Aortic Valve - Science topic

Objective: The choice between implanting a mechanical and bioprosthetic aortic valve (AV) for significant stenosis and/or regurgitation necessitates individualized decision-making. We sought to investigate the potential impact of effective orifice area (EOA) and EOA index on long-term survival between mechanical and bioprosthetic valves. Methods:...

Valvular calcification, developing either in the mitral or the aortic valve, is highly prevalent in patients suffering from chronic kidney disease (CKD), in whom their presence correlates with higher cardiovascular and all-cause mortality risk. To date, the exact mechanisms that promote heart valve calcification remain unclear, and none of the trea...

Cardiac surgery and the associated ischemia-reperfusion injury trigger an inflammatory response, which, in turn, can contribute to organ damage, prolonged hospitalization, and mortality. Therefore, the present study performed comprehensive monitoring of neutrophil-related inflammation in patients who underwent aortic valve surgery, including extrac...

Infective endocarditis (IE) is a common complication in patients who inject drugs. We present the case of a 36-year-old woman with IE affecting both the aortic and tricuspid valves, along with a cardiac implantable electronic device infection, 11 weeks after combined aortic valve replacement, tricuspid valve replacement, and pacemaker implantation....

Girls and women with Turner syndrome (TS) suffer from increased risk of cardiovascular diseases. We hypothesized that left ventricular (LV) myocardial strain and aortic elasticity will be impaired in girls with TS. Cardiac MRI of 45 girls with TS and 14 healthy control girls was performed. Tissue tracking was used to assess LV Global Longitudinal (...

Introduction Pre-employment screening is of utmost importance in high-risk occupations for the early diagnosis and prevention of cardiac and non-cardiac disease, and for risk mitigation. Recommendations for echocardiography screening, however, are contradictory. It was the aim of this study to retrospectively analyze echocardiography data from Germ...

Right-left bicuspid aortic valve (R-L BAV) is the most frequent phenotype of the most common congenital heart disease. Its etiology is based on two associated morphogenetic defects during cardiac outflow tract (OFT) septation: abnormal migration of cardiac neural crest (CNC) cells, and excessive fusion of the conal ridges (CRs). The aim of this stu...

Quantifying aortic valve calcification is critical for assessing the severity of aortic stenosis, predicting cardiovascular risk, and guiding treatment decisions. This study evaluated the feasibility of a deep learning-based automatic quantification of aortic valve calcification using contrast-enhanced coronary CT angiography and compared the resul...

Background Sutureless bioprosthetic valves (SBVs) are engineered to enable a less invasive surgical valve replacement procedure in patients at high surgical risk. Valve degeneration is a relatively common occurrence across all types of surgical valves, including SBVs. Valve-in-valve (ViV) procedures are increasingly becoming the preferred treatment...

Patients undergoing aortic valve repair or replacement with associated alterations in stiffness characteristics often develop abnormalities in the aortic sinus vortex, which may impact aortic valve function. The correlation between altered aortic sinus vortex and aortic valve function remains poorly understood due to the complex fluid dynamics in t...

Aims The prevalences of aortic stenosis (AS) and transthyretin amyloid cardiomyopathy (ATTR‐CM) increase with age. Identification of occult ATTR‐CM in patients with AS can help explain out‐of‐proportion myocardial dysfunction, aid in prognostication and prompt initiation of disease‐modifying treatment. Studies have suggested that many patients refe...

Infective endocarditis remains a deadly disease with a significant mortality rate. While ventricular septal defects (VSDs) have been linked to an increased risk of infective endocarditis, cases of acquired VSDs resulting from infective endocarditis are not well-documented in the literature. Our report highlights a rare case of acquired VSD that res...

To verify and validate the reliability of diastolic function parameters and valvular flow velocities acquired during the handheld ultrasound device (HUD) echocardiographic examination. Study population consisted of the consecutive patients referred for consultation due to dyspnea or impaired exercise tolerance. All patients underwent brief bedside...

Background Rapid deployment aortic valve replacement (RDAVR) has been widely adopted, but concerns about postoperative paravalvular leak (PVL) associated with its use remain. PVL is linked to an increased risk of long-term mortality; however, there is no consensus on its treatment. Case presentation Case 1: A 76-year-old female with severe aortic...

