error. Sources for this may be due to the observer's missing an abnormality, or to faulty technique resulting in incorrect test measurement, or to misinterpretation of the data. Two varieties are inter-observer variation (the amount observers vary from one another when reporting on the same material) and intra-observer variation (the amount one observer varies between observations when reporting more than once on the same material).Pulmonary Subvalvular Stenosis: Narrowing below the PULMONARY VALVE or well below it in the infundibuluar chamber where the pulmonary artery originates, usually caused by a defective VENTRICULAR SEPTUM or presence of fibrous tissues. It is characterized by restricted blood outflow from the RIGHT VENTRICLE into the PULMONARY ARTERY, exertional fatigue, DYSPNEA, and chest discomfort.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Endocarditis, Bacterial: Inflammation of the ENDOCARDIUM caused by BACTERIA that entered the bloodstream. The strains of bacteria vary with predisposing factors, such as CONGENITAL HEART DEFECTS; HEART VALVE DISEASES; HEART VALVE PROSTHESIS IMPLANTATION; or intravenous drug use.Mitral Valve Prolapse: Abnormal protrusion or billowing of one or both of the leaflets of MITRAL VALVE into the LEFT ATRIUM during SYSTOLE. This allows the backflow of blood into left atrium leading to MITRAL VALVE INSUFFICIENCY; SYSTOLIC MURMURS; or CARDIAC ARRHYTHMIA.Constriction, Pathologic: The condition of an anatomical structure's being constricted beyond normal dimensions.Pyloric Stenosis: Narrowing of the pyloric canal with varied etiology. A common form is due to muscle hypertrophy (PYLORIC STENOSIS, HYPERTROPHIC) seen in infants.Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.Rheumatic Heart Disease: Cardiac manifestation of systemic rheumatological conditions, such as RHEUMATIC FEVER. Rheumatic heart disease can involve any part the heart, most often the HEART VALVES and the ENDOCARDIUM.Phonocardiography: Graphic registration of the heart sounds picked up as vibrations and transformed by a piezoelectric crystal microphone into a varying electrical output according to the stresses imposed by the sound waves. The electrical output is amplified by a stethograph amplifier and recorded by a device incorporated into the electrocardiograph or by a multichannel recording machine.Discrete Subaortic Stenosis: A type of constriction that is caused by the presence of a fibrous ring (discrete type) below the AORTIC VALVE, anywhere between the aortic valve and the MITRAL VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Diastole: Post-systolic relaxation of the HEART, especially the HEART VENTRICLES.Hypertrophy, Left Ventricular: Enlargement of the LEFT VENTRICLE of the heart. This increase in ventricular mass is attributed to sustained abnormal pressure or volume loads and is a contributor to cardiovascular morbidity and mortality.Infant, Newborn: An infant during the first month after birth.Cardiac Valve Annuloplasty: A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annuli of HEART VALVES. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.Venous Valves: Flaps within the VEINS that allow the blood to flow only in one direction. They are usually in the medium size veins that carry blood to the heart against gravity.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Echocardiography, Three-Dimensional: Echocardiography amplified by the addition of depth to the conventional two-dimensional ECHOCARDIOGRAPHY visualizing only the length and width of the heart. Three-dimensional ultrasound imaging was first described in 1961 but its application to echocardiography did not take place until 1974. (Mayo Clin Proc 1993;68:221-40)Aortic Coarctation: A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion.Endocarditis: Inflammation of the inner lining of the heart (ENDOCARDIUM), the continuous membrane lining the four chambers and HEART VALVES. It is often caused by microorganisms including bacteria, viruses, fungi, and rickettsiae. Left untreated, endocarditis can damage heart valves and become life-threatening.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Aortic Aneurysm: An abnormal balloon- or sac-like dilatation in the wall of AORTA.Noonan Syndrome: A genetically heterogeneous, multifaceted disorder characterized by short stature, webbed neck, ptosis, skeletal malformations, hypertelorism, hormonal imbalance, CRYPTORCHIDISM, multiple cardiac abnormalities (most commonly including PULMONARY VALVE STENOSIS), and some degree of INTELLECTUAL DISABILITY. The phenotype bears similarities to that of TURNER SYNDROME that occurs only in females and has its basis in a 45, X karyotype abnormality. Noonan syndrome occurs in both males and females with a normal karyotype (46,XX and 46,XY). Mutations in a several genes (PTPN11, KRAS, SOS1, NF1 and RAF1) have been associated the the NS phenotype. Mutations in PTPN11 are the most common. LEOPARD SYNDROME, a disorder that has clinical features overlapping those of Noonan Syndrome, is also due to mutations in PTPN11. In addition, there is overlap with the syndrome called neurofibromatosis-Noonan syndrome due to mutations in NF1.Aortic Stenosis, Subvalvular: A pathological constriction occurring in the region below the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Heart Septal Defects, Ventricular: Developmental abnormalities in any portion of the VENTRICULAR SEPTUM resulting in abnormal communications between the two lower chambers of the heart. Classification of ventricular septal defects is based on location of the communication, such as perimembranous, inlet, outlet (infundibular), central muscular, marginal muscular, or apical muscular defect.Tricuspid Valve Insufficiency: Backflow of blood from the RIGHT VENTRICLE into the RIGHT ATRIUM due to imperfect closure of the TRICUSPID VALVE.Reoperation: A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Tomography, X-Ray Computed: Tomography using x-ray transmission and a computer algorithm to reconstruct the image.Thoracotomy: Surgical incision into the chest wall.Mitral Valve Annuloplasty: A type of heart valve surgery that involves the repair, replacement, or reconstruction of the annulus of the MITRAL VALVE. It includes shortening the circumference of the annulus to improve valve closing capacity and reinforcing the annulus as a step in more complex valve repairs.

Investigation of distal aortic compliance and vasodilator responsiveness in heart failure due to proximal aortic stenosis in the guinea pig. (1/1864)

Hypotension and syncope are recognized features of chronic aortic stenosis. This study examined vasomotor responses and dynamic compliance in isolated abdominal aortae after chronic constriction of the ascending aorta. Guinea pigs underwent constriction of the ascending aorta or sham operation. Sections of descending aorta were removed for studies of contractile performance and compliance. Dynamic compliance was measured using a feedback-controlled pulsatile pressure system at frequencies of 0.5, 1.5 and 2.5 Hz and mean pressures from 40 to 100 mmHg. Chronic (149+/-6 days) aortic constriction resulted in significant increases in organ weight/body weight ratios for left ventricle (58%), right ventricle (100%) and lung (61%). The presence of heart failure was indicated by increased lung weights, left ventricular end-diastolic pressure and systemic vascular resistance, reduced cardiac output and increased levels of plasma atrial natriuretic peptide (166%), adrenaline (x20), noradrenaline (106%) and dopamine (x3). Aortic rings showed similar constrictor responses to phenylephrine and angiotensin II, but maximal vasodilator responses to acetylcholine and isoprenaline were significantly increased (144% and 48% respectively). Dilator responses to sodium nitroprusside, forskolin and cromokalim were unchanged. Compliance of all vessels decreased with increasing pulsatile frequency and to a lesser extent with increased mean pressure, but were similar in aortic-constricted and control groups. Chronic constriction of the ascending aorta resulted in heart failure and increased vasodilator responses to acetylcholine and isoprenaline in the distal aorta while dynamic compliance was unchanged. We hypothesize that increased endothelium-mediated vasodilatation may contribute to hypotension and syncope in patients with left ventricular outflow obstruction.  (+info)

Extent and severity of atherosclerotic involvement of the aortic valve and root in familial hypercholesterolaemia. (2/1864)

OBJECTIVE: To compare the frequency of valvar and supravalvar aortic stenosis in homozygous and heterozygous familial hypercholesterolaemia (FH). DESIGN: Analysis of life time cholesterol exposure and prevalence of aortic atherosclerosis in 84 consecutive cases attending a lipid clinic. SETTING: A tertiary referral centre in London. PATIENTS: Outpatients with FH (six homozygous, 78 heterozygous). INTERVENTIONS: Maintenance of lipid lowering treatment. MAIN OUTCOME MEASURES: Calculated cholesterol x years score (CYS) and echocardiographic measurement of aortic root diameter, aortic valve thickness, and transaortic gradient. RESULTS: Four homozygotes with a mean (SD) CYS of 387 (124) mmol/1 x years had severe aortic stenosis (treatment started after seven years of age), whereas the other two had echocardiographic evidence of supravalvar thickening but no aortic valve stenosis (treatment started before three years of age). On multivariate analysis, mean transaortic gradient correlated significantly with CYS (mean = 523 (175) mmol/1 x years) in heterozygotes (p = 0.0001), but only two had severe aortic valve and root involvement. CONCLUSIONS: In patients with familial hypercholesterolaemia, aortic stenosis is common in homozygotes, and aortic root involvement is always present despite the lower CYS than in heterozygotes. It appears to be determined by short term exposure to high cholesterol concentrations in early life. Conversely, aortic root and valve involvement are rare in heterozygotes and occur only with severe, prolonged hypercholesterolaemia, possibly accelerating age related degenerative effects.  (+info)

Development of atherosclerotic lesions in cholesterol-loaded rabbits. (3/1864)

To examine both of the target vessels and the optimal time of their endothelial denudation to study vascular restenosis after balloon injury in cholesterol-loaded rabbits, we made 36 atherosclerotic rabbits by feeding a hypercholesterol diet, and histologically examined the onset time and the development of atherosclerosis. Atheromatous changes were observed first after the 5th week in the thoracic aorta from the start of the diet, and then extended to the abdominal aorta, coronary artery with time. The atherosclerotic lesions in the thoracic aorta and the proximal portion of the coronary artery showed high-grade concentric intimal thickening with luminal stenosis. The abdominal aortic lesion mildly progressed. In the renal, carotid and femoral arteries, in contrast, slight atheroscleromatous changes developed during the diet period. These results suggest that the thoracic and abdominal aortas and the coronary artery would be suitable as target vessels to study vascular restenosis after balloon injury, and the endothelial denudation of these vessels should be performed between the 8th and 15th week in this diet protocol for an accurate analysis.  (+info)

Bileaflet mechanical prostheses for aortic valve replacement in patients younger than 65 years and 65 years of age or older: major thromboembolic and hemorrhagic complications. (4/1864)

OBJECTIVE: To determine major thromboembolic and hemorrhagic complications and predictive risk factors associated with aortic valve replacement (AVR), using bileaflet mechanical prostheses (CarboMedics and St. Jude Medical). DESIGN: A case series. SETTING: Cardiac surgical services at the teaching institutions of the University of British Columbia. PATIENTS AND METHODS: Patients 2 age groups who had undergone AVR between 1989 and 1994 were studied. Group 1 comprised 384 patients younger than 65 years. Group 2 comprised 215 patients 65 years of age and older. RESULTS: The linearized rates of major thromboembolism (TE) occurring after AVR were 1.54%/patient-year for group 1 and 3.32%/patient-year for group 2; the rates for major TE occurring more than 30 days after AVR were 1.13%/patient-year for group 1 and 1.55%/patient-year for group 2. The crude rates for major TE occurring within 30 days of AVR were 1.04% for group 1 and 3.72% for group 2. The death rate from major TE in group 1 was 0.31%/patient-year and in group 2 was 0.88%/patient-year. Of the major TE events occurring within 30 days, 100% of patients in both age groups were inadequately anticoagulated at the time of the event, and for events occurring more than 30 days after AVR, 45% in group 1 and 57% in group 2 were inadequately anticoagulated (INR less than 2.0). The overall linearized rates of major hemorrhage were 1.54%/patient-year for group 1 and 2.21%/patient-year for group 2. There were no cases of prosthesis thrombosis in either group. The mean (and standard error) overall freedom from major TE for group 1 patients at 5 years was 95.6% (1.4%) and with exclusion of early events was 96.7% (1.3%); for group 2 patients the rates were 90.0% (3.2%) and 93.7% (3.0%), respectively. The mean (and SE) overall freedom from major and fatal TE and hemorrhage for group 1 patients was 90.1% (2.3%) and with exclusion of early events was 91.2% (2.3%); for group 2 patients the rates were 87.9% (3.1%) and 92.5% (2.9%), respectively. The 5-year rate for freedom from valve-related death for group 1 patients was 96.3% (2.1%) and for group 2 patients was 97.2% (1.2%). CONCLUSION: The thromboembolic and hemorrhagic complications after AVR with bileaflet mechanical prostheses occur more frequently and result in more deaths in patients 65 years of age and older than in patients years younger than 65 years.  (+info)

Minimally invasive aortic valve replacement through a transverse sternotomy: a word of caution. (5/1864)

OBJECTIVES: To compare aortic valve replacement (AVR) using a minimally invasive approach through a transverse sternotomy with the established approach of median sternotomy. DESIGN: Retrospective, case-control study. PATIENTS: Fourteen high risk patients (median age 78, Parsonnet score of 18%) who underwent AVR performed through a minimally invasive transverse sternotomy were compared with a historical group of patients matched for age, sex, and Parsonnet score who underwent AVR performed through a median sternotomy by the same surgeon. OUTCOME MEASURES: Cross clamp time, total bypass time, intensive care stay, postoperative in-hospital stay, morbidity, and mortality. RESULTS: There were two deaths in the minimally invasive group and none in the control group (NS). The cross clamp and total bypass times were longer in the minimally invasive group (67 and 92 minutes v 46 and 66 minutes, p < 0.001). There was a higher incidence of re-exploration for bleeding (14% v 0%) and paravalvar leaks (21% v 0%) in the minimally invasive group but these differences were not significant. The minimally invasive group had a longer postoperative in-hospital stay (p = 0.025). The incidence of mortality or major morbidity was 43% (six of 14) in the minimally invasive group and 7% (one of 14) in the matched pairs (p = 0.013). CONCLUSIONS: AVR can be performed through a transverse sternotomy but the operation takes longer and there is an unacceptably high incidence of morbidity and mortality.  (+info)

