New Imaging for Aortic Valve Disease. Anthony DeMaria Judy and Jack White Chair Director, Sulpizio CV Center University of California, San Diego
|
|
- Christopher Haynes
- 6 years ago
- Views:
Transcription
1 New Imaging for Aortic Valve Disease Anthony DeMaria Judy and Jack White Chair Director, Sulpizio CV Center University of California, San Diego
2 Imaging in Aortic Stenosis Valve morphology calcification Valve gradient and area Concomitant regurgitation Ventricular function Ascending aorta
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17 Aortic Stenosis and 3D Echo Goland et al, Heart, 2007
18 Aortic Stenosis and 3D Echo Goland et al, Heart, 2007
19 Aortic Stenosis and 3D Echo Goland et al, Heart, 2007
20 Aortic Stenosis and 3D Stroke Volume Poh et al; EHJ, 2008
21 Aortic Stenosis and 3D Stroke Volume Poh et al; EHJ, 2008
22 Aortic Stenosis and 3D Stroke Volume Poh et al; EHJ, 2008
23 Ao Fibroelastoma
24
25 Stress Echo in AS No LV Reserve; Fixed AV LV Reserve; Pliable AV O Connor et al; Arch CV Dis,2009
26
27 Low Gradient (Severe) Aortic Stenosis LGAS Marked reduction of stroke volume Severe LV dysfunction with low EF Normal EF with small LV and high impedance Small LV EDV, marked concentric hypertrophy High valvuloaortic impedance (Zva) Women, older patients, hypertensives
28 AS with Low Gradient: Assessment Catheterization Image aortic leaflets TEE 3D Valve resistance or stroke work loss Dobutamine stress CMR or CTA
29 It s hard to improve on the safety pin
30
31
32
33
34 Flow Imaging by CMR
35 Aortic Stenosis and CMR John et al: JACC, 2003
36 CMR and Aortic Stenosis
37
38 Cardiac Magnetic Resonance Advantages Quality images Uniformly attainable Inherently 3D High reproducibility Fibrosis and scar Perfusion?Coronary anatomy Disadvantages Often unavailable Stationary Complex Expensive Patient isolated Claustraphobic No pacemaker/icd Valves less certain
39 CTA of Normal Aortic Valve
40 Aortic Stenosis: MDCT vs TEE Feuchtner et al; JACC, 2006
41 AS: MDCT vs Echo vs Cath Lembcke et al: Invest Radiol, 2009
42 AS: MDCT vs Echo vs Cath Lembcke et al: Invest Radiol, 2009
43 Valve Stenosis by MDCT Tops et al: JACC: CV Img, 2008
44 Value of Imaging in AS Morph Ca++ Grad AVA Regurg LV Fnct Asc Ao Echo CMR MDCT
45 Aortic Stenosis Most common valve disease of industrialized world 3% over 75 yrs have severe AS With aging, prevalence will double in the next 20 years
46 No prospective, randomized, control trials comparing conservative medical to surgical therapy of asymptomatic aortic stenosis have been performed
47 Criteria for AS Severity Aortic Peak Velocity m/sec Aortic Mean Gradient 40 mm/hg
48 Medical Therapy of AS No therapy of proven benefit exists Control coronary risk factors BP, smoking, lipids, etc Statins: SEAS trial negative Disease level may have been too advanced ACEI: not contraindicated Physical exertion related to AS severity No restriction for mild asymptomatic AS
49 Clinical Status of AS Asymptomatic Unrecognized Symptoms Sudden Death
50 Sudden Death in AS: Prospective Studies AVE 1%/year Surgical mortality: 1-5%/year
51 Effect Rates and Risk in AS
52 Post-op Sudden Death in AS However, even after corrective surgery, patients exhibit elevated risk of sudden death (11). In fact, sudden death has been reported to be the most frequent mode of death after aortic valve surgery and appears to associate with greater left ventricular hypertrophy (12). Some of these sudden deaths are likely due to causes other than arrhythmia, such as embolism or valvular dehiscence. However, Blackstone and colleagues found normal prosthetic valve and peri-prosthetic myocardium in 8 of 15 autopsies after sudden death post valve replacement (13). It appears, therefore, that even after corrective surgery for aortic stenosis, some patients remain predisposed to sudden death. Nazarian S. In press, JACC 11.Bloomfield P, Wheatley DJ, Prescott RJ, Miller HC. Twelve-year comparison of a Bjork-Shiley mechanical heart valve with porcine bioprostheses. N Engl J Med 1991;324: Foppl M, Hoffmann A, Amann FW, et al. Sudden cardiac death after aortic valve surgery: incidence and concomitant factors. Clin Cardiol 1989;12: Blackstone EH, Kirklin JW. Death and other time-related events after valve replacement. Circulation 1985;72:
53 Risk Factors in AS aortic valve calcification rapid increase in pressure gradient higher aortic valve velocities inappropriate high left ventricular mass abnormal response or symptoms on exercise testing Elevated BNP Increased valvulo-arterial impedance Echo/Doppler parameters (eg stress)
54 AS Survival vs Velocity Rosenhek et al; Circ, 2010
55 (2000)
56
57 Stress test Incremental Prognostic Value
58 Course of Asymptomatic AS Pellikka et al; Circ, 2005
59
60 Risk Factors in Euroscore
61 Risk Levels in Euroscore
62
63 AS Guidelines of ESC
64 AS Guidelines of ACC/AHA
65
66 ESC Guidelines for AS
67 Limitations of Existing Reports Study results (eg echo) are often reported May influence the decision for surgery Symptoms or surgery are often endpoints Decision to operate is subjective Death in un-operated is often non-cardiac Medical patients have more co-morbidities Pts may refuse surgery upon symptoms
68
69 Asymptomatic AS: Final Thoughts In absence of symptoms, close medical follow up is generally indicated Surgery for established risk factors Reduced EF Heavy calcification Rapidly increasing velocity Abnormal exercise test AVR only if risk of surgery is low TAVI may change the landscape
Natural History and Echo Evaluation of Aortic Stenosis
Natural History and Echo Evaluation of Aortic Stenosis Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM AORTIC STENOSIS First valvular disease
More informationManagement of significant asymptomatic aortic stenosis. Alec Vahanian Bichat Hospital University Paris VII Paris, France
Management of significant asymptomatic aortic stenosis. Alec Vahanian Bichat Hospital University Paris VII Paris, France Background Aortic stenosis (AS) is the most frequent valve disease among referred
More informationAortic stenosis aetiology: morphology of calcific AS,
How to improve patient selection in aortic stenosis? Fausto J. Pinto, FESC Aortic stenosis aetiology: morphology of calcific AS, bicuspid valve, and rheumatic AS (Adapted from C. Otto, Principles of
More informationSevere aortic stenosis should be operated before symptom onset CONTRA. Helmut Baumgartner
Severe aortic stenosis should be operated before symptom onset CONTRA Helmut Baumgartner Westfälische Wilhelms-Universität Münster Adult Congenital and Valvular Heart Disease Center Dept. of Cardiology
More informationShahbudin H. Rahimtoola MB, FRCP, MACP, MACC, FESC, D.Sc. (Hon.)
Shahbudin H. Rahimtoola MB, FRCP, MACP, MACC, FESC, D.Sc. (Hon.) DISCLOSURE As Editor, Current Problems in Cardiology Elsevier Honoraria for educational lectures from: American College of Cardiology Foundation;
More informationECHO HAWAII. Role of Stress Echo in Valvular Heart Disease. Not only ischemia! Cardiomyopathy. Prosthetic Valve. Diastolic Dysfunction
Role of Stress Echo in Valvular Heart Disease ECHO HAWAII January 15 19, 2018 Kenya Kusunose, MD, PhD, FASE Tokushima University Hospital Japan Not only ischemia! Cardiomyopathy Prosthetic Valve Diastolic
More informationExercise Testing/Echocardiography in Asymptomatic AS
Exercise Testing/Echocardiography in Asymptomatic AS Raluca Dulgheru, MD Heart Valve Clinic, University of Liège, CHU Sart Tilman, BELGIUM Disclosure related to this presentation: None VALVULAR HEART DISEASE
More informationComprehensive Echo Assessment of Aortic Stenosis
Comprehensive Echo Assessment of Aortic Stenosis Smonporn Boonyaratavej, MD, MSc King Chulalongkorn Memorial Hospital Bangkok, Thailand Management of Valvular AS Medical and interventional approaches to
More informationNothing to Disclose. Questions. Disclosure Asymptomatic Severe Aortic Stenosis: (When) Should One Intervene? Paul Wood at the Nathanson Lecture, 1958