Background Aortic annuloplasty, involving the implantation of an external ring around the aortic root to reduce annular dimensions, is a promising treatment for aortic valve insufficiency. However, its hemodynamic effects remain underexplored due to the absence of computational models validated by experimental and clinical data. Methods This study...

AIM: Gastrointestinal (GI) complications following cardiac surgery are infrequent, but associated with high rates of postoperative mortality. The aim of our study was to identify risk factors predisposing patients to GI complications following cardiac surgery and describe the outcomes of patients suffering a GI complication. METHODS: This was a ret...

Quadricuspid aortic valve (QAV) is a rare congenital anomaly of the aortic valve, with an incidence of 0.05-0.1%, often associated with aortic regurgitation. The condition typically presents between the ages of 46 and 50, with a slight male predominance. While diagnosis is generally made via transthoracic echocardiography (TTE), this method can occ...

Background: Prosthesis-patient mismatch (PPM) has been demonstrated to affect the outcome of both surgical (SAVR) and transcatheter aortic valve replacement (TAVR) patients. Supra-annular transcatheter valves (SAV) appear to offer a superior solution to intra-annular valves (IAV) in this regard. However, data on the comparison of the intra-annular...

Aortic valve stenosis (AS), the leading valvular disease in aging populations, is driven by complex extracellular matrix (ECM) modifications and progressive calcification. Despite its clinical significance, the molecular mechanisms underlying AS remain poorly understood, limiting therapeutic options to invasive valve replacement. This study employs...

Background Previous reports of longer-term outcomes of transcatheter aortic valve implantation (TAVI) focus on higher risk patients and suggest potential temporal changes. Aims To evaluate the longer-term and temporal performances of TAVI compared to surgical aortic valve replacement (SAVR). Methods Randomized controlled trials reporting outcomes...

Bicuspid Aortic Valve (BAV) is the most prevalent congenital heart defect with an autosomal dominant inheritance. With up to 2% of the general population affected by the condition, mortality remains high likely due to the development of aortopathy which pre-disposes to the development of aortic dissection. Current guidelines focus on surgical manag...

Background Aortic valve calcification (AVC) is an underlying pathophysiological mechanism in aortic stenosis, which shares many risk factors with diabetes. However, the association between dysglycemia and early stages of AVC remains unclear. The aim was to examine the associations between stages of dysglycemia and signs of AVC among middle-aged ind...

Aortic valve reconstruction in the pediatric population presents significant surgical challenges as the ideal repair requires an individualized approach considering various factors. This study aims to analyze the factors influencing outcomes of aortic valve neocuspidization (AV Neo) in pediatric patients. A retrospective cohort study involving pedi...

Background Patients with moderate aortic stenosis (AS) may experience symptoms and adverse outcomes. The aim of this study was to determine whether patients with moderate AS exhibited objective evidence of exercise limitation, compared with age and sex matched controls and if so, to determine which echocardiographic parameters predicted exercise ab...

Introduction Despite technological advancements and new generation devices availability, transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve (BAV) stenosis still presents unique technical challenges. Methods and results We report an uncommon but critical complication of acute right coronary artery occlusion resulting from valve...

This article provides an overview of perioperative strokes—a pressing concern given the rising number of surgical or interventional procedures performed worldwide. Mechanisms underlying perioperative stroke include atherosclerotic plaque instability, induction of a pro-inflammatory state (aggravated by vascular risk factors), hemodynamic dysfunctio...

Background: Prognostic models for cardiovascular death, but not all-cause death, after transcatheter aortic valve implantation (TAVI) have not been established yet. Methods and Results: In 252 patients with aortic stenosis (AS) who underwent TAVI (men/women 83/169; mean age 85 years), we explored predictive models by machine learning for cardiovasc...

Background: A reduction in carotid artery blood flow (CABF) and ultimately in wall shear stress (WSS) is a major driver of heightened peripheral chemoreceptor (PCh) activity in animal models of heart failure. However, it is yet to be translated to humans. To provide more insight into this matter, we considered severe aortic stenosis (AS) before and...

Background In congenital aortic stenosis (CAS), commissurotomy is an option in patients not suitable to receive a valve prosthesis. However, there is often a need for future additional interventions on the aortic valve. The fate of the aortic valve is, however, essentially unknown. This study reports the need for reinterventions after surgical comm...