Double outlet right ventricle. Study of 27 cases. (6/1864)

Out of 1610 children's hearts with congenital malformations there were 27 specimens showing double outlet right ventricle. Cases with dextrocardia, situs inversus, or l-venticular loop were excluded. Anatomical examination was performed with particular reference to the infundibular region, the great vessels, and the ventricular septum. The commonest associated malformations were ventricular septal defect and pulmonary stenosis. Aortic stenosis was the predominant finding in those cases dying in the neonatal period. An aortic conus was associated with pulmonary stenosis, ventricular septal defect, and d-transposition, a pulmonary conus with ventricular septal defect and a double conus with stenosis of either great vessel. The anterior vessel always had a muscular conus and the posterior vessel was commonly stenotic.  (+info)

Combined aortic and mitral stenosis in mucopolysaccharidosis type I-S (Ullrich-Scheie syndrome). (7/1864)

The genetic mucopolysaccharidosis syndromes (MPS) are autosomal recessive inborn errors of metabolism. Heart valve involvement in MPS is not uncommon but only a few case reports of successful cardiac surgery are available. In particular, reports of combined aortic and mitral stenosis associated with MPS type I-S are very rare. Both type I and type VI MPS are associated with significant left sided valvar heart disease that requires surgical valve replacement because of irregular valve thickening, fibrosis, and calcification. A 35 year old man had severe mitral valve stenosis after successful surgical replacement of a stenotic aortic valve. Valvar heart disease was investigated by cardiac ultrasound and left heart catheterisation. Histomorphological characterisation of the affected mitral valve was performed. The case illustrates typically associated clinical features of cardiac and extracardiac abnormalities found in MPS type I-S.  (+info)

Effect of NO donors on LV diastolic function in patients with severe pressure-overload hypertrophy. (8/1864)

BACKGROUND: Previous experimental studies have shown that nitric oxide (NO) modulates cardiac function by an abbreviation of systolic contraction and an enhancement of diastolic relaxation. However, the response to NO donors of patients with severe pressure-overload hypertrophy and diastolic dysfunction is unknown. METHODS AND RESULTS: Intracoronary NO donors were given to 17 patients with severe aortic stenosis. A dose-response curve was obtained with nitroglycerin (30, 90, and 150 microg) in 11 patients and sodium nitroprusside (1, 2, and 4 microg/min) in 6. Left ventricular (LV) high-fidelity pressure measurements with simultaneous LV angiograms were performed at baseline and after the maximal dose of NO. The dose-response curve for intracoronary NO donors showed a marked fall in LV end-diastolic pressure, from 23 to 14 mm Hg (-39%; P<0.0001), whereas LV peak systolic pressure fell only slightly, from 206 to 196 mm Hg (-4%; P<0.01). End-diastolic chamber stiffness decreased from 0.12 to 0.07 mm Hg/mL (P<0.0001) and end-systolic stiffness from 1.6 to 1.3 mm Hg/mL (P<0.01). Heart rate, right atrial pressure, LV ejection fraction, the time constant of isovolumic pressure decay (tau), and LV filling rates remained unchanged. CONCLUSIONS: In patients with severe pressure-overload hypertrophy, intracoronary NO donors exert a marked decrease in LV end-diastolic pressure without affecting LV systolic pump function. Thus, the hypertrophied myocardium appears to be particularly susceptible to NO donors, with a marked improvement in diastolic function.  (+info)

*GSIS-Meralco bribery case

... and aortic valve stenosis (AS)." Reyes's physician, Dr. Francisco Lukban, however, later declared him stable. Associate Justice ...

*Donald S. Miller

Garcia, D (2000). "Assessment of Aortic Valve Stenosis Severity". Circulation. 101: 765-771. doi:10.1161/01.cir.101.7.765. ...

*Pulse

It is seen in aortic valve stenosis. Pulsus paradoxus: a condition in which some heartbeats cannot be detected at the radial ... Pulsus bisferiens: an unusual physical finding typically seen in patients with aortic valve diseases. If the aortic valve does ... such as aortic outflow tract obstruction, mitral stenosis, aortic arch syndrome) etc. A bounding pulse signifies high pulse ... unless there is coexisting aortic regurgitation). The delay can also be observed in supravalvar aortic stenosis. Several pulse ...

*Fetal aortic stenosis

... resulting in systemic circulation failure in babies born with aortic valve stenosis. Fetal aortic valve stenosis can be ... Fetal aortic stenosis is a disorder that occurs when the fetus' aortic valve does not fully open during development. The aortic ... Aortic Valve Stenosis. Retrieved from: http://www.childrenshospital.org/health-topics/conditions/aortic-valve-stenosis Barron, ... Then a 0.014 inch guide wire is passed across the stenosis aortic valve, where a balloon is inflated to stretch the aortic ...

*Miniature Bull Terrier

Aortic valve stenosis and mitral valve dysplasia are heart diseases. Diagnosis is made by colour doppler echocardiography ...

*Pulse pressure

A narrow pulse pressure is also caused by aortic valve stenosis and cardiac tamponade.[citation needed] Usually, the resting ... Anemia Aortic dissection Atherosclerosis Arteriovenous fistula Chronic aortic regurgitation Aortic root aneurysm Aortic root ... aortic regurgitation (a leak in the aortic valve), arteriovenous malformation (an extra path for blood to travel from a high ...

*Angiodysplasia

argue that apart from aortic valve stenosis, some other conditions that feature high shear stress might also increase the risk ... A classic association is Heyde's syndrome (coincidence of aortic valve stenosis and bleeding from angiodysplasia). In this ... Obscure gastrointestinal bleeding and calcific aortic stenosis (Heyde's syndrome) Neumann H, Mönkemüller K, Malfertheiner P ( ... is proteolysed due to high shear stress in the highly turbulent blood flow around the aortic valve. vWF is most active in ...

*Aortic stenosis

Finally, in calcific aortic stenosis at least, the calcification in and around the aortic valve can progress and extend to ... Symptoms related to aortic stenosis depend on the degree of stenosis. Most people with mild to moderate aortic stenosis do not ... In aortic stenosis, the opening of the aortic valve becomes narrowed or constricted (stenotic) (i.e., due to calcification). ... Another major cause of aortic stenosis is the calcification of a congenital bicuspid aortic valve (30-40% of cases) typically ...

*Pressure-volume loop analysis in cardiology

Aortic valve stenosis is abnormal narrowing of the aortic valve. This results in much greater LV pressures than the aortic ... Aortic valve diseases like aortic stenosis and insufficiency also increase the afterload, whereas mitral valve regurgitation ... Aortic insufficiency (AI) is a condition in which the aortic valve fails to close completely at the end of systolic ejection, ... This is a narrowing of the mitral valve orifice when the valve is open. Mitral stenosis impairs LV filling so that there is a ...

*Hybrid cardiac surgery

The conventional approach for treatment of aortic valve stenosis is surgical replacement of the aortic valve. This procedure ... 2008). Transcatheter valve implantation for patients with aortic stenosis: a position statement from the European Association ... However, TAVI (transcatheter aortic valve implantation) has emerged as a valid alternative for patients in whom conventional ... The repair of a defected mitral valve is a potential future hybrid procedure, that is still dependent on approval of the ...

*Von Willebrand disease

A form of vWD occurs in patients with aortic valve stenosis, leading to gastrointestinal bleeding (Heyde's syndrome). This form ... noted that patients with acquired vWD and aortic stenosis who underwent valve replacement experienced a correction of their ... July 2003). "Acquired von Willebrand syndrome in aortic stenosis". N. Engl. J. Med. 349 (4): 343-9. doi:10.1056/NEJMoa022831. ... hemostatic abnormalities, but that the hemostatic abnormalities can recur after 6 months when the prosthetic valve is a poor ...

*Ventricular outflow tract obstruction

Aortic valve stenosis Supravalvar aortic stenosis Coarctation of the aorta Hypoplastic left heart syndrome Bashore TM (2007). " ... Pulmonary atresia Pulmonary valve stenosis Hypoplastic right heart syndrome Tetralogy of Fallot A left ventricular outflow ... may be due to a defect in the aortic valve, or a defect located at the subvalvar or supravalvar level. ... A right ventricular outflow tract obstruction (RVOTO) may be due to a defect in the pulmonic valve, the supravalvar region, the ...

*Aortic valve repair

... of the aortic valve. Thus, congenital aortic stenosis may be treated by aortic valve repair. In acquired aortic stenosis valve ... Key problem A congenital aortic valve stenosis can be treated by aortic valve repair if there is no relevant calcification. In ... In most instances aortic valve repair will be performed for aortic regurgitation (insufficiency). Aortic valve repair may also ... aortic valve. The colleagues of Dwight Harken reported in 1958 on their experience with aortic valve repair for aortic ...

*Lyme disease

"Detection of Borrelia bissettii in cardiac valve tissue of a patient with endocarditis and aortic valve stenosis in the Czech ...

*Von Willebrand factor

Most cases of vWD are hereditary, but abnormalities of vWF may be acquired; aortic valve stenosis, for instance, has been ... "Acquired von Willebrand syndrome in aortic stenosis". The New England Journal of Medicine. 349 (4): 343-9. doi:10.1056/ ...

*Aortic valve area calculation

A valve area of less than 0.8 cm² is considered to be severe aortic stenosis. There are many ways to calculate the valve area ... Aortic valve area calculation is an indirect method of determining the area of the aortic valve (aortic valve area or AVA). The ... Aortic Valve Area (cm 2 ) = LVOT diameter 2 ⋅ 0.78540 ⋅ LVOT VTI Aortic Valve VTI {\displaystyle {\text{Aortic Valve Area (cm ... The Gorlin equation states that the aortic valve area is equal to the flow through the aortic valve during ventricular systole ...

*Bartolomeu Anania

Following unsuccessful treatment in Vienna in early 2011, Anania died in Cluj-Napoca of heart failure and aortic valve stenosis ...

*Sodium nitroprusside

This compound has also been used as a treatment for aortic valve stenosis, oesophageal varices, myocardial infarction, ... "Hemodynamic effects of nitroprusside on valvular aortic stenosis". The American Journal of Cardiology. 69 (4): 361-366. doi: ...

*Heyde's syndrome

In people with aortic valve stenosis, the stenotic aortic valve becomes increasingly narrowed resulting in an increase the ... followed by echocardiography to measure aortic valve area (see diagnosis of aortic stenosis). While Heyde's syndrome may exist ... that demonstrated a strong association between von Willebrand factor defects and the severity of aortic valve stenosis. They ... in 2003 a study of 50 people with aortic stenosis severe enough to warrant immediate valve replacement found GI bleeding in 21 ...

*Heart murmur

Stenosis of Bicuspid aortic valve is similar to the aortic valve stenosis heart murmur, but a systolic ejection click may be ... In mild aortic stenosis, the crescendo-decrescendo is early peaking whereas in severe aortic stenosis, the crescendo is late- ... Systolic Aortic valve stenosis typically is a crescendo/decrescendo systolic murmur best heard at the right upper sternal ... Pulmonary and aortic stenoses are systolic while pulmonary and aortic insufficiency (regurgitation) are diastolic. Mitral and ...

*ADAMTS13

Finally, since the link between aortic valve stenosis and angiodysplasia was proven to be due to high shear stress (Heyde's ...

*University of Missouri Hospital

Zuhdi Lababidi performs the first pediatric angioplasty to correct aortic valve stenosis in newborns 1982 - Foundation of Staff ...

*ACE inhibitor

Impaired renal function Aortic valve stenosis or cardiac outflow obstruction Hypovolemia or dehydration Hemodialysis with high- ... However, the decrease may be significant in conditions of decreased renal perfusion, such as renal artery stenosis, heart ...

*Turner syndrome

Other congenital cardiovascular malformations, such as partial anomalous venous drainage and aortic valve stenosis or aortic ... facial features Webbed neck from cystic hygroma in infancy Aortic valve stenosis Coarctation of the aorta Bicuspid aortic valve ... Calcification also occurs in the valves, which may lead to a progressive valvular dysfunction as evidenced by aortic stenosis ... Up to 15% of adults with Turner syndrome have bicuspid aortic valves, meaning only two, instead of three, parts to the valves ...

*R. Ravi Kumar

... and aortic valve stenosis (shrunk).Had robotic double valve replacement. World's first Robotic combined Mitral Valve ... Patient had aortic valve stenosis (shrunk) and regurgitation (leak) with reduced pumping of the heart. He underwent robotic ... Patient had combined robotic mitral valve replacement and coronary artery bypass surgery. India's first Robotic Aortic Valve ... Aortic Valve Replacement, Double Valve Replacement and CABG. His areas of special interest are, all types of Adult heart ...

