Twenty-one patients (age four to 25 years) with bicuspid aortic valves proved by surgery and angiography (12) or angiography alone (9) were studied by echocardiography. Seventeen patients had aortic valve disease (11 stenosis, 6 incompetence) and four had coarctation of the aorta with normally functioning aortic valves. A comparison group of 16 patients (9 with aortic valve disease and 7 without aortic valve disease) who had proven tricuspid aortic valves was also studied. Echocardiograms in tricuspid aortic valve patients showed the closed position of the cusps near the middle of the aortic lumen. In contrast marked eccentricity of the aortic valve cusp echoes in diastole could be demonstrated in all with bicuspid aortic valves. The Eccentricity Index (½ aortic lumen diameter/minimum distance of the diastolic cusp echo from the nearest aortic margin) was low (range 1.0-1.25) with tricuspid aortic valves and high (range 1.5-5.6) with bicuspid aortic valves (P , 0.001). This index was not ...

Compared to patients with a tricuspid aortic valve, patients with a bicuspid valve appear to have ascending aorta dilation that is out of proportion to the severity of aortic stenosis or regurgitation; further, patients with a bicuspid aortic valve are thought to be at greater risk of progressive aortic dilation after aortic valve replacement. These observations form the basis of a proposed genetic aortopathy associated with bicuspid aortic valve, and are the basis of current guideline recommendations for more aggressive treatment of proximal ascending aorta dilation among patients with bicuspid aortic valve at the time of surgical aortic valve replacement. However, other data suggest that flow abnormalities related to fusion patterns may be a major contributor to aortic dilation among patients with bicuspid valve (e.g., MM Bissell, et al. Circ Cardiovasc Imaging 2013;6:499-507). The present study suggests that patients with a bicuspid aortic valve undergoing aortic valve replacement for aortic ...

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 ...

Calcific aortic valve disease (CAVD) is a chronic pathological process involving inflammation, fibrosis and calcification. Pharmacological intervention for prevention of CAVD progression remains unavailable. Calcified aortic valves display higher levels of oxidized low-density lipoprotein (oxLDL), and oxLDL has the potential to interact with Toll-like receptors (TLRs). Interleukin (IL)-37 is an anti-inflammatory cytokine and has been shown to inhibit TLR4-mediated inflammatory responses. We tested the hypotheses that oxLDL induces the osteogenic responses in human aortic valve interstitial cells (AVICs) via TLRs and that IL-37 suppresses the responses and may have therapeutic potential for suppression of CAVD progression.. Methods and Results: Human AVICs from normal valves were treated with oxLDL (20-80 μg/ml) for 72 hours in vitro. OxLDL up-regulated the expression of bone morphogenetic protein-2 (BMP-2) and alkaline phosphatase (ALP) in a dose-dependent fashion. Further, oxLDL induced NF-κB ...

The heart has four chambers and four valves. The valves open and close to keep blood flowing through the heart. One of these valves, the aortic valve, usually has three flaps, or leaflets. But sometimes people are born with an aortic valve that has two flaps. This is called a bicuspid aortic valve.. A bicuspid aortic valve makes certain heart problems, like aortic valve stenosis and aortic valve regurgitation, more likely.. In aortic valve stenosis, the valve has narrowed. Your heart has to work harder to pump blood throughout your body. Symptoms may include chest pain, dizziness, fainting, or shortness of breath. In aortic valve regurgitation, the valve does not close properly. Some of the blood leaks back (regurgitates) through the valve into the heart. Your heart has to work harder to pump blood throughout your body. Symptoms may include weakness and tiredness, shortness of breath, or an uneven heartbeat. Although you have a bicuspid heart valve, your heart can work normally. But you have a ...

Follow-up of a group of subjects in whom an aortic ejection sound was the only abnormal finding revealed a bicuspid aortic valve at necropsy or operation in 6 cases. High speed echophonocardiographic studies in 15 subjects with aortic stenosis and known to have bicuspid valves, showed the ejection sound to be exactly synchronous with final halting of the opening aortic valve cusps. Echocardiographic visualisation of the aortic valve from the apex, looking up the left ventricular outflow tract, showed valve echoes during systole indicating abnormal cusp configuration. This proved a more sensitive indicator of a bicuspid aortic valve than the finding of an eccentric aortic valve closure line. These findings were used to evaluate 37 subjects with the auscultatory finding of an isolated aortic ejection sound and the diagnosis of a non-stenotic bicuspid aortic valve was confirmed in 30. The usual cause of misdiagnosis was a sound associated with late tricuspid valve closure. The auscultatory finding ...

TY - JOUR. T1 - Aortic valve replacement and combined aortic valve replacement and coronary artery bypass grafting. T2 - Predicting high risk groups. AU - Magovern, James A.. AU - Pennock, John L.. AU - Campbell, David. AU - Pae, Walter. AU - Bartholomew, Mary. AU - Pierce, William S.. AU - Waldhausen, John A.. N1 - Copyright: Copyright 2017 Elsevier B.V., All rights reserved.. PY - 1987. Y1 - 1987. N2 - To determine which groups of patients are at highest risk for operative or late mortality, 259 consecutive patients who underwent operation between 1978 and 1984 were studied; 170 underwent aortic valve replacement and 89 underwent aortic valve replacement combined with coronary artery bypass grafting. Multivariate analysis of risk factors selected emergency operation and patient age older than 70 years as the strongest predictors for operative death. Although patients having aortic valve replacement and coronary artery bypass grafting had a higher operative mortality rate (13.5 versus 3.5%), ...

