Bibliographies thématiques / Aortic Replacement

Littérature scientifique sur le sujet « Aortic Replacement »

Auteur : Grafiati
Publié le 14 mars 2023

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Articles de revues sur le sujet "Aortic Replacement"

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Jamieson, WR Eric, Eva Germann, Guy J. Fradet, Samuel V. Lichtenstein et Robert T. Miyagishima. « Bioprostheses and Mechanical Prostheses Predictors of Performance ». Asian Cardiovascular and Thoracic Annals 8, no 2 (juin 2000) : 121–26. http://dx.doi.org/10.1177/021849230000800207.

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From 1975 to 1995, 4200 patients had bioprosthetic valve replacements (2240 aortic, 1607 mitral, 353 multiple) and 2038 had mechanical valve replacements (747 aortic, 928 mitral, 363 multiple). Freedom from major thromboembolism or both major thromboembolism and hemorrhage for aortic and mitral valve replacement at 15 years was significantly greater for bioprostheses than mechanical prostheses. Freedom from valve-related mortality and reoperation for both aortic and mitral valve replacements was the same for bioprostheses and mechanical prostheses. Advancing age increased overall mortality (all positions), valve-related mortality (aortic, mitral), major thromboembolism (aortic), thromboembolism and hemorrhage (aortic, mitral) but decreased reoperation (all positions). Coronary artery bypass grafting increased overall mortality (aortic, mitral) but not valve-related mortality, and it decreased reoperation rate (aortic, mitral). Overall mortality was not influenced by valve type in aortic or multiple valve replacement but it was decreased by bioprostheses in mitral valve replacement. Valve type did not influence valve-related mortality (all positions). Mechanical valves decreased reoperation only for aortic valve replacement but they increased major thromboembolism with and without hemorrhage for both aortic and mitral replacements. There is support for bioprostheses in aortic valve replacement and mechanical prostheses in mitral valve replacement but for neither in multiple valve replacements.
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Sheriff, Sadiq Ahmed. « Left Ventricular Mass Regression in Aortic Valve Replacement for Severe Aortic Stenosis ». Journal of Cardiovascular Medicine and Surgery 4, no 3 (2018) : 225–30. http://dx.doi.org/10.21088/jcms.2454.7123.4318.6.

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Nguyen, Tom C., Alexander P. Nissen, Pranav Loyalka et Eyal E. Porat. « Direct Transcatheter Valve Deployment via Sternotomy for Complex Aortic Valve Reoperation ». Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery 14, no 4 (11 juin 2019) : 365–68. http://dx.doi.org/10.1177/1556984519854825.

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Reoperative aortic valve replacement is associated with increased morbidity. Valve-in-valve transcatheter aortic valve replacement offers a less invasive alternative to traditional reoperation. However, cases of valve failure after valve-in-valve transcatheter aortic valve replacement represent a complex surgical challenge. We present a case requiring a complex reoperative aortic valve replacement due to structural valve deterioration after multiple previous valve-in-valve transcatheter aortic valve replacements. We performed removal of 3 previous valve-in-valve transcatheter aortic valves, bioprosthetic leaflet excision, and intentional bioprosthetic fracture under direct vision for annular enlargement. This facilitated direct insertion of a new transcatheter aortic valve for expedient and successful management of recurrent aortic stenosis in a very high-risk patient. Creative use of leaflet excision, intentional bioprosthetic fracture, and insertion of a new transcatheter aortic valve under direct vision, proved efficient and successful in a high-risk patient with few surgical options.
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Hussain, Ghulam, Naseem Ahmad, Sohail Ahmad, Mirza Ahmad Raza Baig et Sara Zaheer. « AORTIC VALVE REPLACEMENT ». Professional Medical Journal 22, no 12 (10 décembre 2015) : 1565–68. http://dx.doi.org/10.29309/tpmj/2015.22.12.838.

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Precise determination of the size of aortic annulus is very important for thepreoperative evaluation before aortic valve replacement. Objectives: To determine thepreoperative prosthesis size using echocardiography in patients undergoing aortic valvereplacement. Study Design: Prospective observational study. Setting: Ch. Pervaiz ElahiInstitute of Cardiology (CPEIC) Multan. Period: January 2013 to October 2014. Methods: (100patients) Aortic annulus sizes were measured with TTE one week before surgery and with thehelp of sizer per-operatively. The data was analyzed by using SPSS V16. Quantitative variableswere analyzed using mean and standard deviation and percentages were used for qualitativevariables. Dependent sample t test was used to see accuracy of TTE in measuring aortic annulussize. Results: Out of hundred patients, 84(84%) were male. Mean age of the patients was 33.77+13.17 years. 51% patients underwent isolated Aortic valve replacement; redo-operations weredone only in 4% patients. In 96% patient’s mechanical prosthesis was used and in 4% patient’sboiprosthesis was used for valve replacement. We found no significant difference in Aorticannulus measured pre-operatively with the TTE (23.54+ 3.54) and measured per-operativewith the sizer (23.96+3.36) with highly insignificant p-value 0.58.Aortic annulus size was almostsame measured by these two techniques. Conclusion: Aortic annulus size measured with TTEhelps to arrange the optimum size prosthesis before aortic valve replacement surgery.
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Bartzokis, Thomas, Frederick St. Goar, Aria DiBiase, D. Craig Miller et Ann F. Bolger. « Freehand allograft aortic valve replacement and aortic root replacement ». Journal of Thoracic and Cardiovascular Surgery 101, no 3 (mars 1991) : 545–54. http://dx.doi.org/10.1016/s0022-5223(19)36740-6.

