To determine the feasibility of real-time three-dimensional transoesophageal echocardiography (3D-TOE) in the evaluation of aortic valve stenosis, to study its reliability, and to test the concordance of this new method when compared with transthoracic two-dimensional echocardiography (2D-TTE) as the diagnostic standard. Fifty-nine consecutive patients with moderate-to-severe aortic valve stenosis were ...

INTRODUCTION: The role of blood coagulation in the pathogenesis of aortic stenosis (AS) is unknown. Recently, tissue factor (TF) expression in stenotic aortic valves has been reported in animal model. OBJECTIVES: The aim of the study was to investigate TF expression in valve leaflets obtained from AS patients and to ...

Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis has proven to be a feasible and effective treatment modality for inoperable patients. Until now, neither aortic regurgitation nor degenerated bioprostheses has been an indication for TAVI. However, this article reports a successful valve-in-valve implantation of a CoreValve aortic valve prosthesis ...

A 66-year-old man with severe aortic stenosis had previously undergone esophagectomy with retrosternal gastric tube (GT) reconstruction for esophageal cancer. A chest computed tomography scan demonstrated severe aortic calcification, and we treated him with median sternotomy. A small upper laparotomy was made, and the surface of the GT was detected. ...

BACKGROUND: Dilatation of the sinotubular junction (STJ) causes aortic regurgitation (AR) in patients with ascending aneurysm. These patients can regain valve competence by simple reduction of the diameter of STJ. Results of this technique were investigated clinically and echocardiographically. METHODS: Replacement of the ascending aorta with reduction of the diameter ...

Cardiobacterium valvarum, a fastidious Gram-negative bacterium, was detected in the aortic valve of a previously healthy 63-year-old man by broad-range PCR and 16S rRNA gene sequencing. In contrast to the patients in five previously published cases, our patient had neither a congenital bicuspid nor a prosthetic aortic valve. Here, we ...

Calcific cerebral emboli are a known complication of aortic stenosis. Most of these emboli are related to traumatic disruption, via cardiac catheterization, valvotomy, or valve replacement. Spontaneous calcific cerebral emboli are extremely rare and are typically associated with heavily calcified bicuspid aortic valves, especially when they occur in young adults. ...

BACKGROUND: It is unclear whether small differences in transprosthetic gradient between porcine and bovine biologic aortic valves translate into improved regression of left ventricular (LV) hypertrophy after aortic valve replacement. We investigated transprosthetic gradient, aortic valve orifice area, and LV mass in patients randomized to aortic valve replacement with either ...

Two male patients who underwent an aortic valve replacement are presented in this study. After assessment, an aortic valve stenosis was diagnosed in both patients, and a multislice computed tomography scan confirmed the heavily calcified aorta and severe aortic stenosis. The computed tomography scan demonstrated the huge calcium deposits and ...

BACKGROUND: Valve competence in valve-sparing aortic root replacement has been described as being influenced by commissural height as well as graft size. The aim of this study was to investigate the impact of a gradual reduction of commissural height and graft diameter on aortic insufficiency under physiological conditions in an ...

OBJECTIVE: Transcatheter aortic valves have been successfully implanted into the calcified leaflets of patients with severe aortic stenosis. However, their stability in patients with noncalcified aortic insufficiency is unknown. Similar to thoracic and abdominal aortic stent grafts, transcatheter aortic valves are subjected to antegrade ejection forces during systole. However, retrograde ...

Aortic valve replacement with mechanical or biological heart valves is the treatment of choice for aortic valve stenosis when it is symptomatic or with severe aortic stenosis (< or = 0.6 cm(2)/m(2)) or with left ventricular dysfunction. In an effort to improve the outcomes of patients with stented biological valves, ...

A 27-year-old, G(3)P( 2)A(0) female with acute Staph aureus (SA) endocarditis successfully underwent CPB-assisted aortic valve replacement with a bioprosthetic aortic valve at 22 weeks' gestation. This patient's presentation of acute endocarditis complicated by septic shock, congestive heart failure, severe aortic insufficiency, multiple septic embolic events and borderline renal failure ...

Calcific aortic stenosis (AS) is primarily a disease of the elderly, possessing features that are biomechanical as well as systemic and inflammatory in nature, with risk factors and histopathology similar to atherosclerosis. To date no medical therapy has been shown to conclusively alter the progression of the disease, and for ...

Our aim was to assess the safety and feasibility of the retrograde trans-subclavian approach to transcatheter aortic valve implantation (TAVI) in selected high-risk patients with aortic stenosis (AS) and severe peripheral vasculopathy. TAVI is an emerging therapeutic option to treat inoperable/high-risk patients affected by symptomatic AS. However, these patients are ...

BACKGROUND AND AIM OF THE STUDY: Patients with combined aortic valve pathology (stenosis and insufficiency) are often evaluated as if they had only a single pathology, because a means of evaluating the detrimental effects of combined insufficiency and stenosis does not yet exist. The study aim was to test the ...

