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Littérature scientifique sur le sujet « Aortic valve regurgitation »

Auteur : Grafiati

Publié le 4 juin 2021

Mis à jour le 16 février 2022

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Articles de revues sur le sujet "Aortic valve regurgitation"

Spina, Roberto, Chris Anthony, David WM Muller et David Roy. « Transcatheter Aortic Valve Replacement for Native Aortic Valve Regurgitation ». Interventional Cardiology Review 10, n^o 1 (2015) : 49. http://dx.doi.org/10.15420/icr.2015.10.1.49.

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Transcatheter aortic valve replacement with either the balloon-expandable Edwards SAPIEN XT valve, or the self-expandable CoreValve prosthesis has become the established therapeutic modality for severe aortic valve stenosis in patients who are not deemed suitable for surgical intervention due to excessively high operative risk. Native aortic valve regurgitation, defined as primary aortic incompetence not associated with aortic stenosis or failed valve replacement, on the other hand, is still considered a relative contraindication for transcatheter aortic valve therapies, because of the absence of annular or leaflet calcification required for secure anchoring of the transcatheter heart valve. In addition, severe aortic regurgitation often coexists with aortic root or ascending aorta dilatation, the treatment of which mandates operative intervention. For these reasons, transcatheter aortic valve replacement has been only sporadically used to treat pure aortic incompetence, typically on a compassionate basis and in surgically inoperable patients. More recently, however, transcatheter aortic valve replacement for native aortic valve regurgitation has been trialled with newer-generation heart valves, with encouraging results, and new ancillary devices have emerged that are designed to stabilize the annulus–root complex. In this paper we review the clinical context, technical characteristics and outcomes associated with transcatheter treatment of native aortic valve regurgitation.

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Liu, Lingchao, Tianbo Li, Bo Xu, Chencheng Liu, Fuqin Tang, Yingbin Xiao et Yong Wang. « Mid-term follow-up of aortic valve replacement for bicuspid aortic valve ». Cardiology in the Young 31, n^o 8 (1 mars 2021) : 1290–96. http://dx.doi.org/10.1017/s1047951121000160.

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AbstractObjective:The purpose of this study was to evaluate the mid-term outcome of aortic valve replacement for bicuspid aortic valve and tricuspid aortic valve and the related risk factors.Methods:From January 2014 to June 2019, 177 tricuspid aortic valve patients and 101 bicuspid aortic valve patients who underwent aortic valve replacement in our hospital were collected. 1:1 propensity score matching analysis was used to control the bias in patient selection. The perioperative and follow-up data between the two groups were compared. Independent risk factors which were associated with the continued dilatation of the ascending aorta were identified by univariate or multivariate logistic regression analysis.Results:After the matching procedure, 160 patients were included in the analysis (80 in each group). Baseline characteristics, intraoperative, and perioperative outcomes were similar between the two groups (all p > 0.05). Moreover, 67 patients in the tricuspid aortic valve group and 70 in the bicuspid aortic valve group completed the follow-up. The ascending aorta change, annual change rate, and the proportion of continuous dilation of ascending aorta in bicuspid aortic valve group were significantly higher than those in the tricuspid aortic valve group (p < 0.05). Multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.173; 95% CI 1.772, 15.101; p = 0.003), aortic regurgitation (OR 3.673; 95% CI 1.133, 11.908; p = 0.030), and aortic valve stenosis with regurgitation (OR 6.489; 95% CI 1.726, 24.404; p = 0.006) were independent risk factors for the continued dilatation of the ascending aorta in all AV patients. Furthermore, the multivariate logistic regression analysis showed that type 1 in bicuspid aortic valve (OR 5.157; 95% CI 1.053, 25.272; p = 0.043), age ≥ 40 years (OR 6.956; 95% CI 1.228, 39.410; p = 0.028), and aortic regurgitation (OR 4.322; 95% CI 1.174, 15.911; p = 0.028) were independent risk factors for the continued dilatation of the ascending aorta in bicuspid aortic valve patients.Conclusion:Compared with tricuspid aortic valve patients, the ascending aorta of bicuspid aortic valve patients is more likely to continue to enlarge after aortic valve replacement. Type 1 in bicuspid aortic valve, age ≥ 40 years, and aortic regurgitation were the independent risk factors.

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Borer, Jeffrey S. « Aortic Valve Surgery for Aortic Regurgitation ». Journal of the American College of Cardiology 68, n^o 20 (novembre 2016) : 2154–56. http://dx.doi.org/10.1016/j.jacc.2016.09.003.

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Evangelista, Arturo, Pastora Gallego, Francisco Calvo-Iglesias, Javier Bermejo, Juan Robledo-Carmona, Violeta Sánchez, Daniel Saura et al. « Anatomical and clinical predictors of valve dysfunction and aortic dilation in bicuspid aortic valve disease ». Heart 104, n^o 7 (1 septembre 2017) : 566–73. http://dx.doi.org/10.1136/heartjnl-2017-311560.