Aortic aneurysm (AA) and atherosclerosis (AS) of various vascular beds are asymptomatic for a long time and are relatively common pathological conditions that lead to life-threatening and disabling complications. In this review, we discuss the current understanding of the high variation in direct and inverse comorbidity of AA and AS as presented in...

Aim The aim of this study is to elucidate the prevalence, incidence, patient characteristics, and recent treatment trends of valvular heart disease (VHD) in Japan using a comprehensive claims database. Methods We conducted a cross-sectional study using the national database of health insurance claims in Japan (April 2009—June 2021), which contains...

Introduction: Aortic valve disease (AVD) is an inflammatory, lipid infiltration and calcification disease that has been associated with changes in the conventional linear heart rate variability (HRV) indices showing a marked shift towards sympathetic predominance and a deterioration of the autonomic control. Objective: To explore the HRV dynamics i...

Background: In recent years, transcatheter aortic valve implantation (TAVI) has rapidly emerged as a key treatment option for aortic stenosis. TAVI has been performed at Uppsala University Hospital since 2009. Data on TAVI procedures have been collected in a nation-wide all-comer registry, the Swedish Transcatheter Cardiac Intervention Registry (SW...

Transcatheter aortic valve replacement (TAVR) was introduced in 2002 and has become integral in the management of aortic stenosis. As an alternative to surgical aortic valve replacement, it relies heavily on safe access to the aortic annulus for implantation of a valve prosthesis. Throughout its development and in current practice, the transfemoral...

Background Blood culture-negative infective endocarditis presents a significant clinical and diagnostic challenge owing to its atypical presentation and difficulty in identifying causative pathogens. Bartonella henselae, a rare cause of blood culture-negative infective endocarditis, can further complicate its diagnosis and treatment. Case presenta...

Background: Patients with severe aortic stenosis (AS) who are managed medically have a poor prognosis. No contemporary studies have examined the costs and resource utilization associated with medical management for severe AS. Methods: We used data from the Optum Market Clarity Database, which links electronic health records (EHR) with claims cost a...

Background Calcified amorphous tumour (CAT) is a rare lesion that forms at various sites of the heart, including the mitral annulus. Since it is a systemic embolic source, it often requires resection. In contrast, caseous calcification of the mitral annulus (CCMA) usually receives conservative follow-up; however, it is sometimes resected to prevent...

Background/Objectives: Pleural effusions may be seen in patients with severe AS complicated by hemodynamically significant heart failure. However, there are no data on the association between pleural effusion and long-term mortality in patients undergoing transcatheter aortic valve implantation (TAVI). This study aimed to assess the impact of pre-p...

Background: Aortic stenosis (AS) is one of the most common valvular heart diseases, particularly in the elderly, with a prevalence of approximately 3% in individuals over 75 years of age. Aortic valve replacement (AVR) remains the standard treatment, yet postoperative hemodynamic assessment is often complicated by variations in prosthetic valve siz...

Introduction: This study aimed to analyze long-term survival and valve-related adverse events after 1000 consecutive rapid-deployment surgical aortic valve replacements (RD-SAVRs) in a single center. Methods: A total of 1000 patients following RD-SAVR at our institution were included in a prospective database. Median follow-up was 68 months (IQR: 3...

Advances in imaging with faster scans and routine use of thin-section images have allowed for the regular detection of congenital heart disease (CHD) in adults. Simultaneously, surgical and medical treatments have allowed children with complex CHD to live well into adulthood. The net effect is that more adults are alive with CHD than children. CHD...

Coronary artery disease and aortic valve stenosis are highly prevalent cardio-vascular diseases worldwide, resulting in substantial morbidity and mortality. Surgical interventions, such as coronary artery bypass grafting and surgical aortic valve replacement, offer significant therapeutic benefits, including enhanced postoperative quality of life (...

Background It has been reported that mechanical damage occurs when regurgitant flow from aortic regurgitation (AR) directly impinges on the anterior mitral valve leaflet (AML). However, only a few cases of mitral valve perforation have been reported. Previous reports suggest that AR in such cases tends to be Grade 3 or higher and that haemodynamic...

Connective tissue disorders are known to cause cardiac and vascular complications. We present the case of a 37-year-old female patient with a rare Ehlers Danlos/Osteogenesis Imperfecta Overlap Syndrome, referred to cardiac surgery with aortic valve regurgitation, who underwent a successful Biological Surgical Aortic Valve Replacement (SAVR). A mult...