The purpose of this article is to familiarize the radiologist with the technical aspects of transcatheter aortic valve replacement (TAVR). The wide range of MDCT imaging findings that are critical for planning and performing TAVR will be reviewed. TAVR is developing into an effective and reproducible therapy for aortic valve ...

Osteogenesis imperfecta (OI) is a rare inheritable disorder of connective tissue. While musculoskeletal abnormalities are well known, cardiovascular involvement is rare. Aortic root dilation is the most common cardiovascular manifestation. OI preferentially affects the left-sided heart valves, for unclear reasons, leading to aortic and mitral regurgitation. Valve replacement surgery carries ...

Transcatheter aortic valve implantation (TAVI) is a relatively new treatment option for inoperable patients with severe aortic stenosis (AS). This case describes how a planned conventional surgical aortic valve replacement (AVR) on a 73-year-old woman was successfully converted to a TAVI procedure. On extracorporal circulation it was reconized that the ...

Marfan syndrome (MFS) is a heritable disorder of connective tissue, affecting principally skeletal, ocular, and cardiovascular systems. The most life-threatening manifestations are aortic aneurysm and dissection. We investigated changes in the proteome of aortic media in patients with and without MFS to gain insight into molecular mechanisms leading to aortic ...

OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is an alternative treatment for aortic stenosis in selected cases, but requires appropriate vascular access. We report our initial clinical experience with a novel endovascular approach for TAVI. METHODS: Between 1 April 2007 and 31 August 2008, 48 patients underwent TAVI at our institution. ...

Aortic valve calcification is common in the elderly and in patients with congenital bicuspid aortic valve but unlike calcific mitral valve disease it is not a well recognized risk factor for stroke. Although autopsy studies have revealed evidence of systemic embolism in one-third of cases with calcific aortic valves, there ...

Quadricuspid aortic valve, a rare congenital anomaly, is often related to severe aortic regurgitation and has a significant morbidity. The first described case was reported in 1862. Quadricuspid aortic valve is, in most cases, an isolated malformation, but it can be associated with other concomitant anomalies. We present here the ...

Our experience with the Sapien trans-apical aortic valve (Edwards Lifesciences Inc., Irvine, CA, USA) has been straightforward without per-procedural mortality except in 1/16 consecutive cases who developed non-apical haemorrhage early after valve implantation. We describe the case of an 84-year-old female carrying a very high operative risk (logistic EuroScore of ...

Calcific aortic stenosis is the third leading cause of adult heart disease and the most common form of acquired valvular disease in developed countries. However, the molecular pathways leading to calcification are poorly understood. We reported two families in which heterozygous mutations in NOTCH1 caused bicuspid aortic valve and severe ...

OBJECTIVE: Aortic valve repair is a more recent approach for the treatment of aortic regurgitation. Limited data exist for reconstruction in specific pathologies with isolated cusp pathology. We analyzed the results of aortic valve repair in patients with aortic regurgitation caused by myxomatous cusp prolapse in the presence of tricuspid ...

We report a case of mechanical aortic valve replacement that was complicated by acute occlusion of one of the valve leaflets by the BioGlue (CryoLife Inc, Kennesaw, GA) that had seeped through the suture line on the aorta. This uncommon, but life-threatening complication is one that may go unrecognized, but ...

Transcatheter aortic valve implantation (TAVI) using a balloon-expandable valve has been developed by the authors' group 7 years ago to offer a therapeutic solution to nonoperable or surgical high-risk patients with degenerative aortic stenosis. The technique and the devices used have rapidly evolved thereafter and TAVI has become a clinical ...

Three patients demonstrated severe, central aortic insufficiency noted immediately upon removal of the aortic cross clamp after aortic valve replacement with a bovine pericardial Edwards Magna valve. After maintaining left ventricular decompression, the aortic insufficiency resolved in less than 1 hour. Knowledge of this phenomenon will prevent unnecessary prosthetic valve ...

BACKGROUND: Management of patients with acquired heart malformations, including aortic valve disease, is still challenging. Due to ageing of population, patients undergoing valve surgery are older than in the past. The 3F Therapeutics, conducting a programme of construction of heart valves for transarterial or transapical implatation, prepared the 'Enable' bioprosthetic ...

A young man presented with a new heart murmur. History revealed that the patient was from Ukraine, which was affected by the Chernobyl nuclear plant explosion in 1986. Physical examination revealed murmurs of mitral regurgitation and aortic stenosis. Transesophageal echocardiography revealed severely calcified mitral and calcified tricuspid aortic valves with ...

Off-pump implantation of an apico-aortic bioprothesis-valved conduit in a 75-year-old female symptomatic patient with severe prosthesis-patient mismatch secondary to a previous aortic valve replacement, calcified ascending aorta, tight adhesion with the sternum, was successfully conducted to relieve the left ventricle from severe aortic stenosis.

Aortic valve replacement for aortic regurgitation (AR) has been established as a standard treatment but implies prosthesis-related complications. Aortic valve repair is an alternative approach, but its mid- to long-term results still need to be defined. Over a 12-year period, 640 patients underwent aortic valve repair for regurgitation of a ...

