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Heart Valve Disorder

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1. Drug-induced heart valve disease: a blind spot for cardiologists

(Mediator°) caused hundreds of deaths in France, in particular from heart valve disease. Before the withdrawal of Mediator°, many cardiologists attributed these drug-induced valve disorders to other causes, often rheumatic heart disease, even though rheumatic fever had long since become very rare. (June 2020) Exposure to benfluorex (Mediator°), a drug marketed in France from 1976 to late 2009, caused hundreds of deaths, in particular from heart valve disease. Very few cases of heart valve disease due (...) to Mediator° were reported before the drug was withdrawn from the French market, but many cases now known to be due to Mediator° were detected before late 2009. Before the withdrawal of Mediator° , many cardiologists attributed these drug-induced valve disorders to other causes, often rheumatic heart disease, even though rheumatic fever had long since become very rare in France. Servier, the company that used to market Mediator°, and the French Health Products Agency were late in informing healthcare

2020 Prescrire

2. Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves (Abstract)

Oral anticoagulants in atrial fibrillation with valvular heart disease and bioprosthetic heart valves Current guidelines endorse the use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with atrial fibrillation (AF). However, little is known about their safety and efficacy in valvular heart disease (VHD). Similarly, there is a paucity of data regarding NOACs use in patients with a bioprosthetic heart valve (BPHV). We, therefore, performed a network meta-analysis (...) in the subgroups of VHD and meta-analysis in patients with a BPHV.PubMed, Cochrane and Embase were searched for randomised controlled trials. Summary effects were estimated by the random-effects model. The outcomes of interest were a stroke or systemic embolisation (SSE), myocardial infarction (MI), all-cause mortality, major adverse cardiac events, major bleeding and intracranial haemorrhage (ICH).In patients with VHD, rivaroxaban was associated with more ICH and major bleeding than other NOACs, while

2019 EvidenceUpdates

3. [3D Echocardiography in heart valve diseases]

[3D Echocardiography in heart valve diseases] [3D Echocardiography in heart valve diseases] [3D Echocardiography in heart valve diseases] Klappenbach R, Augustovski F, Pichon-Riviere A, García Martí S, Alcaraz A, Bardach A, Ciapponi A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Klappenbach R, Augustovski F, Pichon-Riviere A, García (...) Martí S, Alcaraz A, Bardach A, Ciapponi A. [3D Echocardiography in heart valve diseases] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 540. 2017 Authors' conclusions Evidence of low quality on 3D echocardiography for heart valve diseases suggests that it would show a mild improvement in its diagnostic capacities when compared with conventional echocardiographic technologies (M mode, 2D

2017 Health Technology Assessment (HTA) Database.

4. Poorly suited heart valve prostheses heighten the plight of patients with rheumatic heart disease. (Abstract)

implementation of guidelines that were derived for very different patients and under distinctly different conditions. Given the fast expansion of cardiac surgery in middle-income countries and a growing number of independently operating centres in low-income countries a critical appraisal of facts underlying the choice of heart valve prostheses for patients with RHD seems opportune.Copyright © 2020. Published by Elsevier B.V. (...) Poorly suited heart valve prostheses heighten the plight of patients with rheumatic heart disease. Rheumatic heart disease (RHD) still affects more patients globally than degenerative valve disease. The vast majority of these patients live in low- to middle-income countries. Once symptomatic, they will need heart valve surgery. Unfortunately, prosthetic valves perform poorly in these patients given their young age, the high incidence of multi-valve disease, late diagnoses and often challenging

2020 International journal of cardiology

5. Valve-in-valve TAVI for aortic bioprosthetic valve dysfunction

treatments and procedure The condition 2.1 The 2 main indications for aortic valve replacement are aortic stenosis and aortic regurgitation. Symptoms of both conditions typically include shortness of breath and chest pain on exertion. The increased cardiac workload can lead to heart failure. Valve-in-valve TAVI for aortic bioprosthetic valve dysfunction (IPG653) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 (...) Some of the patients having this procedure may have concomitant coronary artery disease, and this needs to be considered by the multidisciplinary team when planning treatment. ISBN: 978-1-4731-3436-2 Endorsing organisation This guidance has been endorsed by Healthcare Improvement Scotland. Accreditation Valve-in-valve TAVI for aortic bioprosthetic valve dysfunction (IPG653) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