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Takano, Tamaki, Yuko Wada, Tatsuichiro Seto, Takamitsu Terasaki, Daisuke Fukui et Jun Amano. « Prosthesis-sparing aortic root replacement following aortic valve replacement ». Asian Cardiovascular and Thoracic Annals 22, no 6 (8 octobre 2013) : 734–36. http://dx.doi.org/10.1177/0218492313482316.

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Gössl, Mario, et Aisha Ahmed. « Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement ». JACC : Cardiovascular Interventions 11, no 21 (novembre 2018) : 2217–19. http://dx.doi.org/10.1016/j.jcin.2018.08.007.

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Frankel, Naftali Zvi. « Surgical Aortic Valve Replacement vs Transcatheter Aortic Valve Replacement ». JAMA Internal Medicine 174, no 4 (1 avril 2014) : 495. http://dx.doi.org/10.1001/jamainternmed.2013.12829.

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Agarwal, Shikhar, Imran Baig, Amir Eslami et Tanawan Riangwiwat. « Patient Satisfaction Questionnaire After Transcatheter Aortic Valve Replacement ». Clinical Cardiology and Cardiovascular Interventions 3, no 5 (29 juin 2020) : 01–04. http://dx.doi.org/10.31579/2641-0419/066.

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Health-related quality of life (HRQoL) is a multi-dimensional concept that includes domains related to physical, mental, emotional, and social functioning. Kansas City Cardiomyopathy Questionnaire (KCCQ) is typically utilized to assess the HRQoL after TAVR
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Bockeria, L. A., A. I. Malashenkov et S. V. Rychin. « Aortic arch replacement ». Interactive CardioVascular and Thoracic Surgery 7, no 3 (26 mars 2008) : 429. http://dx.doi.org/10.1510/icvts.2007.164871a.

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Thèses sur le sujet "Aortic Replacement"

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Joyce, Ruth Ann. « Quality of life and cerebral ischaemia following aortic valve replacement and transcatheter aortic valve replacement ». Thesis, St George's, University of London, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.706528.

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Background Aortic valve replacement (AVR) has been associated with postoperative transient ischaemic attack, stroke and neurocognitive decline. Transcatheter aortic valve implantation (TAVI) has been in development for nearly a decade for patients not suitable for surgery. Cognitive change after TAVI is not yet clear. We set out to examine the effects of cognitive dysfunction on quality of life (QoL) following TAVI and AVR. Methods 88 consecutive high risk patients with severe aortic stenosis and discussed at an MDT who underwent TAVI (n=38) or AVR (n=50) were studied. Transcranial Doppler ultrasound (TCD) examinations were recorded for all patients. A comprehensive neurocognitive assessment was performed on patients at baseline and 3 months using a battery of cognitive tests. QoL analysis was completed on patients at baseline, 3, 6 and 12 months using the Short Form 36 (SF-36v2™) with an additional propensity matched group analysed. Results Cerebral embolic load had a mean of 271 (range 160-309) in AVR patients and 280 (range 186- 326) in TAVI patients. Duration of cardiopulmonary bypass (CPB) for AVR and valve deployment for TAVI, were associated with the highest number of embolic signals (ES) recorded (mean 106 and 103 respectively). AVR and TAVI patients had a significant decrease in processing speed (p=0.04 and p=0.04). The AVR group showed a cognitive decline in visual planning and short term memory (p=0.02), TAVI patients in new learning and verbal memory (p=0.02, p=0.03). Both procedures resulted in an increase in patient QoL with no difference in improvements between AVR and TAVI patients in the propensity matched group. Conclusion ES load was recorded for AVR and TAVI, with significantly more ES for duration of bypass in AVR and deployment of the valve in TAVI. AVR and TAVI patients had mild post-operative cognitive changes with both having a significantly decreased processing speed score at 3 months follow up. QoL of patients undergoing AVR and TAVI increased post-procedure at 3, 6 and 12 months. Patients improved equally in terms of QoL in the propensity matched group of AVR and TAVI patients.
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Klieverik, Loes Maria Anne. « Aortic valve replacement in young adults ». [S.l.] : Rotterdam : [The Author] ; Erasmus University [Host], 2007. http://hdl.handle.net/1765/10778.

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Nowell, Justin L. « Anticoagulation Following Tissue Aortic Valve Replacement ». Thesis, St George's, University of London, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.517184.

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Park, Kenneth Stuart. « Stents for transcatheter aortic valve replacement ». Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27372.

