Transcatheter Aortic Valve Replacement Beyond Severe Aortic Stenosis

Journal of the American College of Cardiology, Journal Year: 2025, Volume and Issue: 85(9), P. 944 - 964

Published: March 1, 2025

Language: Английский

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Durability of transcatheter aortic valve implantation

EuroIntervention, Journal Year: 2024, Volume and Issue: 20(14), P. e845 - e864

Published: July 1, 2024

Transcatheter aortic valve implantation (TAVI) is now utilised as a less invasive alternative to surgical replacement (SAVR) across the whole spectrum of risk. Long-term durability bioprosthetic valves has become key goal TAVI this procedure considered for younger and lower-risk populations. The purpose article present state-of-the-art overview on definition, aetiology, risk factors, mechanisms, diagnosis, clinical impact, management dysfunction (BVD) failure (BVF) following with comparative perspective versus SAVR. Structural deterioration (SVD) main factor limiting used or SAVR, but non-structural BVD, such prosthesis-patient mismatch paravalvular regurgitation, well thrombosis endocarditis may also lead BVF. incidence BVF related SVD other causes low (<5%) at midterm (5- 8-year) follow-up compares favourably that long-term data randomised trials conducted first generations transcatheter heart suggest similar in SAVR 10 years, these suffer from major survivorship bias, will need be confirmed by analysis low-risk years.

Language: Английский

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Antithrombotic Therapy in High Bleeding Risk, Part I

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(19), P. 2197 - 2215

Published: Oct. 1, 2024

Language: Английский

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Valve Thrombosis Following Transcatheter Aortic Valve Replacement: State‐of‐the‐Art Review

Catheterization and Cardiovascular Interventions, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 5, 2025

Transcatheter aortic valve replacement (TAVR) is a well-established treatment for severe stenosis, especially in patients over 75 or those at high surgical risk. While these prosthetic valves have lower thrombogenic profile than mechanical heart valves, leaflet thrombosis transcatheter (TAV) occurs an estimated 5%-40% of cases. Most TAV thromboses are subclinical and can be detected via cardiac computed tomography (CCT), which reveals hypo-attenuating thickening reduced motion asymptomatic without elevated transprosthetic gradients on echocardiography. The mechanisms behind involve local triggers, patient predisposing factors, device procedure-related aspects. ideal antithrombotic therapy post-TAVR depends individual characteristics, balancing bleeding risks with the need oral anticoagulants. Data optimal management routine use CT limited. anticoagulation effectively resolves clinically significant prosthesis thrombosis, its benefit cases unclear. There ongoing debate about whether precedes clinical making follow-up after implantation uncertain. This article aims to provide comprehensive review, summarizing current data incidence TAVR underlying mechanisms, imaging diagnosis, strategies, preventive measures, long-term follow-up.

Language: Английский

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Case Report: Leaflet thrombosis after transcatheter valve-in-valve aortic valve replacement in prosthetic valve endocarditis

Frontiers in Cardiovascular Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 6, 2025

A 70-year-old female patient with a history of bioprosthetic aortic valve replacement and coronary artery bypass graft presented failure secondary to prosthetic endocarditis. The was deemed unsuitable for surgery by the heart team, following which she underwent transcatheter valve-in-valve replacement. This resulted in early death due myocardial infarction acute failure. computed tomography revealed subclinical leaflet thrombosis. case highlights importance postoperative anticoagulation therapy.

Language: Английский

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Age‐Related Outcomes of Valve‐in‐Valve Transcatheter Aortic Valve Replacement for Structural Valve Deterioration

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 14, 2025

Background Valve‐in‐valve transcatheter aortic valve replacement (TAVR) is a recognized alternative for treating the structural deterioration of bioprosthetic valves. Recent guidelines and trials have expanded indications TAVR to include younger patients with deterioration. In this study, we aimed examine outcomes valve‐in‐valve across different age groups understand age‐related clinical following surgical TAVR. Methods Results retrospective included who underwent at our center. We compared procedural complications among <75 years (n=99), those 75 84 (n=103), ≥85 (n=71). Echocardiography computed tomography were used follow‐up evaluations. This study 273 revealed low in‐hospital complication rate all groups. Although 3‐year risk all‐cause mortality was higher in >85 age, no significant differences incidence stroke/transient ischemic attack observed All exhibited improvements hemodynamics that persisted 3 years. leaflet thrombosis assessed using imaging 30 days post‐TAVR more prevalent older group, not an independent predictor outcome. Conclusions associated increased despite consistent hemodynamic benefits Age‐related did predict hypoattenuated thickening, indicating further studies are necessary elucidate its implications.

Language: Английский

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Evolving Developments in Cardiac CT

Radiology, Journal Year: 2023, Volume and Issue: 307(3)

Published: March 28, 2023

In this review, the authors describe some of latest cardiac CT advances in evaluation cardiovascular disease. This includes automated coronary plaque quantification and subtyping, fractional flow reserve perfusion as techniques to noninvasively assess physiologic significance stenosis. The also focus on noncoronary applications involving expanding role structural heart disease interventions. Developments for diffuse myocardial fibrosis infiltrative cardiomyopathy functional analysis contractile dysfunction are discussed. Finally, review studies evaluating photon-counting

Language: Английский

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Human Aortic Stenotic Valve-Derived Extracellular Vesicles Induce Endothelial Dysfunction and Thrombogenicity Through AT1R/NADPH Oxidases/SGLT2 Pro-Oxidant Pathway

JACC Basic to Translational Science, Journal Year: 2024, Volume and Issue: 9(7), P. 845 - 864

Published: May 29, 2024

Pathological tissues release a variety of factors, including extracellular vesicles (EVs) shed by activated or apoptotic cells. EVs trapped within the native pathological valves may act as key mediators valve thrombosis. Human aortic stenosis promote activation valvular endothelial cells, leading to dysfunction, and proadhesive procoagulant responses.

Language: Английский

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Mild Paravalvular Leak May Pose an Increased Thrombogenic Risk in Transcatheter Aortic Valve Replacement (TAVR) Patients-Insights from Patient Specific In Vitro and In Silico Studies

Bioengineering, Journal Year: 2023, Volume and Issue: 10(2), P. 188 - 188

Published: Feb. 1, 2023

In recent years, the treatment of aortic stenosis with TAVR has rapidly expanded to younger and lower-risk patients. However, persistent thrombotic events such as stroke valve thrombosis expose recipients severe clinical complications that hamper TAVR’s rapid advance. We presented a novel methodology for establishing link between commonly acceptable mild paravalvular leak (PVL) levels through device increased thrombogenic risk. It utilizes in vitro patient-specific 3D-printed replicas evaluated hydrodynamic performance. High-resolution µCT scans are used reconstruct silico FSI models these replicas, which multiple platelet trajectories studied PVL channels quantify thrombogenicity, showing those highly dependent on flow conditions within channels. demonstrates platelets have potential enter times over successive cardiac cycles, increasing This cannot be reliably approximated by standard hemodynamic parameters. highlights shortcomings subjectively ranked practice indicating an risk patient cases otherwise classified PVL. reiterates need more rigorous evaluation properly diagnosing

Language: Английский

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Deformation in transcatheter heart valves: Clinical implications and considerations

Journal of Cardiology, Journal Year: 2024, Volume and Issue: 83(6), P. 351 - 358

Published: March 1, 2024

Language: Английский

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