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ESC Heart Fail 2019 Feb 18. Epub 2019 Feb 18.

Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, Matsudo, Japan.

Although aortic valve (AV) replacement is a curative procedure for severe aortic stenosis, prosthetic heart valves have many disadvantages and cause serious complications. A new promising surgical procedure-aortic valve neocuspidization (AVNeo)-has recently been developed; it is an original method of AV reconstruction with autologous pericardium. It has been reported to yield excellent medium-term results with respect to durability and complications. Read More

Heart 2019 Feb 16. Epub 2019 Feb 16.

Department of Cardiology, Hospital General Universitario Gregorio Maranon, Madrid, Spain.

Objective: To obtain reference values of aortic valve area (AVA) in a large population and to infer the risk of overestimating aortic stenosis (AS) when focusing on flow-corrected indices of severity.

Methods: We prospectively measured indices of AS in all consecutive echocardiograms performed in a large referral cardiac imaging laboratory for 1 year. We specifically analysed the distribution of AVA, indexed AVA and velocity ratio (Vratio) in patients with and without AS, the latter defined as the coexistence of valvular outflow obstruction (Vmax ≥2. Read More

JACC Cardiovasc Imaging 2019 Feb 11. Epub 2019 Feb 11.

Division of Cardiology, Cook County Health and Hospitals System, Chicago, Illinois.

JACC Cardiovasc Imaging 2019 Feb 11. Epub 2019 Feb 11.

Valve Center, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:

Objectives: This study sought to determine whether baseline left ventricular global longitudinal strain (LV-GLS) and changes in left ventricular ejection fraction (LVEF) in a subgroup of subjects at post-operative follow-up added prognostic value in patients undergoing aortic valve (AV) surgery.

Background: In patients with chronic severe aortic regurgitation (AR) and preserved LVEF, sensitive markers are needed to decide timing of AV surgery.

Methods: This was an observational study in 865 patients (asymptomatic/mildly symptomatic, 52 ± 15 years of age, 79% men) with ≥3+ chronic AR and preserved LVEF of ≥50% who underwent AV surgery between 2003 and 2015. Read More

Front Physiol 2018 30;9:1921. Epub 2019 Jan 30.

Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

The bicuspid aortic valve, a kind of heart disease that comes from parents, has been paid attention around the world. Although most bicuspid aortic valve (BAV) patients will suffer from some complications including aortic stenosis, aortic regurgitation, endocarditis, and heart dysfunction in the late stage of the disease, there is none symptom in the childhood, which restrains us to diagnose and treatment in the onset phase of BAV. Hemodynamic abnormalities induced by the malformations of the valves in BAV patients for a long time will cause BAV-associated aortopathy: including progress aortic dilation, aneurysm, dissection and rupture, cardiac cyst and even sudden death. Read More

Eur Heart J Cardiovasc Imaging 2019 Jan 31. Epub 2019 Jan 31.

Department of Cardiology, Hospital Universitario Fundación Jiménez Díaz, Av. de los Reyes Católicos, 2, 28040 Madrid, Spain.

Aims: To determine the prevalence and characteristics of bicuspid aortic valve (BAV) among elite athletes and to analyse the effect of long-term exercise training on their aortas.

Methods And Results: Consecutive BAV and tricuspid aortic valve (TAV) elite athletes from a population of 5136 athletes evaluated at the Sports Medicine Center of the Spanish National Sports Council were identified using echocardiography. A total of 41 BAV elite athletes were matched with 41 TAV elite athletes, and 41 BAV non-athletic patients from three Spanish tertiary hospitals. Read More

J Magn Reson Imaging 2019 Feb 4. Epub 2019 Feb 4.

Pediatric Cardiology and Congenital Heart Disease, German Heart Center at Technical University of Munich, Munich, Germany.

Background: Alterations in wall shear stress (WSS) assessed using 4D flow MRI have been shown to play a role in various vascular pathologies, such as bicuspid aortic valve aortopathy. Most studies have focused on systolic WSS, whereas altered diastolic hemodynamics in regurgitant semilunar valvular lesions have not so far been well characterized.

