共查询到20条相似文献,搜索用时 264 毫秒
1.
Ronald K. Binder MD David Wood MD John G. Webb MD Anson Cheung MD 《Catheterization and cardiovascular interventions》2013,82(7):E929-E931
An 86‐year‐old lady with recurrent admissions for heart failure due to a severely regurgitant aortic bioprosthesis (SJM Epic 19 mm) was not a candidate for re‐operation due to age and frailty. Her small ilio‐femoral arteries precluded a transfemoral transcatheter valve‐in‐valve (VIV) approach. The small internal diameter of her bioprosthesis (16 mm) forbids the implantation of the smallest available transapical transcatheter heart valve (THV). We, therefore, decided to perform a first‐in‐human transapical aortic VIV implantation using a 20 mm balloon expandable THV and a transfemoral delivery system. The procedure was successfully performed under general anesthesia, without any contrast dye and under fluoroscopy as well as transesophageal echocardiography guidance. The post‐procedural transvalvular gradient was 15 mm Hg (pre‐procedural 14 mm Hg). At 30‐day follow‐up, the lady was living independently at home without shortness of breath during her daily activities. If redo‐surgery for prosthetic regurgitation is not an option, VIV implantation in very small surgical bioprosthesis is feasible and leads to acceptable hemodynamics and clinical improvement.© 2012 Wiley Periodicals, Inc. 相似文献
2.
3.
Gianfranco Butera Gianluca Lucchese Conal Austin Alessandra Frigiola 《Catheterization and cardiovascular interventions》2020,95(5):950-953
Trans‐apical approach has been proved successful in failing surgical bio‐prosthesis in both mitral and aortic position in adult patients. Recently, valve‐in‐valve treatments have been applied even in patients with complex congenital heart disease. Here, we report the case of a 32 years old lady with left atrial isomerism, complete AV septal defect, interrupted inferior vena cava with azygos continuation who underwent Kawashima procedure with atrial Fontan. Severe systemic atrioventricular valve regurgitation necessitated a 33 mm Perimount valve implantation and conversion to lateral tunnel Fontan. After only 4 years there was severe valve stenosis and the patient underwent successful trans‐apical transcatheter implantation of a 29 mm Sapien valve. 相似文献
4.
N‐terminal pro‐B‐type natriuretic peptide‐ratio predicts mortality after transcatheter aortic valve replacement 下载免费PDF全文
Lanja Saleh PhD Volkmar Falk MD Ulf Landmesser MD Fabian Nietlispach MD PhD Francesco Maisano MD Thomas F. Lüscher MD Willibald Maier MD Ronald K. Binder MD 《Catheterization and cardiovascular interventions》2015,85(7):1240-1247
5.
Valve‐in‐valve implantation with a 23‐mm balloon‐expandable transcatheter heart valve for the treatment of a 19‐mm stentless bioprosthesis severe aortic regurgitation using a strategy of “extreme” underfilling 下载免费PDF全文
Florent Chevalier MD Jonathon Leipsic MD Philippe Généreux MD 《Catheterization and cardiovascular interventions》2014,84(3):503-508
We report a case of valve‐in‐valve (ViV) implantation by transfemoral approach with a 23‐mm balloon‐expandable prosthesis inside a stentless 19‐mm acutely degenerated bioprosthesis, using a strategy of “extreme” underfilling. A 74‐year‐old patient presented to our institution in cardiogenic shock. An initial transesophageal echocardiography (TEE) showed severe central aortic regurgitation (AR) due to a torn leaflet. She was deemed inoperable and considered for urgent transcatheter aortic valve replacement. Given the fairly small true internal diameter, a strategy of 3‐cc underfilling of a 23‐mm transcatheter heart valve (THV) was planned. However, the final implantation was performed with 5‐cc underfilling due to the incapacity to deliver the entire amount of fluid contained in the inflation syringe. TEE guidance confirmed the successful positioning and deployment of the prosthesis, with no AR and a mean gradient of 25 mm Hg. While implantation of a smaller prosthesis (20 mm) was debated during the Heart Team discussion, the risk of valve embolization due to inadequate anchoring inside the stentless prosthesis led to the selection of a 23‐mm THV. At 6‐month follow‐up, the patient was in NYHA class I, with no AR and a mean gradient of 28 mm Hg. We report for the first time the use of in vivo THV with 5‐cc underfilling with no acute or short‐term structural failure, and the first ViV implantation by transfemoral approach with a 23‐mm balloon‐expandable prosthesis inside a stentless 19‐mm bioprosthesis. The current report presents the challenges related to ViV implantation inside a small stentless bioprosthesis and offers practical ways to overcome them. © 2014 Wiley Periodicals, Inc. 相似文献
6.