TY - JOUR. T1 - Outcomes of aortic valve repair according to valve morphology and surgical techniques. AU - Corrado, Egle. AU - Fattouch, Khalil. AU - Nasso, Giuseppe. AU - Fattouch, Khalil. AU - Speziale, Giuseppe. PY - 2012. Y1 - 2012. N2 - OBJECTIVES: The aim of this study was to assess the impact of aortic valve morphology and different surgical aortic valve repair techni-ques on long-term clinical outcomes.METHODS: Between February 2003 and May 2010, 216 patients with aortic insufficiency underwent aortic valve repair in our institu- tion. Ages ranged between 26 and 82 years (mean 53 ± 15 years). Aortic valve dysfunctions, according to functional classification, were: type I in 55 patients (25.5%), type II in 126 (58.3%) and type III in 35 (16.2%). Sixty-six patients (27.7%) had a bicuspid valve. Aortic valve repair techniques included sub-commissural plasty in 138 patients, plication in 84, free-edge reinforcement in 80, resection of raphe plus re-suturing in 40 and the chordae technique ...

The current treatment for aortic stenosis includes open surgical aortic valve replacement (SAVR) as well as endovascular transcatheter aortic valve replacement (TAVR). This study aims to compare the 1-year, 2-3 year and 5-year structural durability of TAVR valves with that of SAVR valves. A systematic literature search was conducted in July 2019 on Medline (via PubMed), Embase and Cochrane electronic databases according to the PRISMA guidelines. Thirteen randomized controlled trials were included. From the meta-analysis, we observed higher rates of 1-year (OR: 7.65, CI: 4.57 to 12.79, p | 0.00001), 2-3-year (OR: 13.49, CI: 5.66 to 32.16, p | 0.00001) and 5-year paravalvular regurgitation (OR: 14.51, CI: 4.47 to 47.09, p | 0.00001) associated with the TAVR valves than the SAVR valves. There were also higher rates of 1-year (OR: 5.00, CI: 3.27 to 7.67, p | 0.00001), 2-3-year (OR: 8.14, CI: 3.58 to 18.50, p | 0.00001) and 5-year moderate or severe aortic regurgitation (MD: 14.65, CI: 4.55 to 47.19, p | 0

Currently, aortic valve replacement procedures require a sternotomy and use of cardiopulmonary bypass (CPB) to arrest the heart and provide a bloodless field in which to operate. A less invasive alternative to open heart surgery is transapical or transcatheter aortic valve replacement (TAVR), already emerging as a feasible treatment for patients with high surgical risk. The bioprosthetic valves are delivered via catheters using transarterial or transapical approaches and are implanted within diseased aortic valves. This paper reports the development of a new self-expanding stent for minimally invasive aortic valve replacement and its delivery device for the transapical approach under real-time magnetic resonance imaging (MRI) guidance. Made of nitinol, the new stent is designed to implant and embed a commercially available bioprosthetic aortic valve in aortic root. An MRI passive marker was affixed onto the stent and an MRI active marker to the delivery device. These capabilities were tested in ...

Cells sense forces from the extracellular matrix (ECM) and transduce them into biochemical signals. The molecules produced cause in turn remodeling of the ECM. Molecular altered expression will affect this force sensing mechanism changing cellular properties as migration, differentiation, etc. Therefore, cells mechanical properties can be used as a marker for the early diagnosis of pathologies as cancer or cardiovascular diseases. In this framework, Atomic Force Microscopy (AFM) represents an excellent tool to evaluate the mechanical properties of different cellular systems. In this talk, we will analyze the mechanical properties of aortic valve interstitial cells (VICs), the predominant constituent of aortic valves, governing ECM structure and composition, in the onset of calcific aortic valve disease (CAVD). In particular, we obtained adhesion polymeric substrates with different stiffness onto which human AoV VICs were plated, and subsequently investigated for the cytoskeleton dynamics and the

McKellar S.H., Tester D.J., Yagubyan M., Majumdar R., Ackerman M.J., Sundt T.M.. OBJECTIVES: Bicuspid aortic valve is a common condition and is associated with a significantly increased risk of developing thoracic aortic aneurysms and acute aortic dissection. Patient-specific prediction of the risk of developing thoracic aortic aneurysm, however, is imprecise. We hypothesize that genotypic variations in patients with bicuspid aortic valves contribute to this observed variability in aortic phenotype. We, therefore, investigated the potential relationship between mutations in regions of NOTCH1 recently reported to be associated with bicuspid aortic valve and the phenotype of bicuspid aortic valve and thoracic aortic aneurysms in unrelated patients undergoing surgical repair. METHODS: We performed a targeted mutational analysis of NOTCH1 using genomic DNA from 48 unrelated subjects with concomitant bicuspid aortic valve and thoracic aortic aneurysm using denaturing high-performance liquid ...

EXECUTIVE SUMMARY. Transcatheter Aortic Valve Implantation. Transcatheter Mitral Valve Repair. Transcatheter Pulmonary Valve Implantation. Transcatheter Mitral Valve Implantation. Percutaneous Balloon Valvuloplasty. Companies. Edwards Lifesciences. Medtronic Other Companies. Summary Exhibit 1: Overview of Transcatheter Heart Valve Technologies. Summary Exhibit 2: U.S. Transcatheter Heart Valve Procedures by Type, 2008-2015. Summary Exhibit 3: U.S. Transcatheter Heart Valve Market, Sales by Segment, 2008-2015. Summary Exhibit 4: Projected Rollout of Selected Transcatheter Heart Valve Programs. 1.0 OVERVIEW OF HEART VALVE DISEASE. 1.1 Valve Types and Function. 1.2 Role of Valves in Cardiac Cycle. 1.3 Etiology of Heart Valve Disease. 1.3.1 Rheumatic Heart Disease. 1.3.2 Degenerative Valve Disorders. 1.3.3 Functional Valve Disorders. 1.3.4 Congenital Valve Disorders. 1.3.4.1 Complex Congenital Defects. 1.3.4.2 Bicuspid Aortic Valve Disease. 1.3.5 Bacterial Endocarditis. 1.4 Diagnosis of Heart Valve ...

