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JACC Cardiovasc Interv 2020 Jul;13(13):1503-1514

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:

As transcatheter aortic valve replacement becomes a more dominant treatment option across all risk profiles, the frequency of encountering patients with multivalvular disease will increase. Furthermore, percutaneous interventions to treat other valvular lesions are also evolving. Understanding the clinical implications and treatment options for a second valvular lesion is becoming increasingly important to guide heart team decisions, and this paper aims to review the evidence around these situations. Read More

J Thorac Dis 2020 May;12(5):2926-2935

Department of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Rome, Italy.

Patients undergoing transcatheter aortic valve replacement (TAVR) might have an associated significant MR that can potentially lead to left ventricular (LV) failure after procedure. Considering the specific alterations in the mitral valve in TAVR scenario and the widespread use of TAVR in recent years, it appears important to know and understand the anatomical, functional and clinical implications to develop adequate strategies for the future. Patients with severe mitral regurgitation (MR) have been generally excluded from randomized clinical trials, making poor the impact that associated MR can have on clinical outcomes after TAVR. Read More

Eur Heart J Case Rep 2020 Jun 26;4(3):1-5. Epub 2020 May 26.

Hero DMC (Dayanand Medical College) Heart Institute, Civil Lines, DMC Road, Tagore Nagar, Ludhiana, Punjab 141001, India.

Background: Aneurysms of the sinus of Valsalva (SOV) are thin-walled outpouchings most commonly involving the right or non-coronary sinuses. Because they are asymptomatic, they are rarely discovered before they rupture and form an aorto-cardiac fistula. We present a rare case of unruptured aneurysm of the right coronary SOV burrowing into the interventricular septum with severe aortic incompetence and left ventricular dysfunction. Read More

BMC Vet Res 2020 Jun 30;16(1):224. Epub 2020 Jun 30.

Section of Herd Health and Animal Husbandry, School of Veterinary Medicine, Veterinary Sciences Centre, University College Dublin, Belfield, Dublin 4, Ireland.

Background: Congenital heart diseases are occasionally encountered in the bovine species. Ventricular septal defects (VSD) and atrial septal defects (ASD) are reported to be the most common; however, a vast collection have been reported [1, 2]. Congenital heart diseases is thought to represent less than 3% of all congenital abnormalities in calves [3]. Read More

BMC Vet Res 2020 Jun 29;16(1):217. Epub 2020 Jun 29.

Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.

Background: Echocardiography is the most frequently used non -invasive diagnostic tool to evaluate cardiac anatomy and function in domestic species but increasingly also in non -domestic species, especially since cardiac disease is being recognized as an important cause of death in captive primates. The purpose of this cross -sectional study was to investigate the feasibility of transthoracic echocardiography in healthy squirrel monkeys as well as to provide species specific normal values for standard echocardiographic measurements. A secondary aim was to determine plasma and serum levels of the cardiac biomarkers, N -terminal pro -brain natriuretic peptide (NT -proBNP) and cardiac troponin T (cTnT). Read More

Eur Heart J Cardiovasc Imaging 2020 Jun 20. Epub 2020 Jun 20.

Department of Internal Medicine II, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.

Aims: Concomitant secondary atrioventricular regurgitation is frequent in patients with severe aortic stenosis scheduled for transcatheter aortic valve replacement (TAVR). The future implications of leaving associated valve lesions untreated after TAVR remain unknown. Aim of the present study was to characterize the evolution of concomitant secondary atrioventricular regurgitations and to evaluate their impact on long-term prognosis. Read More

Eur Heart J Cardiovasc Imaging 2020 Jun 15. Epub 2020 Jun 15.

Department of Cardiovascular Surgery, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.

J Cardiovasc Magn Reson 2020 06 15;22(1):45. Epub 2020 Jun 15.

Sydney Translational Imaging Laboratory, Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.