Purpose: To investigate diastolic WSS in aortic and pulmonary regurgitation. Read More

Circ Cardiovasc Imaging 2019 Feb;12(2):e007928

The Heart Institute, Cincinnati Children's Hospital Medical Center, OH (A.Z.B.).

Background: The 2012 World Heart Federation Criteria are the current gold standard for the diagnosis of latent rheumatic heart disease (RHD). Because data and experience using these criteria have grown, there is opportunity to simplify and develop outcome prediction tools. We aimed to develop a simple echocardiographic score applicable for RHD screening with potential to predict disease progression. Read More

Int J Cardiol 2019 Apr 11;280:53-56. Epub 2019 Jan 11.

Unité Médico-Chirurgicale de Cardiologie Congénitale et Pédiatrique, Centre de référence Malformations Cardiaques Congénitales Complexes - M3C, Paris, France; Radiology Department, Hôpital Universitaire Necker Enfants Malades, Paris, France.

Introduction: Neo-aortic root dilatation and regurgitation are common progressive long-term complications of the arterial switch operation (ASO) for transposition of the great arteries (TGA) with increasing clinical burden. While several risk factors have been identified, most are constitutional. The acute aortic angle commonly seen after ASO might alter aortic dynamics and facilitate progression of the neo-aortic root dilatation and aortic regurgitation, but insufficient data is available. Read More

JACC Cardiovasc Imaging 2019 Jan 16. Epub 2019 Jan 16.

Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain and the Divisions of Cardiology and Cardiothoracic Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium. Electronic address:

Objectives: The present study examines whether improvements have reduced the negative impact of guideline triggers on postoperative outcomes.

Background: European and American guidelines for the management of severe aortic regurgitation (AR) define the triggers for AR surgery. These triggers are based on the results of studies performed in the 1990s analyzing outcomes of patients who underwent AR surgery in the 1980s. Read More

Cureus 2018 Oct 31;10(10):e3531. Epub 2018 Oct 31.

Internal Medicine, Cleveland Clinic - Fairview Hospital, Cleveland, USA.

Acute aortic dissection is a deadly disease that should be recognized promptly. We report an exceptional case of a 44-year-old African American female who presented with a rapidly progressing severe frontal headache. Initial computed tomography of the brain was negative. Read More

Circ Cardiovasc Imaging 2019 Dec;12(1):e008341

Department of Medicine and Therapeutics (W.K.C., G.T., K.K.H.K., L.T., A.P.W.L., L.S.T.), Faculty of Medicine, Chinese University of Hong Kong, SAR.

Int Heart J 2019 Jan 10. Epub 2019 Jan 10.

Department of Biotechnology and Pharmaceutical Technology, Yuanpei University of Medical Technology.

Unicuspid aortic valve (UAV) is an extremely rare form of congenital cardiac malformation, leading to aortic stenosis (AS), aortic regurgitation (AR), or both. We report the case of a 55-year-old man with unicommissural UAV associated with severe AS and mild AR using different multimodality imaging approaches. The excised UAV isolated after aortic valve replacement exhibited an eccentric "teardrop" opening with a slit-shaped unicommissural structure. Read More

Heart Surg Forum 2018 Nov 7;21(6):E443-E447. Epub 2018 Nov 7.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Background: We sought to analyze the pathological characteristics of hypertrophic obstructive cardiomyopathy (HOCM) with concomitant mitral valve abnormalities and to discuss the surgical treatment strategies.

Methods: The clinical data of 26 HOCM patients treated from January 2014 to March 2016 were retrospectively analyzed. There were 19 males and 7 females with a mean age of 47 ± 16 years (range, 10-70 years). Read More

Ann Cardiothorac Surg 2018 Nov;7(6):780-786

Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, MI, USA.

The IRIS mitral annuloplasty ring is a transcatheter, transfemoral and transseptal-delivered complete, semi-rigid annuloplasty ring. The IRIS system mimics surgical annuloplasty by reducing the mitral septal-lateral dimension and improving leaflet coaptation. We report the early experience with the IRIS system in seven patients. Read More

J Cardiothorac Surg 2018 Dec 29;13(1):133. Epub 2018 Dec 29.

Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.

Background: The totally thoracoscopic procedure for mitral valve (MV) disease is a minimally invasive method. We investigated the procedure's feasibility, safety and effectiveness when it was performed by an experienced operator.

Methods: We retrospectively analysed 53 consecutive patients with MV disease treated between December 2014 and April 2017 by minimally invasive procedures. Read More

Echocardiography 2019 02 28;36(2):406-410. Epub 2018 Dec 28.

Echocardiography Laboratory, Mount Sinai Heart Institute, Columbia University Division of Cardiology, Miami Beach, Florida.

A quadricuspid aortic valve is an uncommon valve lesion. Its physical manifestations vary, and it may be associated with other cardiac lesions. Echocardiography is the imaging modality of choice, with computerized tomography or cardiac magnetic resonance imaging being utilized as adjunctive imaging modalities in certain cases. Read More

Curr Opin Cardiol 2019 Mar;34(2):173-177

Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Purpose Of Review: The purpose of this study is to review the contemporary evidence surrounding aortic bioprosthetic valve deterioration, with a focus on early failure of surgically implanted valves.

Recent Findings: Structural valve deterioration (SVD) remains the most frequent cause of premature bioprosthetic aortic valve failure. However, recent evidence suggests that SVD represents a spectrum, and that clinically silent hemodynamic valve deterioration frequently precedes and predisposes to overt SVD. Read More

N Engl J Med 2018 Dec;379(24):2362-2372

From the Departments of Medicine (E.M.I., A.A.S., A.E.S.), Radiology (N.M.M.), and Pathology (K.J.T.), Massachusetts General Hospital, and the Departments of Medicine (E.M.I., A.A.S., A.E.S.), Radiology (N.M.M.), and Pathology (K.J.T.), Harvard Medical School - both in Boston.

Circ Cardiovasc Imaging 2018 Dec;11(12):e007611

The Labatt Family Heart Center, Department of Pediatrics, The Hospital for Sick Children and University of Toronto, ON, Canada (L.M., M.K.F.).

Background: The study objective was to assess the severity, progression rate, and risk factors for aortic root dilatation (ARD) in pediatric tetralogy of Fallot (TOF) and to study its relationship to complications including aortic regurgitation.

Methods And Results: Seven hundred sixty-eight TOF patients were studied with echocardiography (median age at repair 6.1 months; interquartile range, 4. Read More

JACC Cardiovasc Imaging 2018 Dec 6. Epub 2018 Dec 6.

Department of Anesthesiology, University of North Carolina, Chapel Hill, North Carolina.

Catheter Cardiovasc Interv 2019 Feb 7;93(3):455-463. Epub 2018 Dec 7.

Department of Pediatrics, Division of Cardiology, UCLA Mattel Children's Hospital, Los Angeles, California.

Objectives: To describe a multi-center experience of percutaneous transcatheter pulmonary valve replacement (TPVR) using the Edwards Sapien S3 Valve.

Background: Off-label use of the Sapien S3 valve can allow for TPVR in patients with congenital heart disease (CHD) and large diameter dysfunctional right ventricular outflow tract (RVOT). The initial experience at five centers with the SAPIEN S3 valve for TPVR is presented with a focus on procedural techniques, success, complications, and efficacy. Read More

JACC Cardiovasc Interv 2018 Dec 28;11(24):2507-2518. Epub 2018 Nov 28.

The Heart Center, Segeberger Kliniken (Academic Teaching Hospital of the Universities of Kiel, Lübeck, and Hamburg), Bad Segeberg, Germany; Cardiology Department, Heart Center Leipzig - University Hospital, Leipzig, Germany. Electronic address:

Objectives: The aim of this study was to compare self-expanding and balloon-expandable transcatheter heart valves (THVs) in large versus small aortic valve annuli.

Background: The degree of THV oversizing varies according to annular size, and this can modify the hemodynamic performance of self-expanding and balloon-expandable THVs.