Gian Paolo Ussia MD FSCAI Massimiliano Mulè MD Corrado Tamburino MD PhD FESC FSCAI 《Catheterization and cardiovascular interventions》2009,73(5):713-716
Percutaneous aortic valve replacement is an emerging alternative to palliative medical therapy for nonsurgical patients with severe aortic valve stenosis. The impossibility of repositioning of the current transcatheter prosthesis in case of suboptimal placement is the main limit of these devices. Here, we report on a case of an 84‐year‐old woman successfully treated with implantation of two 18‐Fr CoreValve® prosthesis (CoreValve®, Irvine, California), because of the suboptimal deployment of the first one, analyzing the procedural technique and the immediate and short‐term clinical and hemodynamic results. © 2009 Wiley‐Liss, Inc. 相似文献
7.
Transcatheter aortic valve‐in‐valve treatment of degenerative stentless supra‐annular Freedom Solo valves: A single centre experience 下载免费PDF全文
James Cockburn MD MRCP Maureen Dooley MRCP Jessica Parker BSc Andrew Hill MD FRCA Nevil Hutchinson MD FRCA Adam de Belder MD FRCP Uday Trivedi MD FRCS David Hildick‐Smith MD FRCP 《Catheterization and cardiovascular interventions》2017,89(3):438-444
8.
Moritz Seiffert MD Olaf Franzen MD Lenard Conradi MD Stephan Baldus MD Johannes Schirmer MD Thomas Meinertz MD Hermann Reichenspurner MD PhD Hendrik Treede MD 《Catheterization and cardiovascular interventions》2010,76(4):608-615
Objectives: We report our experience with transcatheter valve‐in‐valve implantations in patients with degenerated bioprostheses in aortic and mitral position. Background: Xenograft degeneration is a potential problem after biological valve replacement. Reoperation remains the gold standard with very good short‐ and long‐term results. In selected patients not suitable for surgery however, interventional techniques for valve implantation and repair may be valuable alternative treatment options with regard to the good results of transcatheter valve implantation for native aortic valve stenosis. Methods: Five patients presented with significant xenograft degeneration 15.4 ± 5.2 years after aortic (n = 4) and mitral (n = 1) valve replacement. Mean patient age was 82.0 ± 6.5 years and predicted operative mortality was 55.8% ± 18.9% (logistic EuroSCORE). Transcatheter valve‐in‐valve implantation was performed successfully through a transapical access in all patients. A 23‐mm Edwards Sapien valve was deployed into the degenerated valve prosthesis. Results: Mean transvalvular gradients were reduced from 31.2 ± 17.4 to 19.0 ± 12.4 mm Hg in aortic and from 9 to 3 mm Hg in mitral position without significant regurgitation in any of these patients. Two patients died within 30 days due to low cardiac output and acute hemorrhage, respectively, one of whom presented with a EuroSCORE of 88.9%. Conclusions: With growing need for reoperative valve replacement in elderly patients with disproportional operative risks, transcatheter valve‐in‐valve implantation in aortic and mitral position offers an alternative treatment option. Although valve function after transcatheter implantation was good in all patients, two high risk patients died in the postoperative period due to their significant comorbidities, underscoring the bail‐out character of this procedure. © 2010 Wiley‐Liss, Inc. 相似文献
9.
Contemporary transcatheter aortic valve replacement with third‐generation balloon‐expandable versus self‐expanding devices 下载免费PDF全文
Toby Rogers MD PhD Arie Steinvil MD Kyle Buchanan MD M. Chadi Alraies MD Edward Koifman MD Jiaxiang Gai MSPH Rebecca Torguson MPH Petros Okubagzi MD Itsik Ben‐Dor MD Augusto Pichard MD Lowell Satler MD Ron Waksman MD 《Journal of interventional cardiology》2017,30(4):356-361
Objectives
To evaluate balloon‐expandable and self‐expanding third‐generation transcatheter aortic valve replacement (TAVR) devices according to patient selection criteria and outcomes.Background
Two competing third‐generation TAVR technologies are currently commercially available in the US. There are no published head‐to‐head comparisons of the relative performance of these two devices.Methods
257 consecutive patients undergoing TAVR with a third‐generation balloon‐expandable (Edwards Sapien 3) or self‐expanding device (Medtronic CoreValve Evolut R) at a single US medical center were included. Choice of TAVR device was at the discretion of the multidisciplinary Heart Team. Baseline clinical characteristics, echocardiographic and CT imaging, procedural and 30‐day outcomes were prospectively collected.Results
74 patients received a self‐expanding valve (SEV) and 183 received a balloon‐expandable valve (BEV). Patients selected for SEV were more frequently women, with lower body surface area and smaller calcified iliofemoral arteries. Three SEV patients required implantation of a second valve to successfully treat paravalvular leak. Only one BEV patient had moderate paravalvular regurgitation. There was no difference in the rate of stroke, major vascular complication or bleeding. Permanent pacemaker implantation rate was significantly higher with SEV (12.7% vs 4.7%, P = 0.49) and hospital length of stay was longer (8.3% vs 6.5%, P = 0.043), but 30‐day mortality was comparable (1.4% vs 1.6%, P = 1.00).Conclusions
Short‐term outcomes were equivalent between the two technologies. Clinically significant paravalvular regurgitation was rare. SEV were more frequently selected in women and patients with challenging transfemoral access, but were associated with higher permanent pacemaker implantation rate and longer hospital length of stay.10.
