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4 results on '"Severe aortic stenosi"'

1. Annular size and interaction with trans-catheter aortic valves for treatment of severe bicuspid aortic valve stenosis: Insights from the BEAT registry

Author

Stefan Toggweiler, Jan-Malte Sinning, Paolo Calabrò, Horst Sievert, Chiara De Biase, Azeem Latib, Georg Nickenig, Won-Keun Kim, Giulio G. Stefanini, Marco Ancona, Sebastiano Immè, Uri Landes, Antonio Colombo, Francesco Giannini, Ulrich Schäfer, Lars Søndergaard, Corrado Tamburino, Ran Kornowski, Elisabetta Moscarella, Ole De Backer, Giuseppe Tarantini, Antonio Mangieri, Matteo Montorfano, Didier Tchetche, Federico De Marco, Damiano Regazzoli, Francesco Bedogni, Jörg Kempfert, Alfonso Ielasi, Jochen Woehrle, Maurizio Tespili, Massimo Medda, Moscarella, Elisabetta, Mangieri, Antonio, Giannini, Francesco, Tchetchè, Didier, Kim, Won-Keun, Sinning, Jan-Malte, Landes, Uri, Kornowski, Ran, De Backer, Ole, Nickenig, Georg, De Biase, Chiara, Søndergaard, Lar, De Marco, Federico, Bedogni, Francesco, Ancona, Marco, Montorfano, Matteo, Regazzoli, Damiano, Stefanini, Giulio, Toggweiler, Stefan, Tamburino, Corrado, Immè, Sebastiano, Tarantini, Giuseppe, Sievert, Horst, Schäfer, Ulrich, Kempfert, Jörg, Wöehrle, Jochen, Latib, Azeem, Calabrò, Paolo, Medda, Massimo, Tespili, Maurizio, Colombo, Antonio, and Ielasi, Alfonso

Subjects
Male, Annulus dimensions, medicine.medical_specialty, Catheters, Bicuspid aortic valve, medicine.medical_treatment, Severe aortic stenosi, Constriction, Pathologic, Balloon expandable valves, Self-expanding valve, Severe aortic stenosis, Trans-catheter valve replacement, Prosthesis Design, Ventricular Function, Left, Transcatheter Aortic Valve Replacement, Annulus dimension, Bicuspid Aortic Valve Disease, Valve replacement, Internal medicine, medicine, Humans, Registries, Heart valve, Cardiac skeleton, Balloon expandable valve, Ejection fraction, business.industry, Stroke Volume, Aortic Valve Stenosis, medicine.disease, Catheter, Stenosis, Treatment Outcome, medicine.anatomical_structure, Aortic Valve, Heart Valve Prosthesis, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business, Calcification
Abstract

Background: Transcatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as potential interactions between annular dimension and trans-catheter heart valve (THV) type (balloon-expandable (BEV) vs. self-expanding (SEV). Methods: BEAT is a multicenter registry of consecutive BAV stenosis undergoing TAVR. For this sub-study patients were classified according to annular dimension in small-annulus (area&nbsp

Published
2021

2. A comparison of the fully repositionable and retrievable <scp>B</scp> oston <scp>L</scp> otus and direct flow medical valves for the treatment of severe aortic stenosis: A single center experience

Author

Neil Ruparelia, Ottavio Alfieri, Alaide Chieffo, Richard J. Jabbour, Vittorio Romano, Matteo Montorfano, Luca A. Ferri, Francesco Giannini, Marco Ancona, Akihito Tanaka, Matteo Longoni, Azeem Latib, Damiano Regazzoli, Antonio Colombo, Lorenzo Azzalini, Eustachio Agricola, Nicola Buzzatti, Antonio Mangieri, Giannini, Francesco, Latib, Azeem, Montorfano, Matteo, Ruparelia, Neil, Romano, Vittorio, Longoni, Matteo, Ferri, Luca, Jabbour, Richard, Mangieri, Antonio, Regazzoli, Damiano, Ancona, Marco, Buzzatti, Nicola, Azzalini, Lorenzo, Tanaka, Akihito, Agricola, Eustachio, Chieffo, Alaide, Alfieri, Ottavio, and Colombo, Antonio