Methods: Patients undergoing transcatheter aortic valve replacement in the randomized CHOICE (Comparison of Transcatheter Heart Valves in High Risk Patients With Severe Aortic Stenosis: Medtronic CoreValve vs Edwards SAPIEN XT) trial (CoreValve [CV], n = 120; SAPIEN XT [SXT], n = 121) and the nonrandomized CHOICE-Extend registry (Evolut R [ER], n = 100; SAPIEN 3 [S3], n = 334) were compared for THV performance by echocardiography (in all patients) and by cardiac magnetic resonance imaging (MRI) regurgitant fraction (RF) (in a subgroup of patients). Read More

Heart 2018 Dec 4. Epub 2018 Dec 4.

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Background: Aortic dilation and aortic valve disease are known long-term complication of tetralogy of Fallot (TOF), but the risk of aortic dissection and the indications for prophylactic aortic surgery are unknown in this population. The purpose of this study was to: (1) determine the prevalence of significant aortic valve disease and/or significant aortic aneurysm (AVD-AA); (2) determine the incidence of progressive aortic dilation and aortic dissection in patients with TOF.

Methods: Retrospective review of adults with repaired TOF, and no prior aortic valve/aorta surgery, who had ≥2 measurements of the thoracic aorta >12 months apart, 1990-2017. Read More

J Thorac Cardiovasc Surg 2018 Sep 27. Epub 2018 Sep 27.

Department of Cardiac Surgery, Cardiovascular Center, Klinikum Nürnberg, Paracelsus Medical University, Nuremberg, Germany.

Objective: To assess risk factors for paravalvular leak (PVL) after transcatheter aortic valve implantation in a large single-center cohort, including measurement of aortic valve calcification using a reproducible method.

Methods: We retrospectively analyzed preoperative contrast-enhanced multidetector computed tomography scans of patients who underwent transcatheter aortic valve implantation in our center between 2009 and 2016. Calcium volume was calculated for each aortic cusp in the aortic valve, left ventricular outflow tract, and device landing zone. Read More

JACC Cardiovasc Interv 2018 Nov;11(22):2314-2322

University Hospital Düsseldorf, Medical Faculty, Division of Cardiology, Pulmonology and Vascular Medicine, Düsseldorf, Germany.

Objectives: The aim of this study was to investigate the hemodynamic and clinical performance of the Evolut PRO compared with its direct predecessor, the Evolut R.

Background: Recently, the newest commercially available generation of the self-expandable Medtronic CoreValve prosthesis, the CoreValve Evolut PRO, was introduced to the market. This prosthesis is based on the previous Evolut R model and specifically designed to mitigate paravalvular leakage. Read More

Biomech Model Mechanobiol 2018 Nov 20. Epub 2018 Nov 20.

Department of Biomedical Engineering, Stony Brook University, T15-090 Health Sciences Center, Stony Brook, NY, 11794-8151, USA.

Transcatheter aortic valve replacement (TAVR) has emerged as an effective alternative to conventional surgical valve replacement in high-risk patients afflicted by severe aortic stenosis. Despite newer-generation devices enhancements, post-procedural complications such as paravalvular leakage (PVL) and related thromboembolic events have been hindering TAVR expansion into lower-risk patients. Computational methods can be used to build and simulate patient-specific deployment of transcatheter aortic valves (TAVs) and help predict the occurrence and degree of PVL. Read More

JACC Cardiovasc Imaging 2018 Nov 8. Epub 2018 Nov 8.

Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research, John Radcliffe Hospital, Oxford, United Kingdom. Electronic address:

JACC Cardiovasc Imaging 2018 Nov 8. Epub 2018 Nov 8.

Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria. Electronic address:

Objectives: This study investigated the diagnostic and prognostic value of cardiac magnetic resonance (CMR) imaging in chronic aortic regurgitation (AR).

Background: Accurate quantification of AR severity by echocardiography frequently remains difficult. CMR is recommended as the complementary method; however, its accuracy and prognostic utility remain unknown. Read More

Prog Cardiovasc Dis 2018 Nov - Dec;61(5-6):397-403. Epub 2018 Nov 14.