The aortic valve allows oxygen-rich blood to flow from the heart to the aorta. It prevents the blood from flowing back from the aorta into the heart when the pumping chamber relaxes.. Bicuspid aortic valve is present at birth (congenital). An abnormal aortic valve develops during the early weeks of pregnancy, when the babys heart develops. The cause of this problem is unclear, but it is the most common congenital heart disease. It often runs in families.. The bicuspid aortic valve may not be completely effective at stopping blood from leaking back into the heart. This is called aortic regurgitation. The aortic valve may also become stiff and not open up as well, causing the heart to have to pump harder than usual to get blood past the valve (aortic stenosis). The aorta may become enlarged with this condition.. This condition is more common among males than females.. A bicuspid aortic valve often exists in babies with coarctation of the aorta and other diseases in which there is a blockage to ...

Transcatheter aortic valve replacement (TAVR) is a way to replace the aortic valve without open-heart surgery. This procedure is done to treat aortic valve stenosis.. TAVR is often done through an incision (cut) in the groin. But sometimes a small cut is made in the chest. The doctor uses a tube called a catheter and tools that fit inside the catheter. The doctor puts the catheter into a blood vessel and moves it through the blood vessel and into the heart. The artificial valve fits inside the catheter. The doctor then moves the new valve into the damaged aortic valve. The artificial valve expands and takes the place of the damaged valve.. You may have general anesthesia, which makes you sleep during the surgery. Or you may get a sedative that will help you relax.. To see if TAVR might be a choice for you, a team of doctors will check many things about your heart and your overall health. Together you can decide if you want to have the procedure.. ...

September 22nd 217: This is the last time I trying to do this today. Aortic heart valve replacement surgery that I had on Tuesday, well its been five days now since I was installed a new On-X aortic heart valve it seems to be going just fine I dont like of the other news but the heart is good. God bless everybody Brian (PS This video were very hard on me emotional to make...sorry ...

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 ...

Transcatheter aortic valve replacement (TAVR - also known as TAVI or transcatheter aortic valve implantation) is a new technology for use in treating aortic stenosis. A bioprosthetic valve is inserted percutaneously using a catheter and implanted in the orifice of the native aortic valve ...

TY - JOUR. T1 - Imaging Guidance for Transcatheter Aortic Valve Replacement. T2 - Is Transoesophageal Echocardiography the Gold Standard?. AU - Xu, Bo. AU - Mottram, Philip M.. AU - Lockwood, Siobhan. AU - Meredith, Ian T.. PY - 2017/10/1. Y1 - 2017/10/1. N2 - Transcatheter aortic valve replacement (TAVR) is traditionally performed under cardiac imaging guidance. In the early TAVR experience, intra-procedural transoesophageal echocardiography (TOE) is recommended to guide device deployment, in the context of general anaesthesia (GA). Intra-procedural TOE imaging is particularly useful during TAVR deployment as a contrast-saving strategy for patients with renal impairment. Evidence has emerged recently demonstrating that in selected patients, transthoracic echocardiography (TTE) can be used to provide intra-procedural guidance for TAVR. Additionally, there is a growing body of evidence supporting the performance of TAVR using fluoroscopy alone, without additional cardiac imaging. This article ...

Transcatheter Aortic Valve Replacement TAVR Program Information 541-222-1933 Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure for select patients with severe symptomatic aortic stenosis who are not candidates for open chest surgery or are high-risk operable candidates. Sacred Heart is one of three hospitals in Oregon approved to provide this

Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis (homograft from human tissue or xenograft e.g. from pig). It is an alternative to valve repair. There are four procedures Aortic valve replacement Mitral valve replacement Tricuspid valve replacement Pulmonary valve replacement Current aortic valve replacement approaches include closed heart surgery, Very invasive cardiac surgery (VICS) and Very invasive, Scapulae-based aortic valve replacement. Catheter replacement of the aortic valve (called trans-aortic valve replacement or implementation [TAVR or TAVI]) is a minimally invasive option for those suffering from aortic valve stenosis. TAVR is commonly performed by guiding a catheter from the groin to the narrowed valve via the aorta using realtime x-ray technology. A metal stent containing a valve is then deployed using a balloon to press the stent into the valve in effect opening the stenosed (or narrowed) ...

Bicuspid aortic valve (BAV) disease is the most frequent congenital cardiac malformation, occurring in 0.5-1.2% of the US population. In young adults, it is generally a benign abnormality; but in older adults it is associated with thoracic aortic aneurysm or dissection in 20-30% of those with BAV. BAV is strongly associated with early development of aortic valve calcification or incompetence in ,50% of BAV patients, and accounts for ~40% of the ,30,000 aortic valve replacements (AVR) performed in the US each year. Yet, we know little of the etiology, cellular events and modifiers of progression of BAV to calcific aortic valve disease and we still do not understand the genetic cause(s) of BAV despite evidence for its high heritability.. The Specific Aims of this study are:. ...

Patients who are suffering with severe aortic stenosis, which is the narrowing of the hearts aortic valve opening that restricts blood flow, have a minimally invasive surgical option available at the Heart and Vascular Center at Manatee Memorial Hospital. Transcatheter Aortic Valve Replacement (TAVR) is an advanced heart valve replacement procedure that offers new hope to patients who have aortic valve stenosis and are at high or extreme risk for open-heart surgery. TAVR patient Eugene Vaadi describes his experience:

Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for severe aortic stenosis. Learn more about how TAVR (Transcatheter Aortic Valve Replacement) works, its benefits, and where to find available treatment options at Memorial Hermann Heart and Vascular Institute.