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ObjectiveBicuspid aortic valve (BAV) is associated with early valvular dysfunction and proximal aorta dilation with high heterogeneity. This study aimed to assess the determinants of these complications.MethodsEight hundred and fifty-two consecutive adults diagnosed of BAV referred from cardiac outpatient clinics to eight echocardiographic laboratories of tertiary hospitals were prospectively recruited. Exclusion criteria were aortic coarctation, other congenital disorders or intervention. BAV morphotype, significant valve dysfunction and aorta dilation (≥2 Z-score) at sinuses and ascending aorta were established.ResultsThree BAV morphotypes were identified: right–left coronary cusp fusion (RL) in 72.9%, right–non-coronary (RN) in 24.1% and left–non-coronary (LN) in 3.0%. BAV without raphe was observed in 18.3%. Multivariate analysis showed aortic regurgitation (23%) to be related to male sex (OR: 2.80, p<0.0001) and valve prolapse (OR: 5.16, p<0.0001), and aortic stenosis (22%) to BAV-RN (OR: 2.09, p<0.001), the presence of raphe (OR: 2.75, p<0.001), age (OR: 1.03; p<0.001), dyslipidaemia (OR: 1.77, p<0.01) and smoking (OR: 1.63, p<0.05). Ascending aorta was dilated in 76% without differences among morphotypes and associated with significant valvular dysfunction. By contrast, aortic root was dilated in 34% and related to male sex and aortic regurgitation but was less frequent in aortic stenosis and BAV-RN.ConclusionsNormofunctional valves are more prevalent in BAV without raphe. Aortic stenosis is more frequent in BAV-RN and associated with some cardiovascular risk factors, whereas aortic regurgitation (AR) is associated with male sex and sigmoid prolapse. Although ascending aorta is the most commonly dilated segment, aortic root dilation is present in one-third of patients and associated with AR. Remarkably, BAV-RL increases the risk for dilation of the proximal aorta, whereas BAV-RN spares this area.

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Hertault, Adrien, Rachel E. Clough, Thomas Modine, Jean-Luc Auffray, Mohamad Koussa et Stéphan Haulon. « Transcatheter Aortic Valve Implantation as a Bailout Procedure for Acute Aortic Valve Regurgitation During Endovascular Arch Repair ». Journal of Endovascular Therapy 24, n^o 5 (10 juillet 2017) : 656–60. http://dx.doi.org/10.1177/1526602817719880.

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Purpose: To report emergent transcatheter aortic valve implantation (TAVI) to treat acute severe aortic regurgitation caused by valve cusp dysfunction following proximal migration of an endograft implanted in the ascending aorta during endovascular arch repair. Case Report: A 65-year-old man had been previously treated with thoracic and fenestrated endografts in a 2-stage procedure for a chronic type B dissection. At 2-year follow-up, aneurysmal evolution of the distal arch led to development of a proximal type Ia endoleak. The patient was deemed unfit for open repair because of severe nonrevascularizable coronary artery disease. A custom-made endograft was designed consisting of a double inner branch arch endograft with a proximal component to reline the ascending aorta to avoid iatrogenic type A dissection. The first component was successfully deployed. However, this device migrated toward the aortic valve when the delivery system of the branch device was advanced through the aortic valve. Aortography and transesophageal echography showed acute aortic regurgitation due to obstruction of the left coronary valve cusp. An emergency bailout TAVI procedure was performed to successfully treat the aortic regurgitation. Conclusion: TAVI can be used as a bailout procedure for acute aortic valve dysfunction during endovascular arch or ascending aorta repair.

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ALJADAYEL, Hadi Abo, et Hussein ALKANJ. « Effect of Aortic Valve Replacement, for Aortic Stenosis, on Concomitant Mitral Valve Regurgitation ». Turkiye Klinikleri Cardiovascular Sciences 27, n^o 1 (2015) : 22–27. http://dx.doi.org/10.5336/cardiosci.2014-42157.

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Friess, Jan Oliver, Thomas Bruelisauer, Samuel Hurni, Miralem Pasic, Gabor Erdoes et Balthasar Eberle. « Resolution of severe secondary mitral valve regurgitation following aortic valve replacement in infective endocarditis ». SAGE Open Medical Case Reports 9 (janvier 2021) : 2050313X2110343. http://dx.doi.org/10.1177/2050313x211034377.

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We present the case of a patient with infective endocarditis anesthetized for replacement of severely regurgitant aortic valve. Intraoperative transesophageal echocardiography revealed a new diagnosis of severe secondary mitral regurgitation. After aortic valve replacement and tricuspid valve repair, severe mitral regurgitation resolved rapidly without any intervention. In multivalvular disease, instant spontaneous resolution of secondary mitral regurgitation is possible after surgical correction of an aortic regurgitation causing left ventricular volume overload.

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Hirofuji, Aina, Hirotsugu Kanda, Yuya Kitani et Hiroyuki Kamiya. « Awake Surgical Mitral Valve Repair after Transcatheter Aortic Valve Replacement ». Thoracic and Cardiovascular Surgeon Reports 10, n^o 01 (janvier 2021) : e15-e17. http://dx.doi.org/10.1055/s-0040-1718774.

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AbstractTranscatheter aortic valve replacement has become a popular choice for cases with severe aortic stenosis. However, when severe mitral regurgitation is comorbid in high-risk patients with severe aortic stenosis, therapeutic options must be weighed for each case. Here we present a very frail 88-year-old patient with severe aortic stenosis and severe mitral valve regurgitation who underwent a successful awake minimally invasive mitral valve repair after transcatheter aortic valve replacement.