To investigate the association between preoperative coronary artery disease (CAD) severity, as classified by the Coronary Artery Disease Reporting and Data System (CAD-RADS), and clinical outcomes in patients undergoing isolated aortic valve replacement (AVR). A total of 897 patients (452 women; mean age, 66.1 ± 9.3 years) who underwent isolated AV...

Transcatheter mitral valve repair with the MitraClip device has become an established therapeutic option for the treatment of symptomatic patients with mitral regurgitation and prohibitive surgical risk. Despite its safe profile when performed in experienced centers, complications such as MitraClip device detachment or migration into the left atriu...

Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has emerged as a feasible alternative to reo-perative surgery in patients with degenerated surgical bio-prosthesis. However, data regarding the choice of valve type in ViV-TAVI remain inconclusive. This meta-analysis compares the procedural and clinical outcomes of self-expanding (SE...

Accurate modeling of cardiovascular tissues is crucial for understanding and predicting their behavior in various physiological and pathological conditions. In this study, we specifically focus on the pulmonary artery in the context of the Ross procedure, using neural networks to discover the most suitable material model. The Ross procedure is a co...

Surgical Aortic Valve Replacement (SAVR) is still one of the pillars of cardiac surgery practice, and its role is evolving into a more complex operation. The competition with structural valve therapies and the urgent demand for less invasive solutions have unleashed surgeons’ creativity in adapting to these new challenges. All the possible ways to...

Aims Few studies have examined the incidence, prevalence, survival rate and death risk for non‐rheumatic and rheumatic aortic stenosis (AS; RAS), aortic insufficiency (AR; RAR) and aortic stenosis with insufficiency (ASAR; RASAR). This study aims to identify the epidemiology of AS, AR, ASAR, RAS, RAR and RASAR. Methods and results Data were collec...

Little is currently known about the pathological changes after aortic wrapping. This study investigated long-term outcomes including pathological findings after ascending aortic wrapping. Of the 30 patients who underwent aortic wrapping from 2004 to 2012, redo surgery was later performed in six patients. All the patients underwent ascending aorta r...

Background: Although sutureless aortic valve replacement is rising in popularity, there are few reports on its use in patients on dialysis. This study aimed to investigate the early and mid-term surgical outcomes of the procedure in these patients. Methods: Twenty-one dialysis (mean age, 77.4 ± 5.2 years) patients with aortic stenosis who underwent...

Bicuspid aortic valve (BAV), a prevalent congenital cardiac defect, predisposes patients to severe complications. Despite its high heritability, previously identified protein-coding and common regulatory mutations account for only a small fraction of cases. To address this gap, we investigated the role of rare regulatory mutations. By integrating h...

The underlying pathophysiology of aortic stenosis and factors affecting its clinical progression remain poorly understood. Apart from B-type natriuretic peptide (BNP), novel and emerging biomarkers have been described in association with aortic stenosis, emphasising the potential for these biomarkers to illuminate on yet unknown mechanisms of its p...

The ideal aortic valve substitute in adults remains a matter of intense debate. With the advent of transcatheter procedures, the concept of lifetime management of aortic valve disease has gained further momentum. The Ross procedure represents the only replacement option that ensures long-term viability of the aortic valve substitute. This provides...

Aortic valve disease (AVD) is a highly prevalent condition worldwide. Aortic valve replacement (AVR) is the surgical treatment for those with severe disease. Common etiologies of AVD include aortic stenosis (AS), aortic insufficiency (AI), endocarditis, and congenital diseases. Shared decision-making plays a large role in the treatment methodology...

Abstract: Background: Early safety outcomes following transcatheter aortic valve implantation (TAVI) for severe aortic stenosis are critical for patient prognosis. Accurate prediction of adverse events can enhance patient management and improve outcomes. Aim: This study aimed to develop a machine learning model to predict early safety outcomes in...

Aortic dissection in pediatrics is an extremely rare condition, which is generally related to predisposing factors such as connective tissue disorders, congenital heart disease and systemic arterial hypertension. A 3-year-old girl, with a history of bicuspid aortic valve, hypoplasia of the aortic arch and repaired aortic coarctation at one month of...

