Percutaneous Heart Valve Replacement
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Percutaneous Heart Valve Replacement
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Author : U. S. Department of Health and Human Services
language : en
Publisher: Createspace Independent Pub
Release Date : 2013-05-06
Percutaneous Heart Valve Replacement written by U. S. Department of Health and Human Services and has been published by Createspace Independent Pub this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-05-06 with Medical categories.
As the proportion of older adults increases in the U.S. population, the prevalence of degenerative heart valve disease is also increasing. Calcific aortic stenosis (narrowing) and ischemic and degenerative mitral regurgitation (leakage) are the most common valvular disorders in adults aged 70 years and older. For patients with severe valve disease, heart valve replacement involving open heart surgery can improve functional status and quality of life. A variety of conventional mechanical and bioprosthetic heart valves are readily available. However, some individuals are considered too high risk for open heart surgery. These patients may benefit from a less invasive procedure. Percutaneous heart valve replacement is a relatively new interventional procedure involving the insertion of an artificial heart valve using a catheter, rather than through open heart surgery. The portal of entry is typically either via the femoral vein or artery, or directly through the myocardium via the apical region of the heart. An expandable prosthetic heart valve is delivered and deployed at the site of the diseased native valve. The percutaneous heart valve replacement procedure usually takes less time to perform and is less invasive than open heart surgery. The Agency for Healthcare Research and Quality (AHRQ) has commissioned this Technical Brief to: Describe the types of conventional and percutaneous heart valves now in use or in development and their theoretical advantages and disadvantages for different patient populations; Describe the literature comparing various types of conventional heart valves in adults and determine whether a systematic review of this literature is feasible and needed; Describe the literature evaluating percutaneous heart valves in adults, including the patient populations and major outcomes studied to date; Describe implantation techniques for percutaneous heart valves and the factors associated with surgery or setting that may impact outcomes. The research team further clarified and refined the overall research objectives and the key questions. The key questions addressed are as follows: Question 1. What are the different types of heart valves in use and in development (including tissue, mechanical, and percutaneous valves)? a. What are the existing or potential U.S. Food and Drug Administration (FDA) indications for each valve (patient characteristics, etc.)? b. What are the theoretical advantages and disadvantages of different valves for different patient populations? Question 2. From a systematic literature scan of studies on different types of tissue and mechanical valves, describe the types of comparative studies, including basic study design, size of study, length of followup, and outcomes assessed. This literature scan will provide data to determine if a systematic review of this literature is possible and needed, and to provide needed context for understanding the evaluation and development of percutaneous heart valves. Question 3. From a systematic literature scan of studies on different types of percutaneous heart valves, provide a synthesis of the following variables: a. Number for each type of valve. b. Type of studies—comparative and non-comparative randomized controlled trials (RCTs), non-randomized controlled clinical trials, case series, etc. c. Variables associated with surgery (implantation technique), setting, etc. d. Size of studies/length of followup. e. Patient population/concurrent and prior treatments. f. Hemodynamic success rates reported. g. Harms reported. Question 4. What are the variables associated with surgery or setting that may impact outcomes for percutaneous heart valves? a. What are the different implantation techniques (i.e., position of implantation, delivery, and axis techniques)? What is the evidence of success (i.e., absence of narrowing and regurgitation) and harms? i. For percutaneous aortic valves. ii. For percutaneous mitral valves.
Percutaneous Treatment Of Left Side Cardiac Valves
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Author : Corrado Tamburino
language : en
Publisher: Springer
Release Date : 2018-03-13
Percutaneous Treatment Of Left Side Cardiac Valves written by Corrado Tamburino and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2018-03-13 with Medical categories.
After the success of the first two editions, this expanded and extensively revised edition provides the interventional cardiologist with detailed, state of the art information on key techniques and approaches to percutaneous treatment of left side cardiac valve disease, keeping pace with the rapid and dynamic evolution in the discipline. Many new techniques and resources are now available, including new devices for transcatheter aortic valve implantation and new approaches to transcatheter mitral valve replacement. Numerous images will help the reader to understand the steps of each procedure and the characteristics of the different devices available. The potential complications and expected or potential morbidity from each procedure are discussed in depth, along with the best ways to manage them. Transcatheter aortic valve implantation has revolutionized the field of interventional cardiology. Initially envisaged as a palliative technique for inoperable patients, it now offe rs high-risk patients a viable alternative to surgery. Several techniques are also available of transcatheter mitral valve repair, and initial cases of transcatheter mitral valve replacement have also been reported: the interest in these techniques is such that further significant technological advances are expected to be seen over the next few years. This highly informative, easy to read, and carefully structured guide provides interventional cardiologists with updated knowledge on the application of transcatheter techniques to cardiac valves.
Transcatheter Valve Repair
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Author : Ziyad M. Hijazi
language : en
Publisher: CRC Press
Release Date : 2006-01-17
Transcatheter Valve Repair written by Ziyad M. Hijazi and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2006-01-17 with Medical categories.