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Jiang, Jubo, Xianbao Liu, Yuxin He, Qiyuan Xu, Qifeng Zhu, Sanjay Jaiswal, Lihan Wang et al. « Transcatheter Aortic Valve Replacement for Pure Native Aortic Valve Regurgitation : A Systematic Review ». Cardiology 141, n^o 3 (2018) : 132–40. http://dx.doi.org/10.1159/000491919.

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Background: Transcatheter aortic valve replacement (TAVR) is a recent and an effective treatment option for high- or extreme-surgical-risk patients with symptomatic severe aortic stenosis. However, pure severe native aortic valve regurgitation (NAVR) without aortic stenosis remains a contraindication to TAVR. The aim of our systemic review analysis was to evaluate TAVR in patients with pure NAVR. Methods: We searched the published articles in the PubMed and Web of Science databases (2002–2017) using the Boolean operators for studies of NAVR patients undergoing TAVR. Reference lists of all returned articles were searched recursively for other relevant citations. Pooled estimates were calculated using a random-effects meta-analysis. Results: Finally, a total of 10 studies were included in this analysis. The CoreValve was more frequently used with a lower rate of device success and a higher rate of residual aortic regurgitation. The new-generation transcatheter heart valves (THVs) performed a significantly higher rate with less residual aortic regurgitation and a success rate close to 100%. The 30-day all-cause mortality rates ranged from 0 to 30% with an estimate summary rate of 9% (95% CI: 5–15%; I2 = 33%). Cerebrovascular events, major or life-threatening bleeding, major vascular complications, acute kidney disease, and new permanent pacemaker implantation occurred similarly in both the new- and old-generation THV devices. Conclusions: Aortic regurgitation remains a challenging pathology for TAVR. TAVR is a feasible and reasonable option for carefully selected patients with pure aortic regurgitation.

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Chaudhury, Arnab. « An Unusual Complication of Infective Endocarditis Involving Bicuspid Aortic Valve ». International Journal of Clinical Case Reports and Reviews 6, n^o 3 (20 janvier 2021) : 01–04. http://dx.doi.org/10.31579/2690-4861/100.

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Bicuspid aortic valve is commonly associated with infective endocarditis with serious peri annular complications. We report a case of 37-year-old male patient presented with infective endocarditis involving bicuspid aortic valve with leaflet perforation and severe aortic regurgitation. Mitral valve was involved secondary to aortic valve endocarditis as a kissing lesion with severe mitral regurgitation. Anterior mitral leaflet (AML) had aneurysmal dilatation with mobile vegetations inside it. In colour Doppler, AML aneurysm was looking like a fireball inside the left atrium. Patient was treated with antibiotics and referred to surgery for aortic and mitral valve replacement.

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Thèses sur le sujet "Aortic valve regurgitation"

Sarembock, Ian J. « A sequential evaluation of left ventricular function in asymptomatic and symptomatic patients with chronic severe aortic regurgitation ». Doctoral thesis, University of Cape Town, 1987. http://hdl.handle.net/11427/25737.

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The optimal timing of valve replacement surgery in chronic severe aortic regurgitation (AR) has remained a major clinical problem in the management of these patients. Although the onset of symptoms is the generally accepted indication for aortic valve replacement (AVR), the unpredictable development of pre-symptomatic left ventricular (LV) dysfunction as a result of prolonged volume overload has resulted in numerous reports attempting to formulate a risk profile for these patients. Although aortic root and LV cineangiography have been the "gold standard" for defining the severity of AR and its effect on LV performance, serial follow-up by these means is impractical. More recently numerous non-invasive measures of LV size (echocardiogram) and function both at rest and on exercise (echocardiogram and equilibrium radionuclide angiocardiography., ERNA) have been serially utilised~ In these endeavours, the thinking has been clouded by a tendency to equate these two measures and failing to appreciate that apparent preoperative LV dysfunction (particularly on exercise) may be rapidly reversible by AVR and the consequent changes in LV loading conditions. This study was a prospective, sequential evaluation of left ventricular function using both non-invasive and invasive techniques in symptomatic and asymptomatic patients with isolated chronic, severe (4+) AR at cardiac catheterisation. The aims of the study were to (I) Identify differences in the clinical, echocardiographic, resting and exercise haemodynamic and I radionuclide measures of left ventricular function in symptomatic and asymptomatic patients with chronic severe A.R. with particular reference to the incidence of presymptomatic development of left ventricular dysfunction. (II) Critically evaluate the role of exercise stress (both isotonic and isometric) in the assessment of patients with chronic severe A.R. (III) Evaluate the influence of time (sequential studies) on the haemodynamic burden in asymptomatic patients. (IV) Study the impact of successful aortic valve replacement on the reversibility of abnormal pre-operative LV function in an attempt to predict which patients would benefit from this therapeutic intervention and whether operation for symptoms alone is the correct clinical practice.

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Schneeberger, Yvonne [Verfasser]. « Transkatheter Herzklappen zur Behandlung der nicht-kalzifizierenden Aortenklappeninsuffizienz : Transcatheter heart valves for treatment of non-calcified aortic valve regurgitation / Yvonne Schneeberger ». Hamburg : Staats- und Universitätsbibliothek Hamburg Carl von Ossietzky, 2020. http://d-nb.info/1221135422/34.

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Sadeghi, Malvajerdi Neda. « Preliminary Analysis of an Internal Annuloplasty Ring for the Aortic Valve ». Thesis, Université d'Ottawa / University of Ottawa, 2017. http://hdl.handle.net/10393/36142.