We assessed the effects of aortic valve pathology type on the long-term outcomes of patients who underwent concomitant aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) surgery. We retrospectively reviewed 150 patients who underwent AVR-CABG at our institution between January 1997 and December 2006. We divided patients into ...

BACKGROUND: We recently demonstrated the first in-vitro cutting results of a minimal-invasive aortic valve resection tool. The current study was designed to assess the cutting accuracy of this new device improved by the implementation of a linear motor-based propulsion unit. METHODS: Native aortic valves of isolated swine hearts (valve diameter ...

We present a 30-year-old man with an acute middle cerebral artery territory infarction. A transesophageal echocardiogram showed a large, highly mobile mass attached to the patient's aortic valve. We discuss the differential diagnosis of a cardiac mass that includes infection, tumor, and thrombus. A complete workup showed no evidence of ...

OBJECTIVES: The aim of this study was to assess current evidence supporting the use of percutaneous heart valves (PHV) in degenerative aortic valve and congenital pulmonary outflow tract disease, as compared to conservative medical therapy or traditional surgical valve replacement. METHODS: A systematic review of the literature on PHV was ...

OBJECTIVE: The aim of this study was to evaluate the clinical and echocardiographic results after aortic valve reconstruction with a novel surgical technique consisting of basal cusp enlargement with an autologous pericardial patch. METHODS: Between December 2005 and June 2008, a total of 106 consecutive patients underwent elective valve-sparing aortic ...

To better understand aortic valves amenable to percutaneous aortic valve implantation, operatively excised stenotic aortic valves were examined and divided into 2 groups: heavier and lighter valves. Among 2,247 operatively excised stenotic aortic valves in adults aged >20 years without associated mitral stenosis or mitral valve replacement, 1,608 valves were ...

Double-orifice mitral valve (DOMV) is a rare congenital malformation characterized by two separate valve orifices of varying sizes in association with the abnormalities of the subvalvular apparatus. It has been reported to be associated with a variety of other congenital malformations. We report a rare case of incomplete form of ...

There have been major advances in the management of aortic valve disease. Because bicuspid aortic valve is common and predicts an increased risk of adverse aortic events, these patients merit aortic surveillance and consideration for ascending aortic replacement when its diameter exceeds 4.0 cm. Serial quantitative echocardiographic analysis, as compared ...

A 14-day-old boy with tetralogy of Fallot (ToF), ductus-dependent pulmonary circulation, and significant aortic valve stenosis (AVS) underwent primary repair of ToF without aortic valve intervention. The pressure gradient through the aortic valve decreased spontaneously after the operation. This may have been due to the reduction of blood flow through ...

Left ventricular dimensions tend to reduce after aortic valve replacement in patients with aortic stenosis. Whether concomitant coronary artery disease has an influence on postoperative ventricular dimensions has not been evaluated. Between 1998 and 2002, 112 patients underwent aortic valve replacement for aortic stenosis; 68 had isolated aortic valve replacement, ...

A conduit was made by sewing a bovine pericardial valve into a graft conduit with the pseudo-sinuses of Valsalva. The graft collar below the valve cuff ring was sewn to the aortic annulus with interrupted pledgeted sutures. From August 2005 to February 2008, 68 patients underwent aortic root replacements with ...

Transcatheter transapical or transfemoral aortic valve replacement has emerged as an alternative therapy of severe, symptomatic valvular aortic stenosis in surgically nonamenable patients. We report a transapical treatment of a severely stenosed 21-mm aortic Mitroflow valve bioprosthesis (Sorin Group, Vancouver, British Columbia, Canada) in an 82-year-old woman using a 23-mm ...

BACKGROUND: Transcatheter aortic valve implantation is an alternative to open heart surgery in patients with aortic stenosis. However, long-term data on a programmatic approach to aortic valve implantation remain sparse. METHODS AND RESULTS: Transcatheter aortic valve implantation was performed in 168 patients (median age, 84 years) in the setting of ...

PURPOSE: Important comorbid conditions in elderly patients referred for aortic valve replacement require alternative treatment options with possible reduction of the extracorporeal circuit time and reliable hemodynamic features. We report on clinical experiences with the sutureless, nitinol-stented 3f Enable (ATS Medical, Minneapolis, MN) aortic valve prosthesis in 32 patients. DESCRIPTION: ...

PURPOSE: We sought to determine the accuracy of multislice spiral computed tomography (MSCT) for assessing of aortic valve stenosis and to establish threshold values of the planimetric aortic valve orifice area (AVA) that best separate between different grades of stenosis severity. MATERIALS AND METHODS: A total of 202 patients (among ...

BACKGROUND: Few studies have reported population-based outcomes for aortic valve replacement patients. METHODS: Patients with severe aortic valve stenosis who underwent aortic valve replacement with or without concomitant coronary artery bypass graft surgery from January 1, 2003, to December 31, 2005, were included in the study. Statistical models were developed ...

With improved life expectancy, the incidence of aortic stenosis is rising. However, up to one-third of patients who require lifesaving surgical aortic valve replacement are denied surgery due to a high operative mortality rate. Such patients can only be treated with medical therapy or percutaneous aortic valvuloplasty, neither of which ...