КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2023, Volume and Issue: 16(24), P. 2982 - 2985
Published: Dec. 1, 2023
Language: Английский
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
Citations
1
Circulation Cardiovascular Interventions, Journal Year: 2025, Volume and Issue: 18(2)
Published: Feb. 1, 2025
BACKGROUND: Hypoattenuated leaflet thickening (HALT) is believed to reflect thrombosis; however, no systematic histological examination of HALT has ever been performed. The aim this study was evaluate findings explanted self-expanding transcatheter aortic bioprosthetic valves from clinical trials and compare microCT suspected with histology valve thrombosis its characterization over time. METHODS: A total 123 were collected through autopsy (n=89) or surgical explant (n=34) 11 CoreValve/Evolut trials. Histological in leaflets evaluated. MicroCT imaging used histology. Cases infective endocarditis (10/123) valve-in-surgical procedures (3/123) excluded. RESULTS: 110 cases divided into 3 groups based on implant duration: <30 days (n=42), 30 365 (n=35), >365 (n=33). Thrombus inflammation scores consistent across groups, while for pannus, calcification, structural change increased analysis by performed 320 any degree observed 46.5% (149/320) leaflets. Histologically, confirmed as an acute, organizing, organized thrombus (ie, pannus). In the group, all due acute thrombus, most thrombi >30 days. types could not be differentiated imaging. CONCLUSIONS: represents presence a progression. Our data suggest that treatment would likely effective early stages before becomes emphasizes need detection.
Language: Английский
Citations
1
The Thoracic and Cardiovascular Surgeon, Journal Year: 2024, Volume and Issue: 72(05), P. 346 - 357
Published: May 13, 2024
Abstract We reviewed the cardiac surgical literature for 2023. PubMed displayed almost 34,000 hits search term “cardiac surgery AND 2023.” used a PRISMA approach results-oriented summary. Key manuscripts addressed mid- and long-term effects of invasive treatment options in patient populations with coronary artery disease (CAD), comparing interventional therapy (percutaneous intervention [PCI]) (coronary bypass graft [CABG]). The 2023 again confirmed excellent outcomes CABG compared PCI patients left main stenosis, specifically anatomically complex chronic CAD, but even elderly patients, generating further support an infarct-preventative effect as prognostic mechanism CABG. For aortic previous trend early advantage transcatheter (transcatheter valve implantation [TAVI]) later (surgical replacement) was also re-confirmed by many studies. Only Evolut Low Risk trial maintained TAVI over 4 years. In mitral tricuspid field, number publications increased tremendously. A pattern emerges that clinical benefits are associated repair quality, making residual regurgitation not irrelevant. While is more invasive, it currently generates highest rates longest durability. terminal heart failure treatment, donor pool expansion transplantation reducing adverse events assist device were issues Finally, diameter related to technical aspects dominated surgery. This article summarizes perceived important us. It cannot be complete nor free individual interpretation, provides up-to-date information patient-specific decision-making.
Language: Английский
Citations
4
Journal of the Society for Cardiovascular Angiography & Interventions, Journal Year: 2024, Volume and Issue: 3(7), P. 102143 - 102143
Published: May 15, 2024
We aimed to perform a meta-analysis of randomized trials comparing long-term outcomes patients undergoing transcatheter aortic valve replacement (TAVR) vs surgical (SAVR) for severe stenosis. The short-term efficacy and safety TAVR are proven, but unclear.
Language: Английский
Citations
4
Indian Journal of Thoracic and Cardiovascular Surgery, Journal Year: 2025, Volume and Issue: 41(3), P. 257 - 263
Published: Jan. 16, 2025
Language: Английский
Citations
0
Cureus, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 5, 2025
Aortic valve (AV) thrombosis is a rare but clinically significant condition with fewer than 80 cases of native AV reported over the past 50 years. The clinical presentation varies widely, ranging from asymptomatic to acute myocardial infarction (MI), or without cardiogenic shock. MI has been identified as most common and hypercoagulability prevalent underlying etiology. Extracorporeal membrane oxygenation (ECMO) documented cause due potential for clot formation in setting insufficient left ventricle (LV) offloading decreased LV function. People inherited thrombophilias those on ECMO have an increased risk developing via different mechanisms settings. Diseases predispose patient venous thromboembolism (VTE) intrinsic blood abnormalities. Patients face mechanical challenges that can arise circuit itself systemic inflammation. Transesophageal echocardiography (TEE) diagnostic modality choice, which offers highest sensitivity detection thrombus compared cardiac computed tomography angiography magnetic resonance imaging. While many interventions exist management thrombosis, there are no current guidelines outline best treatment approach. Here we present case developed following elective heart catheterization (LHC). suffered series complications led her requiring central veno-arterial (VA) when unable be weaned bypass. During evaluation turndown TEE guidance, was found large thrombus. Given patient's extremely poor prognosis, decision made pursue compassionate wean. Current include anticoagulation, surgical thrombectomy, thrombolytics. However, lack randomized control trials outlining approach remain unclear. it may not feasible given critical nature its rarity, further research needed guide thrombosis.
Language: Английский
Citations
0
КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(5), P. 711 - 711
Published: March 1, 2024
Citations
0
КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2024, Volume and Issue: 17(5), P. 709 - 710
Published: March 1, 2024
Language: Английский
Citations
0
Current Opinion in Cardiology, Journal Year: 2024, Volume and Issue: 39(5), P. 457 - 464
Published: June 19, 2024
Purpose of review Subclinical leaflet thrombosis (SLT) is often an incidental finding characterized by a thin layer thrombus involving one, two or three leaflets, with typical appearance on multi-detector computed tomography (MDCT) hypo-attenuating defect at the aortic side leaflet, also called thickening (HALT). SLT may occur following both transcatheter replacement (TAVR) biological surgical valve (SAVR). The aim this to present overview current state knowledge incidence, diagnosis, clinical impact, and management TAVR SAVR. Recent findings occurs in 10–20% patients somewhat more frequent than SAVR (5–15%). regress spontaneously without treatment about 50% cases but progress clinically significant some cases. Oral anticoagulation vitamin K antagonist reasonable if detected echocardiography and/or MDCT during follow-up generally efficient reverse SLT. associated mild increase risk stroke has no impact survival. been linked accelerated structural deterioration thus durability long-term outcomes. Summary that 5–15% thrombo-embolic event mortality be reduced durability.
Language: Английский
Citations
0
Zeitschrift für Herz- Thorax- und Gefäßchirurgie, Journal Year: 2024, Volume and Issue: 38(6), P. 350 - 357
Published: July 22, 2024
Language: Английский
Citations
0