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Among the four valves of the heart, the aortic valve (AV) is frequently affected by disease. When progressive dilatation of the valve produces a leak when the valve should close (regurgitation), repair may be possible. AV repair is a desirable option because, contrary to AV replace-ment using a prosthesis, it does not require life-long anticoagulation treatment, and retains the original tissues that naturally combat structural degradation. All the AV repair procedures developed by cardiac surgeons require a good stabilization of the ventriculo-aortic junction (VAJ) diameter, through annuloplasty or reimplantation, for long-term success. In the present work, a preliminary design for a new type of annuloplasty ring is proposed that surgeons could tailor to the each valve’s shape and suture inside the VAJ. The design consists in wrapping a commonly available surgical biomaterial into a ring of controlled radial flexibility. For sizing and material selection, several models of increasing complexity were created to account for the anisotropic, hyperelastic nature of all the materials involved. First, an analytical model was programmed in MATLAB to assess the radial flexibility of annuloplasty rings formed with different biomaterials and select those that could match the physiological VAJ radial flexibility between systolic and diastolic pressures. The same program was also used to reproduce the experimental radial and longitudinal stretches of the human VAJ from 0 to 140 mmHg pressures. The analytical models were used to calibrate the parameters of independent finite element (FE) models of the VAJ and ring. Finally, the FE approach was extended to simulate the ring after suturing inside the VAJ, to determine the radial flexibility of the assembly under pulsatile pressure. Supple Peri-Guard® bo-vine pericardium patches used in transverse orientation emerged as the best currently available material option for the proposed ring, although a material providing more physiological radial flexibility would be desirable.

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Boer, Berta Paula Napchan. « Comparação da função diastólica entre o pré e pós-operatório de pacientes portadores de estenose aórtica ou insuficiência aórtica, baseados em dados bioquímicos e ecocardiográficos ». Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-30032010-181154/.

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INTRODUÇÃO: Avaliação da função diastólica de pacientes portadores de estenose ou insuficiência aórtica submetidos à troca valvar. OBJETIVOS: Avaliação da função diastólica através da análise do NTpró-BNP como método não invasivo para caracterização da insuficiência cardíaca diastólica, comparando com os dados ecocardiográficos através do Doppler Pulsado em Fluxo Mitral, Doppler Pulsado em Veias Pulmonares e Doppler Tecidual em portadores de IAO e EAO. MÉTODOS: Foram avaliados 63 pacientes, 32 pacientes com IAO (25 pacientes do sexo masculino e 7 do sexo feminino), 31 pacientes com EAO (11 pacientes do sexo masculino e 20 pacientes do sexo feminino). As variáveis foram comparadas na média entre os pacientes portador de IAO e EAO no pré e pós-operatório. RESULTADOS: A idade dos pacientes variou de 21 a 81 com média de 55 anos. Observa-se diferença quanto à média de idades entre as diferentes patologias (t-Student p< 0,0001). Os pacientes com IAO apresentam uma média de idade igual a 45,7±14,3 com variação entre 21 e 79 anos e os pacientes com EAO apresentam uma média de idade igual a 61,5±14,7 com variação entre 21 e 81 anos. Na IAO em relação à disfunção diastólica tivemos os seguintes dados com significância estatística do pré para o pós-operatório (6 meses): TRIV (p=0,0011), diferença entre Tempo de onda A mitral e onda A pulmonar (p=0,0097), Vol. Sistólico de AE (p=0,0019), Vol Sistólico de AE Indexado (0,0011), Vol. Diastólico de AE (p=0,0110), DDVE (p<0,0001), DSVE (p<0,0001), VSF (p<0,0001), VDF (p<0,0001), Massa Indexada de VE (p<0,0001) e Relação Volume/Massa do VE (p<0,0001). Na EAO em relação à disfunção diastólica tivemos os seguintes dados com significância estatística do pré para o pós-operatório (6 meses): E/E (p=0,0379), TRIV (p=0,0072), diferença entre o tempo de onda A mitral e tempo de onda A pulmonar (p=0,0176), Vol sistólico de AE(p=0,0242), Vol. Sistólico de AE indexado (p=0,0237), FEdeAE (p=0,0339), DDVE (p=0,0002), DSVE (p=0,0085), VDF (p=0,0194), Massa Indexada de VE (p<0,0001) e Relação Volume/Massa de VE(p<0,0001). O NTpró-BNP se correlacionou positivamente com os diversos graus de disfunção diastólica tanto no pré como pós-operatório CONCLUSÃO: Foram verificados no estudo da função diastólica variação com significância estatística tanto na IAO como na EAO na comparação do pré e o pós-operatório. Da mesma forma notamos variação do NT-proBNP com correlação com as variáveis ecocardiográficas que caracterizam a disfunção diastólica.
INTRODUCTION: Assessment of diastolic function in patients with aortic stenosis or aortic regurgitation waiting for aortic valve replacement. OBJECTIVE: Assesment of diastolic function with Doppler methods:Doppler signals from transvalvar mitral inflow, tissue Doppler imaging (TDI) and Doppler in pulmonary veins(DPV) correlating with serum brain peptide natriuretic (NTproNP) before and 6 months after aortic valve replacement (AVR). METHODS: We have analyzed 63 patients, 32 with AR (25 males and 7 females), 31 AS (11 males and 20 females).The indices were compared with AS and AR before and after AVR. RESULTS: The ages of patients ranged from 21 to 81 mean age was 55 years old.We have seen difference between mean age of AS and AR (t-Student-p<0.0001). Patients with AR have had mean age 45.67 plus/minus 14.28, range 21 to 79 years old and patients with AS have had mean age 61.50 plus/minus 14.72, range 21 to 81 years old. The patients who had AR the indices showed differences: Isovolumetric Relaxation Time IRT(p=0.0011), Diference between the pulmonary A wave duration and mitral A duration (p=0.0097), Left Atrial Systolic Volume (p=0.0019), Left Atrial Systolic Volume Index(p=0.0011), Left Atrial Diastolic Volume (p=0.0110), Left Ventricular Diastolic Diameter (p<0.0001), Left Ventricular Systolic Diameter (p<0.0001), End Systolic Volume (p<0.0001), End Diastolic Volume (p<0.0001), Left Ventricular Mass Index (p<0.0001) and Left Ventricular Volume and Left Ventricular Mass Index ratio (p<0.0001). Analyzing patients with AS the indices who showed differences: (The ratio of mitral velocity to early diastolic velocity of the mitral annulus) E/E (p=0.0379)(Isovolumetric Relaxation Time)(p=0.0072) IRT, Diference between the pulmonary A wave duration and mitral A duration (p=0.0176), Left Atrial Sistolic Volume (p=0.0242), Left Atrial Systolic Volume Index (p=0.0237), Left Atrial Ejection Fraction (p=0.0339) Left Ventricular Diastolic Diameter (p=0.0002), Left Ventricular Systolic Diameter (p=0.0085), End Diastolic Volume (LVEDV) (p=0.0194), Left ventricular Mass Index(p<0.0001), Left Ventricular Volume and Mass Index Ratio (p<0.0001). CONCLUSIONS: As we studied diastolic function we have verified significant statistic variation in aortic regurgitation and aortic stenosis comparing before and after aortic valve replacement. Likewise we have seen there is correlation between NTproBNP and echocardiographic variables that show diastolic dysfunction.