Aortic valve disease affects nearly one-third of adults over the age of 60. The aortic valve is responsible for controlling the flow of blood as it leaves the heart and travels to the rest of the body. When valve disease occurs, the leaflets - or flaps - that open and close with each heartbeat become damaged, causing the heart to work harder and less efficiently. Patients suffering from aortic stenosis, a narrowing of the aortic valve, may notice symptoms such as shortness of breath, chest pain or pressure, dizziness, fatigue and swelling of the feet, legs or abdomen.. Without treatment, aortic valve disease can lead to a significantly decreased quality of life and life-threatening complications. In order to fix the problem, the aortic valve must be replaced.. There are multiple options for valve replacement, including open-heart surgery and TAVR. ...

Aortic Valve Replacement India offers information on Aortic Valve Repair or replacement in India, Aortic Valve Repair cost India, Aortic Valve Replacement hospital in India, Delhi, Mumbai, Chennai, Hyderabad & Bangalore.

Transcatheter aortic valve implantation (TAVI), also referred to as transcatheter aortic valve replacement (TAVR), is a procedure that replaces your diseased aortic valve with a man-made valve.

Bicuspid aortic valves (BAVs) represent a wide morphologic and functional spectrum. In coarctation of the aorta, BAVs are common, but the proportion of BAV subtypes and their relation to aortic dimensions and development of late valve dysfunction are unknown. Sixty-two cardiovascular magnetic resonance investigations of patients with coarctation of the aorta were reviewed with respect to aortic valve morphology, aortic valve function, and aortic dimensions. BAVs were identified in 45 patients (72.6 %), of which 13 (20.9 %) were type-0 (two commissures), 28 (45.1 %) type-1 (three commissures but fusion of one commissure with a raphe) and 4 (6.5 %) valves were bicuspid but not possible to classify further. Patients with BAVs type-0 had larger dimensions in their sinus of Valsalva (35.5 ± 6.8 vs. 29.7 ± 2.7 mm, p = 0.002), ascending aorta (33.1 ± 6.2 vs. 26.0 ± 4.3 mm, p = 0.005) and sino-tubular junction (29.3 ± 7.4 vs. 24.2 ± 3.5 mm, p = 0.040) compared with tricuspid aortic valves (TAVs). ...

Transcatheter aortic valve replacement (TAVR) Market - Global Industry Analysis, Size, Share, Trends and Forecast, 2014 - 2022 Transcatheter aortic valve replacement (TAVR) Market - - Market research report and industry analysis - 10925577

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). In this procedure, doctors insert a catheter in your leg or chest and guide it to your heart. A replacement valve is inserted through the catheter and guided to your heart. A balloon is expanded to press the valve into place. Some TAVR valves are self-expanding.. ...

Methods and Results-Data were obtained using the national inpatient sample between the years 2011 and 2014. We used the International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 350.5 and 350.6 to identify patients undergoing transcatheter aortic valve replacement. Primary outcome of interest was in-hospital mortality. A 2-tailed P value ,0.01 was considered to denote statistical significance for all analyses. We identified 42 189 patients who underwent transcatheter aortic valve replacement between the years 2011 and 2014. Of these, 62.1% (n=26 229) had no CKD/ESRD, 33.7% (n=14 252) had CKD, and 4% (n=1708) had ESRD. Patients with CKD or ESRD had greater in-hospital mortality, hospital length of stay, hemorrhage requiring transfusion, and permanent pacemaker implantation (P,0.001). ...

BACKGROUND: Patients undergoing surgical aortic valve replacement (SAVR) are considered at high risk of infective endocarditis (IE). However, data on the risk of IE following transcatheter aortic valve replacement (TAVR) are sparse and limited by the lack of long-term follow-up as well as a direct comparison with patients undergoing SAVR.. OBJECTIVES: This study sought to investigate the long-term incidence of IE in patients undergoing TAVR and to compare the long-term risk of IE with patients undergoing isolated SAVR.. METHODS: In this nationwide observational cohort study, all patients undergoing TAVR and isolated SAVR from January 1, 2008, to December 31, 2016, with no history of IE and alive at discharge were identified using data from Danish nationwide registries.. RESULTS: A total of 2,632 patients undergoing TAVR and 3,777 patients undergoing isolated SAVR were identified. During a mean follow-up of 3.6 years, 115 patients (4.4%) with TAVR and 186 patients (4.9%) with SAVR were admitted ...

Since the pioneering works by Andersen et al. (1) and Cribier et al. (2), transcatheter aortic valve replacement (TAVR) has become a well-established and evidence-based therapy for severe and symptomatic aortic stenosis in patients at higher surgical risk. TAVR has been associated with lower all-cause mortality than best medical therapy in patients who were ineligible for surgical aortic valve replacement (SAVR) (3), as well as noninferiority or even superiority to SAVR with respect to all-cause mortality in patients at high surgical risk (4,5). In patients at intermediate risk, TAVR has been reported non-inferior to SAVR regarding death from any cause or disabling stroke (6). In addition, the first randomized trial comparing TAVR and SAVR in all-comer patients indicated that these findings may apply to patients at lower surgical risk (7). Furthermore, a meta-analysis of the 4 randomized clinical trials including 3,806 patients comparing TAVR and SAVR showed that TAVR was associated with a 13% ...