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Rheumatic heart disease (RHD) is the leading cause of aortic valve disease in the world. Surgery to repair or replace the diseased valves is the only means to save a patient's life once the disease becomes symptomatic. Transcatheter aortic valve replacement (TAVR) has revolutionised the treatment of age-related degenerative aortic valve disease, but is currently not suitable for the majority of RHD sufferers due to the rapid degeneration of flexible leaflet valves in younger patients, contraindications of commercial devices to regurgitant or non-calcific aortic valve disease, and also due to resource or funding limitations. The current research project aimed to develop and test novel compressible balloon-expandable stents suitable for patients with symptomatic rheumatic aortic valve disease, and which would allow for a percutaneous polymeric valve to be manufactured, be crimped onto balloon-based devices, and be expanded into a compliant or non-calcific native aortic valve. Several stent concepts were developed and evaluated using Finite Element Analysis (FEA) and two favoured concepts were selected for more complex FEA, in which the balloon was simulated using an Ogden material model, and rigorous testing. The stent material, a nickel-cobalt-chromium alloy, was modelled as an isotropic elasto-plastic material with isotropic hardening. The novel stent designs incorporated a native leaflet-mimicking crown shape for continuous leaflet attachment and mechanisms to anchor the stented valve within compliant aortic roots. The first of the favoured designs provided tactile location during delivery and anchored using self-expanding arms on a balloon-expandable frame of the same material ("self-locating stents"). The second design anchored using arms that protruded during deployment as a consequence of plastic deformation incurred during crimping ("expanding arm stents"). Prototypes were successfully manufactured through laser cutting and electropolishing and showed good surface quality. In vitro testing included determination of crimping and expansion behaviour and measurement of mechanical properties such as resistance to migration in the anatomy. Valve performance was evaluated through in vitro haemodynamics in a pulse duplicator and durability was tested in a high-cycle fatigue tester. Simulated use testing was performed using cadaveric animal hearts. Finally, valves were also implanted into the aortic valve position of pigs (in acute termination experiments) through a transapical approach in order to verify valve deployment behaviour and function in vivo, and determine the stent's ability to anchor in the native anatomy. Stents could be crimped to diameters below 6mm and deployed using commercial balloons and proprietary non-occlusive deployment devices. FEA simulations of stent crimping and deployment matched experimental behaviour well and provide a tool to optimise stent performance. Peak Von Mises stresses during deployment (1437 MPa and 1633 MPa for self-locating and expanding arm stents, respectively) were comparable to a "zig-zag" stent simulated for control purposes (1650 MPa). Radial strength, evaluated for expanding arm stents, was lower than the Control stent (116 N vs. 347 N). This design, although predicted to be safe under fatigue loading, had a lower fatigue safety factor than the Control stent. Stents resisted migration to forces of at least 22 N, which is four times greater than physiological loading on the valves. Polymeric valves incorporating the stents were constructed and demonstrated good in vitro haemodynamic performance (Effective Orifice Areas ≥2.0cm², ΔP<9 mmHg, regurgitation <6%) and durability of over 400 million cycles. Designs functioned as intended in simulated use tests. Valves constructed using self-locating stents could be successfully deployed without rapid pacing in eight of nine pigs, and valve position was correct in seven of these. Valves of expanding arm stents remained anchored in six of eight attempted implants in pigs. This study has demonstrated proof of concept for a novel balloon-expandable stent for a polymeric transcatheter heart valve that is capable of anchoring in a compliant native aortic valve.
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Lopez, Marco Ana. « Low-flow low-gradient aortic stenosis : outcomes after aortic valve replacement ». Doctoral thesis, Universitat de Barcelona, 2019. http://hdl.handle.net/10803/667817.