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Gisler, Fabian. « Effectiveness of angiotensin-converting enzyme inhibitors in pediatric patients with mid to severe aortic value regurgitation / ». [S.l.] : [s.n.], 2009. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000281144.

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Disha, Kushtrim. « New insights into the left ventricular morphological and functional changes in patients with bicuspid aortic valve disease ». 2018. https://ul.qucosa.de/id/qucosa%3A32347.

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Benjamim, de Oliveira Adriana. « Évolution échocardiographique et prédicteurs de progression de la sténose valvulaire aortique ». Thèse, 2014. http://hdl.handle.net/1866/11795.

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El, Yamani Nidal. « Interventions innovantes dans le traitement des maladies valvulaires mitrales et aortiques : options de traitement actuelles et perspectives futures ». Thesis, 2020. http://hdl.handle.net/1866/25185.

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Les maladies valvulaires constituent une cause importante de morbidité et de mortalité. Dans les pays industrialisés, l’insuffisance mitrale et la sténose aortique sont les pathologies valvulaires les plus fréquentes et leur prévalence augmentent avec l’âge. Étant donné l’augmentation de l’espérance de vie dans ces pays, la prévalence des valvulopathies dégénératives deviendra plus importante et aura un impact non négligeable sur la santé publique. Les avancées en chirurgie cardiaque ainsi que les nouvelles percées en cardiologie interventionnelle ont modifié considérablement la prise en charge des patients avec des valvulopathies en offrant des approches minimalement invasives, surtout pour les patients à haut risque chirurgical. Dans le cadre de ce mémoire, deux études rétrospectives de cohorte ont été réalisées. La première consiste à comparer les résultats postopératoires et sur trois ans de la chirurgie conventionnelle par rapport à la procédure transcathéter MitraClip chez 259 patients avec une insuffisance mitrale ischémique sévère. La deuxième étude compare les résultats postopératoires de trois approches de remplacement de la valve aortique, soit la sternotomie, la ministernotomie et la minithoracotomie. La première étude permet de conclure que la procédure MitraClip a un taux de mortalité postopératoire et sur 3 ans inférieur à celui de la chirurgie mais qu’elle est associée à un plus haut taux de récurrence de l’insuffisance mitrale après 3 ans. La deuxième étude démontre que les deux approches minimalement invasives, la ministernotomie et la mini-thoracotomie, ont un taux équivalent de mortalité intra-hospitalier à la sternotomie. La mini-thoracotomie est associée à moins de saignement périopératoire et moins de douleur au repos que la sternotomie. En conclusion, les approches minimalement invasives offrent une excellente alternative à la chirurgie conventionnelle dans le traitement de la maladie valvulaire. Les bénéfices cliniques sont d’autant plus évidents lorsque les patients sont adéquatement sélectionnés; d’où l’importance d’une ‘Heart Team’ qui collabore pour une meilleure prise en charge des patients.
Valvular heart disease is an important cause of morbidity and mortality. In western countries, mitral regurgitation and aortic stenosis are the most frequent valvular pathologies and their prevalence increases with age. With the increase in life expectancy in these countries, the prevalence of degenerative valve disease will increase with a significant burden on healthcare systems. Advances in cardiac surgery as well as new breakthroughs in interventional cardiology have considerably modified the management of patients with valvular disease, by offering minimally invasive approaches, especially for patients at high surgical risk. In this thesis, two retrospective cohort studies were carried out. The first compares the postoperative and 3 years outcomes of mitral valve surgery vs MitraClip, a transcatheter procedure, in 259 patients with severe ischemic mitral regurgitation. The second study compares the postoperative results of two minimally invasive techniques (ministernotomy and minithoracotomy) for aortic valve replacement to conventional sternotomy. In the first study, MitraClip procedure had lower postoperative and 3-year mortality rate than surgery, but it was associated with higher recurrence rate of mitral regurgitation after 3 years. The second study showed that the two minimally invasive approaches had similar intrahospital mortality rate to sternotomy. Minithoracotomy was associated with less perioperative bleeding and less pain at rest than sternotomy. In conclusion, minimally invasive approaches offer an excellent alternative to conventional surgery in the treatment of valvular disease. The clinical benefits are more highlighted when patients are properly selected; hence the importance of a "Heart Team" that collaborates for better patient care.