Background: As the average age of patients with severe aortic stenosis (AS) who receive procedural intervention continue to age, the need for non-invasive modalities that provide accurate diagnosis and operative planning is increasingly important. Advances in cardiovascular magnetic resonance (CMR) over the past two decades mean it is able to provide haemodynamic data at the aortic valve, along with high fidelity anatomical imaging.

Methods: Electronic databases were searched for studies comparing CMR to transthoracic echocardiography (TTE) and transoesophageal echocardiography (TEE) in the diagnosis of AS. Read More

Echocardiography 2020 Jun 12. Epub 2020 Jun 12.

Department of Cardiology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.

Ortner's syndrome (cardiovocal syndrome) is a rare cause of unilateral vocal cord paralysis that results from compression of the left recurrent laryngeal nerve by enlarged vascular structures. Most commonly, it is caused by an enlarged left atrium, but other rare causes include ascending aortic aneurysm or pulmonary artery aneurysm. Although very rarely encountered nowadays, bilharziasis is still one of the main causes of pulmonary artery aneurysm in endemic areas. Read More

Cardiol Young 2020 Jul 11;30(7):1046-1049. Epub 2020 Jun 11.

Section of Pediatric Cardiology, Departments of Pediatrics and Cardiovascular Surgery, Cohen's Children's Hospital, Northwell Health, Donald and Barbara Zucker School of Medicine at Hofstra University, New York, NY, USA.

Isolated aortic regurgitation and myocardial infarction are a rare congenital defect among neonatal patients. We present a case of a neonate with an unusual aortic valve morphology causing both regurgitation and obstruction of the left coronary artery ostium. Despite both non-invasive and invasive imaging modalities, accurate diagnosis of the valve morphology was only determined by direct visualisation at the time of surgical repair. Read More

JACC Cardiovasc Interv 2020 Jun;13(11):1312-1313

Department of Cardiology, Centrum voor Hart en Vaatziekten, Universitaire Ziekenhuis Brussels; In Vivo Molecular and Cellular Imaging Center; European Reference Network on Rare Cardiac Disease, Brussels, Belgium. Electronic address:

J Invasive Cardiol 2020 Jun;32(6):E174

UC Davis Medical Center, 4860 Y Street, Suite 2820, Sacramento, CA 95817 USA.

An 80-year-old man with a history of bicuspid AV complicated by severe AI presented with progressive NYHA class III symptoms and severe bioprosthetic AV insufficiency. Transcatheter aortic valve replacement was planned via transfemoral approach. We encountered several technical challenges and describe them herein. Read More

Diagn Interv Imaging 2020 May 22. Epub 2020 May 22.

Aix-Marseille Université, CNRS, CRMBM (Centre de Résonance Magnétique Biologique et Médicale) and Assistance Publique - Hôpitaux de Marseille, CEMEREM (Centre d'Exploration Métaboliques par Résonance Magnétique), 13385 Marseille, France; Assistance Publique - Hôpitaux de Marseille, Department of Radiology and Cardiovascular Imaging, Hôpital Timone, 13385 Marseille, France.

Purpose: The purpose of this study was to investigate the potential additional value of cardiac magnetic resonance (CMR) in the assessment of left ventricular (LV) dilatation and dysfunction by comparison to standard echocardiography in patients with chronic left-sided valvular regurgitation.

Materials And Methods: We prospectively enrolled patients with chronic severe mitral regurgitation (MR) or aortic regurgitation (AR). They underwent standard echocardiography and CMR using aortic flow and LV-function sequences. Read More

Int J Cardiol 2020 May 18. Epub 2020 May 18.

Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, United Kingdom. Electronic address:

Background: Phase contrast velocity mapping sequences utilising ultrashort echo time (UTE) radial k-space sequences have been used to reduce intravoxel dephasing at high velocities. We evaluated the accuracy of the UTE flow sequence for mitral regurgitation (MR) quantification, including patients with atrial fibrillation.