Disclosure Asymptomatic Severe Aortic Stenosis: (When) Should One Intervene? Nothing to Disclose Gabriel Gregoratos, MD, FACC, FAHA Questions Can one improve globally on the asymptomatic state? and if
More informationHypertension in Aortic Valve Disease
Hypertension in Aortic Valve Disease Hanna M. Nosseir MRCP, FRCP Head of Cardiology department Galaa Military Medical Complex Aortic stenosis: Introduction Arterial hypertension and aortic stenosis are
More informationManaging the Low Output Low Gradient Aortic Stenosis Patient
Managing the Low Output Low Gradient Aortic Stenosis Patient R A Nishimura MD Judd and Mary Leighton Professor of CV Mayo Clinic No disclosures Valvular Stenosis Severity of Aortic Stenosis Mean gradient
More informationSpotlight on Valvular Heart Disease Guidelines
Spotlight on Valvular Heart Disease Guidelines Aortic Valve Disease Raphael Rosenhek Department of Cardiology Medical University of Vienna Palermo, April 26 th 2018 1998 2002 2006 2007 2008 2012 2014 2017
More informationEarly Surgery in Asymptomatic Severe Aortic Stenosis Pros and Cons
Early Surgery in Asymptomatic Severe Aortic Stenosis Pros and Cons Duk-Hyun Kang, M.D. Division of Cardiology Asan Medical Center Seoul, Korea Background Dilemma of balancing the risks versus benefits
More informationSevere Asymptomatic Aortic Stenosis
Severe Asymptomatic Aortic Stenosis The Clinician s Perspective Robert O. Bonow, MD, MS Northwestern University Feinberg School of Medicine Bluhm Cardiovascular Institute Northwestern Memorial Hospital
More informationAortic Stenosis: Spectrum of Disease, Low Flow/Low Gradient and Variants
Aortic Stenosis: Spectrum of Disease, Low Flow/Low Gradient and Variants Martin G. Keane, MD, FASE Professor of Medicine Lewis Katz School of Medicine at Temple University Basic root structure Parasternal
More informationHIGHLIGHT SESSION. Imaging. J. L. Zamorano Gomez (Madrid, ES) Disclosures: Speaker Philips
Imaging. J. L. Zamorano Gomez (Madrid, ES) Disclosures: Speaker Philips Agenda ECHO Diagnosis & Prognosis : Functional MR Severity Aortic Stenosis CT How to select pts for TAVI Adding prognostic info to
More informationMulti-imaging modality approach. Covadonga Fernández-Golfín Cardiac Imaging Unit. Cardiology Department. Ramón y Cajal Hospital.
Multi-imaging modality approach Covadonga Fernández-Golfín Cardiac Imaging Unit. Cardiology Department. Ramón y Cajal Hospital.Madrid Faculty Disclosure Covadonga Fernández-Golfín I have no financial relationships
More informationSténose aortique à Bas Débit et Bas Gradient
3.6 m/s Sténose aortique à Bas Débit et Bas Gradient Philippe Pibarot, DVM, PhD, FACC, FAHA, FESC, FASE Canada Research Chair in Valvular Heart Diseases Doctorate Honoris Causa, Université de Liège Institut
More informationWorldwide rheumatic fever is the most common cause of valve disease. In industrialized areas, valvular disease of old age predominates
Michael Sumners DO Epidemiology Worldwide rheumatic fever is the most common cause of valve disease In industrialized areas, valvular disease of old age predominates Calcific aortic stenosis Functional
More informationOutcome of elderly patients with severe but asymptomatic aortic stenosis
Outcome of elderly patients with severe but asymptomatic aortic stenosis Robert Zilberszac, Harald Gabriel, Gerald Maurer, Raphael Rosenhek Department of Cardiology Medical University of Vienna ESC Congress
More informationLow Gradient AS Normal LVEF
Low Gradient AS Normal LVEF Shahbudin H. Rahimtoola MB, FRCP, MACP, MACC, FESC, D.Sc.(Hon) Distinguished Professor University of Southern California Griffith Professor of Cardiology Professor of Medicine
More informationThe best in heart valve disease Aortic valve stenosis
The best in heart valve disease Aortic valve stenosis Marie Moonen, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, BELGIUM My declaration of interest : I have nothing to declare Prevalence
More informationHOW IMPORTANT ARE THESE ECHO MEASUREMENTS ANYWAY?