The Division of Cardiology, Mayo College of Medicine, Mayo Clinic, Rochester, MN, United States of America.

Compared with the vast literature concerning the echocardiographic assessment of mitral, or aortic disease, the data concerning the evaluation of tricuspid regurgitation (TR) is very limited. In this review we summarized the present data concerning the assessment of TR. We review the present knowledge concerning the pathogenesis of TR showing that it is extremely multi-factorial, thus, when assessing patients with TR by echocardiography it is imperative to focus on four major aspects: evaluation of severity of TR, assessment of the etiology of TR, evaluation of the mechanism of TR and suitability for surgical or per-cutaneous repair. Read More

Eur Heart J Cardiovasc Imaging 2018 Nov 15. Epub 2018 Nov 15.

Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, 55905 MN, USA.

Aims: Bicuspid aortic valve (BAV) and mitral valve prolapse (MVP) are common but the prevalence and significance of coexistent conditions are unknown. This study investigated the prevalence, phenotypic expression, and clinical significance of coexistent MVP-BAV.

Methods And Results: Retrospective comparison of MVP-BAV and MVP-tricuspid aortic valve (TAV) prevalence including de novo echocardiographic analysis of all MVP-BAV patients between 2005 and 2015 was performed. Read More

Heart 2018 Nov 15. Epub 2018 Nov 15.

Departments of Cardiology and Cardiac Surgery, University Hospital of Wales, Cardiff, UK.

A 29-year-old man crashed at high speed into another vehicle at traffic lights. He was able to get out of his van but then collapsed after running a few metres. On arrival in the emergency department he was conscious, with a pulse of 140 beats/min and blood pressure of 110/32 mm Hg. Read More

Swiss Med Wkly 2018 11 15;148:w14675. Epub 2018 Nov 15.

, 3010, Bern, SWITZERLAND.

BACKGROUND The term “predisposition” is used as an indication of antimicrobial prophylaxis to prevent infective endocarditis and as a criterion for diagnosing infective endocarditis according to the modified Duke criteria. The criterion for diagnosing infective endocarditis in native valves is not well defined. OBJECTIVES To identify conditions that increase the risk for infective endocarditis in native valves, for the diagnosis of infective endocarditis according to the modified Duke criteria. Read More

Catheter Cardiovasc Interv 2018 Nov 15. Epub 2018 Nov 15.

Imperial College London, London, United Kingdom.

Objectives: To evaluate the in vivo feasibility of aortography with one accurately timed diastolic low-volume contrast injection for quantitative assessment of aortic regurgitation (AR) post transcatheter aortic valve replacement (TAVR).

Background: With the rise of a minimalistic approach for TAVR, aortography (re)emerges as a pragmatic tool for AR assessment. In a mock circulation system, we have validated the accuracy of a single diastolic injection triggered by electrocardiogram (ECG) with low-contrast volume. Read More

Heart 2019 Jan;105(Suppl 1):s57-s63

Royal Air Force Aviation Clinical Medicine Service, RAF Centre of Aviation Medicine, RAF Henlow, Bedfordshire, UK.

Valvular heart disease (VHD) is highly relevant in the aircrew population as it may limit appropriate augmentation of cardiac output in high-performance flying and predispose to arrhythmia. Aircrew with VHD require careful long-term follow-up to ensure that they can fly if it is safe and appropriate for them to do so. Anything greater than mild stenotic valve disease and/or moderate or greater regurgitation is usually associated with flight restrictions. Read More

Catheter Cardiovasc Interv 2018 Nov 8. Epub 2018 Nov 8.

Structural Heart and Valve Center, New York Presbyterian Hospital/Columbia University Medical Center, New York, New York.