Methods: Forty patients underwent cardiac MRI for indirect MR quantification by assessment of aortic flow using a UTE phase contrast sequence (TE 0. Read More

Echo Res Pract 2020 May 1. Epub 2020 May 1.

J Khan, Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom of Great Britain and Northern Ireland.

A 31-year old male was admitted with suspected infective endocarditis given intravenous drug use, lung and cerebral abscesses and Staphyloccus aureus bacteraemia. TTE imaging was limited given supine positioning and mechanical ventilation but suggested a posterior mitral valve leaflet (PMVL) mass. Three-dimensional TOE provided uniquely detailed assessment of two complex infective masses. Read More

Echocardiography 2020 Jun 19;37(6):935-938. Epub 2020 May 19.

Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.

Infective endocarditis is a heterogeneous disease with a wide array of pathological lesions. We present a 55-year-old man with severe mitral and aortic regurgitation on transthoracic echocardiography. Transesophageal echocardiogram characterized the mechanisms detecting a windsock mitral valve perforation, aortic root abscess, and Gerbode ventricular septal defect, with the deep transgastric view showing all three pathologies concurrently. Read More

Kardiol Pol 2020 05 15;78(5):498-507. Epub 2020 May 15.

1st Department of Cardiology, Biegański Hospital, Medical University of Lodz, Łódź, Poland

The ongoing pandemic of coronavirus disease 2019 (COVID‑19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), represents a major challenge for healthcare. The involvement of cardiovascular system in COVID‑19 has been proven and increased healthcare system resources are redirected towards handling infected patients, which induces major changes in access to services and prioritization in the management of patients with chronic cardiovascular disease unrelated to COVID‑19. In this expert opinion, conceived by the task force involving the Working Groups on Valvular Heart Diseases and Cardiac Surgery as well as the Association of Cardiovascular Intervention of the Polish Cardiac Society, modification of diagnostic pathways, principles of healthcare personnel protection, and treatment guidelines regarding triage and prioritization are suggested. Read More

Open Heart 2020 May;7(1)

General und Interventional Cardiolgy/Angiology, Heart and Diabetes Center North Rhine-Westphalia, Bad Oeynhausen, Nordrhein-Westfalen, Germany

Objective: Residual paravalvular regurgitation (PVR) has been associated to adverse outcomes after transcatheter aortic valve replacement (TAVR). This study sought to evaluate the impact of device landing zone (DLZ) calcification on residual PVR after TAVR with different next-generation transcatheter heart valves.

Methods: 642 patients underwent TAVR with a SAPIEN 3 (S3; n=292), ACURATE (NEO; n=166), Evolut R (ER; n=132) or Lotus (n=52). Read More

J Thorac Cardiovasc Surg 2020 Mar 12. Epub 2020 Mar 12.

Clinic for Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany; DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany. Electronic address:

Objective: We aimed to analyze the association among flow patterns, gene expression, and histologic alterations of the proximal aorta in patients with aortic valve disease.

Methods: A total of 131 patients referred for aortic valve replacement were grouped by valve dysfunction (aortic stenosis vs aortic regurgitation) and valve morphology (bicuspid vs tricuspid). On the basis of magnetic resonance imaging, aortic tissue from outer and inner curvature was collected for gene expression and histologic analysis. Read More

Surg Technol Int 2020 May;36:217-223

Department of Cardiovascular Surgery, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, New York.

Severe tricuspid regurgitation (TR) is associated with significant mortality and morbidities. Currently, surgical tricuspid repair with annuloplasty is the gold standard treatment. However, the prohibitive risks of open surgery and increasing evidence that severe TR should be intervened on early has led to an outburst in the development and evolution of transcatheter tricuspid valve interventions (TTVI). Read More

Am Heart J 2020 06 8;224:105-112. Epub 2020 Feb 8.