Risk assessment models for transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement in high-risk patients and TAVR versus palliation in inoperable patients are based on surgical data and have limited discrimination and calibration in the setting of TAVR. Several novel risk models specifically designed for TAVR have improved discrimination over existing models but require further validation. Several clinical and echocardiographic variables, such as chronic lung disease, mitral regurgitation, and stroke volume index, influence outcomes. This article reviews current and novel risk models and important predictors of TAVR outcomes and proposes a framework to integrate them into clinical decision-making for patients with severe, symptomatic aortic stenosis.

Transcatheter aortic valve replacement (TAVR) continues to grow and flourish with more than 300,000 procedures performed to date worldwide and an expected expansion over the next decade. Currently restricted to high-risk and otherwise inoperable patients (1), recent data favor TAVR rather than surgical aortic valve replacement in intermediate risk patients (2,3). A combination of new-generation devices, increased experience, better understanding of the disease, and improved screening is associated with improved outcomes, and there is a continuous trend to simplifying the procedure (4). Consequently, among early major issues associated with TAVR, paravalvular regurgitation may now be considered as a thing of the past and bleeding/vascular complications are on the decrease thanks to smaller size devices and better selection. Hence, overt stroke remains the most feared complication and is strongly associated with morbidity and mortality.. Early randomized studies have raised concerns about stroke ...

The perfect heart valve substitute has not yet been developed and matching the patient to existing options to optimize survival and reduce valve-related complications remains challenging. The choices for aortic valve replacement (AVR) are mechanical valves, bioprosthetic valves, and biological valves such as aortic valve homograft and the Ross procedure (pulmonary autograft). The latter is a complex operation because it transfers the patients own pulmonary valve into the aortic position and uses a biological valve to replace the pulmonary valve, transforming a single-valve disease into a 2-valve disease. These considerations are not important to most North American patients who undergo AVR because they are older and the durability of bioprosthetic valves in this age group is excellent (1,2). The risk of bioprosthetic valve failure 20 years after AVR is ,10% in patients 70 years of age and older (1,2). A report based on the Society of Thoracic Surgeons Database from January 1997 to December 2006 ...

The aortic valve controls blood flow from the heart to the body. In some people, the valve becomes stiff and has trouble opening. This condition is called aortic stenosis. It is a progressive disease. In aortic stenosis, the heart has to work harder to push blood through the valve to the rest of the body. Over time, the extra stress can cause the heart muscle to get weaker. People who have aortic stenosis can feel tired and short of breath and have chest pain and fainting.. At Hackensack University Medical Center, our multidisciplinary team is offering transcatheter aortic valve replacement (TAVR) as a life-changing option for many patients with aortic stenosis. TAVR is a minimally invasive procedure that allows our cardiac experts to repair a valve without removing it. If you have aortic stenosis and your doctor feels that traditional open-heart surgery may be a risk, TAVR can be an option for you. TAVR is sometimes recommended for people who are older, have a weaker heart, had previous heart ...

OBJECTIVE: There is an ongoing discussion regarding the mechanism of aortic dilatation in bicuspid aortic valve (BAV) disease, that is, is this a hemodynamic effect or related to an inborn weakness of the aortic wall? This study evaluated the possibility of BAV morphology being related to ascending aorta morphology as such a correlation would strengthen the idea that hemodynamic alterations cause the dilatation of the aorta. METHODS: The morphology of the ascending aorta of 300 patients admitted for aortic valve and/or ascending aorta disease was evaluated by echocardiography and related to the surgeons inspection of the aortic valve. RESULTS: A tricuspid aortic valve (TAV), BAV, or unicuspid aortic valve (UAV) was present in 130, 160, and 10 patients, respectively. Ascending aortic aneurysm was more common in patients with BAV compared with TAV (36% and 12%, respectively; p < 0.001), while ectasia of the aorta was similarly common (8% in both groups). Aortic stenosis or regurgitation was ...

Aortic valve replacement is recommended as standard management for patients with symptomatic aortic valve disease, independent of age.19-22 Following surgery, patients usually have a dramatic improvement in their cardiovascular symptoms and have improved survival rates at 5, 10, and 15 years.23,24 Persistent AV block requiring permanent pacing is an uncommon but serious postoperative complication which increases mechanical ventilation times, intensive care unit stay, and overall hospital day.12-15. Previous studies have already evaluated perioperative risk predictors of PPI after cardiac surgery in large cohorts of patients with different diseases.12-18 However, there are only scanty data on the development of irreversible AV block requiring PPI after aortic valve replacement, especially in the presence of isolated aortic regurgitation or in the case of combined aortic stenosis and regurgitation.. In our series of 276 patients (39% with isolated aortic stenosis, 29% with isolated aortic ...

Patients with a BAV have a higher risk of developing aortopathy of the ascending aorta. The exact mechanisms through which BAV-associated aortopathy arises are still poorly understood. Knowledge of the underlying processes could advance patient risk assessments and aid in the development of early diagnostic tools.. We examined the impact of NO depletion to identify effects of BAV-associated aortopathy in mice. We describe for the first time that Nos3−/− mice develop dissections in the ascending aorta as a result of effects on signalling pathways involved in elastic fibre formation.. Studies by Koenig and colleagues have reported evidence of aortopathy in mice with haploinsufficiency of Notch1 in a Nos3−/− mixed background (Koenig et al., 2015). Later studies by the same group, however, reported that Notch1 haploinsufficiency in 129SV mice also causes ascending aortic aneurysm, making the role of Nos3 in aortopathy less clear (Koenig et al., 2017). Reports examining HPH-1 mice, a mouse ...