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Aortic stenosis is the commonest valve disorder in the Western World. The natural history of the disease is very well described; with a decreased survival once symptoms occur. There is currently, no medical therapy available to reduce the natural progression of the aortic stenosis, and therefore, aortic valve replacement has been recognised as the standard of care treatment for symptomatic aortic stenosis, with TAVI having merged as alternative for those cases with high/prohibitive surgical risk. All types of aortic stenosis have in common a reduced valve area (AVA <1.0cm2), but depending on the mean gradients and the stroke volume index, there are different types: Normal-Flow High-Gradient (NFHG AS) and Low-Flow Low-Gradient (LFLG AS) aortic stenosis. The latter is further subdivided into Classical and Paradoxical forms depending on the ejection fraction value. NFHG AS is the most common type. The left ventricle is capable of generating a normal flow through the stenotic valve, that it is translated onto high gradients. This type has been thoroughly studied and has an excellent prognostic with aortic valve replacement, with very low in-hospital mortality and long-term survival similar to the age-matched population. LFLG AS, on the other hand, is defined by a reduced stroke volume (SVi < 35 ml/min) and a low gradient (mean gradient < 40mmHg). The Classical form (CLFLG AS) has impaired ventricular function. These patients have dilated ventricles that are not able to generate enough flow through the stenotic valve and hence the low gradient. Dobutamine stress echocardiography is key for the diagnosis of this subtype, as it differentiates it from the Pseudo-Severe aortic stenosis (in which the problem is not in the aortic valve but in the left ventricle, and therefore there is no benefit from aortic valve replacement) and it has also prognostic value by determining the contractile reserve. These patients have been reported to have the highest mortality post aortic valve replacement and a reduced long-term survival; however, those who survive achieve excellent functional class. The other subtype of LFLG, the Paradoxical form (PLFLG AS) has a preserved ventricular function. These patients have a ventricular restrictive physiology, with reduced SVi due to a combination of mechanism such as subendocardial fibrosis, concentric remodeling, impaired diastolic filling and high afterload. It is paramount here to confirm the diagnosis by accurate echocardiography, ruling out measurement errors and other causes of reduced SVi. PLFLG AS patients have worse prognosis than NFHG AS but better prognosis than CLFLG AS patients. The primary hypothesis of our research project was that aortic valve replacement could be performed in patients with LFLG AS with low in-hospital mortality. Therefore, with the objectives of determining operative and mid-term outcomes of surgical intervention in LFLG AS compared to NFHG AS, we conducted a retrospective analysis of all patients who underwent isolated aortic valve replacement in our centre. Primary end-points were mortality (in-hospital, at one and five years) and the secondary end-points analysed were postoperative complications and clinical status at follow-up. Patients in the LFLG AS group were significantly older and had more cardiovascular risk factors and comorbidities than the NFHG AS group. Despite those differences, in-hospital mortality was equivalent and remarkably low in both groups. As expected, LFLG AS patients had a reduced mid-term survival but those who survived remained in an excellent functional class. With the separate analysis of the LFLG AS subgroups, we confirmed that CLFLG AS had higher in-hospital and mid-term mortality than PLFLG AS patients. In both groups, the in-hospital mortality was remarkably low compared to previous literature reports. Aortic valve replacement provided symptomatic relief and excellent functional class during the mid-term follow-up as well as recovery of the ventricular function in most of the patients. Based on our results, we concluded that aortic valve replacement should be recommended for symptomatic severe LFLG AS.
La estenosis aórtica es la enfermedad valvular más frecuente en el tercer mundo. La historia natural de la enfermedad es bien conocida desde hace décadas, siendo una enfermedad con mal pronóstico a medio-corto plazo que hace necesario someter a estos pacientes a recambio valvular aórtico tras la aparición de síntomas. La forma mas común de estenosis aórtica, con flujo normal y gradiente alto, tiene un pronóstico excelente tras el recambio valvular aórtico, con una supervivencia similar a la de la población normal. Sin embargo, la estenosis aórtica de bajo-flujo y bajo-gradiente, es una entidad menos conocida y de peor pronóstico. Estos pacientes tienen una mortalidad mucho mayor tras recambio valvular aórtico y menor supervivencia a largo plazo. El diagnóstico en el bajo-flujo bajo-gradiente es vital para seleccionar correctamente los pacientes con estenosis aórtica que se beneficiarán de tratamiento quirúrgico, teniendo también valor pronóstico, dependiendo de la categoría de bajo flujo (Clásica o Paradójica) y otros determinantes como la presencia/ausencia de reserva contráctil del ventrículo izquierdo. Nuestra hipótesis fue que la estenosis aórtica de bajo-flujo y bajo-gradiente, pueden ser tratada con recambio valvular aórtico con una mortalidad hospitalaria similar a aquellos con flujo normal y alto gradiente. Los objetivos del proyecto fueron el análisis de resultados hospitalarios y a medio plazo (mortalidad hospitalaria, a 1 y 5 años) así como la clase funcional y recuperación de la función ventricular, en pacientes con estenosis aórtica de bajo-flujo bajo-gradiente sometidos a recambio valvular aórtico comparado con flujo normal alto-gradiente. Nuestros resultados nos llevan a la conclusión de que el recambio valvular aórtico en pacientes con estenosis aórtica de bajo-flujo bajo-gradiente se puede lograr con baja mortalidad quirúrgica, comparable con pacientes con flujo normal y alto gradiente. A pesar de que tener una mayor mortalidad a medio-plazo, los supervivientes exhiben una excelente clase funcional y desaparición de síntomas, que apoyan la indicación quirúrgica en estos pacientes.
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Hatoum, Hoda. « Fluid Mechanics of Transcatheter Aortic Valve Replacement ». The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1541781379381912.

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Nai, Fovino Luca. « Coronary access after transcatheter aortic valve replacement ». Doctoral thesis, Università degli studi di Padova, 2019. http://hdl.handle.net/11577/3424785.