*List of ICD-9 codes 390-459: diseases of the circulatory system

392) Rheumatic chorea (394) Diseases of mitral valve (395) Diseases of aortic valve (396) Diseases of mitral and aortic valves ... Occlusion and stenosis of basilar artery (433.1) Occlusion and stenosis of carotid artery (433.2) Occlusion and stenosis of ... Aortic aneurysm and dissection (441.0) Aortic Dissection (441.3) Abdominal Aortic Aneurysm, ruptured (441.4) Abdominal aortic ... 440) Atherosclerosis (440.1) Stenosis of renal artery (440.2) Peripheral Arterial Disease (440.21) Peripheral Arterial Disease ...
Degenerative aortic stenosis is the most prevalent aortic valve disease in western countries. Ageing processes and increased life expectancy of the population increase the prevalence of this valvular heart disease.w1 Surgical aortic valve replacement is the first therapeutic option for patients with severe symptomatic aortic stenosis. However, in selected subgroups of patients, the operative risk may outweigh the clinical benefits of surgery. Older age, severe left ventricular systolic dysfunction, and associated comorbidities such as neurological diseases are the main determinants of non-referral for surgery in almost 30% of patients with severe symptomatic aortic stenosis.w2. Technological advances in the field of percutaneous cardiovascular interventions have favoured the development of less invasive therapeutic strategies. The emerging transcatheter aortic valve implantation (TAVI) techniques have been shown to be a feasible alternative to surgical aortic valve replacement.w3 To date, ,40 ...
Transcatheter aortic valve implantation is being established as an alternative treatment for some patients with symptomatic severe aortic stenosis who are not considered suitable for surgical aortic valve replacement because of prohibitive surgical risk.1-3 One of the potential complications is complete atrioventricular block requiring definitive pacemaker implantation. This complication occurs in 4% to 5% with the Edwards-Sapiens prosthesis (Edwards Lifesciences, Irvine, Calif),1 and in ,30% with the CoreValve system (Medtronic CV, Luxembourg),3 but it also occurs in 5% of patients after percutaneous aortic valvuloplasty4 or surgical aortic valve replacement.5. The cause of complete atrioventricular block after transcatheter aortic valve implantation is unknown. Apart from traumatic lesions produced by aortic valve prosthesis expansion, ischemia of the conduction pathways resulting from insufficient myocardial protection might play a role. Here, necropsy findings in a patient with complete ...
Routine predeployment balloon aortic valvuloplasty (BAV) has historically been considered an essential part of the transcatheter aortic valve replacement (TAVR) procedure, ensuring unimpeded delivery of the prosthetic valve across the stenotic aortic valve, optimal valve expansion, and hemodynamic stability during valve deployment. This was particularly pertinent for first‐generation valves with very large profiles (22‐F and 24‐F Edwards Sapien valve [Edwards Lifesciences, Irvine, CA]1 and 24‐F Medtronic CoreValve [Medtronic, Dublin, Ireland]2), for which valve crossing was often challenging. However, its continued role as a routine adjunct given more advanced delivery systems with lower profiles (14‐F to 16‐F for the Edwards S3 and Medtronic Evolut R valves) and improved trackability remains uncertain. Routine predeployment BAV for every TAVR might not be necessary, especially as operators strive to minimize TAVR‐related risks. A tailored approach to predeployment BAV for specific ...
Objectives The aim of this study was to evaluate clinical outcome after CoreValve implantation in patients (pts) with low-gradient aortic stenosis (LGAS). We were especially interested in the 30 days mortality and in longterm outcome in respect to the presence or absence of contractile reserve (CR) evaluated by low dose dobutamine stessechocardiography (LDSE). Background Pts with LGAS have a considerable high operative mortality, especially if pts show no CR during LDSE. Percutaneous aortic valve repair (TAVI) is a new emerging technology for interventional treatment of severe aortic valve stenosis in surgical high-risk patients and offers a less invasive approach in these pts. Hence one might speculate that TAVI represents a promising treatment for these patients. Methods From April 2010 to february 2012 in total 165 patients (age 80.6 +0.8 years ) with high perioperative risk (log Euroscore , 20%) underwent TAVI at our hospital using the CoreValve Revalving system (26/29/31mm) in local ...
A 78-year-old woman with chest discomfort and progressive exertional dyspnea was admitted to our center. Transthoracic echocardiography (TTE) suggested severe aortic stenosis (AS) (mean pressure gradient 70 mm Hg; peak jet velocity 5.4 m/s) and moderate aortic regurgitation (AR). Left ventricular ejection fraction was 64%. Bicuspidy of the aortic valve and aneurysmal dilation of the ascending aorta (56 mm in diameter) were noted on TTE. She was declined for surgery on account of high operative risk (logistic EuroSCORE 31.67%) after consultations by the heart team, thus she was evaluated for transcatheter aortic valve implantation (TAVI). Coronary angiogram showed the absence of significant coronary lesions. Three-dimensional computed tomographic angiography (CTA) confirmed the bicuspidy (Fig. 1A) and measured the diameter of the ascending aorta at 53 mm (Fig. 1B); the annulus was elliptical with a long-axis diameter of 25.6 mm and a short-axis diameter of 19.5 mm. TAVI was conducted in a hybrid ...
To analyze our experience with percutaneous aortic balloon valvuloplasty in newborn infants with aortic stenosis, emphasizing the extraordinary importance of myocardial perfusion. Over a 10-year-period, 21 neonates underwent percutaneous aortic balloon valvuloplasty. Age ranged from 2 to 27 days, weight ranged from 2.2 to 4.1 kg and 19 were males. All patients presented with congestive heart failure that could not be treated clinically. The onset of symptoms in the first week of life occurred in 9 patients considered as having critical aortic stenosis. Severe aortic stenosis occurred in 12 patients with the onset of symptoms in the second week of life. Mortality reached 100% in the patients with critical aortic stenosis. The procedure was considered effective in the 12 patients with severe aortic stenosis. Vascular complications included the loss of pulse in 12 patients and rupture of the femoral artery in 2 patients. Cardiac complications included acute aortic regurgitation in 2 patients and ...
TY - JOUR. T1 - Correlation between calcific aortic stenosis diagnosed by two‐dimensional echocardiography and cardiac catheterization. AU - Nair, C. K.. AU - Aronow, W. S.. AU - Sketch, M. H.. AU - Mohiuddin, S. M.. AU - Stokke, K.. AU - Ryschon, K.. PY - 1984/1/1. Y1 - 1984/1/1. N2 - This retrospective study correlates the severity of calcific aortic stenosis determined by two-dimensional (2-D) echocardiography with the aortic valve area determined by catheterization in 57 patients. Aortic valve leaflet calcification was diagnosed by cineangiography in 50 (88%) of 57 patients and by 2-D echo in 57 (100%) of 57 patients (p. AB - This retrospective study correlates the severity of calcific aortic stenosis determined by two-dimensional (2-D) echocardiography with the aortic valve area determined by catheterization in 57 patients. Aortic valve leaflet calcification was diagnosed by cineangiography in 50 (88%) of 57 patients and by 2-D echo in 57 (100%) of 57 patients (p. UR - ...
TY - JOUR. T1 - Prognostic value of pre-procedural left ventricular strain for clinical events after transcatheter aortic valve implantation. AU - Suzuki-Eguchi, Noriko. AU - Murata, Mitsushige. AU - Itabashi, Yuji. AU - Shirakawa, Kosuke. AU - Fukuda, Memori. AU - Endo, Jin. AU - Tsuruta, Hikaru. AU - Arai, Takahide. AU - Hayashida, Kentaro. AU - Shimizu, Hideyuki. AU - Fukuda, Keiichi. PY - 2018/10/1. Y1 - 2018/10/1. N2 - Background Transcatheter aortic valve implantation (TAVI) is an alternative therapy for surgically highrisk patients with severe aortic stenosis (AS). Although TAVI improves survival of patients with severe AS, the mechanism of this effect remains to be clarified. We investigated the effects of TAVI on left ventricular (LV) function and identified the predictive parameters for cardiac events after TAVI. Methods and results We studied 128 patients with severe symptomatic AS who underwent TAVI. Echocardiographic assessments were performed before and after TAVI. In addition to ...
Aortic valve replacement (AVR) has been the mainstay of treatment of symptomatic severe aortic stenosis (AS). The role of transcatheter aortic valve implantation (TAVI; also known as transcatheter aortic valve replacement or TAVR) as an alternative t
TY - JOUR. T1 - Combined spinal-epidural anesthesia for lumbar discectomy in a patient with asymptomatic severe aortic stenosis -a case report-. AU - Kim, Young Sung. AU - Park, Ji Hye. AU - Lee, Shin Young. AU - Lim, Byung Gun. AU - Kim, Heezoo. AU - Lee, Il Ok. AU - Kong, Myounghoon. PY - 2014/1/1. Y1 - 2014/1/1. N2 - The use of neuraxial anesthesia has traditionally been contraindicated in patients with severe aortic stenosis. However, general anesthesia can be riskier than neuraxial anesthesia for severe aortic stenosis patients undergoing spinal surgeries in the prone position as this can cause a major reduction in cardiac output secondary to diminished preload. In addition, general anesthesia, muscle relaxation, and positive-pressure ventilation can decrease venous return and reduce vascular tone, further compromising cardiac output. Combined spinal-epidural anesthesia with closely monitored, careful titration of the local anesthetic dose can be an efficient and safe anesthetic method for ...
Aortic Valve Stenosis Aortic Valve Stenosis is the narrowing or obstruction of the hearts aortic valve. The aorta is a large artery that originates in the
In patients with asymptomatic aortic stenosis (AS), the prognostic value of reduced left ventricular (LV) ejection fraction is well known. Consequently, there is class I indication for surgery in these patients when LV ejection fraction ,50%. However, there is growing evidences suggesting that subclinical LV dysfunction, and more particularly longitudinal myocardial dysfunction, may be a powerful early predictor of outcome, even when LV ejection is still preserved. In asymptomatic AS patients with LV ejection fraction ,50%, a reduced LV global longitudinal strain, as assessed using speckle tracking imaging with transthoracic echocardiography, may be an accurate marker to identify early subclinical LV dysfunction and thus, to improve the risk stratification, the management and the timing of surgery. Several mono-centric observational small studies recently reported results emphasizing the role of LV global longitudinal strain in AS patients. Therefore, a meta-analysis may be conducted and may ...
The purpose of the study is to investigate the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with severe, symptomatic Aortic Stenosis (AS) at intermediate surgical risk by randomizing patients to either Surgical Aortic Valve Replacement (SAVR) or TAVI with the Medtronic CoreValve® System.. Single Arm: The purpose of this trial is to evaluate the safety and effectiveness of transcatheter aortic valve implementation (TAVI) in patients with sever symptomatic Aortic Stenosis (AS) at intermediate surgical risk with TAVI. This is a non-randomized phase of the pivotal clinical trial. ...
Background-The prognostic importance of left ventricular (LV) mass in nonsevere asymptomatic aortic stenosis has not been documented in a large prospective study.. Methods and Results-Cox regression analysis was used to assess the impact of echocardiographic LV mass on rate of major cardiovascular events in 1656 patients (mean age, 67 years; 39.6% women) with mild-to-moderate asymptomatic aortic stenosis participating in the Simvastatin Ezetimibe in Aortic Stenosis (SEAS) study. Patients were followed during 4.3 years of randomized treatment with combined simvastatin 40 mg and ezetimibe 10 mg daily or placebo. At baseline, LV mass index was 45.9+14.9 g/m2.7, and peak aortic jet velocity was 3.09+0.54 m/s. During follow-up, 558 major cardiovascular events occurred. In Cox regression analyses, 1 SD (15 g/m2.7) higher baseline LV mass index predicted increases in hazards of 12% for major cardiovascular events, 28% for ischemic cardiovascular events, 34% for cardiovascular mortality, and 23% for ...
Mack MJ, Leon MB, Smith CR, et al; PARTNER 1 trial investigators. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet. 2015 Mar 15. Epub ahead of print. 25788234 ...
As life expectancy has increased, so has the prevalence of heart valve disease, including a type called aortic valve stenosis. Now a minimally invasive procedure called TAVR is providing an alternative to open-heart surgery for treating the condition.
Aortic valve stenosis is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump blood into the aorta. This may not have symptoms initially, but it can worsen over time. Typically the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two cusps (bicuspid aortic valve).. ...
Introduction: Aortic valve stenosis imposes a pressure overload on the left ventricle. Congestive heart failure is one of the complications which can appear, even years after the operation. The main questions are: why do patients still develop heart failure? Which types of congestive heart failure can be expected? Which factors related to it are known? Methods: A literature search was performed with the terms aortic valve disease/replacement AND heart failure. Some secondary references derived from their reference list were also included. The study design of the selected papers differed considerably. Therefore, the analysis is descriptive and concerns factors which can be related to congestive heart failure. Furthermore, surrogate outcomes are ejection fraction, hypertrophy, long axis ventricular function, torsion, left atrial indices, pressures in the left sided heart and in the pulmonary circulation as well as a number of other echocardiographic parameters. Results: It has become clear that ...
ABSTRACT: The optimal treatment for coronary artery disease in patients who are candidates for percutaneous aortic valve implantation (PAVI) remains unclear. The operating team should take into consideration that the symptoms of ischemic heart disease could be identical to those of severe aortic stenosis and that performing percutaneous coronary intervention (PCI) in these frail patients prior to, or following PAVI, is not trivial. We describe a patient with severe aortic stenosis and significant coronary artery disease who was treated during the same interventional session: PCI that was followed immediately by PAVI. We review the different treatment strategies for patients who are candidates for PAVI and have coronary artery disease, discuss the relative advantages of each approach, and propose an algorithm for their treatment. _______________________________________________. J INVASIVE CARDIOL 2009;21:E237-E241. Key words: PaceC elevation. Calcific aortic stenosis is associated with ...
TY - JOUR. T1 - Severe aortic stenosis in patients 60 years of age or older. T2 - left ventricular function and 10-year survival after valve replacement.. AU - Murphy, Edward. AU - Lawson, R. M.. AU - Starr, Albert. AU - Rahimtoola, S. H.. PY - 1981/8. Y1 - 1981/8. N2 - From 1962-1977, 99 patients, mean age 65 +/- 0.5 years (range 60-81 years) underwent valve replacement for severe calcific aortic valve stenosis. Ninety-three percent of the patients were in New York Heart Association functional class III or IV. The aortic valve gradient was 76 +/- 3 mm Hg and the aortic valve area index was 0.34 +/- 0.01 cm2/m2. Left ventricular systolic pressure was 207 +/- 4 mm Hg, cardiac index was 2.5 +/- 0.1 l/min/m2, left ventricular ejection fraction was 0.57 +/- 0.02 and left ventricular end-diastolic volume index was 108 +/- 60 ml/m2; left ventricular ejection fraction and end-diastolic volume were normal in 63% of the patients. The operative mortality was 16%. Mean follow-up is 55 +/- 4 months. Using ...
The importance of bleeding and its sequelae have been increasingly recognised by interventional cardiologists. We are undertaking increasingly complex percutaneous interventions, performed upon higher-risk patients, who are more elderly with a greater range of comorbidities,1 and using multiple anticoagulant pharmacotherapies,2 which may all increase susceptibility to bleeding. The advent of transcatheter aortic valve implantation (TAVI) has allowed cardiologists and surgeons to offer treatment for aortic valve disease to a similarly high-risk cohort of patients. The PARTNER randomised trial having demonstrated a survival benefit,3 the challenge is now to improve the safety profile of the procedure, and addressing the risk of bleeding is paramount to this.. Borz et al4 present data from a single centre using the Edwards bioprosthesis (Edwards Lifesciences, Irvine, California, USA). They report notable bleeding and life-threatening bleeding (LTB) rates of 27.6% and 13.2%, respectively. Their ...
This story was written by Nish Patel, MD, FACC, Albany Associates in Cardiology, a member of St. Peters Health Partners Medical Associates.]. In its upcoming February 27 print edition, The New England Journal of Medicine is set to publish a study that shows patients who underwent minimally invasive transcatheter aortic valve replacement (TAVR) surgery had similar clinical outcomes as patients who had traditional open-heart surgery.. The five-year study compared long-term outcomes of TAVR versus open-heart approaches to treating aortic valve stenosis. According to the American Heart Association, nearly 1.5 million people in the U.S. have aortic valve stenosis, which, if left untreated, often results in heart failure or death.. Aortic valve stenosis is a narrowing or hardening of the aortic valve most often caused by calcium buildup on the heart valve flaps. When the valve cannot fully open, less oxygen-rich blood flows to the body. This forces the heart to work harder to pump blood, and ...