Minimally invasive aortic valve replacement versus aortic valve replacement through full sternotomy: the Brigham and Womens Hospital experience

Valve replacement surgery has a high rate of success and a low risk of causing other problems if you are otherwise healthy. Although most people have successful outcomes, there is a risk of death and serious problems during surgery. Valve replacement surgery is high-risk for people who have a failing left ventricle and who have had a heart attack. About 5 or less out of 100 people who have valve surgery die.footnote 3. If you have severe aortic valve regurgitation or stenosis, the risks of not replacing the valve may be greater than the risks of surgery, unless you have other health problems that make surgery too dangerous.. Even if valve replacement surgery is a success, you may have problems after surgery, such as:. ...

Objectives. This study was undertaken to elucidate the prevalence of aortic valve abnormalities in the elderly.. Background. The age of persons treated actively for valve disorders is increasing. More information is needed about the prevalence of aortic valve disease in old age.. Methods. Randomly selected men and women in the age groups 75 to 76, 80 to 81 and 85 to 86 years (n = 501) participating in the Helsinki Ageing Study were studied with imaging and Doppler echocardiography. Additionally, 76 persons 55 to 71 year of age were included. The systolic aortic valve area was calculated by the continuity equation. The velocity ratio (peak velocity in the left ventricular outflow tract/peak velocity across the aortic valve) was a supplementary criterion for aortic stenosis. Valve regurgitation and cusp calcification were assessed visually.. Results. Evaluation of the aortic valve was possible in 552 persons (96%). Mild calcification was found in 222 (40%) and severe calcification in 72 (13%). Two ...

TY - JOUR. T1 - Noninvasive assessment of filling pressure and left atrial pressure overload in severe aortic valve stenosis. T2 - Relation to ventricular remodeling and clinical outcome after aortic valve replacement. AU - Dahl, Jordi S.. AU - Videbæk, Lars. AU - Poulsen, Mikael K.. AU - Pellikka, Patricia A.. AU - Veien, Karsten. AU - Andersen, Lars Ib. AU - Haghfelt, Torben. AU - Møller, Jacob E.. PY - 2011/9/1. Y1 - 2011/9/1. N2 - Objective: One of the hemodynamic consequences of aortic valve stenosis is pressure overload leading to left atrial dilatation. Left atrial size is a known risk factor providing prognostic information in several cardiac conditions. It is not known if this is also the case in patients with aortic valve stenosis after aortic valve replacement. Methods: A total of 119 patients with severe aortic valve stenosis scheduled for aortic valve replacement were evaluated preoperatively and divided into 2 groups according to left atrial volume index (≥40 mL/m2). ...

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 ...

There are 2 transcatheter heart valves commonly used: The Sapien XT transcatheter heart valve made by Edwards Lifesciences and the CoreValve made by Medtronic. There are now over 130,000 implants worldwide using these 2 valves. Several large randomized studies have shown the promise of this technology. The PARTNER trial Figure 4: Transcatheter Aortic Valve Implantation (Transfemoral approach), (University HVI, 2017) Figure 5: Sapient XT TAVI valve (THVC, 2014) Figure 6: CoreValve TAVI valve (THVC, 2014) (using the Sapien valve) showed that TAVR was superior to (better than) medical therapy in patients with severe aortic valve stenosis (AS) who were inoperable and was non-inferior (equal) to open heart AVR in patients at high surgical risk. Very recently, the CoreValve trial demonstrated that TAVR using the CoreValve was superior to (better than) open heart AVR in high risk patients. Thus TAVR is now the treatment of choice for inoperable patients and may be a safer treatment option in patients ...

Patients with Marfan syndrome displayed higher rates of aortic complications in long-term follow-up after aortic valve replacement (AVR) than patients with bicuspid aortic valve disease, according to results of a study published June 1 in the Journal of the American College of Cardiology. In a retrospective comparison, Shinobu Itagaki, MD, et al. assessed the long-term follow-up of thoracic aortopathy after AVR in patients with bicuspid aortic valve disease and those with Marfan syndrome. The study compared the outcomes of 13,205 patients-2,079 with bicuspid aortic valves and 73 with Marfan syndrome-who had AVR replacement between 1995 and 2010. The results of the study showed that patients with Marfan syndrome were 14 times more likely to present with aortic dissection during long-term follow-up and five times more likely to undergo thoracic aortic surgery. The authors of the study note that these results provide additional support for the discrete treatment algorithms for patients with ...

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

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).. ...

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 ...

Objective: To estimate the bias associated with specific nonrandomized study attributes among studies comparing transcatheter aortic valve implantation with surgical aortic valve replacement for the treatment of severe aortic stenosis.Data sources and study sele...

In addition to fibrosis, calcification is a defining feature of aortic valve lesions. Calcification may contribute to lesion rigidity, thereby worsening obstruction to left ventricular outflow. Moreover, the extent of lesion calcification correlates both with more rapid disease progression and worse clinical outcomes.61,62. Aortic valve calcification now has been shown unequivocally to be an active, rather than a passive, process. Valvular calcium deposits contain both calcium and phosphate11,57,63,63 as hydroxyapatite,57,63 the form of calcium-phosphate mineral present in both calcified arterial tissue64 and bone. Proteins involved in regulation of tissue calcification have been detected in calcified valvular tissue, including osteopontin,13,14 bone morphogenic proteins (BMPs) 2 and 4,15 and receptor activator of nuclear factor NF-κB ligand (RANKL).65 Osteoprotegrin (OPG), which prevents mineral resorption in bone tissue, is a soluble decoy receptor that resembles RANK and acts as a ...

