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By Alessandro Iadanza Interventional Cardiologist at Siena University Hospital
Francesco Burzotta, Carlo Trani
Aortic stenosis developed in bicuspid valves is commonly characterized by a complex anatomy TAVR may be considered for high risk patients with bicuspid valve stenosis but procedure is usually technically challenging High (supra-annular) implantation of self-expandable TAVR prostheses may be a valuable option for selected patients with bicuspid valve stenosis.
April 1, 2018: Catheterization and Cardiovascular Interventions
Ole De Backer, Lars Søndergaard
TAVR for bicuspid AS is not associated with excess mortality, but paravalvular leak and pacemaker implant is increased compared to tricuspid AS cohorts undergoing TAVR. Operators should weigh these potential complications against the clinical benefit obtained with TAVR for bicuspid AS patients at high surgical risk. A randomized controlled trial comparing TAVR with SAVR in younger, low-surgical risk patients with-or at least not excluding-bicuspid AS is strongly needed.
April 1, 2018: Catheterization and Cardiovascular Interventions
Robert A Guyton, Muralidhar Padala
No abstract text is available yet for this article.
April 25, 2016: JACC. Cardiovascular Interventions
Zhen-Gang Zhao, Hasan Jilaihawi, Yuan Feng, Mao Chen
Transcatheter aortic valve implantation (TAVI) is an established therapeutic option for high-risk patients with tricuspid aortic valve stenosis. Historically, the presence of a bicuspid aortic valve (BAV) has been regarded as a contraindication to TAVI, on the basis of putative concerns about the associated risks of elliptical deployment, accelerated leaflet degeneration, periprosthetic leaks, and aortic complications. Fortunately, with technological refinements and mounting experience, reasonable success has been achieved with TAVI in selected patients with a BAV...
February 2015: Nature Reviews. Cardiology
David G Guzzardi, Alex J Barker, Pim van Ooij, S Chris Malaisrie, Jyothy J Puthumana, Darrell D Belke, Holly E M Mewhort, Daniyil A Svystonyuk, Sean Kang, Subodh Verma, Jeremy Collins, James Carr, Robert O Bonow, Michael Markl, James D Thomas, Patrick M McCarthy, Paul W M Fedak
BACKGROUND: Suspected genetic causes for extracellular matrix (ECM) dysregulation in the ascending aorta in patients with bicuspid aortic valves (BAV) have influenced strategies and thresholds for surgical resection of BAV aortopathy. Using 4-dimensional (4D) flow cardiac magnetic resonance imaging (CMR), we have documented increased regional wall shear stress (WSS) in the ascending aorta of BAV patients. OBJECTIVES: This study assessed the relationship between WSS and regional aortic tissue remodeling in BAV patients to determine the influence of regional WSS on the expression of ECM dysregulation...
August 25, 2015: Journal of the American College of Cardiology
Sung-Han Yoon, Thierry Lefèvre, Jung-Ming Ahn, Gidon Y Perlman, Danny Dvir, Azeem Latib, Marco Barbanti, Florian Deuschl, Ole De Backer, Philipp Blanke, Thomas Modine, Gregor Pache, Franz-Josef Neumann, Philipp Ruile, Takahide Arai, Yohei Ohno, Hidehiro Kaneko, Edgar Tay, Niklas Schofer, Erik W Holy, Ngai H V Luk, Gerald Yong, Qingsheng Lu, William K F Kong, Jimmy Hon, Hsien-Li Kao, Michael Lee, Wei-Hsian Yin, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Hyo-Soo Kim, Christian Butter, Omar K Khalique, Ulrich Schaefer, Fabian Nietlispach, Susheel K Kodali, Martin B Leon, Jian Ye, Bernard Chevalier, Jonathon Leipsic, Victoria Delgado, Jeroen J Bax, Corrado Tamburino, Antonio Colombo, Lars Søndergaard, John G Webb, Seung-Jung Park
BACKGROUND: Few studies have evaluated the clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS). Particularly, limited data exist comparing the results of TAVR with new-generation devices versus early-generation devices. OBJECTIVES: This study sought to evaluate the clinical outcomes of TAVR for bicuspid AS with early- and new-generation devices. METHODS: The Bicuspid TAVR Registry is an international multicenter study enrolling consecutive patients with bicuspid AS undergoing TAVR between April 2005 and May 2015...
September 13, 2016: Journal of the American College of Cardiology
Sung-Han Yoon, Sabine Bleiziffer, Ole De Backer, Victoria Delgado, Takahide Arai, Johannes Ziegelmueller, Marco Barbanti, Rahul Sharma, Gidon Y Perlman, Omar K Khalique, Erik W Holy, Smriti Saraf, Florian Deuschl, Buntaro Fujita, Philipp Ruile, Franz-Josef Neumann, Gregor Pache, Masao Takahashi, Hidehiro Kaneko, Tobias Schmidt, Yohei Ohno, Niklas Schofer, William K F Kong, Edgar Tay, Daisuke Sugiyama, Hiroyuki Kawamori, Yoshio Maeno, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Shingo Kuwata, Gerald Yong, Hsien-Li Kao, Michael Lee, Hyo-Soo Kim, Thomas Modine, S Chiu Wong, Francesco Bedgoni, Luca Testa, Emmanuel Teiger, Christian Butter, Stephan M Ensminger, Ulrich Schaefer, Danny Dvir, Philipp Blanke, Jonathon Leipsic, Fabian Nietlispach, Mohamed Abdel-Wahab, Bernard Chevalier, Corrado Tamburino, David Hildick-Smith, Brian K Whisenant, Seung-Jung Park, Antonio Colombo, Azeem Latib, Susheel K Kodali, Jeroen J Bax, Lars Søndergaard, John G Webb, Thierry Lefèvre, Martin B Leon, Raj Makkar
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). OBJECTIVES: This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry. METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics...