Aortic Valve Stenosis: A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.
Peak left ventricular pressure during balloon inflation was measured in 20 patients who underwent balloon valvuloplasty for severe aortic stenosis to define the determinants of ventricular pressure development in response to increased loading conditions. The peak left ventricular pressure ranged from 150 ± 5 to 386 ± 22 mm Hg (mean ± Sl), was reproducible in each patient with each balloon inflation (mean coefficient of variation 7.8%) and correlated with concurrent echocardiographic measurements of ejection fraction (r = 0.89, p = 0.0001) and mass/volume ratio in systole (r = 0.91, p = 0.0001) or diastole (r = 0.88, p = 0.0001). Thirteen patients with class II or more severe congestive heart failure had lower values for peak left ventricular pressure than did those without failure (225 ± 46 versus 305 ± 45 mm Hg, p = 0.002), whereas no difference in rest left ventricular systolic pressure was seen between the two groups. The measurement of peak left ventricular pressure was inversely ...
Aortic valve stenosis is a narrowing of the aortic valve. The aortic valve allows blood to flow from the hearts lower left chamber into the aorta.
Only recently was the first data from the GARY Registry published. The GARY registry is a nationwide complete survey of patients with aortic valve stenosis undergoing invasive procedures including surgical (AVR), catheter-based (TAVI) transfemoral, catheter-based (TAVI) transapical procedures, and valvuloplasty. The aim of this unique registry initiated by cardiologists and heart surgeons together is to evaluate catheter-based procedures in comparison to surgical aortic valve replacement. In detail, the registry will allow for the development of criteria for adequate patient selection for the best treatment modality. From 01/01/2011 to 31/12/2011, 13,860 patients were included of whom 6,523 received SAVR without CABG, 3,462 SAVR with CABG, 2,694 transvascular TAVI, and 1,181 transapical TAVI. Outcome parameters are available for 1 year and show a continuous increase in mortality after hospital discharge, predominately in high-risk groups. In low and intermediate risk groups, surgical AVR without ...
PURPOSE: We sought to determine the accuracy of multislice spiral computed tomography (MSCT) for assessing of aortic valve stenosis and to establish threshold values of the planimetric aortic valve orifice area (AVA) that best separate between differ
Aortic stenosis patients with left ventricular dysfunction are at increased risk for morbidity and mortality following surgical aortic valve replacement. There are few published data regarding the outcomes of patients with severe aortic stenosis and
Thirty adult patients with aortic stenosis had Doppler echocardiography within 1 day of cardiac catheterization. Noninvasive measurement of the mean transaortic pressure gradient was calculated by applying the simplified Bernoulli equation to the continuous wave Doppler transaortic velocity recording. Stroke volume was measured noninvasively by multiplying the systolic velocity integral of flow in the left ventricular outflow tract (obtained by pulsed Doppler ultrasonography) by the cross-sectional area of the left ventricular outflow tract (measured by two-dimensional echocardiography). Non-invasive measurement of aortic valve area was calculated by two methods. In method 1, the Gorlin equation was applied using Doppler-derived mean pressure gradient, cardiac output and systolic ejection period. Method 2 used the continuity equation. These noninvasive measurements were compared with invasive measurements using linear regression analysis, and mean pressure gradients correlated well (r = 0.92). ...
Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment.
Background: The availability of transcatheter aortic valve replacement (TAVR) has expanded the proportion of patients with severe aortic stenosis (AS) who are candidates for valve replacement. Nevertheless, many patients decline or are not candidates for TAVR or surgical replacement, and their prognosis and risk factors for mortality are incompletely understood.. Methods: We examined 148 patients with severe AS referred for TAVR, but not treated with an aortic valve procedure, and with complete echocardiography and at least 3 months of follow-up. We determined all-cause mortality using the social security death index, and compared patient characteristics and echocardiography findings between survivors and non-survivors.. Results: Mean age was 78.9±10.4 years, and 53.4% were male. Mean follow-up was 10.3±8.7 months, and death occurred in 63 (42.6%) of patients. Mean follow-up for survivors was 14.4±8.6 months, and mean time to death was 4.7±5.2 months. Cumulative survival was 55.7% and 47.2% ...
Your aortic valve plays a key role in getting oxygen-rich blood to your body. Aortic valve stenosis is a common and serious heart problem when the valve doesnt open fully. Learn about what causes it and how it can be treated.
Aortic valve stenosis is a narrowing of the aortic valve that can stop blood from flowing properly out of the heart. Learn more from Boston Childrens Hospital.
TY - JOUR. T1 - Critical aortic stenosis in the first month of life. T2 - Surgical results in 26 infants. AU - Karl, Tom R.. AU - Sano, Shunji. AU - Brawn, William J.. AU - Mee, Roger B B. PY - 1990. Y1 - 1990. N2 - Between 1980 and 1989, 26 infants aged less than 1 month underwent open aortic valvotomy for critical aortic stenosis. All had congestive heart failure requiring inotropic agents (58%), ventilation (42%), and/or prostaglandin E1 (35%) preoperatively. Nine patients with isolated aortic stenosis had an operative mortality of 0%, whereas 17 patients with other anatomical lesions had a 47% mortality (p ,0.01). Univariate analysis failed to identify additional risk factors other than year of operation (p ,0.05). There were four late deaths, three probably related to arrhythmia (actuarial survival at 113 months = 0.53). Two patients have required late reoperation; neither required valve replacement.. AB - Between 1980 and 1989, 26 infants aged less than 1 month underwent open aortic ...
This is the first study to investigate the incidence and magnitude of pressure recovery in a large cohort of prospectively recruited patients with asymptomatic AS. The findings demonstrate that clinically important pressure recovery is present in a significant number of asymptomatic patients with AS and a transvalvular velocity of 2.5 to 4.0 m/s. As expected from experimental data (1,2,17) and confirmed in small clinical studies (18–20), the absolute magnitude of pressure recovery was greater in subjects with higher transvalvular velocities and more severe AS. However, the functional significance of pressure recovery was proportionately larger in patients with a lower degree of stenosis, confirming results in previous experimental and invasive studies (17,19).. Based on the present results, a substantial number of asymptomatic AS patients are likely to be misclassified as having severe AS if pressure recovery is not taken into account. Compared with previously published smaller studies ...
Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and atrial augmentation of preload compensate for the increase in afterload caused by aortic stenosis. As the disease worsens, these compensatory mechanisms become inadequate, leading to symptoms of heart failure, angina, or syncope. Aortic valve replacement is recommended for most symptomatic patients with evidence of significant aortic stenosis on echocardiography. Watchful waiting is recommended for most asymptomatic patients. However, select patients may also benefit from aortic valve replacement before the onset of symptoms. Surgical valve replacement is the standard of care for patients at low to moderate surgical risk. Transcatheter aortic valve replacement may be considered in patients at high or prohibitive surgical risk.
Question - Have moderate aortic stenosis as a result of BAV, pain in chest. What can be inferred from EKG results?. Ask a Doctor about diagnosis, treatment and medication for Aortic valve stenosis, Ask a Cardiologist
Approximately 40% of patients with aortic stenosis (AS) show discordant Doppler-echocardiographic parameters with aortic valve area (AVA) <1 cm2 and/or index iAVA <0.6 cm2/m2 (consistent with severe AS) and the mean gradient (MG) <40 mmHg, consistent with mild/moderate AS. Accurate diagnosis of true severe low flow low gradient AS versus pseudo-severe aortic stenosis is important for prognosis and optimal timing for intervention. Doppler echocardiography using intravenous low dose dobutamine challenge is widely used for differentiating pseudo-severe from true severe aortic stenosis. However, relying on echocardiography alone may have limitations in accurate diagnosis. Reliable diagnosis using echocardiography is dependent on multiple factors like the angle of interrogation of the aortic jet, the assumption that the LVOT area is circular in cross section, optimal echo windows, the presence of underlying subclinical coronary artery disease prior to dobutamine challenge etc. In this chapter, we
Herrmann et al. (18), in a post-hoc analysis of the PARTNER trial, were the first and only group to date to compare clinical outcomes of patients with low ejection fraction (,50%), low-gradient (,40 mm Hg) severe AS (AVA ,0.8 cm2 or indexed AVA ,0.5 cm2·m−2) according to treatment modality. The investigators found that TAVR improved 2-year survival compared with MT (PARTNER B cohort) and revealed for the first time that LEF-LG severe AS patients undergoing TAVR and SAVR had similar clinical outcomes at 2 years (PARTNER A cohort) (18). However, this study was limited by the fact that the PARTNER trial systematically excluded all patients with CAD requiring revascularization and an LVEF ,20%, and no follow-up echocardiography was reported (18). However, previous studies have shown that 66% to 69% of LEF-LG severe AS patients have concomitant CAD, and 60% to 62% of LEF-LG severe AS patients undergoing SAVR also undergo concomitant CABG (4,6). The present study provides "real-world" clinical ...
The prognosis and treatment of patients with low-flow (LF) severe aortic stenosis are controversial.The Placement of Aortic Transcatheter Valves (PARTNER) trial randomized patients with severe aortic stenosis to medical management versus transcatheter aortic valve replacement (TAVR; inoperable cohort) and surgical aortic valve replacement versus TAVR (high-risk cohort). Among 971 patients with evaluable echocardiograms (92%), LF (stroke volume index =35 mL/m(2)) was observed in 530 (55%); LF and low ejection fraction (,50%) in 225 (23%); and LF, low ejection fraction, and low mean gradient (,40 mm Hg) in 147 (15%). Two-year mortality was significantly higher in patients with LF compared with those with normal stroke volume index (47% versus 34%; hazard ratio, 1.5; 95% confidence interval, 1.25-1.89; P=0.006). In the inoperable cohort, patients with LF had higher mortality than those with normal flow, but both groups improved with TAVR (46% versus 76% with LF and 38% versus 53% with normal flow; ...
in European Heart Journal - Cardiovascular Imaging (2016). AIMS: The objective assessment of maximal exercise capacity (MEC) using peak oxygen consumption (VO2) measurement may be helpful in the management of asymptomatic aortic stenosis (AS) patients. However ... [more ▼]. AIMS: The objective assessment of maximal exercise capacity (MEC) using peak oxygen consumption (VO2) measurement may be helpful in the management of asymptomatic aortic stenosis (AS) patients. However, the relationship between left ventricular (LV) function and MEC has been relatively unexplored. We aimed to identify which echocardiographic parameters of LV systolic function can predict MEC in asymptomatic AS. METHODS AND RESULTS: Asymptomatic patients with moderate to severe AS (n = 44, aortic valve area ,1.5 cm2, 66 +/- 13 years, 75% of men) and preserved LV ejection fraction (LVEF , 50%) were prospectively referred for resting echocardiography and cardiopulmonary exercise test. LV longitudinal strain (LS) of each ...
Sclerosis and calcification of the aortic valvular cusps are the ultimate pathological changes which lead to aortic stenosis. These morphological changes thicken and harden the cusps, resulting in poor opening of the aortic valve, and thus stenosis of the aortic valve outlet. Chronic hemodynamic shear forces and turbulent flow across these cusps are likely the root cause of progressive sclerosis and thickening. In individuals with anatomically normal aortic valves, such changes may take years to result in sclerotic and calcific pathology and thus disease manifests late in life, if ever. However, in individuals with preexisting aortic valvular deformities which enhance shear forces and turbulence, pathological progression is accelerated and disease may manifest much earlier in life. Below we discuss the most common etiologies that lead to aortic stenosis ...
There is a distinct need for more minimally-invasive therapies that provide direct access to the diseased aortic valve," said John Liddicoat, senior vice president, Medtronic, and president of the Medtronic Structural Heart Business. "Transapical valve delivery can be a valuable alternative for cardiac surgeons, who will want to consider various approaches for patients who are at high risk for open-heart surgery or patients suffering from conditions - such as peripheral artery disease - that can make other transcatheter procedures less suitable.". ...
As the aortic valve narrows, the left ventricle has to work harder to pump blood out through the valve. To do this extra work, the muscles in the ventricle walls become thicker. This can lead to chest pain. As the pressure continues to rise, blood may back up into the lungs. Severe aortic stenosis can limit the amount of blood that reaches the brain and the rest of the body.. Aortic stenosis may be present from birth (congenital), but most often it develops later in life. Children with aortic stenosis may have other conditions present from birth.. Aortic stenosis mainly occurs due to the buildup of calcium deposits that narrow the valve. This is called calcific aortic stenosis. The problem mostly affects older people. Calcium buildup of the valve happens sooner in people who are born with abnormal aortic or bicuspid valves. In rare cases, calcium buildup can develop more quickly when a person has received chest radiation (such as for cancer treatment).. Another cause is rheumatic fever. This ...
Objectives. To describe short-term clinical and echocardiography outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR). To explore patient selection criteria for treatment with TAVI. Design. TAVI patients (n = 45) were matched to SAVR patients (n = 45) with respect to age within +/- 10 years, sex and systolic left ventricular function. Results. TAVI patients were older, 82 +/- 8 versus 78 +/- 5 years (p = 0.005) and they had higher logEuroSCORE, 16 +/- 11% versus 8 +/- 4% (p andlt; 0.001). There were no significant differences in 30 days mortality, stroke and myocardial infarction. TAVI patients received less erythrocyte (53% vs. 78%, p = 0.03) and thrombocyte (7% vs. 27%, p = 0.02) transfusions. Postoperative atrial fibrillation was less common (18% vs. 60%, p andlt; 0.001) in the TAVI group. Paravalvular regurgitation was more common in TAVI patients (87% vs. 0%, p andlt; 0.001) and 27% had access site complications. Aortic ...
TY - JOUR. T1 - Valve replacement in aortic stenosis with preoperative mean gradient ,50 mmHg. T2 - Hemodynamic outcome. AU - Blackshear, Joseph L.. AU - Miller, Fletcher A Jr.. AU - Loutfi, Hassan. AU - Finck, Sanford J.. AU - Snyder, Harold E.. AU - Agnew, Richard C.. AU - Orszulak, Thomas A.. PY - 1996/11. Y1 - 1996/11. N2 - Background and aims of the study: No prior studies have defined pre- versus postoperative hemodynamics of large numbers of patients with low mean transvalvular gradients. This was our objective. Methods: Retrospective analysis was undertaken of preoperative and postoperative echo/Doppler data in 294 patients who underwent aortic valve replacement (AVR) for aortic stenosis (AS). Some 136 patients had a preoperative mean gradient of ,50 mmHg. The relationship of preoperative to pre- minus postoperative (Δ) mean gradient (GRAD), peak valvular velocity (V2), left ventricular outflow tract velocity (V1), V1/V2ratio, V-V1, and aortic valve area (AVA) were plotted and analyzed ...
GIUNTA, Gustavo et al. Rosuvastatin Slows the Progression of Aortic Stenosis Caused by Hypertension Regardless of Its Lipid-Lowering EffectsRosuvastatin Slows the Progression of Aortic Stenosis Caused by Hypertension Regardless of Its Lipid-Lowering Effects. Rev. argent. cardiol. [online]. 2012, vol.80, n.1, pp. 14-20. ISSN 1850-3748.. Background There is epidemiological evidence associating cardiovascular risk factors with aortic valve stenosis. The development of aortic valve stenosis has been recently demonstrated in a hypertensive animal model. We hypothesize that treatment with rosuvastatin modifies this transformation. Objective To evaluate the effect of rosuvastatin on the development of aortic valve stenosis. Material and Methods Hypertension was induced in 43 male NZ rabbits by a onekidney, one-clip Goldblatt procedure. The animals were randomly assigned to 3 groups: HT (n=17) without treatment; HT+R (n=14) treated with rosuvastatin 2.5 mg/kg/day and HT+R+C (n=12) treated with ...