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TY - JOUR. T1 - Aortic Valve Stenosis Increases Helical Flow and Flow Complexity: A Study of Intra-operative Cardiac Vector Flow Imaging. AU - Hansen, Kristoffer Lindskov. AU - Møller-Sørensen, Hasse. AU - Kjaergaard, Jesper. AU - Jensen, Maiken Brit. AU - Jensen, Jørgen Arendt. AU - Nielsen, Michael Bachmann. PY - 2017. Y1 - 2017. N2 - Aortic valve stenosis alters blood flow in the ascending aorta. Using intra-operative vector flow imaging on the ascending aorta, secondary helical flow during peak systole and diastole, as well as flow complexity of primary flow during systole, were investigated in patients with normal, stenotic and replaced aortic valves. Peak systolic helical flow, diastolic helical flow and flow complexity during systole differed between the groups(p , 0.0001), and correlated to peak systolic velocity (R 5 0.94, 0.87 and 0.88, respectively). The study indicates that aortic valve stenosis increases helical flow and flow complexity, which are measurable with vector flow ...

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The Journal of Heart Valve Disease, Contents, 2018, Volume 27 Number 1 January 2018, AORTIC VALVE DISEASE, Evolution of Veterans Affairs Transcatheter Aortic Valve Replacement Program: The First 100 Patients

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 ...

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.

Coronary anomalies are detected in about 1 % of the general population by coronary angiography and have little clinical significance (Angelini et al. 2002). However, a minority of coronary artery anomalies, particularly in which the coronary artery takes an interarterial course, are known to have a risk of myocardial ischemia or sudden cardiac death (Rigatelli et al. 2005). Several possible causes of myocardial ischemia in cases with anomalous coronary artery origin from the wrong aortic sinus with a course between the aorta and the pulmonary artery have been suggested: acute angle take-off of the coronary artery producing a slit-like lumen; closure of the abnormal coronary orifice by a valve-like ridge at aortic expansion; compression of the artery when it courses within the aortic wall (intramural course) or between the aorta and the pulmonary artery; and spasm of the anomalous coronary artery (Basso et al. 2000; Virmani et al. 1984). Virmani et al. (1984), after observing postmortem coronary ...

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 ...

Press Release issued Mar 3, 2016: A heart valve is present in arteries and veins and facilitates blood flow only in one direction through the heart. The four major valves in the heart are two atrioventricular valves known as bicuspid valve and tricuspid valve and two semilunar valves known as aortic valve and pulmonary valve. A heart valve separates the atria, ventricles and blood vessels from each other. A heart valve is pushed open to allow blood flow and it closes and prevents backflow of blood. This closing is sealed tightly by nodules present at the tip of the cusps, which are the opening leaflets of the heart valve. The dysfunction of the heart valve causes valvular heart disease. There are two types of valvular heart disease, regurgitation or valvular insufficiency where blood flows in wrong direction due to dysfunctional heart valve and the second is valvular stenosis (Severe Aortic Stenosis) where the heart valve becomes narrow. Injured and defective heart valves are repaired or replaced by

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% ...

For more than 50 years, surgical aortic valve replacement (SAVR) has been the standard treatment for severe symptomatic aortic stenosis and for aortic regurgitation.

TY - JOUR. T1 - 2012 ACCF/AATS/SCAI/STS Expert Consensus Document on Transcatheter Aortic Valve Replacement. T2 - Developed in collaboration with the American Heart Association, American Society of Echocardiography, European Association for Cardio-Thoracic Surgery, Heart Failure Society of America, Mended Hearts, Society of Cardiovascular Anesthesiologists. AU - Holmes, David R.. AU - MacK, Michael J.. AU - Kaul, Sanjay. AU - Agnihotri, Arvind. AU - Alexander, Karen P.. AU - Bailey, Steven R.. AU - Calhoon, John H.. AU - Carabello, Blase A.. AU - Desai, Milind Y.. AU - Edwards, Fred H.. AU - Francis, Gary S.. AU - Gardner, Timothy J.. AU - Kappetein, A. Pieter. AU - Linderbaum, Jane A.. AU - Mukherjee, Chirojit. AU - Mukherjee, Debabrata. AU - Otto, Catherine M.. AU - Ruiz, Carlos E.. AU - Sacco, Ralph L.. AU - Smith, Donnette. AU - Thomas, James D.. PY - 2012/4/1. Y1 - 2012/4/1. UR - http://www.scopus.com/inward/record.url?scp=84859152273&partnerID=8YFLogxK. UR - ...

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 ...

TUESDAY, Aug. 11, 2020 (American Heart Association News) -- Black people with severely malfunctioning heart valves are less likely than their white peers to receive lifesaving valve replacements, according to a new study.. The study, published Tuesday in the Journal of the American Heart Association, looked at the treatment rates by race for aortic valve stenosis, a condition when the valve doesnt open and close properly and may leak blood.. Recent valve replacement technology has increased the life expectancy for people with the worst cases. If left untreated, half of patients with severe aortic valve stenosis die within two years, the study said. With treatment, however, they can get relief from symptoms and return to a normal life trajectory.. Researchers examined a decade of electronic health records for 32,853 people with severe aortic valve stenosis and found valve replacement rates were low regardless of race: Only 36% of patients got the procedure within a year of their ...

One of Harefield Hospitals leading consultant surgeons, Mr Toufan Bahrami, discusses the latest developments in aortic valve replacement. The techniques of aortic valve replacement are rapidly evolving, with multiple approaches and valve options available. At Harefield Hospital, great success has been seen with the newer generation Edwards INTUITY-Elite® valve, which is a balloon-expandable stented trileaflet bovine pericardial bioprosthesis (magna ease with known excellent durability of up to 15 years).