Giuliana Capretti Marina Urena Claire Bouleti Dominique Himbert 《Catheterization and cardiovascular interventions》2020,95(1):65-67
Transcatheter tricuspid valve‐in‐valve replacement (TTVR) represents an attractive therapeutic option in very high surgical risk patients with degenerated tricuspid bioprostheses. However, the procedural management of these patients might be challenging due to their comorbidities, long lasting heart valve disease and the presence of left‐sided mechanical prostheses. Thus, a more “minimally disruptive” procedure would have several potential benefits in such a frail population. We present the cases of four patients admitted for congestive heart failure due to severe degeneration of their tricuspid bioprostheses who were treated with a minimalist TTVR. The protocol combined continuation of the oral anticoagulant treatment with no bridging therapy, the use of a single venous access with local anesthesia, rapid pacing via the stiff right ventricular wire, and transthoracic echocardiographic guidance and assessment, with no need for contrast injection. Our protocol aims at simplifying the TTVR procedure and might be a useful tool to avoid procedural complications and reduce hospital stay. 相似文献
11.
Ronen Gurvitch MBBS Anson Cheung MD Francesco Bedogni MD John G. Webb MD 《Catheterization and cardiovascular interventions》2011,77(3):439-444
Transcatheter aortic valve implantation (TAVI) for failed surgical bioprostheses, or “valve‐in‐valve” implantation, is a therapeutic option for high‐risk patients. While coronary occlusion during TAVI for native aortic stenosis has been described, in the setting of valve‐in‐valve implantation the bioprsthetic posts may be protective against this complication. We describe the first two cases of coronary occlusion following valve‐in‐valve therapy, both occurring during treatment of degenerated Mitroflow bioprostheses. Aortic root anatomy, coronary ostial position, and the specifics of the bioprosthetic valve type need to be considered in assessing and preventing this rare complication. © 2011 Wiley‐Liss, Inc. 相似文献
12.
Usefulness of two‐ and three‐dimensional transesophageal echocardiography in combined mitral valve‐in‐valve implantation and paraprosthetic leak closure 下载免费PDF全文
Mustafa I. Ahmed MD Mohammed J. Arisha MD Navin C. Nanda MD Clifton T. P. Lewis MD Kyle W. Eudailey MD 《Echocardiography (Mount Kisco, N.Y.)》2018,35(4):501-505
We demonstrate the usefulness of two‐ and live/real time three‐dimensional transesophageal echocardiography in a procedure, which combined transcatheter mitral valve‐in‐valve deployment and paraprosthetic leak closure in the same setting using the less invasive transfemoral approach in an adult patient with bioprosthetic mitral valve degeneration. We also highlight the additive value of three‐dimensional echocardiography over the two‐dimensional technique. 相似文献
13.
14.
Itsik Ben‐Dor Toby Rogers Lowell F. Satler Ron Waksman 《Catheterization and cardiovascular interventions》2019,93(3):555-558
Transcatheter aortic valve replacement has become a mainstay alternative to surgical aortic valve replacement in patients with severe aortic stenosis at high and intermediate surgical risk. Two commercially approved valves are available in the United States: balloon‐expandable and self‐expanding. We report here a rare complication of a self‐expanding Evolut PRO (Medtronic, Minneapolis, Minnesota) valve failing to expand due to nitinol frame infolding. This results in a malopposed valve with a severe paravalvular leak, even though treated successfully with balloon valvuloplasty. It is important to recognize the characteristic angiographic signature of this complication—the “straight line” sign—and how to avoid this potentially serious complication by balloon valvuloplasty or by recapture and deployment of a new valve. 相似文献
15.