Transcatheter aortic valve replacement (TAVR) is not currently approved for pure native valve aortic incompetence, and is typically performed on a compassionate basis in selected patients who are at high risk for conventional surgery. We describe the first use of TAVR to treat iatrogenic severe acute pure aortic incompetence following mitral valve surgery. A 71-year-old gentleman developed life-threatening acute aortic regurgitation (AR) within hours of a very challenging fifth open heart mitral valve replacement. Read More

J Investig Med High Impact Case Rep 2018 Jan-Dec;6:2324709618807504. Epub 2018 Oct 28.

State University of New York Upstate Medical University, Syracuse, NY, USA.

In this article, we report the case of a 75-year-old man who was presented with new low back pain for 2 weeks. His past history was significant for severe aortic stenosis necessitating bioprosthetic aortic valve placement 4 years ago, hypertension, and coronary artery disease. His physical examination was positive for point tenderness over the lower lumbar spine. Read More

Ophthalmic Surg Lasers Imaging Retina 2018 Oct;49(10):e151-e153

A newborn with severe neonatal Marfan syndrome (NMS), characterized by aortic root dilation, mitral and tricuspid valve regurgitation, diaphragmatic eventration with respiratory distress, intestinal malrotation, and various skeletal abnormalities, developed bilateral pupillary block from luxated crystalline lenses. He underwent bilateral immediate sequential vitrectomy and lensectomy to prevent further episodes of pupillary block. Bilateral surgery was performed due to the extremely high anesthesia risk. Read More

Int J Cardiovasc Imaging 2018 Oct 30. Epub 2018 Oct 30.

Department of Cardiology, West China Hospital of Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.

The aim of this study was to evaluate the diagnostic performance of the diastolic retrograde ratio in the descending aorta in patients with aortic regurgitation (AR) by vector flow mapping (VFM). Conventional Doppler echocardiography and VFM were performed in 73 patients with various degrees of AR and 40 controls. AR severity was assessed by an expert using the currently recommended integrative approach, including vena contracta width (VCW), jet width to left ventricular outflow tract (jet width/LVOT) ratio, and effective regurgitant orifice area (EROA). Read More

Catheter Cardiovasc Interv 2019 Feb 23;93(2):324-329. Epub 2018 Oct 23.

Department of Pediatrics, Division of Cardiology, UCLA Mattel Children's Hospital, Los Angeles, California.

Objectives: To describe a multicenter experience of percutaneous transcatheter pulmonary valve replacement (TPVR) using the Edwards SAPIEN S3 valve without the use of a prior stent ("pre-stenting").

Background: The SAPIEN S3 and XT valves have durable cobalt-chromium stent frames which may allow for TPVR in large diameter dysfunctional right ventricular outflow tracts (RVOTs) without pre-stenting the landing zone.

Methods: A retrospective review was performed of all patients with Congenital Heart Disease and dysfunctional RVOT who underwent TPVR using the SAPIEN valve without the use of a pre-stent. Read More

Natl Med J India 2018 Jan-Feb;31(1):22-23

Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, Kerala, India.

An isolated right-sided aortic arch with no congenital heart disease is extremely rare. We report an adult woman with longstanding rheumatic heart disease causing severe calcific mitral stenosis, moderate mitral regurgitation and moderate pulmonary hypertension, for which she underwent mitral valve replacement and tricuspid annuloplasty. On preoperative work-up, she was detected to have a right-sided aortic arch with mirror image branching along with a ductal dimple. Read More

Eur Heart J Cardiovasc Imaging 2018 Oct 17. Epub 2018 Oct 17.

Department of Pediatrics, Division of Cardiology, The Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8, Canada.

Aims: The aims of this study were to provide a detailed descriptive analysis of pre-intervention morphologic and functional echocardiographic parameters in a large, unselected, multicentre cohort of neonates diagnosed with critical left heart obstruction and to compare echocardiographic features between the different subtypes of left-sided lesions.

Methods And Results: Pre-intervention echocardiograms for 651 patients from 19 Congenital Heart Surgeons' Society (CHSS) institutions were reviewed in a core lab according to a standardized protocol including >150 morphologic and functional variables. The four most common subtypes of lesions were: aortic atresia (AA)/mitral atresia (MA) (29% of patients), AA/mitral stenosis (MS) (20%), aortic stenosis (AS)/MS (26%), and isolated AS (iAS) (18%). Read More

Echocardiography 2018 12 18;35(12):2109-2112. Epub 2018 Oct 18.