Aortic stenosis means that your child has a heart valve that is too narrow or is blocked. The aortic valve is 1 of 4 heart valves that keep blood flowing through the heart. The valves make sure blood flows in only 1 direction. The aortic valve keeps blood flowing from the left ventricle to the aorta. Your child may be born with aortic stenosis (congenital). Or it may happen later (acquired). It occurs more often in boys than in girls.. A normal aortic valve has 3 cusps (leaflets) that act as a 1-way door. With aortic stenosis, the valve doesnt work as it should or has an abnormal number of leaflets that dont work correctly. That makes it harder for the leaflets to open and let blood flow from the left ventricle to the aorta.. Aortic stenosis may be mild, moderate, or severe. It depends on how much of the blood is blocked. The condition may get worse over time. It may also occur with other heart problems or conditions.. Moderate to severe aortic stenosis may affect the heart and blood vessels ...
This is the first study with a sufficient sample size to evaluate the association of Bbl therapy with cardiovascular end points in asymptomatic mild to moderate AS. The primary finding was that in propensity‐matched analyses and inverse‐probability adjustment, Bbl therapy was not associated with worse outcome but instead with lower rates of all‐cause and cardiovascular death as well as sudden cardiac death. Furthermore, Bbl treatment was not associated with an increased incidence of heart failure before AVR. These findings were confirmed in competing risk analyses with all‐cause mortality as a competing event. Thus, this study supports the notion that Bbls are a safe antihypertensive treatment option in patients with asymptomatic mild to moderate AS and preserved LV ejection fraction.. Of note, Bbl was associated with higher rates of major cardiovascular events, almost exclusively driven by a doubling in the use of AVR. This could potentially be driven by reverse causation with Bbl being ...
To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVAindex). Cut-off values for severe stenosis are ...
Shifting paradigms for treatment of symptomatic aortic stenosis in lower risk populations: role of a newer generation balloonexpandable transcatheter aortic valve implantation device
Nevertheless in a retrospective echocardiographic study, ACE-Inhibitor therapy did not seem to significantly slow hemodynamic progression of aortic stenosis with progression rates of 0.29 ± 0.44 m/s/yr and of 0.35 ± 0.44 m/s/yr in patients with and without ACEI treatment, respectively (p=0.29)(4).. In contrast, four retrospective echocardiographic studies have observed a significantly slower rate of aortic stenosis progression among statin-treated patients(4-7). These studies include between 156 and 211 patients who were followed between 21 and 44 months. Rates of hemodynamic progression of aortic stenosis (expressed as an increase in peak gradient, peak aortic jet velocity or reduction of the valve area) in the different trials for patients receiving or not receiving statin therapy, respectively were: Aronow et al.(5) (3.4±1.0 mmHg/yr vs. 6.3±1.4 mmHg/yr, p,0.0001), Novaro et al.(7) (-0.06±0.16cm2/yr vs. -0.09±0.17cm2/yr, p,0.03); Bellamy et al.(4) (-0.04±0.15cm2/yr vs. ...
Transcatheter Aortic Valve Implantation With or Without Pre-implantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta-analysis
A relatively large proportion (30% to 50%) of AS patients with preserved LVEF have LF (stroke volume index ,35 ml/m2) and because of the LF state, these patients often have a LG despite the presence of severe stenosis. The high prevalence of LF in the AS population is not necessarily surprising given that this population is predominantly elderly, with frequent comorbidities (systemic hypertension, coronary artery disease, diabetes, atrial fibrillation, mitral regurgitation, tricuspid regurgitation, mitral stenosis) and associated complications (pronounced LV concentric remodeling, impaired LV diastolic filling, ventricular dyssynchrony, impaired LV systolic longitudinal function). These comorbidities and associated complications may all contribute to reduce stroke volume and increase risk of mortality and morbidity. Accordingly, in most previous studies (4,6,8,15-22), patients with paradoxical LF-LG AS had worse symptomatic status and prognosis compared with those with MAS, NF-LG, or HG AS. ...
Using the standard gamble, Hussain et al15 ,17 evaluated the surgical mortality risk that patients were willing to accept if full health resulted from their surviving an AVR. The study was conducted in Norway from May 2010 to May 2015 and recruited consecutive patients with severe aortic stenosis referred to an outpatient clinic (Oslo University Hospital) for AVR. The 439 participating patients, of whom 40% were women (n=175), had a mean age of 75 years (SD 11). The median predicted mortality using the STS-PROM Score was 11.9% (IQR 7.5-17.1).. Regarding risk of bias, the authors enrolled a consecutive sample of patients, had a 98% response rate, used a verbal interview and visuals to represent the health state and instrument and analysed results appropriately. The authors did not, however, assess understanding of the standard gamble exercise by the participants. This raises the possibility that participants may not have understood the exercise, which could possibly explain what might be ...
Despite the promising results of the Placement of Aortic Transcatheter Valves (PARTNER) trial, featured in the Oct. 21 issue of the New England Journal of Medicine, a cardiothoracic surgeon from Boston Medical Center (BMC) ...
Aortic valve gradients are inversely related to the square of aortic valve area and directly related to the square of flow. Because of this, gradients can underestimate the severity of AS in any low-flow condition. Low-flow low-gradient severe AS typically has been associated with severe LV systolic dysfunction, in which a low-flow state is readily apparent. In 2007, Pibarot and colleagues first described patients (and associated adverse outcomes) with low-flow low-gradient severe AS with paradoxical normal LVEF (Hachicha Z, et al. Circulation 2007;115:2856-64). Among these patients, stroke volume is low despite normal LVEF presumably due to a small LV cavity and/or LV contractile dysfunction despite preserved LVEF. However, because echo/Doppler effective orifice area (EOA) is subject to error in calculation, controversy has existed as to whether low-flow low-gradient severe AS and paradoxical normal LVEF is mostly due to error in echo/Doppler calculation of EOA rather than genuine ...
Eberhard, Matthias; Mastalerz, Monika; Pavicevic, Jovana; Frauenfelder, Thomas; Nietlispach, Fabian; Maisano, Francesco; Tanner, Felix C; Nguyen-Kim, Thi Dan Linh (2017). Value of CT signs and measurements as a predictor of pulmonary hypertension and mortality in symptomatic severe aortic valve stenosis. International Journal of Cardiovascular Imaging, 33(10):1637-1651. ...
Taken together, these data indicate that there is no inherent advantage in using the elliptic, larger, CT-derived ALVOT instead of the circular, smaller, echocardiography-derived ALVOT with the continuity equation to calculate the AVA. The CT-derived AVA on average was ∼20% larger than the echocardiography-derived AVA.. How can it be that, despite a clearly smaller and falsely circular ALVOT compared with CT, the echocardiography-based continuity equation AVA corresponds as well as the CT-based AVA with gradients and prognosis? On closer inspection, the echocardiographic application of the continuity equation for the calculation of the AVA contains several important simplifications. For example, the aortic annular area does not correspond to the region of interest of the pulsed-wave Doppler VTILVOT measurement, which is placed more inside the left ventricle, and where the available cross section of flow is smaller than at the annulus level, especially if a septal bulge is present. Further, as ...
Aims To evaluate the safety, efficacy, and performance of the TriGuard (TM) HDH Embolic Deflection Device (TriGuard) compared with no cerebral protection in patients undergoing transcatheter aortic valve implantation (TAVI). Methods and results From February 2014 to March 2015, 85 subjects undergoing TAVI at 13 centres in Europe and Israelwere ... read more randomized to TriGuard protection vs. no protection. Subjects underwent neurologic and cognitive evaluation at baseline, pre-discharge and 30 days; cerebral diffusion-weighted magnetic resonance imaging was performed at 4 +/- 2 days post-procedure and at 30 days. Technical success, which included complete 3-vessel cerebral coverage, was achieved in 88.9% (40/45) of cases. The primary in-hospital procedural safety endpoint (death, stroke, life-threatening or disabling bleeding, stage2 or 3 acute kidney injury, or major vascular complications) occurred in 21.7% ofTriGuard and 30.8% of control subjects (P = 0.34). In the Per Treatment population ...
Study surprises researchers in that surgical aortic valve replacement outcomes equal those of minimally invasive procedure HOUSTON (January 24, 2017) - Elderly patients with aortic stenosis (AS) and medium surgical risk experienced better than expected results after undergoing traditional surgical aortic valve replacement (SAVR), according to research presented at the 53rd Annual Meeting of The Society of Thoracic Surgeons.
TAVR Surgery. Doctors from the Hospital of the University of Pennsylvania have achieved a breakthrough in treating 93-year-old Herbert Auspitz with a severe case of aortic valve stenosis. The condition is characterised by narrowing of the valve that controls blood flow from the heart and there is no way to prevent it and no drugs to treat it.. Doctors involved in the surgery used the recently approved TAVR technique by Federal Regulator wherein people with high risk from open-heart surgery are treated. The hour long operation involved inserting a new valve made from the lining of a cows heart through a catheter and then opening it like an umbrella. Aortic valve stenosis is an illness of ageing and this makes it difficult for doctors to perform an open heart surgery as it poses a serious threat to the patients life.. The technique is now being tested on younger patients who are likely to develop this condition in the near future. This will eventually replace surgery for all age groups who need ...
Health, ...Munich Germany August 28 2012: Transcatheter aortic valve implantati...Aortic stenosis is the most common valvular heart disease with increas...TAVI introduced in 2002 by Dr Alain Cribier from France and 2005 by D...The prospective multicentre German transcatheter aortic valve interven...,TAVI,improves,quality,of,life,in,patients,with,severe,aortic,stenosis,for,at,least,1,year,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
Dr. Hadied responded: The symptoms ranges. From mild to severe. Aortic valve stenosis signs and symptoms typically develop when narrowing of the valve is severe and can include: |a href="/topics/chest-pain" track_data="{
Our study demonstrates that a CT-derived AVA of ,1 cm2 is present in up to a quarter of patients with severe haemodynamic AS on echocardiography, regardless of ejection fraction and stroke volume. Higher stroke volume and outflow-tract flow rates on echocardiography are associated with increased inconsistency with CT grading. CFD analysis also supports that high LVOT flow rates are associated with inconsistency and may be responsible for the skewed velocity profile through the AV orifice, thus leading to higher haemodynamic parameters in the presence of larger CT valve area.. As expected, the E-AVA was the most inconsistent parameter when compared with Doppler indices, as well as CT-AVA, and results from the measurement of small LVOT diameter as discussed earlier.15 16 21 Another reason that has been used to explain a smaller E-AVA in relation to directly measured AVA is the concept that the former represents the area of the smaller vena contracta distal to the anatomical AVA.25 While this may ...
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The Cardiology team of CARE Hospitals, Banjara Hills, Hyderabad successfully performed its first TAVI - Transcatheter Aortic Valve Implantation recently. TAVI offers hope for patients considered high risk for open heart surgery, such as the elderly. Until now, such patients didnt have any alternative treatment option. TAVI involves implanting a life-saving artificial aortic valve in patients suffering from Aortic Stenosis using a minimally invasive approach, without the associated risks of open heart surgery.. The patient was an 82-year-old cancer survivor with severe aortic stenosis. She had multiple health issues and was confined to the bed. She needed open heart surgery, which would have been too high risk for her. The CARE Cardiac team deemed her fit for TAVI. The procedure, a first for the CARE Group, was performed on 22nd September and the patient is doing well.. ...
Marilyn Reeves heart issues started with quadruple bypass surgery at age 59. Ten years later, she began having trouble walking short distances, needing to stop often to catch her breath. The diagnosis was aortic valve stenosis. Due to her health history, open-heart surgery was out of the question, according to her doctor. "She recommended I go to the University of Michigan to see if there was anything they could do for me," Marilyn says.. Fortunately, Marilyn was a candidate for Transcatheter Aortic Valve Replacement (TAVR), a procedure for those who cannot tolerate open-heart surgery. Marilyns TAVR procedure was a success. "I had my procedure on a Friday and was home on Monday. Its marvelous what they can do," she says.. Today, at age 70, Marilyn is back to doing all her own yard work as well as other physical things she couldnt have done two years ago. She credits the entire U-M TAVR team with helping her get her health back. "U-M is the best hospital ever," she says. Continue reading ...
We retrospectively reviewed the clinical and hemodynamic findings in 397 patients with valvular aortic stenosis at their first hemodynamic evaluation. This series is considered representative of aortic stenosis because it is heavily weighted toward older patients (average age, 61.1 years) and severe aortic stenosis (87.3% of patients had aortic valve area less than 1 cm2). We identified two categories of symptoms: angina and syncope, which develop during a fully compensated stage of aortic stenosis ("prefailure symptoms"); and dyspnea or congestive failure, which signifies various degrees of left ventricular malfunction. The preponderance of soft or medium intensity systolic murmur and normal or widened pulse pressure emphasizes the changing clinical picture of aortic stenosis in an aging population. Coexisting coronary artery disease was found in 60% of patients, but those with and without coronary disease did not differ significantly, even in the presence of angina. ...
The cardiologists, nurses and technicians of Sacramentos first transcatheter aortic valve replacement (TAVR) team celebrated a milestone on March 6. For five years, they have provided a minimally invasive treatment option to patients with aortic valve stenosis.
I left a response in the other thread, but it disappeared for some reason. Im too lazy to type it up again. The gist of it: JUPITER was the largest (if not the only) serious study since 2005 looking at statins in healthy people. Most others looked at statins in people with some kind of preexisting problem. Statins reduce the risk of stroke and AMI, but lowering the cholesterol wont keep you from dying from heart failure or cure your aortic valve stenosis. And, since studies of people with systolic heart failure or aortic valve stenosis tend to be small, you may end up seeing a 20% reduction in the rate of AMI that also happens not to be statistically significant at the group size, and give fuel to people like de Lorgeril whod use it to argue that statins dont work ...
The health problems of two NFL coaches highlight the importance of taking care of yourself, especially in high-stress jobs.. Denver Broncos coach John Fox had heart surgery Saturday and Houston Texans coach Gary Kubiak collapsed Sunday night after having a transient ischemic attack, also known as a mini-stroke or a TIA.. The job of […]. ...
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For more than 20 years, BroadcastMed has been innovating digital strategies for healthcare organizations. The company was first in the world to broadcast live surgeries on the internet using its ORLive solution which provides an intimate look inside the operating room.. ...
The Mammalian Phenotype (MP) Ontology is a community effort to provide standard terms for annotating phenotypic data. You can use this browser to view terms, definitions, and term relationships in a hierarchical display. Links to summary annotated phenotype data at MGI are provided in Term Detail reports.
Boston Scientific announced the German District Court of Düsseldorf has determined that Edwards Lifesciences Corporation and its German subsidiarys Sapien 3™ device infringed two patents of Boston Scientific Scimed, Inc. related to the seals for transcatheter heart valves, specifically the German parts of EP 2 749 254 B1 and EP 2 926 766 B1.. The Lotus™ Valve System is designed for aortic valve replacement in patients with severe aortic stenosis who are considered at high risk for surgical valve replacement. Instead of open heart surgery, the replacement valve is delivered via transcatheter percutaneous delivery. The Lotus Valve Adaptive Seal™ is a technology that creates an external seal to prevent leakage around the valve known as paravalvular leak or PVL, which is a proven predictor of mortality.. Boston Scientific and its German subsidiary were also found not to infringe upon Edwards German part of EP 1 441 672 B1, but to infringe upon Edwards German part of EP 2 399 550 B1; ...