Transcatheter Valve Repair discusses all aspects related to percutaneous and established valve repair methods. The book is divided into few major sections covering all four valves and other topics. Each section contains several chapters discussing everything related to that valve. Beginning with the pulmonary valve, since it was the first valve to be tackled in the catheterization laboratory, and then moving to the aortic, then the mitral and then finally end with the tricuspid valve. 1.5M US citizens alone have some degree of aortic valve stenosis, with half (750K) requiring aortic valve replacement. Aortic valve replacement, on the whole, is performed by surgeons, requiring bypass machines and technicians, as well as the usual operating team. The operation is expensive and occupies a considerable amount of operating room time. Mostly, the aortic valve is calcified and the usual option available to patients is valve replacement with a variety of choices, ranging from porcine valves to synthetic, for which there are many manufacturers. It should be noted that the aortic valve is the most problematic of valves. Percutaneous procedures are the answer. The bottom line is that given the growing elderly population, many more patients will require valve repair, thus increasing health care costs with not only surgical operations but also hospitalisation. Percutanous valve repair, whilst requiring a cath lab team, does not involve bypass machines nor extended hospitalisation. Like percutaneous transluminal coronary artery interventions (PTCA) has replaced coronary artery bypass grafts (once the golden standard), and now stenting having replaced PTCA and its balloons. We now see drug eluting stents replacing ordinary stents (though at a much higher cost. There will be a huge movement toward percutanous valve repair, which should presumably cut costs but also morbidity and mortality.
Percutaneous Mitral Valve Interventions Repair Current Indications And Future Perspectives
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Author : Alfonso Ielasi
language : en
Publisher: Frontiers Media SA
Release Date : 2020-12-31
Percutaneous Mitral Valve Interventions Repair Current Indications And Future Perspectives written by Alfonso Ielasi and has been published by Frontiers Media SA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-12-31 with Medical categories.
This eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contact.
Percutaneous Heart Valve Replacement
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Author :
language : en
Publisher:
Release Date : 2010
Percutaneous Heart Valve Replacement written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with categories.
OBJECTIVES: To describe the types of prosthetic heart valves now in use and in development, summarize clinical studies completed or under way, and discuss factors that may impact clinical outcomes for percutaneous heart valve (PHV) replacement. DATA SOURCES: MEDLINE(r), EMBASE(r), and gray literature sources. REVIEW METHODS: We searched the English-language literature to identify systematic reviews and comparative clinical studies of conventional heart valves and studies of PHVs in adults. We define PHV replacement as the delivery of a prosthetic heart valve via a catheter inserted either through a vein or artery (femoral vein; femoral, subclavian, or axillary arteries; or the ascending aorta) or through the apex of the heart via an incision in the chest wall (transapical approach). RESULTS: We identified numerous mechanical and bioprosthetic heart valves. Six systematic reviews compared various conventional valves; the single high-quality review found better short-term hemodynamic performance but longer operating times with stentless compared to stented bioprosthetic valves. A large primary literature (57 randomized controlled trials [RCTs], 40 observational studies) compares various conventional heart valves. Seven manufacturers of PHVs were identified in 62 fully published case reports or non-comparative case series that studied 856 unique patients. All but 19 of these patients received valves produced by one of two PHV manufacturers. The route of access was via the femoral artery in 580 patients (68 percent). The transapical approach was used in 223 patients (26 percent). The route of access for the remaining 53 patients (6 percent) was via the femoral vein, subclavian artery, axillary artery, or ascending aorta. All but two of the prosthetic valves were implanted in the aortic valve position in patients with symptomatic aortic stenosis at high operative risk. Successful implantation was achieved in 92 percent of patients; 30-day survival was 86 percent. The lack of comparative studies limits the ability to determine which variables associated with PHV replacement are causally related to outcomes. A multicenter RCT comparing PHV to conventional heart valve replacement or medical management is currently underway in the United States. CONCLUSIONS: A large number of heart valve prostheses are in use, but there are limited data to inform the selection of one valve over another. There is sufficient existing primary literature to support systematic reviews or meta-analyses to help inform several important clinical questions pertaining to conventional heart valve replacement. PHV replacement is a rapidly emerging technology that has been proven feasible and is a promising therapeutic option for patients with severe, symptomatic aortic stenosis who have a higher risk of poor outcome with surgical aortic valve replacement. Well-designed observational studies and decision modeling could help inform clinical and health policy in the absence of RCTs.
Atlas Of Percutaneous Edge To Edge Mitral Valve Repair
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Author : Ted Feldman
language : en
Publisher: Springer Science & Business Media
Release Date : 2013-01-09
Atlas Of Percutaneous Edge To Edge Mitral Valve Repair written by Ted Feldman and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-01-09 with Medical categories.