6. Can We Grow Valves Inside the Heart? Perspective on Material-based In Situ Heart Valve Tissue Engineering Full Text available with Trip Pro

is not well understood. In addition, it remains to be determined whether the resulting neo-tissue can grow with the body and preserves functional homeostasis throughout life. More important yet, it is still unknown if and how in situ tissue formation can be controlled under conditions of genetic or acquired disease. Here, we discuss the recent advances of material-based in situ heart valve tissue engineering and highlight the most critical issues that remain before clinical application can be expected. We (...) argue that a combination of basic science - unveiling the mechanisms of the human body to respond to the implanted biomaterial under (patho)physiological conditions - and technological advancements - relating to the development of next generation materials and the prediction of in situ tissue growth and adaptation - is essential to take the next step towards a realistic and rewarding translation of in situ heart valve tissue engineering.

2018 Frontiers in cardiovascular medicine

7. Loss of ADAMTS19 causes progressive non-syndromic heart valve disease. Full Text available with Trip Pro

Loss of ADAMTS19 causes progressive non-syndromic heart valve disease. Valvular heart disease is observed in approximately 2% of the general population1. Although the initial observation is often localized (for example, to the aortic or mitral valve), disease manifestations are regularly observed in the other valves and patients frequently require surgery. Despite the high frequency of heart valve disease, only a handful of genes have so far been identified as the monogenic causes of disease2-7 (...) . Here we identify two consanguineous families, each with two affected family members presenting with progressive heart valve disease early in life. Whole-exome sequencing revealed homozygous, truncating nonsense alleles in ADAMTS19 in all four affected individuals. Homozygous knockout mice for Adamts19 show aortic valve dysfunction, recapitulating aspects of the human phenotype. Expression analysis using a lacZ reporter and single-cell RNA sequencing highlight Adamts19 as a novel marker for valvular

2020 Nature Genetics

8. Transcatheter aortic valve replacement- management of patients with significant coronary artery disease undergoing aortic valve interventions: surgical compared to catheter-based approaches in hybrid procedures. Full Text available with Trip Pro

Transcatheter aortic valve replacement- management of patients with significant coronary artery disease undergoing aortic valve interventions: surgical compared to catheter-based approaches in hybrid procedures. Coronary artery disease (CAD) is associated with poorer outcomes after aortic valve replacement (AVR). For high-risk patients with complex CAD, combined transcatheter aortic valve replacement (TAVR) plus off-pump/minimally-invasive coronary artery bypass (OPCAB/MIDCAB) has been (...) proposed.A prospective registry analysis was performed to compare the characteristics and outcomes of patients undergoing TAVR+OP/MIDCAB with those undergoing TAVR plus percutaneous coronary intervention (PCI) and surgical AVR plus coronary artery bypass grafting (CABG) between 2008 and 2015 at a single site in Germany.464 patients underwent SAVR+CABG, 50 underwent TAVR+OP/MIDCAB, and 112 underwent TAVR+PCI. The mean ages (p < 0.001) and logistic EuroSCOREs (p < 0.001) were similarly higher in TAVR+OP

2019 BMC Cardiovascular Disorders

9. Cardiac arrhythmias in coronary heart disease

of this guideline for the purpose of implementation in NHSScotland. Cardiac arrhythmias in coronary heart diseaseContents 1 Introduction 1 1.1 The need for a guideline 1 1.2 Remit of the guideline 2 1.3 Statement of intent 3 2 Key recommendations 5 2.1 Arrhythmias associated with cardiac arrest 5 2.2 Arrhythmias associated with acute coronary syndrome 5 2.3 Arrhythmias associated with chronic coronary heart disease/left ventricular dysfunction 5 3 Arrhythmias associated with cardiac arrest 6 3.1 Primary (...) prevention of sudden cardiac death 6 3.2 Bystander cardiopulmonary resuscitation 6 3.3 Defibrillation 7 3.4 Adjunctive therapies in the peri-arrest period 8 4 Arrhythmias associated with acute coronary syndrome 11 4.1 Atrial fibrillation 11 4.2 Conduction disturbances and bradycardia 12 4.3 Ventricular arrhythmias 13 5 Arrhythmias associated with chronic coronary heart disease/left ventricular dysfunction 16 5.1 Atrial fibrillation 16 5.2 Ventricular arrhythmias 23 6 Arrhythmias associated with coronary