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Coronary artery disease (CAD) and aortic stenosis (AS) often coexist. While the clinical impact of CAD on subjects with AS undergoing transcatheter aortic valve replacement (TAVR) is controversial, current guidelines suggest revascularization of proximal severe CAD before TAVR. This recommendation is mainly based on concerns about the possibility to reaccess the coronary arteries once the transcatheter heart valve (THV) is in place. In fact, previous case series report challenges in cannulation of coronary ostia after TAVR, particularly with self-expandable THVs. These aspects are important as indication to TAVR is moving towards younger patients, who are more likely to need CA, giving the progressive nature of CAD and their longer life expectancy. The first objective of our research was to assess the incidence of coronary access (CA) after TAVR at long-term follow up in a high-volume center, evaluating safety and feasibility of coronary angiography and percutaneous coronary intervention (PCI) after TAVR with different types of THVs. At a median follow up over 3 years, incidence of CA after TAVR was 5.3%. In one out of three patients, indication to CA was an acute coronary syndrome, and PCI was performed in over half of the cases. Independent predictors of CA after TAVR were younger age, previous PCI and CABG. CA of both vessels was feasible in all patients with an intra-annular THV, while the right coronary artery was not engaged in two patients with a supra-annular THV. PCI was successful in all but one case. All-cause mortality tended to be higher for patients needing CA for acute coronary syndrome. Secondly, we evaluated advantages and pitfalls of CA after TAVR in the presence of bicuspid aortic valve (BAV) stenosis. We performed post-TAVR 3-dimensional computed tomography in patients with BAV treated both with balloon-expanding and self-expandable THVs. In this particular anatomical setting, CA after TAVR as advantages and pitfalls. For instance, the potential asymmetrical prosthesis expansion when the rafe is located between the left and right coronary cusp generates a larger free space between the valve frame and the coronary ostia, thereby simplifying CA. On the contrary, the higher implantation of the THV in the setting of BAV represents a potential challenge for CA. Finally, we aimed to assess the feasibility of CA after TAVR-in-TAVR. In fact, as TAVR indication is moving towards patients with longer life expectancy, THV degeneration will be increasingly common. TAVR-in-TAVR is an appealing therapeutic option in this setting, but concerns have been raised about the risk of acute coronary obstruction and the possibility to re-access the coronaries once the second prosthesis is in place. In fact, when the second THV is implanted, the leaflets of the first prosthesis are displaced vertically, creating a cylindric cage which will impair CA and possibly coronary flow. Consequently, there is a risk plane under which the first valve frame will not be crossable after TAVR-in-TAVR. We therefore developed a novel, imaging-based algorithm to predict possible coronary access impairment after TAVR-in-TAVR, based on the way CA is gained after the index TAVR and on the distance between prosthesis frame and aortic wall under the level of the RP. We then tested our hypothesis by performing coronary angiography after TAVR in 137 consecutive patients. According to our algorithm, CA after TAVR-in-TAVR might be impaired in almost 1/3 of patients currently treated by TAVR. This risk appears to be less frequent with intra-annular SAPIEN 3 as compared to supra-annular Evolut R/Pro and Acurate Neo THVs. Implantation of a supra-annular device, female gender and small sino-tubular junction are independent predictors of possible CA impairment after TAVR-in-TAVR. These results, which will need to be validated in clinical practice, are important for patient counseling and prosthesis selection in subjects with longer life expectancy
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Janicki, Andrew Joseph. « ANALYSIS OF PARTICLES THOROUGH THE AORTIC ARCH DURING TRANSCATHETER AORTIC VALVE REPLACEMENT ». DigitalCommons@CalPoly, 2015. https://digitalcommons.calpoly.edu/theses/1448.

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Ischemia caused by particles becoming dislodged during transcatheter aortic valve replacement (TAVR) is a possible complication of TAVR. The particles that become dislodged can travel out of the aortic valve, into the aortic arch, and then into either the brachiocephalic artery, the left common carotid artery, the left subclavian artery or continue into the descending aorta. If the particles continue into the descending aorta it poses no risk of causing ischemia however if it travels into the other arteries then it increases the possibility of the particle causing an ischemic event. The goal of this study is to determine what parameters cause the particle to enter one artery over another. The parameters analyzed are the particle diameter, the particle density, the blood pressure, and the diameter of the catheter used in the surgery. This was done by creating a finite element model in COMSOL Multiphysics® to track the particles flowing through a scan of an actual aortic arch. It was determined that the particle diameter, particle density, and the blood pressure affect which artery the particles take to exit the aortic arch. However the diameter of the surgical catheter used in a transaortic approach is not statistically significant when determining which artery the particles will exit. The study shows that larger diameter particle would lead to a higher transmissions probability into the brachiocephalic artery, the left common carotid artery, and the left subclavian artery while a smaller diameter particle would have a higher transmission probability for the descending aorta. Averaging all particle diameters, densities and blood pressure found that 54.95 ± 13.66% of the particles released will travel into the cerebral circulatory system.
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He, Zhengfu [Verfasser]. « Percutaneous Aortic Valve Replacement [[Elektronische Ressource]] ： The Anatomy of Aortic Root Structures and Postmortem Aortic Valve Stent Implantation / Zhengfu He ». Kiel : Universitätsbibliothek Kiel, 2011. http://d-nb.info/1020200936/34.

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Musa, Tarique Al. « Transcatheter and surgical aortic valve replacement for severe aortic stenosis : insights from cardiovascular magnetic resonance imaging ». Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/15238/.

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Background: Surgical aortic valve replacement (SAVR) remains first-line treatment for symptomatic severe aortic stenosis, whereas transcatheter aortic valve implantation (TAVI) is indicated in patients who are inoperable or considered too high-risk for surgery. Current focus is centred on differences in the impact of valve replacement upon cardiovascular function to guide patient selection and the development of novel prosthetic valves to improve outcomes. Cardiovascular Magnetic Resonance (CMR) imaging is the investigative modality of choice for such a purpose. Objectives: To compare the impact of SAVR and TAVI upon aortic stiffness, right ventricular function and myocardial strain, and to compare two vendor designs in the quantity of post-TAVI aortic regurgitation and reverse remodelling. Methods: A prospective study of patients with severe aortic stenosis under surveillance and subsequently requiring SAVR or TAVI, recruited between September 2009 and December 2015. A 1.5 Tesla CMR study was performed pre and 6 months post SAVR, and pre, immediately and 6 months post implantation of Medtronic CoreValve and Boston Lotus TAVI. Aortic distensibility (AD), pulse wave velocity (PWV), right ventricular (RV) volumes, myocardial strain and aortic regurgitation (AR) were quantified. Results: At 6 months, SAVR was associated with a significant worsening in PWV (6.38±4.47 vs. 11.01±5.75ms-1, p=0.001) and ascending AD (1.95±1.15 vs. 1.57±0.68x10-3mmHg-1, p=0.044), whereas no change was seen following TAVI. A significant reduction in RV ejection fraction (58±8 vs. 53±8%, p=0.005) was seen flowing SAVR, with no change following TAVI. A significant and comparable decline in LV torsion and twist was observed. Baseline circumferential strain was significantly associated with all-cause mortality (hazard ratio, 1.03; 1.01–1.05; p=0.009). Significantly less AR was seen immediately following Lotus than CoreValve TAVI (4.3±3.4 vs.11.7±8.4%, p=0.001) with equivalent degrees of reverse remodelling observed at 6 months. Conclusion: Compared with TAVI, SAVR is more detrimental upon aortic stiffness and right ventricular function at 6 months. CMR derived circumferential strain is associated with survival following SAVR and TAVI.
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Livres sur le sujet "Aortic Replacement"

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Watkins, A. Claire, Anuj Gupta et Bartley P. Griffith. Transcatheter Aortic Valve Replacement. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93396-2.