The field of structural heart disease interventions is experiencing a stage of rapid growth with the development of percutaneous mitral valve repair therapies and percutaneous aortic valve replacement therapies. The MitraClip represents a new therapeutic frontier for mitral regurgitation and is expected to revolutionize repair of the mitral valve. For the first time in the world, physicians now have the capability to repair the mitral valve percutaneously without the need for a sternotomy or cardiopulmonary bypass. However, as with all new endeavors, there is a steep learning curve, not just for the individual operator but also for the entire field. The MitraClip technology and technique is technically complex and is guided by echocardiography and fluoroscopy. It is an imaging intensive procedure that requires deep 3-dimensional understanding of normal and abnormal cardiac anatomy. Not all mitral regurgitation cases are suitable and not all cases are straightforward. It is therefore crucially important for physicians in this specialty to communicate their experience, successes, failures and complications with each other. Written by the leaders in this breakthrough field, the Atlas of Percutaneous Edge-to-Edge Mitral Valve Repair is the first of its kind for the new percutaneous MitraClip procedure. The Editors have designed the book to be a comprehensive reference manual and to provide cardiologists with true examples of basic and complex cases of percutaneous mitral valve repair using the technology. In addition, this book provides step-by-step guides to the procedure and complications as well as steps to recover from them are discussed. The Atlas is anticipated to be a very valuable reference for both novice and experienced interventional cardiologists and echocardiologists. As percutaneous valve repair becomes more common it will also be of great interest to general cardiologists and surgeons.
Transcatheter Aortic Valve Implantation
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Author : Patrick W. Serruys
language : en
Publisher: CRC Press
Release Date : 2024-09-10
Transcatheter Aortic Valve Implantation written by Patrick W. Serruys and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2024-09-10 with Medical categories.
Written by pioneers in the field of interventional cardiology, this new edition provides readers with the information and expert guidance needed to perform safe and effective transcatheter aortic valve implantation/replacement (TAVI/TAVR). The book is supplemented by visual aids, including more than 300 illustrations and videos.
Transcatheter Aortic Valve Implantation
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Author : Luca TESTA
language : en
Publisher: Edizioni Minerva Medica SpA
Release Date : 2024-05-07
Transcatheter Aortic Valve Implantation written by Luca TESTA and has been published by Edizioni Minerva Medica SpA this book supported file pdf, txt, epub, kindle and other format this book has been release on 2024-05-07 with Medical categories.
This book will explore the many aspects of the transcatheter aortic valve replacement, from the clinical data supporting the observed worldwide diffusion, to the technicalities that evolved over time in parallel with the continuous new iterations of available devices. Both the interventionalists looking for a reference to literature milestones and the interventionalists searching for the description and execution of the procedure will find what they are looking for. Many answers will be there through the pages, but also some pending questions to fuel future developments and to further refine a procedure that truly changed the landscape of cardiology.
Percutaneous Heart Valve Replacement For Valvular Heart Disease
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Author :
language : en
Publisher:
Release Date : 2010
Percutaneous Heart Valve Replacement For Valvular Heart Disease written by and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2010 with categories.
The second technique (transapical) requires a small incision in the ribcage and through the apex of the ventricle to access the aortic valve.2 A third procedure, the antegrade trans-septal technique, has fallen out of use.2 Disclaimer:. [...] Some of the valve failures were related to the design of the device and changes were made by the manufacturer. [...] The number of procedural complications fell from 6% in the first cohort of 50 patients to 2.9% in the second cohort (105 patients) as experience was gained with the procedure.2 In the case series summarized in the two HTAs, median NYHA functional class improved from class II preoperatively to class 1 after 10 months. [...] The Austrian HTA recommended restricted reimbursement for the procedure in specialized centers and mandatory registration of cases for ongoing re-evaluation.2 The recommendations from the NICE review are summarized in the guidelines section of this document. [...] Considering the limited number of patients and the technical expertise required, the authors suggested that the number of centers performing the procedure should be restricted.
Transcatheter Mitral Valve Repair And Replacement An Issue Of Interventional Cardiology Clinics
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Author : Matthew Price
language : en
Publisher: Elsevier Health Sciences
Release Date : 2019-05-11
Transcatheter Mitral Valve Repair And Replacement An Issue Of Interventional Cardiology Clinics written by Matthew Price and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-05-11 with Medical categories.
This issue of Interventional Cardiology Clinics will explore Transcatheter mitral valve repair and replacement. Curated by the series Editor-in-Chief, Dr. Matthew J. Price, this issue will cover topics and advances in the field that are relevant for practicing clinicians. This issue is one of four selected each year by Dr. Price. The volume will include articles on: Transcatheter Mitral Valve Direct Annuloplasty With the Millipede Device, Transcatheter Mitral Valve Replacement with Intrepid, Transcatheter Mitral Valve Replacement with Tendyne, Treatment of functional mitral regurgitation with transcatheter edge-to-edge repair, Transcatheter Edge-to-Edge repair for Degenerative Mitral Regurgitation, Predicting Left Ventricular Outflow Tract Obstruction Following Transcatheter Mitral Valve Replacement, Prevention and Treatment of Left Ventricular Outflow Tract Obstruction after Transcatheter Mitral Valve Replacement, and Transatrial implantation of transcatheter heart valve for mitral disease, among others.