Department of Cardiology, Duke University Medical Center, Durham, NC. Electronic address:

Background: Patients with bicuspid aortic valve stenosis (BAV) were excluded from all the trileaflet aortic valve stenosis (TAV) pivotal trials, and therefore, their outcomes are not clearly defined. The aim of the study was to evaluate the outcomes of transcatheter aortic valve replacement (TAVR) in patients with BAV and compared them with those of TAV.

Methods: We evaluated the outcomes following TAVR of patients with BAV at our institution between April 2011 and November 2016 and compared them with the outcomes of patients with TAV treated with TAVR. Read More

Medicine (Baltimore) 2020 May;99(18):e19928

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan.

Rationale: Point-of-care ultrasound is widely used in patients with cardiac arrest, allowing for diagnosing, monitoring, and prognostication as well as assessing the effectiveness of the chest compressions. However, the detection of intraoperative cardiac arrest by Point-of-care ultrasound was rarely reported.

Patient Concerns: A 21-year-old male with Marfan syndrome which manifested Valsalva sinus aneurysms was admitted for aortic valve replacement. Read More

Quant Imaging Med Surg 2020 Apr;10(4):853-861

Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.

Background: Aortic valve (AV) repair has evolved towards a treatment alternative in young patients with AV regurgitation and was accompanied by the development of surgical repair strategies. An efficient and reproducible AV annulus stabilization (i.e. Read More

JAAPA 2020 May;33(5):1-4

In the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins Medical Institutions in Baltimore, Md., Gregory Schalla is a PA resident and Michael Grant is an assistant professor. The authors have disclosed no potential conflicts of interest, financial or otherwise.

A patient who presented after falling out of bed had signs of right-sided stroke, which, after imaging, was suspicious for embolism with cardiac origin. Further investigation revealed a large aortic valve vegetation with mild aortic insufficiency, and the patient eventually developed heart failure requiring surgical intervention. Infective endocarditis is slowly becoming more prevalent, and clinicians should have a high index of suspicion when patients present with common complications of this disease, such as valvular dysfunction, heart failure, or stroke. Read More

Eur Radiol 2020 Apr 22. Epub 2020 Apr 22.

University Clinic of Radiology, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria.

Objectives: To prospectively compare unenhanced quiescent-interval single-shot MR angiography (QISS-MRA) with contrast-enhanced computed tomography angiography (CTA) for contrast-free guidance in transcatheter aortic valve intervention (TAVI).

Methods: Twenty-six patients (mean age 83 ± 5 years, 15 female [58%]) referred for TAVI evaluation underwent QISS-MRA for aortoiliofemoral access guidance and non-contrast three-dimensional (3D) "whole heart" MRI for prosthesis sizing on a 1.5-T system. Read More

Am J Cardiol 2020 Jun 2;125(12):1884-1889. Epub 2020 Apr 2.

Service de cardiologie, Hôpital Croix-Rousse and Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université de Lyon; CREATIS UMR5220; INSERM U1044; INSA-15 Lyon, France. Electronic address:

Despite major technological advances, 1-year morbi-mortality after transcatheter aortic valve implantation (TAVI) is still high. Further outcome improvements may be obtained provided proper identification of prognostic factors. A change of prognostic value over time should be the hallmark of an outcome-implicated factor. Read More

AMIA Annu Symp Proc 2019 4;2019:190-199. Epub 2020 Mar 4.

Weill Cornell Medicine, New York, NY.

While natural language processing (NLP) of unstructured clinical narratives holds the potential for patient care and clinical research, portability of NLP approaches across multiple sites remains a major challenge. This study investigated the portability of an NLP system developed initially at the Department of Veterans Affairs (VA) to extract 27 key cardiac concepts from free-text or semi-structured echocardiograms from three academic edical centers: Weill Cornell Medicine, Mayo Clinic and Northwestern Medicine. While the NLP system showed high precision and recall easurements for four target concepts (aortic valve regurgitation, left atrium size at end systole, mitral valve regurgitation, tricuspid valve regurgitation) across all sites, we found moderate or poor results for the remaining concepts and the NLP system performance varied between individual sites. Read More

Int J Cardiovasc Imaging 2020 Apr 18. Epub 2020 Apr 18.