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Min, James K., Daniel S. Berman et Jonathon Leipsic, dir. Multimodality Imaging for Transcatheter Aortic Valve Replacement. London : Springer London, 2014. http://dx.doi.org/10.1007/978-1-4471-2798-7.

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Xiao, Cangsong, Yang Wu et Weihua Ye. Mini Access Redo Valve-Sparing Aortic Root, Total Arch Replacement and Stented Graft Implantation after Type A Aortic Dissection Repair. Singapore : Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-15-0149-4.

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Klicpera, Martin. Chronic aortic regurgitation : Prognostic parameters for patients with chronic aortic regurgitation undergoing aortic valve replacement : value of invasive and non-invasive methods and pharmacological interventions (systemic vasodilation). Wien : Facultas Universitätsverlag, 1985.

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Xiao, Cangsong, Yang Wu et Weihua Ye. Mini Access Valve-Sparing Aortic Root and Total Arch Replacement and Stented Graft Implantation in Acute DeBakey Type I Aortic Dissection. Singapore : Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-15-0160-9.

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Xiao, Cangsong, Yang Wu et Weihua Ye. Re-implantation Valve-Sparing Aortic Root, Total Arch Replacement, Stented Graft Implantation and CABG. Singapore : Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-15-0159-3.

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Xiao, Cangsong, Yang Wu et Weihua Ye. Mini-Access Re-implantation Valve-Sparing Aortic Root Replacement in Acute DeBakey Type II Dissection. Singapore : Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-15-0154-8.

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Dake, Michael D. Transcaval Aortic Catheterization for Transcatheter Aortic Valve Replacement and Thoracic Endovascular Aortic Repair Device Delivery. Sous la direction de S. Lowell Kahn, Bulent Arslan et Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0014.

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During the past decade, development of catheter-based techniques for treatment of thoracic aortic and aortic valve pathologies has required that interventionalists focus on the anatomic suitability of vascular access to allow safe introduction of large size devices. Both thoracic endovascular aortic repair (TEVAR) and transcatheter aortic valve implantation (TAVI) procedures require 20 French and larger sheaths and most of major complications during these procedures have been access related. This chapter reviews transcaval aortic access techniques for delivering large devices during TEVAR and TAVI. Alternative arterial access or adjunctive femoral access techniques that increase the safety of access and reduce the overall procedural risk for patients with challenging access are critically important for the success of TEVAR or TAVI. The procedure involves transcatheter puncture of the abdominal aorta from the inferior vena cava, with delivery of a large vascular sheath and tract closure post device delivery using a nitinol occlusion device.
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Berman, Daniel S., James K. Min et Jonathon Leipsic. Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer, 2016.

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Berman, Daniel S., James K. Min et Jonathon Leipsic. Multimodality Imaging for Transcatheter Aortic Valve Replacement. Springer London, Limited, 2013.

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Chapitres de livres sur le sujet "Aortic Replacement"

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Dominik, Jan, Pavel Zacek et Jan Vojacek. « Aortic Valve Replacement ». Dans Aortic Regurgitation, 123–52. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_14.

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Coselli, Joseph S. « Arch and Thoracoabdominal Replacement ». Dans Cardio-aortic and Aortic Surgery, 113–14. Tokyo : Springer Japan, 2001. http://dx.doi.org/10.1007/978-4-431-65934-1_17.

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Westaby, Stephen. « Stentless Aortic Valve Replacement ». Dans Cardio-aortic and Aortic Surgery, 21–23. Tokyo : Springer Japan, 2001. http://dx.doi.org/10.1007/978-4-431-65934-1_4.

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Schäfers, Hans-Joachim. « Valve-Preserving Root Replacement ». Dans Cardio-aortic and Aortic Surgery, 24. Tokyo : Springer Japan, 2001. http://dx.doi.org/10.1007/978-4-431-65934-1_5.

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Hanzel, George S. « Transcatheter Aortic Valve Replacement ». Dans Aortic Stenosis, 253–69. London : Springer London, 2015. http://dx.doi.org/10.1007/978-1-4471-5242-2_15.

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Folliguet, Thierry, et François Laborde. « Aortic valve replacement and transvalvular aortic valve replacement ». Dans Endovascular and Hybrid Therapies for Structural Heart and Aortic Disease, 194–203. Oxford : John Wiley & Sons, 2013. http://dx.doi.org/10.1002/9781118504536.ch17.

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Ross, D. N., et Roxane McKay. « Aortic Root Replacement ». Dans Reoperations in Cardiac Surgery, 259–70. London : Springer London, 1989. http://dx.doi.org/10.1007/978-1-4471-1688-2_19.

