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Interventional Cardiology Clinics

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https://read.qxmd.com/read/30449425/update-in-congenital-interventions
#1
EDITORIAL
Daniel S Levi
No abstract text is available yet for this article.
January 2019: Interventional Cardiology Clinics
https://read.qxmd.com/read/30449424/biodegradable-stents-for-congenital-heart-disease
#2
REVIEW
Tre R Welch, Alan W Nugent, Surendranath R Veeram Reddy
The quest for an ideal biodegradable stent for both adult coronary and pediatric congenital heart disease applications continues. Over the past few years, a lot of progress has been made toward development of a dedicated pediatric biodegradable stent that can be used for congenital heart disease applications. At present, there are no biodegradable stents available for use in congenital heart disease. In this article, the authors review the different biodegradable materials and their limitations and provide an overview of the current biodegradable stents being evaluated for congenital heart disease applications...
January 2019: Interventional cardiology clinics
https://read.qxmd.com/read/30449423/self-expanding-pulmonary-valves-for-large-diameter-right-ventricular-outflow-tracts
#3
REVIEW
Evan Michael Zahn
Congenital heart defects that involve obstruction to the right ventricular outflow tract are common. Surgical repair involves early relief of right ventricular outflow tract obstruction, which typically results in pulmonary regurgitation and large irregularly shaped "native" right ventricular outflow tract. This type of anatomy represents the majority of patients who could potentially benefit from transcatheter pulmonary valve therapy. Currently approved balloon-expandable devices were not designed for this application and the unique anatomy of these patients presents tremendous challenges for designing a valve that is...
January 2019: Interventional cardiology clinics
https://read.qxmd.com/read/30449422/transcatheter-pulmonary-valve-replacement-in-congenital-heart-disease
#4
REVIEW
Sanjay Sinha, Jamil Aboulhosn, Daniel S Levi
Patients with dysfunctional right ventricular outflow tracks comprise a large portion of patients with severe congenital heart disease. Transcatheter pulmonary valve replacement in patients with dysfunctional right ventricular outflow tracks is feasible, safe, and efficacious. This article reviews current transcatheter valve replacement technology for dysfunctional right ventricular outflow tract and pulmonary valvular disease and its applications to patients with congenital heart disease. Discussed are the approach and preprocedural planning, current options, and applications of transcatheter pulmonary valve therapy...
January 2019: Interventional cardiology clinics
https://read.qxmd.com/read/30449421/current-transcatheter-approaches-for-the-treatment-of-aortic-coarctation-in-children-and-adults
#5
REVIEW
Sarosh P Batlivala, Bryan H Goldstein
Coarctation of the aorta is a common congenital heart defect and can present at any age. Infants may carry a fetal diagnosis, or are generally diagnosed after auscultation of a murmur, although rarely present in shock. Those that escape early childhood detection typically present in adolescence and adulthood, generally with upper-extremity hypertension. Percutaneous therapies have evolved to include balloon angioplasty and stent placement, and generally are the preferred first-line therapy for most adolescent/adult patients...
January 2019: Interventional cardiology clinics
https://read.qxmd.com/read/30449420/pulmonary-artery-stenting
#6
REVIEW
Jenny E Zablah, Gareth J Morgan
Stent implantation for pulmonary artery stenosis has advanced. Newer generations of stents allow confidence in long-term results, even in pediatric interventions. Primary intravascular stent implantation is recommended in significant branch pulmonary artery stenosis when the vessel or patient is large enough to accommodate a stent that can be dilated to an adult diameter. A variety of specialized stents are now available, improving applicability despite complex vessel size characteristics. Developments in bioresorbable stents and patient-specific rapid prototyping are anticipated...
January 2019: Interventional Cardiology Clinics
https://read.qxmd.com/read/30449419/new-patent-ductus-arteriosus-closure-devices-and-techniques
#7
REVIEW
Hitesh Agrawal, Benjamin Rush Waller, Sushitha Surendan, Shyam Sathanandam
Patent ductus arteriosus (PDA) in extremely low-birth-weight infants puts this vulnerable population at high risks of morbidity and mortality. Inclusion of a multidisciplinary team and newly available transcatheter PDA occlusion devices in the management of these infants can mitigate those risks and promote better long-term outcomes. It is important that specific techniques with venous-only approach outlined in this article be followed to achieve optimal results.