HOW IMPORTANT ARE THESE ECHO MEASUREMENTS ANYWAY? John D. Carroll, MD Professor, Director of Interventional Cardiology and Co-Medical Director of the Cardiac and Vascular Center, University of Colorado
More informationRole of Stress Echo in Valvular Heart Disease. Satoshi Nakatani Osaka University Graduate School of Medicine Osaka, Japan
Role of Stress Echo in Valvular Heart Disease Satoshi Nakatani Osaka University Graduate School of Medicine Osaka, Japan Exercise echocardiography Dobutamine echocardiography Usefulness of exercise echo
More informationAortic valve Stenosis: Insights in the evaluation of LV function. Erwan DONAL Cardiologie CHU Rennes
Aortic valve Stenosis: Insights in the evaluation of LV function Erwan DONAL Cardiologie CHU Rennes erwan.donal@chu-rennes.fr Preload Afterload Myocardial Fiber Shortening Circumferential Longitudinal
More informationAortic Stenosis in the Elderly: Difficulties for the Clinician. Are Symptoms Due to Aortic Stenosis?
Aortic Stenosis in the Elderly: Difficulties for the Clinician Are Symptoms Due to Aortic Stenosis? Raphael Rosenhek Department of Cardiology Medical University of Vienna No disclosure European Society
More information«Paradoxical» low-flow, low-gradient AS with preserved LV function: A Silent Killer
«Paradoxical» low-flow, low-gradient AS with preserved LV function: A Silent Killer Philippe Pibarot, DVM, PhD, FACC, FAHA, FESC, FASE Canada Research Chair in Valvular Heart Diseases Université LAVAL
More informationNew Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology
New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor Cardiothoracic Radiology Disclosure I have no disclosure pertinent to this presentation.
More informationAssessment and Preparation of Patients with TAVI. Rob Tanzola Associate Professor, Queen s University
Assessment and Preparation of Patients with TAVI Rob Tanzola Associate Professor, Queen s University My patient has aortic stenosis and needs non-cardiac surgery Should (s)he get a TAVI? Rob Tanzola Associate
More informationLow Gradient Severe? AS
Low Gradient Severe? AS Philippe Pibarot, DVM, PhD, FACC, FAHA, FESC, FASE Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de Québec / Québec Heart
More informationAortic Valve Replacement Improves Outcome in Patients with Preserved Ejection Fraction: PRO!
ESC 2011, Paris Controversies in Low-Flow, Low-Gradient Aortic Stenosis Aortic Valve Replacement Improves Outcome in Patients with Preserved Ejection Fraction: PRO! Philippe Pibarot, DVM, PhD, FACC, FAHA,
More informationValvular disease : Ο ρόλος του CMR. Sophie Mavrogeni MD FESC. Onassis Cardiac Surgery Center Athens Greece
Valvular disease : Ο ρόλος του CMR Sophie Mavrogeni MD FESC Onassis Cardiac Surgery Center Athens Greece Aortic Valve CMR EVALUATION OF AORTIC VALVE Phase-contrast CMR of the aorta to determine aortic
More informationAortic Valve Practice Guidelines: What Has Changed and What You Need to Know
Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know James F. Burke, MD Program Director Cardiovascular Disease Fellowship Lankenau Medical Center Disclosure Dr. Burke has no conflicts
More informationTAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central
TAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central Michigan University 1 Disclosure Chiesi Pharma- Consultant
More informationMichigan Society of Echocardiography 30 th Year Jubilee
Michigan Society of Echocardiography 30 th Year Jubilee Stress Echocardiography in Valvular Heart Disease Moving Beyond CAD Karthik Ananthasubramaniam, MD FRCP (Glas) FACC FASE FASNC Associate Professor
More informationCardiac catheterisation in AS
AORTIC STENOSIS MANAGEMENT OF VALVULAR AORTIC STENOSIS Dr Badri Paudel Third most common cardiovascular disease Most prevalent valvular heart disease in the world Commonest acquired valvular lesion with
More informationLow Gradient AS: Multi-Imaging Modalities
Low Gradient AS: Multi-Imaging Modalities Philippe Pibarot, DVM, PhD, FACC, FAHA, FESC, FASE Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de
More informationAortic Valve Stenosis: When stress TTE and/or TEE is required to make the diagnosis and guide treatment
Aortic Valve Stenosis: When stress TTE and/or TEE is required to make the diagnosis and guide treatment Stefanos Karagiannis MD PhD Cardiologist Director Echocardiology Dpt Athens Medical Center ESC 2017
More informationValvular Guidelines: The Past, the Present, the Future
Valvular Guidelines: The Past, the Present, the Future Robert O. Bonow, MD, MS Northwestern University Feinberg School of Medicine Bluhm Cardiovascular Institute Northwestern Memorial Hospital Editor-in-Chief,
More informationReshape/Coapt: do we need more? Prof. J Zamorano Head of Cardiology University Hospital Ramon y Cajal, Madrid
Reshape/Coapt: do we need more? Prof. J Zamorano Head of Cardiology University Hospital Ramon y Cajal, Madrid Patient records 76 y.o. male Hypertension. Dyslipidemia. OPLD. Smoked in the past. Diabetes
More informationProsthesis-Patient Mismatch or Prosthetic Valve Stenosis?