2018 SIGN

10. A Case of Carcinoid Syndrome Due to Malignant Metastatic Carcinoid Tumor with Carcinoid Heart Disease Involving Four Cardiac Valves Full Text available with Trip Pro

A Case of Carcinoid Syndrome Due to Malignant Metastatic Carcinoid Tumor with Carcinoid Heart Disease Involving Four Cardiac Valves BACKGROUND Carcinoid tumor, benign, low-grade malignant, and high-grade malignant, can be associated with the release of vasoactive substances that cause symptoms including cutaneous flushing, diarrhea, and bronchospasm. In 50-60% of patients with carcinoid syndrome, the vasoactive substances cause fibrosis of the pulmonary and tricuspid heart valves which lead (...) appendiceal carcinoid tumor with bilateral ovarian metastases. Post-operatively, a computed tomography (CT) scan showed cardiomegaly. Transthoracic echocardiography showed morphologic changes that affected all four heart valves, consistent with carcinoid heart disease but without a patent foramen ovale (PFO). The patient was evaluated for valve replacement surgery, but surgery was not performed due to the degree of heart failure. CONCLUSIONS This report describes a rare case of carcinoid heart disease

2018 The American journal of case reports

11. Staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery versus combined coronary artery bypass graft and mitral valve surgery for two-vessel coronary artery disease and moderate to severe ischemic mitral regurgitation Full Text available with Trip Pro

Staged percutaneous coronary intervention followed by minimally invasive mitral valve surgery versus combined coronary artery bypass graft and mitral valve surgery for two-vessel coronary artery disease and moderate to severe ischemic mitral regurgitation The optimal treatment for concomitant two-vessel coronary artery disease (CAD) and moderate to severe ischemic mitral regurgitation (IMR) remains unclear. We compared the results of a staged percutaneous coronary intervention followed (...) by minimally invasive mitral valve surgery (PCI+MIVS) versus combined coronary artery bypass graft and mitral valve surgery (CABG+MVS) in this population.All consecutive patients with two-vessel CAD and moderate to severe IMR, who underwent PCI+MIVS or CABG+MVS at our institution between February 2009 and April 2014, were retrospectively evaluated.There were nine patients identified who underwent PCI+MIVS, and 15 who underwent CABG+MVS, with a mean age of 71±7, and 70±7 years, respectively (P=0.86

2017 Journal of thoracic disease

12. Changes in the concentrations of mediators in exhaled breath condensate during cardiac valve replacement under cardiopulmonary bypass and their relations with postoperative acute respiratory distress syndrome. Full Text available with Trip Pro

Changes in the concentrations of mediators in exhaled breath condensate during cardiac valve replacement under cardiopulmonary bypass and their relations with postoperative acute respiratory distress syndrome. To investigate the changes in the concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), and 8-iso-prostaglandin F2α (8-isoPGF2α) in exhaled breath condensate (EBC) in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB (...) ) and its relationship with postoperative acute respiratory distress syndrome (ARDS).A prospective, case-control study was performed on 55 patients undergoing elective cardiac valve replacement under cardiopulmonary bypass, between November 2017 and May 2019. According to the diagnosis of postoperative ARDS, the patients were divided into ARDS group and control group. We compared the clinical characteristics, outcomes, respiratory mechanics, oxygenation parameters, and mediators in the 2 groups