Subjects
Male, Radiology, Nuclear Medicine and Imaging, medicine.medical_specialty, Time Factors, Transcatheter aortic, medicine.medical_treatment, Severe aortic stenosi, 030204 cardiovascular system & hematology, Prosthesis Design, Single Center, Severity of Illness Index, Direct flow, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Embolization, Paravalvular leak, Clinical efficacy, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Lotus valve system, fungi, Hemodynamics, Aortic Valve Stenosis, Recovery of Function, General Medicine, medicine.disease, Surgery, Stenosis, Treatment Outcome, Trans-femoral aortic valve implantation, Italy, Echocardiography, Aortic Valve, Heart Valve Prosthesis, Cardiology, Female, Technological advance, Cardiology and Cardiovascular Medicine, business, Direct flow medical valve system
Abstract

Background Second generation transcatheter aortic valve implantation (TAVI) devices have been designed to reduce the rate of paravalvular leak (PVL) and other complications. An important technological advancement has been the ability to fully reposition devices to facilitate optimal implantation depth and position to reduce the likelihood of PVL. Objectives To compare procedural and 30-day outcomes according to the Valve Academic Research Consortium (VARC)-2 criteria following TAVI with the fully repositionable and retrievable Lotus and DFM devices. Methods and Results 175 patients with severe aortic stenosis underwent transfemoral TAVI with the Lotus (n = 60) and DFM (n = 115) valve. Baseline clinical characteristics did not differ between the two groups. All devices were successfully implanted, with one case of valve embolization in the Lotus group. Device success (95 vs. 98.2%, P = 0.89), VARC-defined combined safety (90 vs. 93%, P = 0.48), and clinical efficacy (86.7 vs. 90.4%, P = 0.65) rates at 30-days were similar between Lotus and DFM groups. There was no severe PVL; one patient in both Lotus and DFM group developed moderate PVL after the procedure. The Lotus valve was associated with a higher rate of new pacemaker implantation (37.3 vs. 11.2%, P

Published
2017
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3. Procedural and clinical outcomes of type 0 versus type 1 bicuspid aortic valve stenosis undergoing trans-catheter valve replacement with new generation devices: Insight from the BEAT international collaborative registry

Author

Marco Ancona, Ran Kornowski, Chiara De Biase, Massimo Medda, Matteo Montorfano, Corrado Tamburino, J.M. Sinning, Damiano Regazzoli, Lars Søndergaard, Jochen Woehrle, Giulio G. Stefanini, Georg Nickenig, Ulrich Schäfer, Azeem Latib, Antonio Colombo, Elisabetta Moscarella, Sebastiano Immè, Uri Landes, Won-Keun Kim, Alfonso Ielasi, Giuseppe Tarantini, Ole De Backer, Didier Tchetche, Horst Sievert, Federico De Marco, Francesco Bedogni, Antonio Mangieri, Jörg Kempfert, Paolo Calabrò, Francesco Giannini, Maurizio Tespili, Stefan Toggweiler, Ielasi, A., Moscarella, E., Mangieri, A., Giannini, F., Tchetche, D., Kim, W. -K., Sinning, J. -M., Landes, U., Kornowski, R., Backer, Nickenig, G., De Biase, C., Sondergaard, L., De Marco, F., Bedogni, F., Ancona, M., Montorfano, M., Regazzoli, D., Stefanini, G., Toggweiler, S., Tamburino, C., Imme, S., Tarantini, G., Sievert, H., Schafer, U., Kempfert, J., Woehrle, J., Latib, A., Calabro', P., Medda, M., Tespili, M., and Colombo, A.

Subjects
Aortic valve, medicine.medical_specialty, Catheters, Bicuspid aortic valve, medicine.medical_treatment, Severe aortic stenosi, Constriction, Pathologic, 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, Valve replacement, Bicuspid Aortic Valve Disease, Internal medicine, medicine, Humans, 030212 general & internal medicine, Registries, business.industry, Severe aortic stenosis, Aortic Valve Stenosis, medicine.disease, BAV morphology, Trans-catheter valve replacement, Stenosis, Catheter, medicine.anatomical_structure, Treatment Outcome, Baseline characteristics, Aortic Valve, Cardiology, Permanent pacemaker, Cardiology and Cardiovascular Medicine, business
Abstract