Department of Cardiac Surgery, University of Leipzig - HELIOS Heart Center, Strümpellstraße 39, 04289, Leipzig, Germany.

Transthoracic echocardiography (TTE) and cardiac magnetic resonance (CMR) are current standard for assessing aortic regurgitation (AR). Regurgitant fraction (RF) can also be estimated by Doppler examination of the left subclavian artery (LSA-Doppler). However, a comparison of AR grading scales using these methods and a TTE multiparametric approach as reference is lacking. Read More

JACC Cardiovasc Imaging 2020 Apr 10. Epub 2020 Apr 10.

Department of Cardiology, Rambam Medical Center, and B. Rappaport Faculty of Medicine, Technion Medical School, Haifa, Israel. Electronic address:

Objectives: The objective of this study was to determine risk factors for progression to hemodynamically significant tricuspid regurgitation (TR) and the population burden attributable to these risk factors.

Background: Few data are available with regard to risk factors associated with the development of hemodynamically significant functional TR.

Methods: A total of 1,552 subjects were studied beginning with an index echocardiogram demonstrating trivial or mild TR. Read More

Int J Cardiovasc Imaging 2020 Apr 17. Epub 2020 Apr 17.

Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Faculty of Medical Science in Zabrze, Medical University of Silesia, Katowice, Poland.

The ascending aorta dilatation in the bicuspid aortic valve (BAV) patients is often attributed to congenital abnormalities of the aortic wall, but it may be related to hemodynamic disturbances in the course of BAV disease. At present, ascending aortic diameter is used as almost sole but weak predictor of aortic dissection and rupture in BAV. We examined the association between aortic wall mechanics and severity of aortic valve disease including different cusps fusion patterns using conventional echocardiography and tissue Doppler imaging (TDI). Read More

Gen Thorac Cardiovasc Surg 2020 Apr 13. Epub 2020 Apr 13.

Department of Cardiovascular Surgery, Heart Center, Shizuoka City Shizuoka Hospital, 10-93, Ohte-machi, Aoi-ku, Shizuoka, 420-8630, Japan.

We present a successful case of the management of a 46-year-old woman with an abnormal aortic valve formed by four cusps (three equal large cusps and one smaller cusp; type B according to the Hurwitz and Roberts classification) with a marked loss of coaptation that caused a severe aortic insufficiency (AI). The patient underwent an aortic valvuloplasty of the defect using the glutaraldehyde (GA)-pretreated autologous pericardium, restoring the subnormal function and competency of the aortic valve. The postoperative course was unremarkable. Read More

Methodist Debakey Cardiovasc J 2020 Jan-Mar;16(1):65-67

HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER, HOUSTON, TEXAS.

J Thorac Dis 2020 Mar;12(3):319-328

Department of Cardiology, Xinhua Hospital Affiliated with the School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.

Background: To assess the diagnostic value of echocardiography in detecting the various types of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA).

Methods: A total of 30 patients with an established diagnosis of ALCAPA were retrospectively analyzed, and classified into infant- (n=20) and adult-type (n=10) groups according to the age of symptom manifestation and the mode of presentation. All patients underwent echocardiography examination. Read More

J Cardiovasc Comput Tomogr 2020 Feb 27. Epub 2020 Feb 27.

Department of Radiology, 200 First Street SW, Mayo Clinic, Rochester, MN, 55905, USA. Electronic address:

Objectives: To obtain 3D CT measurements of mitral annulus throughout cardiac cycle using prototype mitral modeling software, assess interobserver agreement, and compare among patients with mitral prolapse (MP) and control group.