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Orion, Kristine. « Thoracoabdominal Aortic Replacement ». Dans Practical Tips in Aortic Surgery, 241–63. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-78877-3_65.

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Elefteriades, John A., et Bulat A. Ziganshin. « Aortic Valve Replacement ». Dans Practical Tips in Aortic Surgery, 139–42. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-78877-3_50.

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Shapiro, Leonard M., et Antoinette Kenny. « Aortic Valve Replacement ». Dans Cardiac Ultrasound, 65–68. London : Routledge, 2021. http://dx.doi.org/10.1201/9781315138800-7.

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Actes de conférences sur le sujet "Aortic Replacement"

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Tsvelodub, S., M. Schermer, I. Trulley, S. Melzer, D. Sparr, M. Laß et T. Hanke. « Continuous Antegrade Heart Perfusion during Ascending Aorta and Aortic Arch Replacement in Patients with Aortic Aneurysm or Acute Aortic Dissections ». Dans 50th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1725782.

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Kato, Takayoshi, Tomohiro Tsunekawa, Yusuke Motoji, Tatsuomi Kinoshita, Yasuhide Okawa et Shinji Tomita. « 19 Aortic valve replacement for severe aortic stenosis with low ejection fraction ». Dans 1st Asia Pacific Advanced Heart Failure Forum (APAHFF), 15th December 2017, Hong Kong. BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association, 2018. http://dx.doi.org/10.1136/heartasia-2018-apahff.19.

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Fujita, B., K. Bozkurt, M. Saad, E. Emmel, I. Eitel, A. Aboud, H. Langer, S. Ensminger et T. Kurz. « Surgical versus Transcatheter Aortic Valve Replacement for Treatment of Bicuspid Aortic Valve Stenosis ». Dans 49th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705303.

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Mehdiani, A., K. Smiris, F. Sipahi, U. Boeken, P. Akhyari et A. Lichtenberg. « Singe-Center Experience : Minimally Invasive Aortic Valve Replacement ». Dans 50th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery (DGTHG). Georg Thieme Verlag KG, 2021. http://dx.doi.org/10.1055/s-0041-1725762.

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Nordmeyer, S., M. Kelm, L. Goubergrits, F. Hellmeier, J. Bruening, V. Falk, F. Berger et T. Kühne. « Impact of Aortic Valve Replacement on Flow Profiles in the Ascending Aorta ». Dans 50th Annual Meeting of the German Society for Pediatric Cardiology (DGPK). Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0037-1617411.

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Sirois, Eric M., Tsuicheng Chiu, Martin Fox et Wei Sun. « Characterization of Aortic Root Compliance at Different Heights ». Dans ASME 2008 International Mechanical Engineering Congress and Exposition. ASMEDC, 2008. http://dx.doi.org/10.1115/imece2008-67824.

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Aortic valve stenosis is a significant cause of morbidity and mortality [1]. Currently, the preferred treatment of severe aortic stenosis is aortic valve replacement, which carries a significant risk for patients with comorbidities [2]. Recently, percutaneous aortic valve (PHV) replacement represents an endovascular alternative to conventional open heart surgery without the need for sternotomy, aortotomy, or cardiopulmonary bypass [3]. However, there are significant serious adverse events associated with the percutaneous procedure, such as myocardial infarction, peripheral embolism, injury to the aorta, perivalvular leak and access site injury [3–5]. Furthermore, long-term durability and safety of these valves need to be evaluated and studied carefully. We hypothesize that the device (dys)function could be more accurately predicted if a better understanding of the biomechanical interaction between the native aortic valve/root and the PHV were available. In this study, our objective is to characterize the mechanical properties of the aortic root such that its interaction with the PHV device can be quantified.
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Minagawa, Tadanori, Yoshifumi Saijo, Sri Oktamuliani, Takafumi Kurokawa, Hiroyuki Nakajima, Kaoru Hasegawa, Takayuki Matsuoka et al. « Left Ventricular Blood Flow Dynamics In Aortic Stenosis Before And After Aortic Valve Replacement ». Dans 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). IEEE, 2018. http://dx.doi.org/10.1109/embc.2018.8512954.

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Saha, S., A. F. Jebran, N. Waezi, C. Bireta, A. Al Ahmad, B. Danner, H. Baraki, H. Niehaus et I. Kutschka. « Operating the Inoperable : Reoperations after Transcatheter Aortic Valve Replacement ». Dans 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1679003.

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Tubaldi, Eleonora, Marco Amabili et Michael P. Paidoussis. « Fluid Structure Interaction for Nonlinear Response of Aorta Replacement ». Dans ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-50950.