Cardiology B Department of CHU Ibn Sina, Rabat, Morocco.

The interventricular septal dissection is an uncommon, and is occasionally associated with sinus of Valsalva aneurysm. A spontaneous dissection with a normal sinus of Valsalva is extremely rare and is mostly a result of a congenital defect. We report the case of a 23-year-old male admitted for complete heart block and presenting as an incidental finding during the TTE multiple and huge cystic-like mass in the interventricular septum (IVS) which is the TTE characteristic of IVS dissection. Read More

Cardiovasc Revasc Med 2018 Oct 4. Epub 2018 Oct 4.

King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.

Background: Partner 2 and SURTAVI trials (mean STS score of 5.8 and 4.5) support extending TAVR into the intermediate risk group. Read More

Semin Thorac Cardiovasc Surg 2018 Oct 10. Epub 2018 Oct 10.

Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio.

With heart disease increasing worldwide, demand for new minimally invasive techniques and transcatheter technologies to treat structural heart disease is rising. Cardioscopy has long been considered desirable, as it allows direct tissue visualization and intervention to deliver therapy via a closed chest, with real-time fiber-optic imaging of intracardiac structures. Herein, the feasibility of the advanced cardioscopic platform, allowing both transapical and fully percutaneous access is reported. Read More

J Cardiovasc Imaging 2018 Sep 18;26(3):165-174. Epub 2018 Sep 18.

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Background: Transcatheter device closure of ventricular septal defect (VSD) has become an attractive alternative to surgery. We report here on our early experiences of transcatheter closure of VSD using Cocoon devices, which are now available in Korea.

Methods: We reviewed the medical records and angiographic images of 13 patients who underwent transcatheter closure of VSD with a Cocoon occluder at Samsung Medical Center. Read More

Echo Res Pract 2018 Sep 1(5). Epub 2018 Sep 1.

Wessex Cardiac & Cardiothoracic Unit, University Hospital Southampton, Southampton, UK

A 77-year-old male underwent elective bioprosthetic aortic valve replacement (23 mm Carpentier-Edwards Perimount MagnaEase) for severe aortic stenosis. His pre-discharge transthoracic echocardiogram (TTE) was normal. He presented 9 days after surgery with dyspnea and fever. Read More

JACC Cardiovasc Imaging 2018 Oct;11(10):1499-1513

Heart and Vascular Institute, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio.

The authors review the optimal sequence of multimodality imaging studies in patients with chronic asymptomatic aortic regurgitation (AR). The initial questions in evaluating such patients are: 1) is AR severe; and 2) does it significantly impact the left ventricle? Although transthoracic echocardiography is usually able to answer these questions, a cardiovascular magnetic resonance imaging study might be necessary if the data from echocardiography are conflicting or inadequate. If AR is severe and the left ventricle is severely dilated, surgery is indicated. Read More

J Cardiol Cases 2018 Jul 16;18(1):13-16. Epub 2018 Apr 16.

Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

Unicuspid aortic valve (UAV) is an extremely rare congenital heart valve abnormality while bicuspid valve (BAV) has been reported as one of the most common cardiac anomalies. With a UAV usually showing similar presentations to a BAV, such as aortic regurgitation or aortic stenosis (AS), it is challenging to differentiate them from each other in clinical settings. Despite some features shared between both valve disorders, there can be a clinical significance in distinguishing UAV from BAV for the management of patients with these heart anomalies. Read More

J Cardiol Cases 2018 Jul 4;18(1):1-4. Epub 2018 Apr 4.

Department of Cardiology, Tenri Hospital, Tenri, Nara, Japan.

A 37-year-old man presented with heart failure caused by severe aortic regurgitation (AR). He had a history of being involved in a traffic accident 3 months earlier. Imaging tests at admission detected no abnormalities in the aortic valve or aortic wall; however, the left coronary cusp prolapsed slightly on transthoracic echocardiography. Read More