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Valve Implantation (valve + implantation)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Valve Implantation

  • transcatheter aortic valve implantation
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    Selected Abstracts

    Surgical Techniques: Transcatheter Aortic Valve Implantation with "No Touch" of the Aortic Arch for the Treatment of Severe Aortic Stenosis Associated with Complex Aortic Atherosclerosis

    JOURNAL OF CARDIAC SURGERY, Issue 5 2010
    Rodrigo Bagur M.D.
    [source]

    Treatment of severe valvular aortic stenosis and subvalvular discrete subaortic stenosis and septal hypertrophy with Percutaneous CoreValve Aortic Valve Implantation,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 5 2010
    Ariel Finkelstein MD
    Abstract Background: Percutaneous Aortic Valve Implantation (PAVI) is a procedure gaining popularity and becoming more widely used for the treatment of patients with severe aortic stenosis who are at high risk for surgery. Here we show, for the first time, that a successful and complete elimination of both valvular and subvalvular pressure gradients can be achieved with a slight modification of the valve implantation technique. Methods and Results: A 91-year-old woman presented with shortness of breath at rest, effort angina, and pulmonary congestion. Echocardiography revealed calcified aortic stenosis with a peak gradient of 75 mm Hg accros the valve, and discrete subaortic stenosis (DSS) and marked hypertrophy of the basal septum with systolic anterior motion of the mitral valve (SAM). The intra ventricular gradient had a dynamic pattern across the DSS and the septal hypertrophy and measured 75 mm Hg. The total gradient across the left ventricular outflow (valvular and subvalvular) was 125 mmHg. PAVI with a 23 mm CoreValve was performed with an intentional lower positioning of the valve towards the LV outflow tract; so that the valve struts cover the subaortic membrane and part of the thickened basal septum. At the end of the procedure, the SAM disappeared, and the left ventricular ouflow was widely open. At 1 month follow up the patient was asymptomatic, no pressure gradient was measured between the LV apex and the aorta. Conclusions: This is the first report of successful treatment of severe valvular aortic stenosis and combined subvalvular aortic stenosis due to DSS and septal hypertrophy with SAM with percutaneous aortic valve implantation. © 2010 Wiley-Liss, Inc. [source]

    Experimental Setup to Evaluate the Performance of Percutaneous Pulmonary Valved Stent in Different Outflow Tract Morphologies

    ARTIFICIAL ORGANS, Issue 1 2009
    Riccardo Vismara
    Abstract Percutaneous pulmonary valve implantation is a potential treatment for right ventricular outflow tract (RVOT) dysfunction. However, RVOT implantation site varies among subjects and the success of the procedure depends on RVOT morphology selection. The aim of this study was to use in vitro testing to establish percutaneous valve competency in different previously defined RVOT morphologies. Five simplified RVOT geometries (stenotic, enlarged, straight, convergent, and divergent) were manufactured by silicone dipping. A mock bench was developed to test the percutaneous valve in the five different RVOTs. The bench consists of a volumetric pulsatile pump and of a hydraulic afterload. The pump is made of a piston driven by a low inertia programmable motor. The hydraulic afterload mimics the pulmonary input impedance and its design is based on a three element model of the pulmonary circulation. The mock bench can replicate different physiological and pathological hemodynamic conditions of the pulmonary circulation. The mock bench is here used to test the five RVOTs under physiological-like conditions: stroke volume range 40,70 mL, frequency range 60,80 bpm. The valved stent was implanted into the five different RVOT geometries. Pressures upstream and downstream of the valved stent were monitored. Flow rates were measured with and without the valved stent in the five mock RVOTs, and regurgitant fraction compared between the different valved stent RVOTs. The percutaneous valved stent drastically reduced regurgitant flow if compared with the RVOT without the valve. RVOT geometry did not significantly influence the flow rate curves. Mean regurgitant fractions varied from 5% in the stenotic RVOT to 7.3% in the straight RVOT, highlighting the influence of the RVOT geometry on valve competency. The mock bench presented in this study showed the ability to investigate the influence of RVOT geometry on the competence of valved stent used for percutaneous pulmonary valve treatment. [source]