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Vascular prostheses used for repairing and replacing damaged and diseased the thoracic aorta in cases of aneurysm, dissection or coarctation have distinctly different mechanical properties than the native aorta. Very little is known about the dynamic behavior of vascular prostheses that can cause unwanted hemodynamic effects leading to their failure. In this study, a Dacron reconstitution of the aorta is modelled as an isotropic cylindrical shell by means of nonlinear Novozhilov shell theory. A numerical bifurcation analysis employs a refined reduced order model to investigate the dynamic behavior of a pressurized Dacron aortic replacement conveying blood flow. A pulsatile time-dependent blood flow model is considered in order to study the effect of pressurization by applying physiological waveforms of velocity and pressure during the heart beating period. Stresses due to pressurization are evaluated and included in the model. The fluid is modeled as a Newtonian pulsatile flow and it is formulated using a hybrid model that contains the unsteady effects obtained from the linear potential flow theory and the pulsatile viscous effects obtained from the unsteady time-averaged Navier-Stokes equations. Geometrically non-linear vibration response to pulsatile flow is here presented via frequency-response curves and time histories. This study provides a fully coupled fluid-structure interaction model and it allows deep insights in the mechanical loading condition of the aortic replacements; this insight has potential to aid in vascular prostheses design and implementation.
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Fabry, T., J. Steffen, C. Hagl, J. Mehilli, M. Lühr, H. G. Theiss, D. Joskowiak, S. Massberg, M. Pichlmaier et S. Peterss. « Redo Aortic Valve Replacement following Root Replacement with a Homograft : Open Surgery or TAVI ? » Dans 49th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705300.

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Rapports d'organisations sur le sujet "Aortic Replacement"

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Ma, Likang, Zhihuang Qiu, Jun Xiao, Qingsong Wu, Tianci Chai et Liangwan Chen. A systematic review and meta-analysis about hemiarch versus total aortic arch replacement in acute type A aortic dissection. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, mai 2022. http://dx.doi.org/10.37766/inplasy2022.5.0088.

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Liu, Shidong, shuai Dong, Ruisheng Liu, Wei Sun, Pengying Zhao, Shiming Zhang, Bing Song et Cuntao Yu. Comparing Clinical Outcomes of Sutureless Aortic Valve Replacement Versus Transcatheter Aortic Valve Implantation : A Systematic Review and Meta-analysis of Propensity Score Matching. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, novembre 2022. http://dx.doi.org/10.37766/inplasy2022.11.0058.

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Runjic, Frane, Andrija Matetic, Matjaz Bunc, Nikola Crncevic et Ivica Kristic. Small Degenerated Surgical Bioprosthetic Valve should be Treated with SupraAnnular Valve-in-Valve Transcatheter Aortic Valve Replacement. Science Repository, décembre 2021. http://dx.doi.org/10.31487/j.jicoa.2021.04.02.

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Background: Patient-prothesis mismatch (PPM) is a serious potential complication following surgical aortic valve replacement (SAVR). If it develops, valve-in-valve transcatheter aortic valve replacement (TAVR) is a reasonable therapeutic option. However, there is low evidence on the management of small degenerated surgical bioprosthetic valves, not prone to balloon-valve fracture (BVF). Case Presentation: This case report presents a successful valve-in-valve TAVR in acute heart failure due to degenerative surgical bioprosthetic valve Trifecta (21 mm) that is not susceptible to BVF. Standard preparation for transfemoral TAVR with a self-expandable valve was conducted, including the over-the-wire pacing. Thereafter, a successful valve-in-valve primary implantation of the self-expanding, supra-annular valve Evolut R 26 (Medtronic™) has been achieved. Follow-up at 3 months showed mild paravalvular leak in the region with clinical and heart function improvements of the patient. Follow-up echocardiographic parameters showed the reduction of anterograde flow impairment and improved effective orifice area (~0.85 cm2/m2). Conclusion: In conclusion, supra-annular valve-in-valve TAVR is a potential therapeutic option for PPM of small degenerated surgical bioprosthetic valves which are not prone to BVF.
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Chen, Yang, Hao Chen et Bing Song. Efficacy and safety of New-generation devices for transcatheter aortic valve replacement in the treatment of Aortic Regurgitation : a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, octobre 2022. http://dx.doi.org/10.37766/inplasy2022.10.0068.

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Wang, Jialu, Shidong Liu, Xiangxiang Han, Zunhui Wan, Yang chen, Hao chen et Bing song. Impact of chronic kidney disease on the prognosis of transcatheter aortic valve replacement in patients with aortic stenosis：protocol for a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, juin 2021. http://dx.doi.org/10.37766/inplasy2021.6.0023.

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Han, Xiangxiang, Shidong Liu, Jialu Wang, Hao CHen, Yang CHen et Bing Song. Comparison of results of transcatheter femoral aortic valve replacement under local and general anesthesia : a cumulative meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, juillet 2021. http://dx.doi.org/10.37766/inplasy2021.7.0046.

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Han, Xiangxiang, Shidong Liu, Jialu Wang, Hao Chen, Yang Chen et Bing Song. Comparison of results of transcatheter femoral aortic valve replacement under local and general anesthesia : a protocol for systematic review and meta analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, juillet 2021. http://dx.doi.org/10.37766/inplasy2021.7.0078.

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Chen, Yujing, Gangjie Zhu, Xin Liu, Weilin Wu, Minjie Tao, Hui Chai, Dongmei Kong, Yingzi Li et Li Wang. Comparison of cusp-overlap projection and standard three-cusp coplaner view during transcatheter aortic valve replacement : a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, avril 2022. http://dx.doi.org/10.37766/inplasy2022.4.0092.

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du, zhaona, xiuyan lu, Y. Shao et wei xia. After transcatheter aortic valve replacement in patients of different ages Prognosis of new left bundle branch block : a systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, décembre 2022. http://dx.doi.org/10.37766/inplasy2022.12.0091.

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Surgical replacement of aortic valves offers good long-term survival. National Institute for Health Research, mai 2017. http://dx.doi.org/10.3310/signal-000418.

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