May 30, 2017: Journal of the American College of Cardiology
Loren F Hiratzka, Mark A Creager, Eric M Isselbacher, Lars G Svensson, Rick A Nishimura, Robert O Bonow, Robert A Guyton, Thoralf M Sundt, Jonathan L Halperin, Glenn N Levine, Jeffrey L Anderson, Nancy M Albert, Sana M Al-Khatib, Kim K Birtcher, Biykem Bozkurt, Ralph G Brindis, Joaquin E Cigarroa, Lesley H Curtis, Lee A Fleisher, Federico Gentile, Samuel Gidding, Mark A Hlatky, John Ikonomidis, José Joglar, Richard J Kovacs, E Magnus Ohman, Susan J Pressler, Frank W Sellke, Win-Kuang Shen, Duminda N Wijeysundera
Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease" (Circulation. 2010;121:e266-e369) and the "2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease" (Circulation...
February 16, 2016: Circulation
Craig S Broberg, Judith Therrien
Bicuspid aortic valve is a simple yet common condition with surprising clinical complexity. Patients are typically found to have enlargement of the ascending aorta, either root or midascending, independent of valve function. This enlargement is perceived to be a risk of aortic dissection, and therefore, prophylactic surgery is often recommended when the aorta reaches 50-55 mm in diameter. Despite the prevalence and potential health impact, there is to date no published data on the role of medical therapy. The emerging trend, however, is to address this question through clinical research...
July 2015: Trends in Cardiovascular Medicine
Thoralf M Sundt
Despite more than a decade of intense investigation, controversy persists regarding appropriate triggers for aortic replacement in the setting of bicuspid aortic valve. The difficulty is that the data are inescapably imperfect. Although we can count individuals with bicuspid valve who suffer dissection, we have an insufficient understanding of the true denominator of individuals at risk to calculate the probability of dissection for an individual patient. In addition, our own decision-making process is subject to "denominator neglect" or focus on the fact of the occurrence of the event rather than on the risk of the occurrence...
February 2015: Journal of Thoracic and Cardiovascular Surgery
Darren Mylotte, Thierry Lefevre, Lars Søndergaard, Yusuke Watanabe, Thomas Modine, Danny Dvir, Johan Bosmans, Didier Tchetche, Ran Kornowski, Jan-Malte Sinning, Pascal Thériault-Lauzier, Crochan J O'Sullivan, Marco Barbanti, Nicolas Debry, Jean Buithieu, Pablo Codner, Magdalena Dorfmeister, Giuseppe Martucci, Georg Nickenig, Peter Wenaweser, Corrado Tamburino, Eberhard Grube, John G Webb, Stephan Windecker, Ruediger Lange, Nicolo Piazza
BACKGROUND: Limited information exists describing the results of transcatheter aortic valve (TAV) replacement in patients with bicuspid aortic valve (BAV) disease (TAV-in-BAV). OBJECTIVES: This study sought to evaluate clinical outcomes of a large cohort of patients undergoing TAV-in-BAV. METHODS: We retrospectively collected baseline characteristics, procedural data, and clinical follow-up findings from 12 centers in Europe and Canada that had performed TAV-in-BAV...
December 9, 2014: Journal of the American College of Cardiology
Siddharth K Prakash, Yohan Bossé, Jochen D Muehlschlegel, Hector I Michelena, Giuseppe Limongelli, Alessandro Della Corte, Francesca R Pluchinotta, Maria Giovanna Russo, Artur Evangelista, D Woodrow Benson, Simon C Body, Dianna M Milewicz
Bicuspid aortic valve (BAV) is the most common adult congenital heart defect and is found in 0.5% to 2.0% of the general population. The term "BAV" refers to a heterogeneous group of disorders characterized by diverse aortic valve malformations with associated aortopathy, congenital heart defects, and genetic syndromes. Even after decades of investigation, the genetic determinants of BAV and its complications remain largely undefined. Just as BAV phenotypes are highly variable, the genetic etiologies of BAV are equally diverse and vary from complex inheritance in families to sporadic cases without any evidence of inheritance...
August 26, 2014: Journal of the American College of Cardiology
Abdel Rahman Al Emam, Mohammed Chamsi-Pasha, Gregory Pavlides
No abstract text is available yet for this article.
June 1, 2016: International Journal of Cardiology
Samuel C Siu, Candice K Silversides
Bicuspid aortic valve (BAV) disease is the most common congenital cardiac defect. While the BAV can be found in isolation, it is often associated with other congenital cardiac lesions. The most frequent associated finding is dilation of the proximal ascending aorta secondary to abnormalities of the aortic media. Changes in the aortic media are present independent of whether the valve is functionally normal, stenotic, or incompetent. Although symptoms often manifest in adulthood, there is a wide spectrum of presentations ranging from severe disease detected in utero to asymptomatic disease in old age...
June 22, 2010: Journal of the American College of Cardiology
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