Background Although bicuspid aortic valve (BAV) is not considered a “sweet spot” to trans-catheter aortic valve replacement (TAVR), a certain number of BAV underwent TAVR. Whether BAV phenotype affects outcomes following TAVR remains debated. We aimed at evaluating the impact of BAV phenotype on procedural and clinical outcomes after TAVR using new generation trans-catheter heart valves (THVs). Methods patients included in the BEAT registry were classified according to the BAV phenotype revealed at multi-slice computed tomography (MSCT) in type 0 (no raphe) vs. type 1 (1 raphe). Primary end-point was Valve Academic Research Consortium–2 (VARC-2) device success. Secondary end-points included procedural complications, rate of permanent pacemaker implantation, clinical outcomes at 30-day and 1-year. Results Type 0 BAV was present in 25(7.1%) cases, type 1 in 218(61.8%). Baseline characteristics were well balanced between groups. Moderate-severe aortic valve calcifications at MSCT were less frequently present in type 0 vs. type 1 (52%vs.71.1%,p = 0.05). No differences were reported for THV type, size, pre and post-dilation between groups. VARC-2 success tended to be lower in type 0 vs. type 1 BAV (72%vs86.7%;p = 0.07). Higher rate of mean transprosthetic gradient ≥20 mmHg was observed in type 0 vs. type 1 group (24%vs6%,p = 0.007). No differences were reported in the rate of post-TAVR moderate-severe aortic regurgitation and clinical outcomes between groups. Conclusions Our study confirms TAVR feasibility in both BAV types, however a trend toward a lower VARC-2 device success and a higher rate of mean transprosthetic gradient ≥20 mmHg was observed in type 0 vs. type 1 BAV.

Published
2020

4. Right ventricle assessment in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation

Author

Rocio Hinojar, Luisa Salido, Ana María García, J M Monteagudo, Ez-Alddin Rajjoub, Ciro Santoro, Rosana Hernández-Antolín, Ariana González, Ana Pardo Sanz, José Luis Zamorano, Covadonga Fernández-Golfín, Ángel Sánchez Recalde, Pardo Sanz, A., Santoro, C., Hinojar, R., Salido, L., Rajjoub, E. -A., Monteagudo, J. M., Garcia, A., Gonzalez, A., Hernandez-Antolin, R., Sanchez Recalde, A., Zamorano, J. L., and Fernandez-Golfin, C.

Subjects
Male, medicine.medical_specialty, Longitudinal strain, Transcatheter aortic, Heart Ventricles, Ventricular Dysfunction, Right, Population, right ventricle, 030204 cardiovascular system & hematology, Free wall, TAVI, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, pulmonary hypertension, right ventricle strain, medicine, Humans, Radiology, Nuclear Medicine and imaging, In patient, education, Aged, Aged, 80 and over, education.field_of_study, business.industry, Aortic Valve Stenosis, medicine.disease, Pulmonary hypertension, Stenosis, medicine.anatomical_structure, 030228 respiratory system, Ventricle, severe aortic stenosi, Cardiology, Ventricular Function, Right, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Introduction: Limited data are available regarding the evaluation of right ventricular (RV) performance in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). Objective: To evaluate the prevalence of RV dysfunction in patients with severe AS undergoing TAVI and long-term changes. Methods: Consecutive patients with severe AS undergoing TAVI from January 2016 to July 2017 were included. RV anatomical and functional parameters were analyzed: RV diameters, fractional area change, tricuspid annular plane systolic excursion (TAPSE), S-wave tissue Doppler of the tricuspid annulus (RV-S'TDI), global longitudinal strain (RV-GLS), and free wall strain (RV-FWS). Preprocedure and 1-year echo were analyzed. Results: Final population included 114 patients, mean age 83.63 ± 6.31 years, and 38.2% women. The prevalence of abnormal RV function was high, variable depending on the parameter that we analyzed, and it showed a significant reduction 1 year after TAVI implantation: 13.9% vs 6.8% (TAPSE [20]), P =.049; and 48.7% vs 28.9% (RV-FWS > [20]), P =.03. Significant differences were noted between patients with low-flow (LF) vs normal-flow (NF) AS in RV dysfunction prevalence as well as in RV function recovery which is less evident in LF compared with NF patients. Conclusions: RV dysfunction is high among symptomatic AS patients undergoing TAVI, with variable prevalence depending on the echocardiographic parameter used.

Published
2019

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