Background: Pre-procedural imaging is critical for planning of transcatheter mitral valve (MV) replacement. However, there is limited data regarding reliable CT-based measurements to accurately characterize the dynamic geometry of the mitral annulus in patients with MV disease. Read More

Ann Thorac Cardiovasc Surg 2020 Jun 3;26(3):158-165. Epub 2020 Apr 3.

Department of Structural Heart Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China.

Purpose: Our study aimed to investigate the structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI) using J-Valve.

Methods: In all, 14 patients with aortic stenosis (AS) and 4 patients with pure aortic regurgitation (PAR) were available in the study. Four-year follow-up was performed in all patients, and the clinical data and echocardiographic findings were recorded and analyzed. Read More

Neth Heart J 2020 May;28(5):253-265

Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.

Introduction: Transcatheter aortic valve implantation (TAVI) is a safe and effective treatment for inoperable, intermediate- or high-risk patients with severe symptomatic aortic stenosis and has been associated with excellent clinical outcomes. A clinically relevant remaining problem is aortic regurgitation (AR) post-TAVI, which is associated with increased mortality. Therefore, we conducted a prospective randomised trial to assess the safety and efficacy of a first-generation self-expandable valve (SEV; CoreValve) and a third-generation balloon-expandable valve (BEV; Sapien 3) with respect to clinical outcomes and AR as determined quantitatively by magnetic resonance imaging (MRI). Read More

Eur Heart J Cardiovasc Imaging 2020 Apr 3. Epub 2020 Apr 3.

Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Netherlands.

Aims : Indexed effective orifice area (EOAi) charts are used to determine the likelihood of prosthesis-patient mismatch (PPM) after aortic valve replacement (AVR). The aim of this study is to validate whether these EOAi charts, based on echocardiographic normal reference values, can accurately predict PPM.

Methods And Results : In the PERIcardial SurGical AOrtic Valve ReplacemeNt (PERIGON) Pivotal Trial, 986 patients with aortic valve stenosis/regurgitation underwent AVR with an Avalus valve. Read More

Open Heart 2020 15;7(1):e001209. Epub 2020 Mar 15.

Department of Cardiothoracic Surgery, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK.

Objectives: Re-do aortic valve surgery carries a higher mortality and morbidity compared with first time aortic valve replacement (AVR) and often requires concomitant complex procedures. Transcatheter aortic valve replacement (TAVR) is an option for selective patients. The aim of this study is to present our experience with re-do aortic valve procedures and give an insight into the characteristics of these patients and their outcomes. Read More

BMC Vet Res 2020 Mar 20;16(1):93. Epub 2020 Mar 20.

Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium.

Background: Aortic regurgitation (AR) may lead to left ventricular (LV) dilatation, cardiac arrhythmias and heart failure. Close follow-up of horses with AR is therefore paramount to detect onset of cardiac decompensation. The aim of this study was to examine whether two-dimensional speckle tracking (2DST) can be used to detect altered myocardial function in horses with chronic AR compared to control horses. Read More

JACC Cardiovasc Imaging 2020 Jun 16;13(6):1442-1445. Epub 2020 Mar 16.

Circ Cardiovasc Imaging 2020 03 17;13(3):e009717. Epub 2020 Mar 17.

Division of Cardiology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Canada (M.G., R.R., C.M., S.M., Ch.-P.S.F., C.M., L.M.).

Background: Bicuspid aortic valve (BAV) is the most prevalent congenital heart defect affecting 1% to 2% of the population. It is associated with ascending aorta dilatation. Valve morphology, aortic stenosis (AS), and aortic insufficiency (AI) have been proposed as potential risk factors; however, evaluating their role is difficult, as these factors are inherently related. Read More

Circ Cardiovasc Imaging 2020 Mar 17;13(3):e009675. Epub 2020 Mar 17.

Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada (A.F., N.D.).