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Livres sur le sujet "Aortic valve regurgitation"

Klicpera, Martin. Chronic aortic regurgitation : Prognostic parameters for patients with chronic aortic regurgitation undergoing aortic valve replacement : value of invasive and non-invasive methods and pharmacological interventions (systemic vasodilation). Wien : Facultas Universitätsverlag, 1985.

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H, Gaasch William, et Levine Herbert J, dir. Chronic aortic regurgitation. Boston : Kluwer Academic, 1988.

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Chronic Aortic Regurgitation. Springer, 2012.

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Tribouilloy, Christophe, Patrizio Lancellotti, Ferande Peters, José Juan Gómez de Diego et Luc A. Pierard. Heart valve disease (aortic valve disease) : aortic regurgitation. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198726012.003.0033.

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Echocardiography is the cornerstone examination for the assessment of aortic regurgitation (AR): it provides reliable evaluation of the aortic valve and allows diagnosis and identification of the mechanism of regurgitation. The specific aetiology of the disease can be identified in the majority of cases. A combination of quantitative and quantitative Doppler and two-dimensional (2D) echocardiographic parameters allows the evaluation of the severity of AR and determination of the haemodynamic and left ventricular function repercussions. Echocardiography allows the detection of associated lesions of the aortic root or other valves. In symptomatic patients, echocardiography is essential to confirm the severity of AR. In asymptomatic patients with moderate or severe AR, echocardiography is essential for regular follow-up, by providing precise and reproducible measurements of LV dimensions and function, and for identifying patients who should be considered for elective surgical intervention. In most cases, transthoracic echocardiography (TTE) provides all of the necessary information and transoesophageal echocardiography in usually not required. Real-time three-dimensional (3D) TTE can be complementary to 2D echocardiography for the assessment of the mechanism and quantification of AR by increasing the level of confidence, especially when 2D echocardiographic data are inconclusive or discordant with clinical findings. Tissue Doppler imaging and especially the speckle tracking method are promising approaches to detect early LV dysfunction in patients with asymptomatic severe AR. Echocardiography is therefore the key examination for the assessment of AR and at the centre of the strategic discussion concerning the indications and timing of surgery.

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Rahimi, Kazem. Aortic regurgitation. Sous la direction de Patrick Davey et David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0094.

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Aortic regurgitation : Medical and surgical management. New York : Dekker, 1986.

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Aortic Regurgitation : Medical and Surgical Management (Cardiothoracic Surgery Series, Vol 2). Marcel Dekker Inc, 1986.

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Rosenhek, Raphael, Robert Feneck et Fabio Guarracino. Aortic valve disease. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199599639.003.0014.

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Echocardiography is the gold standard for the assessment of patients with aortic valve (AoV) disease. It allows a detailed morphological assessment of the AoV and thereby makes determination of the aetiology possible. In general, the quantification of aortic stenosis is based on the measurement of transaortic jet velocities and the calculation of AoV area, thus combining a flow-dependent and a flow-independent variable. In the setting of low-flow low-gradient AS, dobutamine echocardiography is of particular diagnostic and prognostic importance. The quantification of aortic regurgitation is based on qualitative and quantitative parameters. Awareness of potential pitfalls is fundamental. Haemodynamic consequences of AoV disease on left ventricular size, hypertrophy, and function as well as potentially coexisting valve lesions can be assessed simultaneously. In patients with AoV disease, predictors of outcome and indications for surgery are substantially defined by echocardiography.

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Lancellotti, Patrizio, et Bernard Cosyns. Heart Valve Disease. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198713623.003.0007.

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Echocardiography plays a major role in the evaluation, monitoring and decision making of patients with valvular heart disease. This chapter examines the aetiologies, haemodynamic measurements, and various consequences in aortic, mitral and pulmonary valve stenosis. It also describes how to assess patients with valvular regurgitation (mitral, aortic and pulmonary), valvular prosthesis and definite or suspected infective endocarditis. For each condition, echocardiographic features of poor prognosis, including complications, embolic risk, and the timing for surgery are discussed. Indications for transoesophageal echocardiography and 3D echocardiography are highlighted, especially when a decision of valve repair is envisioned. The timing echocardiographic monitoring of patients with valvular heart disease is also described.

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Ramrakha, Punit, et Jonathan Hill, dir. Valvular heart disease. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199643219.003.0003.