Indications: The Edwards SAPIEN XT transcatheter heart valve, model 9300TFX, and accessories are indicated for relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be at intermediate or greater risk for open surgical therapy (i.e., predicted risk of surgical mortality ≥ 3% at 30 days, based on the Society of Thoracic Surgeons (STS) risk score and other clinical co-morbidities unmeasured by the STS risk calculator).. The Edwards SAPIEN XT transcatheter heart valve and accessories are also indicated for patients with symptomatic heart disease due to failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., STS operative risk score ≥8% or at a ≥15% risk of mortality at 30 days).. Contraindications (Who should not use): ...
What symptoms may a patient with symptomatic aortic stenosis complain of on history?. A patient with symptomatic aortic stenosis may present with dyspnea on exertion, decreased exercise tolerance, angina with activity, and presyncope/syncope with activity.. What features would you look for on clinical exam to help determine the severity of aortic stenosis?. Features on physical exam for severe aortic stenosis may include:. ...
We studied 30 patients with asymptomatic, severe AS with a mean age of 78 + or - 9 years, an aortic valve area of 0.77 + or - 0.16 cm(2), a mean gradient of 50.1 + or - 9.5 mm Hg, and a peak gradient of 84 + or - 22 mm Hg. They were compared to 60 age-matched (within 2 years) and gender-matched (ratio of 1:2) patients with mild-to-moderate AS (controls).. Combined postoperative events were more common for the patients (n = 10; 33%) than for the controls (n = 14; 23%), but the difference was not statistically significant (p = 0.06).. Intraoperative hypotension requiring vasopressor use was more likely for the patients (n = 9; 30%) than for the controls (n = 10; 17%; odds ratio 2.5; p = 0.11). The perioperative myocardial infarction rates were similar for both groups (3%; p = 0.74). No deaths, heart failure events, or ventricular arrhythmias occurred in the patients and 1 death and 1 ventricular arrhythmia episode occurred in the controls ...
Elderly patients once considered too frail or too sick for aortic valve replacement surgery are living longer, with better quality of life, following a minimally invasive surgery, compared to patients who did not undergo surgery, according a study published in The Lancet today. News on NewsHub.org
Pre-interventional assessment and calcification score of the aortic valve and annulus, with multi-detector CT, in transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve ...
miRNAs (microRNAs) have been shown to play a role in myocardial fibrosis. The present study was designed to analyse whether alterations in miRNA expression contribute to the progression of myocardial fibrosis in AS (aortic valve stenosis) patients through up-regulation of the pro-fibrotic factor TGF-β1 (transforming growth factor-β type 1). Endomyocardial biopsies were obtained from 28 patients with severe AS, and from the necropsies of 10 control subjects. AS patients presented increased myocardial CVF (collagen volume fraction) and TGF-β1 compared with the controls, these parameters being correlated in all patients. Patients were divided into two groups by cluster analysis according to their CVF: SF (severe fibrosis; CVF ,15%; n=15) and non-SF (CVF ≤15%; n=13). TGF-β1 was increased in patients with SF compared with those with non-SF. To analyse the involvement of miRNAs in SF, the miRNA expression profile of 10 patients (four with non-SF and six with SF) was analysed showing that 99 ...
Regular checkups by a provider may be all that is needed if your symptoms are not severe. The provider should ask about your health history, do a physical exam, and perform an echocardiogram.. People with severe aortic stenosis may be told not to play competitive sports, even if they have no symptoms. If symptoms do occur, strenuous activity must often be limited.. Medicines are used to treat symptoms of heart failure or abnormal heart rhythms (most commonly atrial fibrillation). These include diuretics (water pills), nitrates, and beta-blockers. High blood pressure should also be treated. If aortic stenosis is severe, this treatment must be done carefully so blood pressure does not drop too far.. In the past, most people with heart valve problems were given antibiotics before dental work or a procedure such as colonoscopy. The antibiotics were given to prevent an infection of the damaged heart. However, antibiotics are now used much less often before dental work and other procedures. Check with ...
We employ transcatheter aortic valve replacement, a minimally-invasive, catheter-based therapy for patients at risk for severe aortic stenosis.
Transcatheter aortic valve replacement (TAVR) is an undergoing evaluation for the treatment of inoperable or high-risk severe aortic stenosis (AS) patients. Patients with symptomatic, severe AS are...
Medtronic has announced a new post-market clinical study to evaluate its CoreValve Evolut PRO valve in everyday clinical practice. Studying patients with severe symptomatic aortic stenosis at an intermediate, high or extreme risk for open heart surgery, the FORWARD PRO Clinical Study will evaluate longer-term performance (out to five years) of the next-generation self-expanding TAVI system, which was recently approved for commercial use in Europe and United States.. The Evolut PRO valve - built off the proven Evolut R platform - is uniquely designed with an outer tissue wrap to further advance valve sealing performance. The biocompatible porcine pericardial tissue wrap, in addition to other design elements, is incorporated to address the occurrence of blood leaking through the sides of the valve.. The first-ever data for Evolut PRO valve presented at ACC.17 showed no moderate/severe paravalvular leak (0 percent), high rates of survival (98.3 percent) and a low rate of disabling stroke (1.7 ...
Aortic stenosis, one of the most common valvular heart diseases in patients 65 years and older, occurs in approximately 2 to 9 percent of persons in this age group and may be a risk factor for perioperative cardiac complications in noncardiac surgery. Results from recent studies have been inconsistent as to whether aortic stenosis increases perioperative cardiac complications after surgery. In one recent study, increased peak aortic gradients were found to be associated with increased cardiovascular morbidity. Kertai and associates evaluated perioperative mortality and nonfatal myocardial infarction (MI) over time in patients with moderate to severe aortic stenosis who were undergoing noncardiac surgery.. The study was a retrospective examination of charts from patients who underwent noncardiac surgery between January 1991 and December 2000 at one medical center. All patients with moderate (mean gradient of 25 to 49 mm Hg) and severe (mean gradient of at least 50 mm Hg) aortic stenosis were ...
Background:Inconsistencies between gradients and aortic valve area are frequent in the echocardiographic evaluation of aortic stenosis (AS). Assessing AS severity is essential for the correct management of the disease. The aim of this study was to evaluate whether ejection dynamics, particularly acc
Purpose: Recent advances in the management of aortic stenosis (AS) including the availability of percutaneous valve therapies have resulted in the evaluation of patients with increased co-morbidities. AS is associated with an increased risk of Gastrointestinal (GI) bleeding which is further increased by antithrombotic and antiplatelet treatment that often accompany hospitalization. The aim of our study was to determine the safety of emergent bedside endoscopies in patients with moderate to severe AS in the Cardiac Intensive Care Unit (CICU) setting presenting with acute GI bleeding.. Objective and Methods: We identified all patients with moderate to severe AS who were admitted to the CICU at the Cleveland Clinic and experienced GI bleeding requiring emergent bedside endoscopies between Jan 2011 and Jan 2013. Data collection included demographics, indication for admission to the CICU, indication for bedside endoscopy, etiologies of GI bleeding, and intra procedural as well as post procedural ...
John Conte, professor of surgery, and Jon Resar, associate professor of medicine, discuss the transcatheter aortic valve replacement (TAVR) procedure-one of the treatment options for aortic stenosis. They also share insights on eligibility, risks, recovery and benefits of TAVR.. ...
A retrospective study determined that the introduction of TAVI was associated with an increase in aortic valve replacement referrals and a decrease in the rate of unoperated AS. This positive impact was due to increases in both TAVI and AVR volume. Increased volume was not associated with worse patient survival.1. Download Aortic Stenosis Brochure. ...
Cardiac diseases (e.g. coronary and valve) are associated with ventricular cellular remodeling. However, ventricular biopsies from left and right ventricles from patients with different pathologies are rare and thus little is known about disease-induced cellular remodeling in both sides of the heart and between different diseases. We hypothesized that the protein expression profiles between right and left ventricles of patients with aortic valve stenosis (AVS) and patients with coronary artery disease (CAD) are different and that the protein profile is different between the two diseases. Left and right ventricular biopsies were collected from patients with either CAD or AVS. The biopsies were processed for proteomic analysis using isobaric tandem mass tagging and analyzed by reverse phase nano-LC-MS/MS. Western blot for selected proteins showed strong correlation with proteomic analysis. Proteomic analysis between ventricles of the same disease (intra-disease) and between ventricles of different
Results: The ejection fraction before and after the surgical treatment was normal. GLS before the surgical treatment was -15, 1%, for 3-chamber GLS the value was -15,3%; for 4-ch it was -14,2% and 2-ch counted -16%. After replacement of the aortic valve with mechanical prosthesis, the echocardiographic assessment done 4 months later showed improvement of the GLS values to -17,1% ( -18,5% for 3-ch, -15,0% for 4-ch and -17,1% for 2-ch). ...
The management of elderly patients with severe, symptomatic aortic stenosis has undergone a significant transformation over the last 10 years.
In the presented scientific works new approaches and techniques were developed for: - Application of 31P-MR spectroscopy in myocardial ischaemia - Reproducibility of MRI for the measurement of left ventricular parameter of mass and volume in dilated cardiomyopathy - Suitability of 2-dimensional MRI techniques for measuring left ventricular parameter of mass and volume in dilated cardiomyopathy - Quantification of stenotic orifices by MRI in hypertrophic cardiomyopathy and aortic valve stenosis - Visualisation of the inflammatory activity of the myocardium in myocarditis - Visualisation of the inflammatory changes in cardiac sarcoidosis - Early visualization of the toxic myocardial injury after anthracycline therapy. The value of MRI was tested in experimental and clinical studies in comparison to established modalities. The results have shown that it is possible to transmit the physical possibilities into clinically applicable protocols and to apply them into clinical routine ...
Percutaneous aortic valve replacement (PAVR), also known as transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR), is the replacement of the aortic valve of the heart through the blood vessels (as opposed to valve replacement by open heart surgery). The replacement valve is delivered via one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone), direct aortic (through a minimally invasive surgical incision into the aorta), and transcaval (from a temporary hole in the aorta near the belly button through a vein in the upper leg). Severe symptomatic aortic stenosis carries a poor prognosis. Until recently, surgical aortic valve replacement was the standard of care in adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure ...
Repair of the Transcatheter aortic valve is a minimally invasive procedure. This technique is used without removing it to treat or restore old and damaged aortic valve. The technique used to insert a new valve to the place of the old aortic valve is called the Transcatheter aortic valve replacement system. Between the left atrium and the left ventricle is the mitral valve. Mitral valve disorder is a condition in which the valve ceases working properly, leading to abnormal blood flow. This abnormal blood flow can lead to diseases such as prolapse of the mitral valve and regurgitation of the mitral valve.. Renub Research latest study report "Transcatheter Heart Valve Replacement Market, Volume, Share by Materials (Mechanical and Tissue) Position (Transcather Mitral Valve Replacement and Transcatheter Aortic Valve Replacement), Region (United States, Germany, China, France, Italy, Japan, Spain, United Kingdom, India and Brazil), Company Analysis" provides a detailed and comprehensive insight of the ...
Bioprosthetic valves are increasingly used in preference to mechanical valves in open SAVR, as lifelong oral anticoagulation is not required and its attendant complications can be avoided. A recent study has shown similar long-term survival rates in patients with bioprosthetic and mechanical valves. However, patients with bioprosthetic valves require reoperations due to their limited durability and expected degeneration;(12) those undergoing such reoperations face increased surgical risk due to their more advanced age (compared with their age during the index SAVR) during the redo surgery and scarring in the non-virgin chest. Consequently, valve-in-valve TAVI appears to be an attractive, minimally invasive method of replacing the degenerated surgical aortic bioprosthesis without the need for a reoperation. Several small case series and a global registry have shown that it is a feasible and viable option for patients at high risk.(5-9). In our initial Asian experience of valve-in-valve TAVI in ...
Looking for online definition of Carpentier-Edwards aortic valve prosthesis in the Medical Dictionary? Carpentier-Edwards aortic valve prosthesis explanation free. What is Carpentier-Edwards aortic valve prosthesis? Meaning of Carpentier-Edwards aortic valve prosthesis medical term. What does Carpentier-Edwards aortic valve prosthesis mean?
According to the latest market report published by Persistence Market Research titled Global Transcatheter Heart Valve Replacement & Repair Market: Global Industry Analysis and Forecast, 2016 - 2026, the global transcatheter heart valve replacement & repair market is projected to expand at a CAGR of 13.9% during the forecast period (2016-2026).. Request for Report [email protected]://www.persistencemarketresearch.com/samples/11167. Transcatheter heart valve replacement is a relatively non-invasive procedure to repair the damaged heart valves with bioprosthetic valves for treatment of valvular heart disease namely aortic stenosis and mitral regurgitation among geriatric population. It is an alternative approach to conventional open heart surgery, especially for extremely high risk patients. Transcatheter heart valve replacement & repair market was valued at US$ 1,605.5 Mn in 2015 and the revenue is expected to increase to US$ 6,701.5 Mn by 2026 at a CAGR of 13.9% over the forecast period.. The report ...
Unlike reported cases in which a transcatheter aortic valve device was implanted in the mitral position in the setting of dense annular calcification or a degenerated bioprosthesis, it might be feasible to use the FORTIS device in the setting of primary or secondary noncalcific MR. This first report of three patients with 6-month follow-up after transcatheter mitral valve replacement is encouraging, yet it might be premature to draw firm conclusions about procedural complication rates and clinical outcomes from this very small single-center experience. If positive results are borne out in a larger, multicenter trial or trials, then transcatheter mitral valve replacement with this or another device might provide an attractive alternative to the limited MR reduction afforded by transcatheter edge-to-edge repair.. ...
A 46-year-old man with a medical history of rheumatic valve disease underwent mitral and aortic valve replacements with On-X and CarboMedics Top Hat supra-annular mechanical valves, respectively. Seven months after the valve replacement surgery, the patient presented with dizziness. A CT scan of the brain was done as part of a thorough workup of dizziness. The CT scan revealed a small metallic density in the M2 branch of the right middle cerebral artery. The metallic density was believed to be a metallic embolus that originated from the mechanical valves or the suturing material, that is, Cor-Knot fastener. Although in our case, the dizziness was believed to be the result of benign paroxysmal positional vertigo, through this case, we aim to highlight this extremely rare structural complication of mechanical valves. This complication can have serious and potentially fatal consequences such as embolic component-related stroke or another organ infarction. ...
An artificial heart valve is a device implanted in the heart of a patient with valvular heart disease. When one of the four heart valves malfunctions, the medical choice may be to replace the natural valve with an artificial valve. This requires open-heart surgery. Valves are integral to the normal physiological functioning of the human heart. Natural heart valves are evolved to forms that perform the functional requirement of inducing unidirectional blood flow through the valve structure from one chamber of the heart to another. Natural heart valves become dysfunctional for a variety of pathological causes. Some pathologies may require complete surgical replacement of the natural heart valve with a heart valve prosthesis. There are three main types of artificial heart valves: the mechanical,the biological, and the tissue engineered valves. Mechanical heart valve Percutaneous implantation Stent framed Not framed Sternotomy/Thoracotomy implantation Ball and cage Tilting disk Bi-leaflet ...