TY - JOUR. T1 - Progressive Dilation of the Ascending Aorta in Children With Isolated Bicuspid Aortic Valve. AU - Holmes, Kathryn W.. AU - Lehmann, Christoph U.. AU - Dalal, Darshan. AU - Nasir, Khuram. AU - Dietz, Harry C.. AU - Ravekes, William J.. AU - Thompson, W. Reid. AU - Spevak, Philip J.. N1 - Copyright: Copyright 2008 Elsevier B.V., All rights reserved.. PY - 2007/4/1. Y1 - 2007/4/1. N2 - Although patients with bicuspid aortic valves (BAVs) are predisposed to ascending aortic (AA) dilation, stenosis, and dissection, the development of aortic disease in children with BAVs is poorly described. The purposes of this study were to determine the rate of change of AA diameter in children with BAVs and to identify risk factors for the development of aortic dilation. The echocardiograms of 276 children aged ,19 years (mean 8.5 ± 5.3) with isolated BAVs were reviewed. Aortic measurements were normalized to z scores on the basis of body surface area. In a subset of 112 patients with serial ...

TY - JOUR. T1 - Atrial fibrillation ablation in patients undergoing aortic valve replacement. AU - Malaisrie, S Chris. AU - Lee, Richard. AU - Kruse, Jane. AU - Lapin, Brittany. AU - Wang, Edward C.. AU - Bonow, Robert O. AU - McCarthy, Patrick M. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Background and aim of the study: Current guidelines suggest that the use of a mechanical prosthesis is favored when patients are already receiving longterm anticoagulation for conditions such as atrial fibrillation (AF). Surgical AF ablation can restore normal sinus rhythm (NSR) and obviate the need for anticoagulation. The study aim was to determine the impact of concomitant AF ablation in patients with AF undergoing aortic valve replacement (AVR) on the restoration of NSR and subsequent requirement for anticoagulation. Methods: Between April 2004 and December 2009, a total of 124 patients (mean age 74 ± 12 years) with pre-existing AF underwent AVR with or without coronary artery bypass grafting. The documented ...

TY - JOUR. T1 - A quarter of a century of experience with aortic valve-sparing operations. AU - David, Tirone E.. AU - Feindel, Christopher M.. AU - David, Carolyn M.. AU - Manlhiot, Cedric. PY - 2014/1/1. Y1 - 2014/1/1. N2 - Objective To examine the late outcomes of aortic valve-sparing operations to treat patients with aortic root aneurysm with and without aortic insufficiency (AI) in a cohort of patients followed up prospectively since 1988. Methods A total of 371 consecutive patients had undergone aortic valve-sparing surgery (mean age, 47 ± 15 years; 78% men) from 1988 through 2010. In addition to the aortic root aneurysm, 47% had moderate or severe AI, 35.5% had Marfan syndrome, 12.1% had type A aortic dissection, 9.2% had bicuspid aortic valve, 8.4% had mitral insufficiency, 16.1% had aortic arch aneurysm, and 10.2% had coronary artery disease. Reimplantation of the aortic valve was used in 296 patients and remodeling of the aortic root in 75. Cusp repair by plication of the free margin ...

In patients with severe aortic valve stenosis, the amount of myocardial fibrosis appears to have significant effect on clinical status and long-term survival after aortic valve replacement. From these results, we believe that new strategies for the earlier detection of myocardial fibrosis are needed …

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 ...

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

By Allareddy, V Ward, M M; Ely, J W; Allareddy, V; Levett, J Aim. Heart valve replacement surgeries account for 20% of all cardiac procedures. In-hospital mortality rates are approximately 6% for aortic valve replacements and 10% for mitral valve replacements. The objectives of the study are to provide nationally representative estimates of complications following aortic and mitral valve replacements and to quantify the impact of different types of complications on in-hospital outcomes. Methods. The Nationwide Inpatient Sample was analyzed for years 2000-2003. The effect of complications on in-hospital mortality, length of stay (LOS), and hospital charges were examined using bivariate and multivariable logistic and linear regression analyses. The confounding effects of age, sex, primary diagnosis, type of valve replacement, type of admission, comorbid conditions, and hospital characteristics were adjusted. Results. A total of 43 909 patients underwent aortic valve replacement as the primary ...

I had an aortic heart valve transplant and before that, my B/P was normal, but since the transplant, my blood pressure is running on the high side…So my heart Doctor changed me from 20 mgs. of lisiinipril to 40 mgs P/day…It doesnt seem to have helped that much soo I wondered if, by me taking 20 mgs, in the AM and 20 mgs in the PM would not be good enough and that I should take the 40 mgs. alll at once in the AM?…Would that make a difference? My heart Doctor is on vacation so, thought I would ask you folks what you think…. Age: ...

30 controls who did not die from aortic dissection or dilation will be recruited from The Department of Forensic Medicine at Aarhus University Hospital.. The investigators will subject samples of aortic tissue from women undergoing prophylactic aortic surgery due to either Marfan syndrome or bicuspid aortic valve to the same panel of examinations (except karyotyping). Lastly the investigators will compare the results from the three groups (Turner syndrome, Marfan syndrome and Bicuspid aortic valve). ...

The main types of heart valve disease are:. Valve Stenosis or obstruction : This is primarily due to age-related hardening (calcification) of the aortic valve leading to progressive narrowing . The valve can either be exceptionally narrow (therefore having a stenosis) or have a blockage which limits the blood flow through the valve. This may result in a back-up of blood behind the valve as if behind a dam, causing the heart to pump inefficiently or building up blood pressure in the lungs. This is most commonly associated with aortic stenosis or mitral stenosis.. Valve Regurgitation or insufficiency : When a valve fails to close completely, the valve itself can become leaky, allowing blood to backwash down through the valve (called regurgitation). In addition, the valve may not ever completely move the volume of blood to the next appropriate chamber. This condition includes mitral regurgitation and aortic regurgitation.. ...

Learn about types of aortic valve disease, including aortic valve regurgitation and aortic stenosis, how these diseases affect the heart, and common symptoms.

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.. ...