Background: Patients with bicuspid aortic valve (BAV) have a higher risk of developing aortic valve dysfunction and progressive proximal aorta dilatation, which can lead to aortic dissection. To this day, identification of children at risk of developing severe aortic dilatation during their pediatric follow-up is still challenging because most studies were restricted to adult subjects. The overarching goal of this study was to identify risk factors of aortic dilatation in children with BAV. Read More

Circ Cardiovasc Imaging 2020 Mar 17;13(3):e010448. Epub 2020 Mar 17.

Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St Thomas' NHS Trust, United Kingdom. Division of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, United Kingdom.

Int Heart J 2020 Mar 14;61(2):273-280. Epub 2020 Mar 14.

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University.

For its high occurrence and elevated risks for aortic valve dysfunction and vascular complications, bicuspid aortic valve (BAV) represents a great health challenge. However, the prevalence and clinical features of BAV in the Chinese population are inadequately illustrated.From January 2011 to December 2015, 3,673 BAV patients with 69. Read More

Open Heart 2020 13;7(1):e001158. Epub 2020 Feb 13.

Department of Cardiology, Hospital Universitario Quironsalud Madrid, Madrid, Madrid, Spain.

Objective: The main objective of the present study was to compare the use of four-dimensional (4D) flow MRI with the habitual sequence (two-dimensional phase-contrast (2DPC) MRI) for the assessment of aortic regurgitation (AR) in the clinical routine.

Methods: This was a retrospective, observational cohort study of patients with varying grades of AR. For the purposes of the present study, we selected all the cases with a regurgitant fraction (RF)>5% as determined by 2DPC MRI (n=34). Read More

Eur Heart J Case Rep 2020 Feb 10;4(1):1-5. Epub 2020 Feb 10.

3rd Medical Department of Cardiology and Intensive Care Medicine, Wilhelminenhospital, Montleartstrasse 37, A-1160 Vienna, Austria.

Background: Non-bacterial thrombotic endocarditis (NBTE) is a rare condition, usually observed in association with malignancy, lupus erythematosus, or antiphospholipid syndrome. Diagnosis of NBTE remains a challenge as patients are often asymptomatic up to their first thromboembolic event. While there is no randomized data available for the guidance of treatment in NBTE, effective anticoagulation remains the main focus in the management of affected patients. Read More

BMC Pediatr 2020 Feb 24;20(1):87. Epub 2020 Feb 24.

Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong district, Shanghai, China.

Background: Low cardiac output syndrome (LCOS) is an important complication of cardiac surgery. It is associated with increased morbidity and mortality. The incidence of LCOS after surgery is high in patients with congenital heart disease (CHD). Read More

Clin Res Cardiol 2020 Feb 18. Epub 2020 Feb 18.

Department of Cardiology, Heart Center, University of Cologne, Kerpener Str. 61, 50937, Cologne, Germany.

Objective: The objective of this study was to assess imaging predictors of mitral regurgitation (MR) improvement and to evaluate the impact of MR regression on long-term outcome in patients undergoing transcatheter aortic valve replacement (TAVR).

Background: Concomitant MR is a frequent finding in patients with severe aortic stenosis but usually left untreated at the time of TAVR.

Methods: Mitral regurgitation was graded by transthoracic echocardiography before and after TAVR in 677 consecutive patients with severe aortic stenosis. Read More

Circ Cardiovasc Imaging 2020 Feb 10;13(2):e009879. Epub 2020 Feb 10.

Department of Cardiology, Imperial College Healthcare NHS Trust, United Kingdom (J.M.T., G.D.C., N.S.P., A.V.).

Arch Cardiovasc Dis 2020 Mar 14;113(3):168-175. Epub 2020 Feb 14.

Montsouris Institut Paris, 75014 Paris, France.

Background: Standardization of aortic valve repair by the external ring annuloplasty approach is an alternative to valve replacement to avoid prosthetic valve-related events. Although the benefit of exercise training to improve postoperative exercise tolerance has been demonstrated in many conditions after cardiac surgery, it has never been described after aortic valve repair.

Objectives: To evaluate the feasibility of an early exercise training programme after aortic valve repair. Read More