Long-Term Prognosis of Ascending Aortic Aneurysm After Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve...Long-Term Prognosis of Ascending Aortic Aneurysm After Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve...

... patients with a bicuspid aortic valve undergoing aortic valve replacement for aortic stenosis have a low risk of future aortic ... with aortic valve stenosis and concomitant ascending aortic dilatation of 40-50 mm underwent isolated aortic valve replacement ... were diagnosed with bicuspid aortic valve stenosis, and the remaining 172 patients (53%) had tricuspid aortic valve stenosis. ... Aortic dissection occurred in three patients in the tricuspid aortic valve group and in no bicuspid aortic valve patients. ...
more infohttp://www.acc.org/latest-in-cardiology/journal-scans/2014/02/11/16/26/long-term-prognosis-of-ascending-aortic-aneurysm

Aortic Valve Stenosis-Topic OverviewAortic Valve Stenosis-Topic Overview

What is aortic valve stenosis?The heart has four chambers. In the lower left chamber (left ventricle), the aortic valve works ... Blood then flows through the aorta to the rest of the body.Aortic valve stenosis ... When the heart pumps, the aortic valve opens to let oxygen - rich blood flow from the left ventricle into a large blood vessel ... Aortic Valve Stenosis - Topic Overview. Articles OnAortic Valve Stenosis. Aortic Valve Stenosis Aortic Valve Stenosis * Topic ...
more infohttps://www.webmd.com/heart-disease/tc/aortic-valve-stenosis-overview

Aortic valve stenosis - Mayo ClinicAortic valve stenosis - Mayo Clinic

Typically the aortic valve has three cusps (tricuspid aortic valve), but some people are born with an aortic valve that has two ... Aortic valve stenosis is a defect that narrows or obstructs the aortic valve opening, making it difficult for the heart to pump ...
more infohttps://www.mayoclinic.org/normal-heart-and-aortic-valve-stenosis/img-20007788

Aortic Valve Stenosis: Symptoms, Causes, Diagnosis, TreatmentAortic Valve Stenosis: Symptoms, Causes, Diagnosis, Treatment

Aortic valve stenosis is a common and serious heart problem when the valve doesnt open fully. Learn about what causes it and ... Your aortic valve plays a key role in getting oxygen-rich blood to your body. ... "Aortic valve stenosis: Causes," "Aortic valve stenosis: Symptoms," "Aortic valve stenosis: Complications," "Aortic valve ... Causes of Aortic Valve Stenosis. Several conditions can cause your aortic valve to thicken. Among them are:. Calcium buildup: ...
more infohttps://www.webmd.com/heart-disease/aortic-valve-stenosis

Aortic Valve StenosisAortic Valve Stenosis

... Topic Overview. What is aortic valve stenosis?. Aortic valve stenosis is a narrowing of the aortic valve ... What causes aortic valve stenosis? Problems that can cause aortic valve stenosis include:. *Calcium buildup on the aortic valve ... Most people who have aortic valve stenosis are born with a normal, healthy aortic valve but develop aortic stenosis late in ... Other tests for aortic valve stenosis. *Stress echocardiogram. This test can show how severe your aortic valve stenosis is. ...
more infohttps://www.adventisthealthcare.com/health/library/topic/?id=uf4520abc

Aortic Valve Stenosis Symptoms and Replacement  | UPMCAortic Valve Stenosis Symptoms and Replacement | UPMC

Aortic valve stenosis limits blood flow and can be detected by a heart murmur. Learn why UPMC may offer you replacement surgery ... Aortic Valve Stenosis. Aortic stenosis means your aortic valve does not open widely enough to allow adequate blood flow from ... Aortic Stenosis Symptoms and Diagnosis. Aortic stenosis symptoms. The effects of aortic valve stenosis range from mild to ... What Is Aortic Stenosis?. Your heart has four valves that work to keep blood flowing in the right direction. Your aortic valve ...
more infohttps://www.upmc.com/services/heart-vascular/conditions-treatments/aortic-stenosis

Balloon Valvuloplasty for Aortic Valve StenosisBalloon Valvuloplasty for Aortic Valve Stenosis

... and young adults in their 20s who have aortic valve stenosis. This group typically has aortic valve stenosis because of a ... The cause of this narrowing in the aortic valve is aortic valve stenosis. ... the aortic valve is wider, but it is still not normal. Over time, the valve can get narrow again, so another procedure or valve ... Balloon Valvuloplasty for Aortic Valve Stenosis. Treatment Overview. Balloon valvuloplasty (also called valvulotomy or ...
more infohttps://www.rexhealth.com/rh/health-library/document-viewer/?id=abl3668

Aortic Valve Stenosis | Boston Childrens HospitalAortic Valve Stenosis | Boston Children's Hospital

Aortic valve stenosis is a narrowing of the aortic valve that can stop blood from flowing properly out of the heart. Learn more ... Aortic Valve Stenosis. What is aortic valve stenosis?. The term "stenosis" describes an abnormal narrowing within a structure ... Severe aortic valve stenosis. A child with severe aortic valve stenosis has such an advanced degree of narrowing in the valve ... Mild aortic valve stenosis. A child with mild aortic valve stenosis has very limited narrowing within the valve. These children ...
more infohttp://www.childrenshospital.org/conditions-and-treatments/conditions/a/aortic-valve-stenosis

Aortic Valve Stenosis  | Boston Childrens HospitalAortic Valve Stenosis | Boston Children's Hospital

Aortic valve stenosis is a narrowing of the aortic valve that can stop blood from flowing properly out of the heart. Learn more ... Severe aortic valve stenosis. A child with severe aortic valve stenosis has such an advanced degree of narrowing in the valve ... Mild aortic valve stenosis. A child with mild aortic valve stenosis has very limited narrowing within the valve. These children ... Aortic valve stenosis, therefore, refers to the narrowing of the hearts aortic valve, a one-way valve located between the left ...
more infohttp://www.childrenshospital.org/conditions-and-treatments/conditions/a/aortic-valve-stenosis/overview

About Aortic Valve Stenosis - Penn MedicineAbout Aortic Valve Stenosis - Penn Medicine

... also called aortic valve stenosis - happens when this valve narrows, preventing normal blood flow. Learn more about symptoms ... What are the Symptoms of Aortic Valve Stenosis?. As one of the most common valve diseases, aortic valve stenosis can also be ... The aortic valve allows the blood to pass between the left ventricle and the aorta. Aortic Stenosis - also called aortic valve ... While aortic valve stenosis can develop as a result of a congenital heart condition such as bicuspid aortic valve disease, most ...
more infohttps://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/aortic-valve-stenosis

aortic valve stenosis Mammalian Phenotype Term (MP:0006117)aortic valve stenosis Mammalian Phenotype Term (MP:0006117)

The Mammalian Phenotype (MP) Ontology is a community effort to provide standard terms for annotating phenotypic data. You can use this browser to view terms, definitions, and term relationships in a hierarchical display. Links to summary annotated phenotype data at MGI are provided in Term Detail reports.
more infohttp://www.informatics.jax.org/vocab/mp_ontology/MP:0006117

Calcific Aortic Valve Stenosis in Old Hypercholesterolemic Mice | CirculationCalcific Aortic Valve Stenosis in Old Hypercholesterolemic Mice | Circulation

Furthermore, LDLr−/−ApoB100/100 mice with aortic stenosis have oxidant stress in valve tissue, a feature of aortic valve ... Calcific aortic valve stenosis is a large and growing health problem in Western societies.1 Studies in explanted valves from ... LDLr−/−ApoB100/100 Mice Develop Aortic Stenosis and Valvular Heart Disease. Systolic aortic valve orifice diameter was reduced ... P=0.004 for LDLr−/−ApoB100/100 mice with aortic stenosis compared with LDLr−/−ApoB100/100 mice without aortic stenosis. ...
more infohttp://circ.ahajournals.org/content/114/19/2065