Paolo A. Pagnotta Jorge Sanz‐Snchez Damiano Regazzoli Giuseppe Ferrante 《Catheterization and cardiovascular interventions》2020,95(3):411-413
Patients presenting with cardiogenic shock and severe combined aortic and mitral regurgitation represent a major clinical challenge. Therapeutic options are limited in this setting as they are often deemed inoperable due to prohibitive risk for surgery, while mechanical circulatory support is usually contraindicated or technically challenging. Medical therapy, on the other hand, is associated with high‐mortality rates. Therefore, percutaneous therapies may represent an appealing alternative. Here, we present a “one‐stop‐shop” totally percutaneous approach for severe aortic and mitral regurgitation in a patient with cardiogenic shock. 相似文献
16.
Urgent trans‐axillary valve‐in‐valve procedure using the Edwards 16‐F expandable introducer 下载免费PDF全文
Vito Giovanni Ruggieri MD PhD Marc Bedossa MD Jean‐Philippe Verhoye MD PhD 《Catheterization and cardiovascular interventions》2014,83(5):E178-E182
Transcatheter aortic valve implantation could represent an alternative option to conventional surgery in high‐risk patients with degeneration of aortic bioprosthesis. Herein, we report the performance of a valve‐in‐valve procedure in urgent conditions and via the left axillary artery in a patient with patent left internal mammary artery coronary graft. A 23‐mm Edwards Sapien® transcatheter valve was deployed within a 23‐mm Edwards Magna Ease bioprosthesis through the novel Edwards 16‐F expandable introducer. In this non‐elective case, the expandable introducer allowed a safe procedure, reduced the risk of subclavian injury, and preserved the left internal mammary artery graft flow. © 2012 Wiley Periodicals, Inc. 相似文献
17.
Simultaneous transcatheter pulmonary and tricuspid valve‐in‐valve implantation for the treatment of failing pulmonary and tricuspid bioprostheses 下载免费PDF全文
Muhammad Baig MD Oluseun Alli MD James Davies MD 《Catheterization and cardiovascular interventions》2016,87(7):1352-1355
We report a case of a patient with a history of bioprosthetic pulmonary and tricuspid valve replacement who developed significant stenosis and regurgitation of the bioprosthetic valves. Due to multiple comorbidities, he was deemed high risk for redo‐valve replacement surgery. He subsequently underwent percutaneous transcatheter pulmonary and tricuspid valve‐in‐valve procedure at the same setting. This is the first of such that is reported in the literature. © 2015 Wiley Periodicals, Inc. 相似文献
18.
Santiago Garcia Mackenzie Mbai Rosemary Kelly Stefan Bertog 《Catheterization and cardiovascular interventions》2019,93(3):559-561
In patients with an Alfieri Stitch transcatheter mitral valve replacement (TMVR) may be difficult due to the double orifice configuration of the mitral valve. We report a case of simultaneous and completely percutaneous TAVR and TMVR using LAMPOON‐related techniques prior to TMVR to allow for optimal valve deployment. 相似文献
19.
Alison Duncan Saeed Mirsadraee Cesare Quarto Simon Davies 《Catheterization and cardiovascular interventions》2020,96(1):228-235
Valve‐in‐valve transcatheter aortic valve implantation (ViV‐TAVI) is an established therapy for a degenerated surgical bioprosthesis. TAVI‐in‐TAVI following ViV‐TAVI has not been previously performed. We report a high‐risk patient presenting with severe left ventricular failure secondary to undiagnosed critical aortic stenosis due to degeneration of the implanted transcatheter heart valve more than a decade after initial ViV‐TAVI for a failing stentless aortic valve homograft. Successful TAVI‐in‐TAVI reversed the clinical and echocardiographic changes of decompensated heart failure with no evidence of coronary obstruction. 相似文献
20.
Alessandra Laricchia Antonio Mangieri Antonio Colombo Francesco Giannini 《Catheterization and cardiovascular interventions》2020,96(1):225-227
In the last years, the use of sutureless devices in frail patients with severe aortic stenosis has increased thanks to their “easier and faster” technique of implantation in comparison to conventional surgery. Results from metanalysis show comparable outcomes in comparison to transcatheter aortic valve replacement (TAVR) in terms of mortality, stroke incidence, and rate of pace‐maker implantation. The incidence of para‐valvular leak (PVL) is even lower for sutureless devices than for TAVR. The few cases described are generally due to incomplete decalcification or incorrect valve sizing and consequent stent distortion. To our knowledge this is the first case describing PVL with massive aortic regurgitation due to early partial embolization of a Perceval valve and its successfully treatment with valve‐in‐valve by using a self‐expanding TAVR device. 相似文献