Background: Mediastinal hematomas, although rare, can result from cardiovascular surgeries, interventions, or trauma and can range from asymptomatic to life-threatening conditions. When a mediastinal hematoma compresses the cardiac chambers, it may closely mimic a right atrial thrombus, complicating diagnosis and treatment. Accurate differentiation...

Backround/Objectives: Aortic stenosis (AS) is the most commonly acquired valvular disorder. Patient risk stratification and the development of an accurate and reliable tool are crucial in identifying suitable candidates for TAVI. The present review summarized the current state of knowledge on the influence of selected factors on the outcomes and co...

Background Elevated lipoprotein(a) (Lp[a]) is an inherited condition that increases cardiovascular disease (CVD) risk, independent of other factors, such as low-density lipoprotein C. Few attempts have been made to explore the life experiences of people with elevated Lp(a). Objective To explore the experiences of people living with or caring for a...

Background The aim of this study was to investigate whether the level of decrease in cerebral oxygen saturation during the valve placement phase of the transcatheter aortic valve implantation (TAVI) procedure under sedation has an effect on postoperative delirium (POD). Methods The study initially assessed 50 patients between the ages of 50 and 90...

Background The study was aimed at assessing clinical status and outcome of patients affected by aorto-left ventricular tunnel (ALVT). Methods A systematic search of keywords relating to ALVT was conducted to identify papers published between 1965 and February 2024 present on Pubmed/Medline and Scopus. Results A total of 109 studies, which in all...

Purpose of Review Prosthetic valve replacement has been the cornerstone of aortic regurgitation (AR) management but presents challenges such as the need for lifelong anticoagulation, limited durability, increased risks of thromboembolism, and reduction in life expectancy. This review aims to explore the evolution of AR management, addressing advanc...

Objective: To evaluate post-transcatheter aortic valve replacement (TAVR) physical activity and explore the factors influencing participation. Design: A quantitatively driven sequential explanatory mixed-methods study was performed from October 2021 to February 2022 in Shanghai, China. Patients: The study sample comprised 195 patients who underwent...

Iodinated contrast media is integral to the evaluation for transcatheter aortic valve implantation; however, some patients may have contraindications to the use of iodinated contrast media. The study reports successful use of a gadolinium-based contrast agent in a patient with severe symptomatic aortic stenosis, contrast allergy and post-contrast a...

There is a very low prevalence of cardiac tumor (fibroma)in the Younger population. Cardiac fibromas arise from heart fibroblasts, and these tumors are primarily located in the ventricles or in the interventricular septum. Symptomatic tumors are treated by resection. By contrast, asymptomatic tumors require a long-term follow-up or surgical resecti...

The demand for accurate vascular simulators is increasing to facilitate effective clinical studies on cardiovascular diseases. The research presents the miniaturized design and precise programable regulation of an artificial magnetic heart valve inspired by the human aortic valve, demonstrating the diverse types of pulsating waves. The heart valve...

Objectives To analyze the prevalence and severity of fetal aortic regurgitation (AR) after undergoing fetal aortic valvuloplasty (FAV) and to evaluate its effects on fetal circulation and left ventricular (LV) growth. Methods This was a retrospective review of all fetuses with critical aortic stenosis who underwent FAV at our center between 2010 a...

Background: Surgical dogma advocates for the use of homograft in invasive aortic valve endocarditis due to a perceived advantage in the prevention of recurrent infection. However, conclusive data to support this strategy are lacking. This study evaluated outcomes of root replacement in invasive aortic valve endocarditis using homografts or prosthet...

Background Transcatheter aortic valve replacement (TAVR) has been widely used to treat patients with aortic stenosis (AS). The anchoring of most transcatheter heart valves (THV) depends on friction with the native aortic valve (AV). Methods A total of 9 patients with severe AS accepted TAVR using Xcor system with transapical access in our center....

Objectives: The aim of this study was to evaluate the influence of three-dimensional transcatheter heart valve (THV) position on mid-term pacing burdens and to examine the effect of stimulation rates on survival after transcatheter aortic valve implantation (TAVI). Methods: In patients receiving a new PPM before discharge after TAVI, we analyzed th...

This study investigates the impact of geographic and socioeconomic barriers on access to transcatheter aortic valve replacement (TAVR). Utilizing Medicare data from the US Centers for Medicare and Medicaid Services, this study analyzed TAVR and surgical aortic valve replacement (SAVR) procedures among beneficiaries from 2017 to 2022. Geographic uni...