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General considerations 144Acute rheumatic fever 146Mitral stenosis: clinical features 150Mitral stenosis: investigations 152Mitral stenosis guidelines 156Mitral regurgitation 158Mitral regurgitation guidelines 161Mitral valve prolapse 162Aortic stenosis 164Management of aortic stenosis 168Aortic regurgitation 170Aortic regurgitation guidelines ...

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Chapitres de livres sur le sujet "Aortic valve regurgitation"

Spatenka, Jaroslav, et Jan Burkert. « Allograft Heart Valve in Aortic Valve Surgery ». Dans Aortic Regurgitation, 155–68. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_16.

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Dominik, Jan, Pavel Zacek et Jan Vojacek. « Aortic Valve Replacement ». Dans Aortic Regurgitation, 123–52. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_14.

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Fernández-Golfín, Covadonga. « Aortic Regurgitation ». Dans Heart Valve Disease, 47–64. Cham : Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-23104-0_4.

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Tuna, Martin, et Miroslav Brtko. « Echocardiography of the Aortic Valve ». Dans Aortic Regurgitation, 91–104. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_11.

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Brtko, Miroslav. « Transcatheter Aortic Valve Implantation (TAVI) ». Dans Aortic Regurgitation, 153–54. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_15.

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Vojacek, Jan, Pavel Zacek, Jan Dominik et Tomas Holubec. « Congenital Anomalies of the Aortic Valve ». Dans Aortic Regurgitation, 43–66. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_6.

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Brtko, Miroslav. « Recommendation for Outpatient Follow-Up After Aortic Valve Surgery ». Dans Aortic Regurgitation, 293–97. Cham : Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-74213-7_23.

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Tsifansky, Michael, Victor O. Morell et Ricardo Muñoz. « Aortic Valve Regurgitation ». Dans Critical Care of Children with Heart Disease, 435–38. London : Springer London, 2009. http://dx.doi.org/10.1007/978-1-84882-262-7_39.

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Scharnagl, Hubert, Winfried März, Markus Böhm, Thomas A. Luger, Federico Fracassi, Alessia Diana, Thomas Frieling et al. « Aortic Valve Regurgitation ». Dans Encyclopedia of Molecular Mechanisms of Disease, 125–26. Berlin, Heidelberg : Springer Berlin Heidelberg, 2009. http://dx.doi.org/10.1007/978-3-540-29676-8_129.

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Tsifansky, Michael D., Victor O. Morell et Ricardo A. Munoz. « Aortic Valve Regurgitation ». Dans Critical Care of Children with Heart Disease, 433–36. Cham : Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-21870-6_38.

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Actes de conférences sur le sujet "Aortic valve regurgitation"

Sarwari, H., A. Schäfer, J. Schirmer, N. Schofer, M. Seiffert, Y. Schneeberger, S. Blankenberg, H. Reichenspurner, D. Westermann et L. Conradi. « Transcatheter Aortic Valve Implantation for Pure Noncalcified Native Aortic Valve Regurgitation ». Dans 49th Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery. Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1705411.

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Azadani, Ali N. « Energy Loss for Evaluating Transcatheter Valve Performance ». Dans ASME 2010 5th Frontiers in Biomedical Devices Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/biomed2010-32025.

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Transcatheter aortic valve implantation (TAVI) has emerged as a new intervention for high surgical risk patients with severe symptomatic aortic stenosis [1]. The outcomes of the early experiences have been promising and the treatment modality is evolving very rapidly. However, mild to moderate paravalvular leaks occur commonly, over 50% of the time, after TAVI. While mild to moderate aortic regurgitation after TAVI may not have significant clinical impact in high surgical risk elderly patients, this degree of regurgitation may have considerable consequences long-term if TAV are implanted in younger and healthier patients.

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Conti, Carlo A., Emiliano Votta, Alessandro Della Corte, Luca Del Viscovo, Ciro Bancone, Maurizio Cotrufo et Alberto Redaelli. « Biomechanical Implications of the Bicuspid Aortic Valve : A Finite Element Study From In Vivo Data ». Dans ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206541.

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The bicuspid aortic valve (BAV) is the second most common congenital cardiac malformation, with an estimated prevalence of 0.9% to 2% in the general population [1]. BAV is widely recognized as a frequent cause of aortic stenosis and/or aortic regurgitation and as a risk factor for the early development of aortic aneurysms [2].

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Gunning, Paul S., Neelakantan Saikrishnan, Ajit P. Yoganathan et Laoise M. McNamara. « Hemodynamic and Structural Implications of Asymmetric Deployment of Transcatheter Aortic Valves : An In Vitro Study ». Dans ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14579.

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Aortic stenosis is an age related degenerative disease of the aortic valve that causes narrowing of the valve and aortic regurgitation [1]. Transcatheter Aortic Valve (TAV) implantation is a percutaneous alternative to open heart surgery, which allows for the treatment of a cohort of patients for whom conventional surgery is deemed excessively risky due to high postoperative mortality rates or pre-existing illness [2].

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Saikrishnan, Neelakantan, Nicole C. Milligan et Ajit P. Yoganathan. « Bicuspid Aortic Valves Are Associated With Increased Turbulence Compared to Pure Aortic Stenosis : An In Vitro Study ». Dans ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80127.

