Search

Along with the coming of aged society，the prevalence of aortic valvular disease is significantly increasing.Nowadays，transcatheter aortic valve replacement（TAVR）has been established as the optimal treatment of aortic stenosis in the population with intermediate and high surgical risk.Moreover，TAVR has also been performed for pure aortic valve regurgitation.Whereas，ineffectiveness of the first valve still might occur confronted with individualized anatomical structure，hemodynamical characteristics and different valve types.Intraprocedural valve-in-valve deployment is increasingly applied in these patients undergoing TAVR with an unsatisfied first valve.The immediate and mid-term clinical and hemodynamic results have demonstrated its safety and feasibility.Here，we briefly review the risk factors in need for a second valve following TAVR，the prognosis and challenges in the valve-in-valve technique. [ABSTRACT FROM AUTHOR]

Objective To evaluate the relationship between left atrial appendage (LAA) ostium parameters with occluder size based on two-dimensional transesophageal echocardiogram (TEE) and three-dimensional TEE and angiography. Methods Patients successfully underwent LAA occlusion with complete acquirements of their pre-procedual two-dimensional TEE,three-dimensional TEE and LAA angiography records during Jan.2018 to Mar.2018 were included.Maximal and minimal dimensions of LAA orifice together with its perimeter derived diameter (PDD) were obtained and interpreted with QLAB 10.8 3DQ software. Results Forty-five patients were finally included and their maximal ostium diameter derived from two-dimensional TEE,three-dimensional TEE and PDD proved a strong correlationship with the real type of occluder (r=0.606,0.634,0.859,P<0.001).KAPPA analysis demonstrated the best satisfactory agreement between predicted occluder size according to PDD and real-world device(K=0.778,P<0.001).Lineal regression analysis showed equations as follows:predicted occluder size=0.902 9×(PDD)+6.101 2,forecasting correct ratio measured as 87%.Adverse events represented as device displacement,device related thrombus,pericardial effusion and residual shunt around device>3 mm were not reported within 6-month follow-up. Conclusions Perimeter-derived diameter through three-dimensional TEE can facilitate appropriate sizing of LAA which may allow cardiologists to further reduce recapture and device change maneuvers. [ABSTRACT FROM AUTHOR]

Copyright of Fudan University Journal of Medical Sciences is the property of Fudan University Journal of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)