2020 Medicine

13. Outcomes of mitral valve repair compared with replacement for patients with rheumatic heart disease. (Abstract)

Outcomes of mitral valve repair compared with replacement for patients with rheumatic heart disease. Whether mitral valve repair is superior to replacement in the population with rheumatic heart disease has been debated. This study aims to compare outcomes of repair with replacement by the propensity score method.This observational, prospective study enrolled patients with rheumatic heart disease who underwent mitral valve repair and replacement from January 2011 to April 2019. The propensity (...) score method was used to select 2 groups with similar baseline characteristics. Baseline, clinical, and follow-up data were collected. Clinical outcomes included death from any cause, reoperation, and valve-related complications.The overall population before matching (N = 1644) included 612 patients who underwent repair and 1032 patients who underwent replacement. The propensity score analysis generated matches for 1058 patients (529 pairs). The median follow-up time was 4.12 years. Early mortality

2020 Journal of Thoracic and Cardiovascular Surgery

14. Tricuspid Intervention Following Pulmonary Valve Replacement in Adults With Congenital Heart Disease. (Abstract)

Tricuspid Intervention Following Pulmonary Valve Replacement in Adults With Congenital Heart Disease. Tricuspid regurgitation (TR) is common among adults with corrected tetralogy of Fallot (TOF) or pulmonary stenosis (PS) referred for pulmonary valve replacement (PVR). Yet, combined valve surgery remains controversial.This study sought to evaluate the impact of concomitant tricuspid valve intervention (TVI) on post-operative TR, length of hospital stay, and on a composite endpoint consisting (...) of 7 early adverse events (death, reintervention, cardiac electronic device implantation, infection, thromboembolic event, hemodialysis, and readmission).The national Canadian cohort enrolled 542 patients with TOF or PS and mild to severe TR who underwent isolated PVR (66.8%) or PVR+TVI (33.2%). Outcomes were abstracted from charts and compared between groups using multivariable logistic and negative binomial regression.Median age at reintervention was 35.3 years. Regardless of surgery type, TR

2020 Journal of the American College of Cardiology

15. Coronary Hemodynamics in Patients With Severe Aortic Stenosis and Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement: Implications for Clinical Indices of Coronary Stenosis Severity. Full Text available with Trip Pro

Coronary Hemodynamics in Patients With Severe Aortic Stenosis and Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement: Implications for Clinical Indices of Coronary Stenosis Severity. In this study, a systematic analysis was conducted of phasic intracoronary pressure and flow velocity in patients with severe aortic stenosis (AS) and coronary artery disease, undergoing transcatheter aortic valve replacement (TAVR), to determine how AS affects: 1) phasic coronary flow; 2 (...) ) hyperemic coronary flow; and 3) the most common clinically used indices of coronary stenosis severity, instantaneous wave-free ratio and fractional flow reserve.A significant proportion of patients with severe aortic stenosis (AS) have concomitant coronary artery disease. The effect of the valve on coronary pressure, flow, and the established invasive clinical indices of stenosis severity have not been studied.Twenty-eight patients (30 lesions, 50.0% men, mean age 82.1 ± 6.5 years) with severe

2018 JACC. Cardiovascular interventions

16. Status of the Epicardial Coronary Arteries in Non-ST Elevation Acute Coronary Syndrome in Patients with Mechanical Prosthetic Heart Valves (from the TROIA-ACS Trial). (Abstract)

Status of the Epicardial Coronary Arteries in Non-ST Elevation Acute Coronary Syndrome in Patients with Mechanical Prosthetic Heart Valves (from the TROIA-ACS Trial). Coronary thromboembolism (CE) is a rare cause of prosthetic valve derived complications. This study investigates the diagnosis and treatment strategies for non-ST elevation acute coronary syndrome (NSTEACS) in patients with prosthetic heart valves. Forty-eight NSTEACS patients with prosthetic heart valves (mitral:27; aortic:14 (...) ; mitral+aortic:7) were included in this study. All patients underwent transthoracic and transesophageal echocardiographic examination and coronary angiography. Normal coronary angiographic findings, or visible trombus in one of the coronary arteries, international normalized ratio <2, concomitant prosthetic valve thrombosis (PVT) and absence of multivessel atherosclerotic disease favored CE rather than atherothrombosis. Thrombolytic therapy (TT) with low-dose slow-infusion of tissue type plasminogen

2018 American Journal of Cardiology

17. In adults with heart valve disease, what is the prognostic value and cost effectiveness of cardiac MRI and cardiac CT to determine the need for intervention?