January 2019: Interventional cardiology clinics
https://read.qxmd.com/read/30449418/state-of-the-art-atrial-septal-defect-closure-devices-for-congenital-heart
#8
REVIEW
Michael L O'Byrne, Daniel S Levi
This article describes current devices and indications for transcatheter device closure of atrial septal defect (TC-ASD) and patent foramen ovale in children and young adults. TC-ASD has a proven record of efficacy and safety, but device erosion raises questions about the relative safety of TC-ASD versus operative open heart surgical ASD closure. New devices for ASD closure with properties to reduce risk of erosion are being developed. Recent studies demonstrating superiority of patent foramen ovale device closure over medical therapy for cryptogenic stroke may lead to changes in practice for structural/interventional cardiologists...
January 2019: Interventional Cardiology Clinics
https://read.qxmd.com/read/30449417/ventricular-septal-defect-closure-devices-techniques-and-outcomes
#9
REVIEW
Brian H Morray
Transcatheter closure of ventricular septal defects (VSDs) was first documented in 1988. The early studies of VSD closure were successful but there were high complication rates, particularly early and late-onset complete heart block. However, the development and use of new vascular occlusion devices in an off-label fashion has improved the range of patients who can be treated and reduced the complication rates. In particular, the rate of complete heart block documented in contemporary studies of VSD closure has fallen to levels at or below those documented in the surgical VSD closure literature...
January 2019: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274617/evolution-of-transcatheter-valve-therapy-for-aortic-stenosis
#10
EDITORIAL
Susheel K Kodali
No abstract text is available yet for this article.
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274616/endovascular-treatment-options-for-the-aortic-arch
#11
REVIEW
Akiko Tanaka, Anthony Estrera
Endovascular aortic repair to treat aortic arch abnormality has rapidly expanded in the last 2 decades, and surgeons now have options to treat patients who are poor candidates for open surgery. The devices and techniques should be tailored to the extension of the aortic abnormality and anatomy of the individual. Recent studies demonstrate promising results with branched endografts, but one of the major drawbacks of the devices is that considerable time is required to prepare the custom-made graft, which may not be available for emergent or urgent cases...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274615/innovations-in-transcatheter-valve-technology-what-the-next-five-years-hold
#12
REVIEW
Carlos E Sanchez, Steven J Yakubov, Arash Arshi
Transcatheter aortic valve replacement is indicated for the treatment of symptomatic severe aortic stenosis in patients at intermediate or greater risk for surgery. Future indications may include low-risk patients, asymptomatic patients, bicuspid valves, moderate aortic stenosis, and pure native aortic valve regurgitation. Key hurdles to overcome include pacemaker risk, vascular injury, paravalvular regurgitation, coronary artery reaccess, durability, and embolic risk. New valve designs include synthetic polymeric valves that may allow for greater durability, in addition to advances in terms of precise positioning and repositioning to reduce the complication rate...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274614/transcatheter-aortic-valve-replacement-for-bicuspid-aortic-valve-challenges-and-pitfalls
#13
REVIEW
Sung-Han Yoon, Raj Makkar
Because of the unfavorable anatomic features of bicuspid aortic stenosis (AS), the outcomes of transcatheter aortic valve replacement (TAVR) in bicuspid AS were suboptimal, particularly when using the first-generation transcatheter valves. However, the newer-generation transcatheter valves significantly improved the outcomes of TAVR in bicuspid AS. Nonetheless, long-term durability of transcatheter valves and concomitant aortopathy should be taken into account. Considering the expanding indication of TAVR to lower the surgical risk and a younger population, these issues should be evaluated in future studies...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274613/coronary-artery-disease-and-transcatheter-aortic-valve-replacement-when-to-intervene
#14
REVIEW
Jayendrakumar S Patel, Samir R Kapadia