    Optimal projection estimation for transcatheter aortic valve implantation based on contrast-aortography,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2010
    Validation of a Prototype Software
    Abstract We investigate the accuracy of a new software system (C-THV, Paieon) designed to calculate the optimal projection (OP) view for transcatheter aortic valve implantation (TAVI) based on two aortograms, and its agreement with the operator's choice. An optimal fluoroscopic working view projection with all three aortic cusps depicted in one line, is crucial during TAVI. In our institution selection of the OP is based on multislice computed tomography (MSCT). Seventy-three consecutive patients referred for TAVI were divided into two groups. For the first group (53 patients, retrospective cohort) we compared the OP views estimated by C-THV with the ones estimated by MSCT. For the second group (20 patients, prospective cohort), we compared the OP views estimated by C-THV with the operator's choice during TAVI. For the retrospective cohort, the mean absolute difference (mean ± SD) between C-THV and MSCT was 6.6 ± 4.9 degrees. In 77% of the cases the mean difference between C-THV and MSCT was <10 degrees. For the prospective cohort, the mean absolute difference (mean ± SD) between C-THV and the operator's choice was 5.5 ± 3.4 degrees. A mean difference of <10 degrees was found in 90% of the cases. In this study we found that the C-THV software estimated the OP view for TAVI with good accuracy. The level of agreement between C-THV and either the MSCT or the operator's choice was deemed satisfactory, with the vast majority of observed differences being <10 degrees. © 2010 Wiley-Liss, Inc. [source]

    Impact of coronary artery disease on outcomes after transcatheter aortic valve implantation,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2010
    Jean-Bernard Masson MD
    Abstract Background: Coronary artery disease (CAD) negatively impacts prognosis of patients undergoing surgical aortic valve replacement and revascularization is generally recommended at the time of surgery. Implications of CAD and preprocedural revascularization in the setting of transcatheter aortic valve implantation (TAVI) are not known. Method: Patients who underwent successful TAVI from January 2005 to December 2007 were retrospectively divided into five groups according to the extent of CAD assessed with the Duke Myocardial Jeopardy Score: no CAD, CAD with DMJS 0, 2, 4, and ,6. Study endpoints included 30-day and 1-year survival, evolution of symptoms, left ventricular ejection fraction (LVEF), and mitral regurgitation (MR) and need of revascularization during follow-up. Results: One hundred and thirty-six patients were included, among which 104 (76.5%) had coexisting CAD. Thirty-day mortality in the five study groups was respectively 6.3, 14.6, 7.1, 5.6, and 17.7% with no statistically significant difference between groups (P = 0.56). Overall survival rate at one year was 77.9% (95% CL: 70.9, 84.9) with no difference between groups (P = 0.63). Symptoms, LVEF, and MR all significantly improved in the first month after TAVI, but the extent of improvement did not differ between groups (P > 0.08). Revascularization after TAVI was uncommon. Conclusion: The presence of CAD or nonrevascularized myocardium was not associated with an increased risk of adverse events in this initial cohort. On the basis of these early results, complete revascularization may not constitute a prerequisite of TAVI. This conclusion will require re-assessment as experience accrues in patients with extensive CAD. © 2010 Wiley-Liss, Inc. [source]

    Transcatheter aortic valve implantation through the left subclavian artery with a patent LIMA graft,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2010
    Maurizio Taramasso MD
    Abstract We report the case of an 80-year-old male with severe aortic valve stenosis previously submitted to surgical myocardial revascularization with patent mammary graft treated by TAVI through left-transaxillary approach because of unsuitable transfemoral and transapical approaches.© 2010 Wiley-Liss, Inc. [source]

    The incidence of nephropathy in patients undergoing transcatheter aortic valve implantation,

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2009
    Ronak Rajani MD
    No abstract is available for this article. [source]

    Percutaneous implantation of an aortic valve prosthesis

    CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 2 2005
    J.C. Laborde MD
    Abstract Recently, percutaneous aortic valve implantation has become an alternative technique to surgical valve replacement in patient at high risk for surgery. Our animal experimentation evaluated the technical feasibility of aortic valve replacement using a bovine pericardium valve sutured on a self-expandable stent in a sheep model. Precise implantation with satisfactory attachment on the adjacent tissues and absence of migration was obtain in 8 out of 14 animals. This study confirmed the feasibility of the endovascular implantation of a pericardium valve sutured on a self-expandable stent in a sheep model. © 2005 Wiley-Liss, Inc. [source]