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In about 1–2% of all live births, the human aortic valve only consists of two anomalous leaflets and is known as the bicuspid aortic valve (BAV). BAVs are the most common congenital cardiac anomaly, and are associated with significant valvular dysfunction, including calcific aortic stenosis (AS) and aortic regurgitation (AR), as well as aortic wall abnormalities including coarctation of the aorta, ascending aortic dilatation and aneurysms [1]. Many studies have proposed a common underlying genetic defect in progression of complications with BAVs [2]. However, other recent studies have also suggested that the altered hemodynamic environment associated with BAVs could also be responsible for accelerated disease progression in these patients [3, 4]. A recent in vitro study showed elevated levels of turbulence associated with BAVs, and indicated that fluid flow patterns in the aortic sinuses are also affected due to the altered valve morphology [5]. The present work seeks to compare the levels of turbulence in BAVs to pure trileaflet aortic stenosis models.

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Barker, A. J., P. van Ooij, K. Bandi, J. Garcia, P. McCarthy, J. Carr, C. Malaisrie et M. Markl. « Viscous Energy Loss in Aortic Valve Disease Patients ». Dans ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14142.

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Purpose : Aortic valve disease (AVD) in the form of stenosis, insufficiency, or congenital defect will disrupt normal function beyond the valve itself. This includes an increase in cardiac afterload and a drastic alteration in post-valvular 3D blood flow patterns 1, 2. The current AHA/ACC standard-of-care guidelines, however, assess disease severity based on simplified measurements local to the valve, such as: peak velocity, effective orifice area, regurgitation, aortic diameter and transvalvular pressure gradient 3. Paradoxically, it is known that similarly classified AVD patients under these guideline metrics can exhibit radically divergent outcomes — implying an incomplete characterization of the disease 4. For this reason, functional assessment and risk-stratification may benefit from a robust methodology capable of quantifying the energetic load placed on the left ventricle (LV) due to the presence of AVD. The measurement of viscous energy loss, a parameter which is directly responsible for increased cardiac afterload and is independent of pressure recovery effects, is a promising candidate to quantify LV loading. With this in mind, the 4D flow technique (time-resolved 3D phase-contrast MRI with all principal velocity directions encoded) provides the necessary information to calculate this parameter. Therefore, we present a theoretical basis for the use of 4D flow MRI to characterize in-vivo energy loss and apply the technique in a pilot study of patients with aortic valve stenosis (n = 13) or aortic dilation (n = 17) as compared to normal controls (n = 12).

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Stevanella, Marco, Emiliano Votta, Massimo Lemma, Carlo Antona et Alberto Redaelli. « Morphometric Characterization and Finite Element Modeling of the Physiological Tricuspid Valve ». Dans ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206600.

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The tricuspid valve (TV) is the right atrio-ventricular valve. The most common TV disease is secondary or functional tricuspid regurgitation (FTR), an important complication of left-sided valvular heart lesions, which frequently persists after mitral and aortic valve operations. FTR is associated with high mortality and morbidity and requires surgical intervention, the preferential solution being TV repair through techniques such as annuloplasty performed during left heart surgery. However, significant residual regurgitation persists or recurs in 10% to 20% after annuloplasty, thus highlighting the incomplete understanding of the underlying mechanisms and the need for deeper insight into TV pathophysiology. At this purpose finite element models (FEMs) could be adopted, as suggested by their effective application to the biomechanical analysis of left heart valves. However, while for those several data are available regarding morphology and tissue mechanical properties, such information is missing for the TV, making it difficult to implement a FEM of the TV.

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Unbehaun, A., S. Buz, C. Klein, M. Kofler, A. Meyer, E. Potapov, M. Kukucka, V. Falk et J. Kempfert. « How to Prepare an Easy Device Landing Zone for Transcatheter Aortic Valve Implantation in Pure Aortic Regurgitation—Proof of Concept ». Dans 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678875.

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Van Doormaal, M. A., X. Zhang, Y. Zhou, D. A. Steinman et R. M. Henkelman. « In Vivo MRI Versus Ex Vivo CT for Image-Based CFD of the Mouse Aorta ». Dans ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80118.

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A novel mouse model of surgically induced aortic valve regurgitation (AR) has been developed which leads to altered hemodynamics in the descending thoracic and abdominal aorta, in turn leading to extensive atherosclerotic lesions in these otherwise lesion free areas [1]. Previous work has shown that maps of oscillatory shear index (OSI) and relative residence time (RRT) are consistent with the plaque distribution [2] and plaque severity in AR mice.

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Bosmans, Bart, Toon Huysmans, Roel Wirix-Speetjens, Peter Verschueren, Jan Sijbers, Johan Bosmans et Jos Vander Sloten. « Statistical Shape Modeling and Population Analysis of the Aortic Root of TAVI Patients ». Dans ASME 2013 Conference on Frontiers in Medical Devices : Applications of Computer Modeling and Simulation. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/fmd2013-16153.

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Transcatheter aortic valve implantation (TAVI) is a relatively new technique offering a treatment option to patients for whom an open-heart surgery represents a high risk of fatality. Due to the percutaneous delivery method of this treatment, there are challenges associated. In this technique the native aortic valve is not resected, making it difficult to judge the required size of the implant and making the sealing unpredictable. After implantation, 50% of the patients suffer from at least a mild degree of leakage alongside the implant, also known as paravalvular regurgitation [1].

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