In adults with heart valve disease, what is the prognostic value and cost effectiveness of cardiac MRI and cardiac CT to determine the need for intervention? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content (...) of induction of cardiac ischemia, duration of ischemia and duration of reperfusion (if applicable). ">Data to be extracted: animal model Example: Dose, timing of administration, frequency of administration, route of administration, vehicle. ">Data to be extracted: intervention of interest Example: Serum creatinine; continuous; umol/L (may be recalculated from mg/dL). ">Data to be extracted: primary outcome(s) Example: Blood urea nitrogen; continuous; mmol/L (may be recalculated from mg/dL); Renal

2020 PROSPERO

18. Macrophage Transitions in Heart Valve Development and Myxomatous Valve Disease. Full Text available with Trip Pro

Macrophage Transitions in Heart Valve Development and Myxomatous Valve Disease. Hematopoietic-derived cells have been reported in heart valves but remain poorly characterized. Interestingly, recent studies reveal infiltration of leukocytes and increased macrophages in human myxomatous mitral valves. Nevertheless, timing and contribution of macrophages in normal valves and myxomatous valve disease are still unknown. The objective is to characterize leukocytes during postnatal heart valve (...) where modified heavy chain hyaluronan is observed in myxomatous valve leaflets. Similar colocalization of modified hyaluronan and increased numbers of macrophages were observed in human myxomatous valve disease.Our study demonstrates the heterogeneity of myeloid cells in heart valves and highlights an alteration of macrophage subpopulations, notably an increased presence of infiltrating CCR2+ monocytes and CD206+ macrophages, in myxomatous valve disease.© 2018 American Heart Association, Inc.

2018 Thrombosis and Vascular Biology

19. Postnatal and Adult Aortic Heart Valves Have Distinctive Transcriptional Profiles Associated With Valve Tissue Growth and Maintenance Respectively Full Text available with Trip Pro

altered in the onset of heart valve disease after birth and provide insights for the development of mechanistic-based therapies. (...) Postnatal and Adult Aortic Heart Valves Have Distinctive Transcriptional Profiles Associated With Valve Tissue Growth and Maintenance Respectively Heart valves are organized connective tissues of high mechanical demand. They open and close over 100,000 times a day to preserve unidirectional blood flow by maintaining structure-function relationships throughout life. In affected individuals, structural failure compromises function and often leads to regurgitant blood flow and progressive heart

2018 Frontiers in cardiovascular medicine

20. Mechanical and Bioprosthetic Heart Valves: Anticoagulant Therapy

Mechanical and Bioprosthetic Heart Valves: Anticoagulant Therapy © 2017 Thrombosis Canada Page 1 of 3 MECHANICAL AND BIOPROSTHETIC HEART VALVES: ANTICOAGULANT THERAPY OBJECTIVE: To summarize evidence-based recommendations for the management of antithrombotic drugs in patients with mechanical and bioprosthetic heart valves. BACKGROUND: Heart valve replacement can be done with either a mechanical or bioprosthetic (tissue) prosthesis. Mechanical Valves There are 3 basic types of mechanical valves (...) : 1. Bileaflet (e.g. St. Jude, most frequently seen today) 2. Tilting disc (e.g. Bjork-Shiley, infrequently seen today) 3. Ball-cage (e.g. Starr-Edwards, rarely seen today) Patients with mechanical heart valves are at increased risk for embolic stroke and thrombosis of the valve itself, and, therefore, require long-term anticoagulation. Even with anticoagulation, the risk of stroke/valve thrombosis is ~0.9%/year with mechanical mitral valves, ~0.5%/year for mechanical aortic valves, and ~1.2%/year

2017 Thrombosis Interest Group of Canada

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