Spontaneous calcific cerebral emboli from calcified aortic valve stenosis.  - PubMed - NCBISpontaneous calcific cerebral emboli from calcified aortic valve stenosis. - PubMed - NCBI

Calcific cerebral emboli (CE) are a rare complication of calcified aortic valve stenosis (CAS). These emboli usually result ... Spontaneous calcific cerebral emboli from calcified aortic valve stenosis.. [Article in English, French] ... The finding of spontaneous cerebral CE is a very strong argument in favour of surgical valve replacement in these patients. ... from diagnostic manoeuvres (e.g. left heart catheterization) or from therapeutic procedures (e.g. heart valve surgery). ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed/8492172?dopt=Abstract

Aortic Valve Stenosis - Lawrence Memorial HospitalAortic Valve Stenosis - Lawrence Memorial Hospital

Aortic Valve Stenosis. Topic Overview. What is aortic valve stenosis?. Aortic valve stenosis is a narrowing of the aortic valve ... What causes aortic valve stenosis? Problems that can cause aortic valve stenosis include:. * Calcium buildup on the aortic ... Most people who have aortic valve stenosis are born with a normal, healthy aortic valve but develop aortic stenosis late in ... Recommended frequency for checking aortic valve stenosisfootnote 1. Severity of aortic valve stenosis. How often you should ...
more infohttps://www.lmh.org/wellness/health-library/document-viewer/?id=hw179837

Erectile Dysfunction and Aortic Valve StenosisErectile Dysfunction and Aortic Valve Stenosis

... aortic valve stenosis, atherosclerosis, risk factors and symptoms from Doctor Eric Roselli. ... "Erectile Dysfunction and Aortic Valve Stenosis?" Asks Deana. By Adam Pick on June 6, 2009 ... She writes, "Hi Adam - My husband was just diagnosed this past January with aortic valve stenosis. His Cardiologist said that ... for aortic stenosis (narrow heart valve) and atherosclerosis. Dr. Roselli referenced that erectile dysfunction is documented as ...
more infohttps://www.heart-valve-surgery.com/heart-surgery-blog/2009/06/06/erectile-dysfunction-aortic-stenosis/

Aortic Valve Stenosis | Nevada Hospitals | Dignity HealthAortic Valve Stenosis | Nevada Hospitals | Dignity Health

Learn more about your risk for aortic valve stenosis in Nevada or how you can treat your heart conditions at Dignity Health St ... What Causes Aortic Valve Stenosis?. There are three causes of aortic valve stenosis: *Calcium buildup on the valve. Your valve ... Symptoms of Aortic Valve Stenosis. Aortic valve stenosis may take years to develop. Some people with mild stenosis may not even ... Find Reliable Care for Aortic Valve Stenosis at Dignity Health - St. Rose Dominican Aortic valve stenosis is a narrowing or ...
more infohttps://www.dignityhealth.org/las-vegas/services/heart-vascular-care/cardiology-conditions/heart-conditions/aortic-valve-stenosis

Apolipoprotein A-I proteolysis in aortic valve stenosis: role of cathepsin S | SpringerLinkApolipoprotein A-I proteolysis in aortic valve stenosis: role of cathepsin S | SpringerLink

Aortic valve stenosis (AVS) is the most common valvular heart disease in the Western world. Therapy based on apolipoprotein A-I ... Improvement of aortic valve stenosis by ApoA-I mimetic therapy is associated with decreased aortic root and valve remodelling ... Aortic valve stenosis (AVS) is the most common valvular heart disease in the Western world. Therapy based on apolipoprotein A-I ... Protease activity Apolipoprotein A-I Aortic valve stenosis Cathepsin S C. Gebhard and F. Maafi contributed equally to this work ...
more infohttps://link.springer.com/article/10.1007%2Fs00395-018-0689-7

Aortic Stenosis: Congenital Aortic Valve Stenosis And Rheumatic Aortic Stenosis | HubPagesAortic Stenosis: Congenital Aortic Valve Stenosis And Rheumatic Aortic Stenosis | HubPages

Read more to know how this is connected with Aortic Stenosis. ... Aortic Stenosis: Congenital Aortic Valve Stenosis And Rheumatic ... Severe Aortic Stenosis. Stenosis may occur below, at or above the aortic valve. These are termed as subaortic. Valvular and ... Congenital aortic valve stenosis. It may be unicuspid or bicuspid, the latter being the commonest. Unicuspid aortic valve is ... Rheumatic aortic stenosis. Active rheumatic endocardities of the aortic valve leads on to thickening of the valve cusps with ...
more infohttps://hubpages.com/health/Aortic-Stenosis-Congenital-Aortic-Valve-Stenosis-And-Rheumatic-Aortic-Stenosis

Aortic Valve Stenosis
      - Aortic Stenosis
     Summary Report | CureHunterAortic Valve Stenosis - Aortic Stenosis Summary Report | CureHunter

... supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from ... Aortic Valve Stenosis: A pathological constriction that can occur above ( ... Aortic Stenosis; Aortic Valve Stenoses; Stenoses, Aortic; Stenoses, Aortic Valve; Stenosis, Aortic; Stenosis, Aortic Valve; ... Aortic Valve Stenosis (Aortic Stenosis). Subscribe to New Research on Aortic Valve Stenosis ...
more infohttp://www.curehunter.com/public/keywordSummaryD001024-Aortic-Valve-Stenosis-Aortic-Stenosis.do

Severe Aortic Valve Stenosis | MemorialCare Health System | Orange County | Los Angeles CountySevere Aortic Valve Stenosis | MemorialCare Health System | Orange County | Los Angeles County

... suffer from aortic valve stenosis - one of the most common and serious heart valve conditions. ... Aortic Valve Stenosis occurs when the hearts aortic valve narrows preventing the valve from fully opening. The narrow valve ... Severe Aortic Valve Stenosis. Service: Heart & Vascular Care About Nearly 1.5 million people in the U.S. suffer from aortic ... With aortic valve stenosis, the heart pumps even harder to get blood to the body. ...
more infohttps://www.memorialcare.org/services/glossary/s/severe-aortic-valve-stenosis

Myocardial deformation in aortic valve stenosis: relation to left ventricular geometry | HeartMyocardial deformation in aortic valve stenosis: relation to left ventricular geometry | Heart

Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis. A high risk subgroup identified ... Assessment of aortic valve stenosis severity: a new index based on the energy loss concept. Circulation 2000;101:765-71. ... aortic valve area by the continuity equation, indexed for body surface area; and pressure recovery adjusted aortic valve area ( ... Left ventricular midwall mechanics in subjects with aortic stenosis and normal systolic chamber function. J Heart Valve Dis ...
more infohttp://heart.bmj.com/content/96/2/106

Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing | HeartTreatment decision in asymptomatic aortic valve stenosis: role of exercise testing | Heart

severe aortic stenosis with aortic valve area ⩽ 1 cm2, without coexisting valve disease; the value of ⩽ 1 cm2 was selected ... Some degree of aortic regurgitation is involved in about 80% of patients with aortic stenosis. Coexisting mitral valve disease ... Aortic valve area. Analysis of the aortic valve area, using the value , 0.7 cm2 or ⩾ 0.7 cm2, showed that there was a ... PATIENT S 66 consecutive patients with isolated severe aortic stenosis (aortic valve area ⩽ 1.0 cm2) were selected over a 58 ...
more infohttp://heart.bmj.com/content/86/4/381

Preoperative Assessment of Aortic Valve Stenosis and Coronary Artery Disease - Full Text View - ClinicalTrials.govPreoperative Assessment of Aortic Valve Stenosis and Coronary Artery Disease - Full Text View - ClinicalTrials.gov

This study includes the assessment of patients with symptomatic valve stenosis. The severity of the aortic valve stenosis is ... Preoperative Assessment of Aortic Valve Stenosis and Coronary Artery Disease. The safety and scientific validity of this study ... Aortic Valve Stenosis. Heart Diseases. Cardiovascular Diseases. Arteriosclerosis. Arterial Occlusive Diseases. Vascular ... Preoperative Assessment of Aortic Valve Stenosis and Coronary Artery Disease: Dual-source Computed Tomography Compared With ...
more infohttps://clinicaltrials.gov/ct2/show/NCT00767013?recr=Open&cond=%22Aortic+Valve+Stenosis%22&rank=5

Search of: Recruiting, Not yet recruiting, Available Studies | Aortic Valve Stenosis - List Results - ClinicalTrials.govSearch of: Recruiting, Not yet recruiting, Available Studies | 'Aortic Valve Stenosis' - List Results - ClinicalTrials.gov

Sizing-sTrategy of Bicuspid AoRtic Valve Stenosis With Transcatheter Self-expandable Valve. *Aortic Valve Stenosis ... Bicuspid Aortic Valve Stenosis and the Effect of vItamin K2 on Calciummetabolism on 18F-NaF PET/MRI. *Aortic Valve Stenosis ... STS/ACC Transcatheter Valve Therapy Registry (TVT Registry). *Aortic Valve Stenosis. *Procedure: Transcatheter Aortic Valve ... Transfemoral Replacement of Aortic Valve With HLT MeriDIAN Valve Feasibility Trial CANADA. *Aortic Valve Stenosis ...
more infohttps://clinicaltrials.gov/ct2/results?recr=Open&cond=%22Aortic+Valve+Stenosis%22

Decreased Nox4 levels in the myocardium of patients with aortic valve stenosis. | Sigma-AldrichDecreased Nox4 levels in the myocardium of patients with aortic valve stenosis. | Sigma-Aldrich

... aortic valve stenosis). Endomyocardial biopsies from 34 patients with AS were obtained during aortic valve replacement surgery ... Decreased Nox4 levels in the myocardium of patients with aortic valve stenosis.. [María U Moreno, Idoia Gallego, Begoña López, ...
more infohttps://www.sigmaaldrich.com/catalog/papers/23550626
  • Children with this mild type of aortic valve stenosis are otherwise healthy and able to go about their daily lives without disruption. (childrenshospital.org)
  • This, the most serious type of aortic valve stenosis, is usually present at birth. (childrenshospital.org)
  • Coronary heart disease is known to increase the likelihood of valve disease, so it stands to reason that by taking steps to lower your heart disease risk, you could be reducing your risk of aortic stenosis as well. (berkeleywellness.com)
  • At the UPMC Heart and Vascular Institute , we offer the full range of treatments for aortic stenosis including surgical and minimally invasive valve replacement. (upmc.com)
  • CONCLUSIONS: Surgical commissurotomy for aortic valve stenosis during the first 3 months of life can be done with low mortality and morbidity. (lu.se)
  • While listening to your heart with a stethoscope, your primary care doctor can detect the condition by hearing abnormal valve sounds called murmurs. (upmc.com)
  • Doctors often first detect a valve problem when they notice a heart murmur while listening through a stethoscope. (berkeleywellness.com)
  • Conclusions- Hypercholesterolemic LDLr −/− ApoB 100/100 mice are prone to develop calcification and oxidative stress in the aortic valve, with functional valvular heart disease, mimicking the clinical syndrome. (ahajournals.org)
  • We hypothesized that hypercholesterolemia would produce calcification in aortic valve tissue and would lead to the syndrome of aortic valvular heart disease in old mice. (ahajournals.org)
  • Aortic valve stenosis (AVS) is the most common valvular heart disease in the Western world. (springer.com)
  • Some young people or pregnant women may have another procedure called balloon valvuloplasty to enlarge the valve opening. (webmd.com)
  • Balloon valvuloplasty (also called valvulotomy or valvotomy) is a procedure that widens a heart valve that is narrowed. (rexhealth.com)
  • Balloon valvuloplasty is done to help the valve work better and improve blood flow through the valve. (rexhealth.com)
  • Balloon valvuloplasty is not an option for most people who have aortic valve stenosis. (rexhealth.com)
  • Balloon valvuloplasty might be used in some children, teens, and young adults in their 20s who have aortic valve stenosis. (rexhealth.com)
  • Balloon valvuloplasty is generally an effective treatment for aortic valve stenosis in children, teens, and young adults but has very limited effectiveness in older adults. (rexhealth.com)
  • A subset of 12 mice underwent invasive hemodynamic assessment of aortic valve function. (ahajournals.org)
  • We sought to determine whether the dual-source computed tomography assessment of aortic valve stenosis and coronary artery disease is equivalent to or even better than conventional invasive coronary angiography and transthoracic echocardiography. (clinicaltrials.gov)
  • Studies investigating the natural history of aortic valve stenosis in adults show that the disease is progressive, but the longer we can preserve a patient's natural valve, the lower the risk of future complications. (bmj.com)
  • Significant long term complications from mechanical and bioprosthetic valves occur at a rate of at least 2-3% a year, and there is a 1% annual incidence of death caused directly by the prosthesis. (bmj.com)
  • Some people who cannot have open-heart surgery may have a minimally invasive procedure to replace the valve. (webmd.com)
  • In most older adults, the valve becomes narrowed again (restenosis) within 6 to 12 months after this procedure. (rexhealth.com)
  • After a valvotomy procedure in a young person, the aortic valve is wider, but it is still not normal. (rexhealth.com)
  • The doctors at Dignity Health - St. Rose Dominican usually treat severe aortic valve stenosis by replacing the valve through open heart surgery or a minimally invasive procedure. (dignityhealth.org)
  • Your doctor may use a procedure called a balloon angioplasty to stretch the valve so that it is more open. (alberta.ca)
  • In the past, surgeons had to perform open-heart surgery to replace a worn-out valve like his, cutting open the chest by splitting the sternum (breastbone) and putting the patient on a heart-lung machine during the procedure. (berkeleywellness.com)
  • 11 Evidence for increased levels of superoxide and its local tissue consequences have not been reported in heart valves. (ahajournals.org)