Percutaneous balloon valvuloplasty is now a widely accepted alternative to surgical valvotomy for patients with congenital aortic valve stenosis. Mitral valve anomalies are well known to coexist and influence the prognosis from all palliative procedures. Two cases of mitral valve injury occurring during balloon aortic valvuloplasty are reported, one an 11 month old boy, the other a 2 day old ba...

Background—Aortic valve replacement with cardiopulmonary bypass is currently the treatment of choice for symptomatic aortic stenosis but carries a significant risk of morbidity and mortality, particularly in patients with comorbidities. Recently, percutaneous transfemoral aortic valve implantation has been proposed as a viable alternative in selected patients. We describe our experience with a ...

In this week’s Circulation, Webb and colleagues1 report on the use of percutaneous “valve-in-valve” rereplacement in the treatment of 24 ill patients with prosthetic valve failure under compassionate-use protocols. Ten procedures addressed the aortic valve; 7, the mitral valve; 6, the pulmonary valve; and 1, the tricuspid valve. The 30-day survival rate was 96%. Clinically, the results were exc...

conclusions high risk patients needing avr are optimal candidates for transcatheter aortic valve implantation. tavi is a valuable solution for high risk patients needing avr. obtained results are comparable to results in transthoracic avr in standard candidates for aortic valve implantation. background transcatheter aortic valve implantation (tavi) has emerged as an alternative treatment to cla...

Moderate-to-severe tricuspid regurgitation (TR) affects ∼1.6 million patients in the USA, of whom only 8000 undergo tricuspid surgery annually; this results in an extremely large number of untreated patients with significant TR. Therefore, there is a large unmet clinical need for patients with severe TR who are not referred for conventional surgery, mainly due to expected high surgical risk. Pe...

OBJECTIVES This study was undertaken to compare the hemodynamic performance of a percutaneous bioprosthesis to that of surgically implanted (stented and stentless) bioprostheses for the treatment of severe aortic stenosis. METHODS Fifty patients who underwent percutaneous aortic valve implantation (PAVI) with the Cribier-Edwards or Edwards SAPIEN bioprosthetic valve (Edwards Lifesciences, Inc...

OBJECTIVE In patients with calcification of the ascending aorta, postoperative stroke and mortality rates remain high after conventional aortic valve replacement, but the results of trans-apical aortic valve implantation in these patients are not known. We evaluate the outcome of trans-apical aortic valve implantation in patients with severely calcified ascending aorta in a single center with e...

Axillary artery access has become increasingly widespread as an alternative to the femoral route for large-bore transcatheter aortic valve replacement (TAVR), endovascular repair (EVAR), and mechanical circulatory support (MCS) procedures. Advantages of percutaneous include avoidance a surgical incision, general anesthesia, conduit graft infection. This statement aims review anatomic considerat...

A 78-year-old man with a history of hypertension, dyslipidemia, and diabetes mellitus was referred to our hospital for the evaluation of a systolic murmur. Echocardiography showed severe aortic stenosis with a pressure gradient of 79.7 mmHg; aortic orifice size, 0.46 cm; and regurgitation, grade III (ejection fraction, 50.5%). Computed tomography revealed marked calcification adhering to the ao...