"In patients with coronary artery disease undergoing transcatheter aortic valve replacement (TAVR), the decision of whether to revascularize, which lesions to revascularize, and the optimal timing of revascularization remains controversial. The sequence of revascularization should be made on a case-by-case basis. Pre-TAVR revascularization (staged or simultaneous with TAVR) is preferred due to unobstructed access to coronary ostia and is important to consider especially in cases in which long self-expanding valves are used...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274612/revisiting-atrial-fibrillation-in-the-transcatheter-aortic-valve-replacement-era
#15
REVIEW
Kinjan Parikh, Jose Dizon, Angelo Biviano
Atrial fibrillation (AF) is a known complication of many cardiac procedures, including those undergoing surgical aortic valve replacement (SAVR). In the transcatheter aortic valve replacement (TAVR) era, AF has been noted not only to be present in these patients but also associated with morbidity and mortality. In this article, we first outline the significance of AF in general and then more specifically in patients undergoing cardiac surgery. We then compare and contrast specific clinical issues related to AF in patients with aortic stenosis undergoing aortic valve replacement, traditionally with SAVR, but now increasingly more common with TAVR...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274611/paravalvular-regurgitation-after-transcatheter-aortic-valve-replacement-is-the-problem-solved
#16
REVIEW
GĂ©raldine Ong, Mohammed-Salah Annabi, Marie-Annick Clavel, Ezequiel Guzzetti, Erwan Salaun, Oumhani Toubal, Abdellaziz Dahou, Philippe Pibarot
Paravalvular regurgitation is a frequent complication after transcatheter aortic valve replacement and its association with worse outcomes depends on the degree of its severity. Despite substantial improvement in transcatheter heart valve design, sizing and implantation technique, moderate or severe paravalvular regurgitation still occurs in 2% to 7% of patients and is associated with a more than 2-fold increase in mortality. This review provides a state-of-the-art approach to (i) paravalvular regurgitation prevention by optimizing patient selection, valve sizing, and positioning and (ii) the detection, quantitation and management of paravalvular regurgitation during and after valve implantation...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274610/minimalist-transcatheter-aortic-valve-replacement-the-right-pathway-forward
#17
REVIEW
Janarthanan Sathananthan, Sandra Lauck, John G Webb, David A Wood
Minimalist transcatheter aortic valve replacement (TAVR) can be implemented with no apparent compromise in patient outcomes. Although this approach is applicable for many patients undergoing TAVR, patient selection by the heart team is critical; one must be cognizant of factors whereby a minimalist approach is unsuitable. In the current era of TAVR, a minimalist approach should encompass the entire process of care and not just the procedure. Streamlining and homogenizing preprocedural workup has potential benefits for patients and health services...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/30274609/when-to-choose-surgery-in-the-era-of-transcatheter-aortic-valve-replacement
#18
REVIEW
Moritz C Wyler von Ballmoos, Colin M Barker, Michael J Reardon
Treatment of severe symptomatic aortic stenosis has undergone significant changes with the advent of transcatheter aortic valve replacement (TAVR). Initially reserved for inoperable patients, these devices have improved; outcomes now rival or outperform surgical treatment. TAVR is recommended for high-risk and certain intermediate-risk patients. As transcatheter aortic valve replacement becomes an option for younger, healthier patients, long-term planning and thoughtful considerations of potential subsequent interventions are paramount...
October 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/29983153/imaging-in-intervention
#19
EDITORIAL
Matthew J Price, Jorge A Gonzalez
No abstract text is available yet for this article.
July 2018: Interventional Cardiology Clinics
https://read.qxmd.com/read/29983152/three-dimensional-printing-for-planning-of-structural-heart-interventions
#20
REVIEW
Dee Dee Wang, Neil Gheewala, Rajan Shah, Dmitry Levin, Eric Myers, Marianne Rollet, William W O'Neill
Three-dimensional (3D) printing is a process leading to the creation of a physical 3D model used for teaching, patient education, device evaluation, and procedural planning. 3D printed models of patient-specific anatomy can be generated from 3D transesophageal, cardiac MRI, or cardiac computed tomographic datasets. This article discusses the potential advantages of 3D printing, reviews the different modalities to acquire a 3D dataset, and highlights the application of 3D printing to enhance patient screening and procedural planning in structural heart intervention...
July 2018: Interventional cardiology clinics
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