EuroValves 2015, Nice Prosthesis-Patient Mismatch or Prosthetic Valve Stenosis? Philippe Pibarot, DVM, PhD, FACC, FAHA, FASE FESC Canada Research Chair in Valvular Heart Diseases Université LAVAL Disclosure
More informationLoad and Function - Valvular Heart Disease. Tom Marwick, Cardiovascular Imaging Cleveland Clinic
Load and Function - Valvular Heart Disease Tom Marwick, Cardiovascular Imaging Cleveland Clinic Indications for surgery in common valve lesions Risks Operative mortality Failed repair - to MVR Operative
More informationAortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV?
Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Samin K Sharma, MD, FACC, FSCAI Director Clinical & Interventional
More informationTranscatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data
Transcatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data Echo Florida 2013 Jonathan J. Passeri, M.D. Co-Director, Heart Valve Program Director,
More informationOptimal Imaging Technique Prior to TAVI -Echocardiography-
2014 KSC meeting Optimal Imaging Technique Prior to TAVI -Echocardiography- Geu-Ru Hong, M.D. Ph D Associate Professor of Medicine Division of Cardiology, Severance Cardiovascular Hospital Yonsei University
More informationAortic Stenosis and Perioperative Risk With Non-cardiac Surgery
Aortic Stenosis and Perioperative Risk With Non-cardiac Surgery Aortic stenosis (AS) is characterized as a high-risk index for cardiac complications during non-cardiac surgery. A critical analysis of old
More informationLow gradient severe aortic stenosis with preserved left ventricular ejection fraction
Review Article Low gradient severe aortic stenosis with preserved left ventricular ejection fraction Alper Ozkan Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA Corresponding to: Alper
More informationAsymptomatic Valvular Disease:
Asymptomatic Valvular Disease: Can Echocardiography Help You Decide When to Intervene? Neil J. Weissman, MD MedStar Health Research Inst at MedStar Washington Hospital Center & Professor of Medicine Georgetown
More informationCIPG Transcatheter Aortic Valve Replacement- When Is Less, More?
CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology
More informationAortic Stenosis Steven F. Bolling, M.D. Professor of Cardiac Surgery University of Michigan
Aortic Stenosis - 2011 Steven F. Bolling, M.D. Professor of Cardiac Surgery University of Michigan Aortic Surgery Aortic Stenosis EB CT - Ca++ everywhere! Surgery for Aortic Stenosis 100,000 USA + 100,000
More informationAortic Stenosis: UPDATE Anjan Sinha, MD Krannert Institute of Cardiology
Aortic Stenosis: UPDATE 2010 Anjan Sinha, MD Krannert Institute of Cardiology None Disclosures 67-Year-Old Male Dyspnea and angina Class III heart failure No PND or orthopnea 3/6 late peak SEM Diminished
More informationSeverity of AS Degree of AV calcification (? Bicuspid AV), annulus size, & aortic root
The role of Cardiac Imaging modalities in evaluation & selection of patients for Trans-catheter Aortic Valve Implantation Dr.Saeed AL Ahmari Consultant Cardiologist Prince Sultan Cardaic Center, Riyadh
More informationTRANSCATHETER AORTIC VALVE IMPLANTATION: PSCC EXPERIENCE DR HUSSEIN ALAMRI PSCC RIYADH
TRANSCATHETER AORTIC VALVE IMPLANTATION: PSCC EXPERIENCE DR HUSSEIN ALAMRI PSCC RIYADH Available systems: Edwards (TA and TF) and Core valve. INTRODUCTION 3 4% 0f > 65 y. 30 40% of elderly denied surgery,.
More informationUsually we DON T need to go beyond the gradient
Aortic Stenosis Going Beyond the Gradient James D. Thomas, MD, FACC, FASE Director, Center for Heart Valve Disease Bluhm Cardiovascular Institute Professor of Medicine, Feinberg School of Medicine, Northwestern
More informationA Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision
A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision Prof. Pino Fundarò, MD Niguarda Hospital Milan, Italy Introduction
More informationProcedural Guidance of TAVR: How to Assure it Goes Right and What to Do If It Doesn t
Procedural Guidance of TAVR: How to Assure it Goes Right and What to Do If It Doesn t James D. Thomas, M.D., F.A.C.C. Department of Cardiovascular Medicine Heart and Vascular Institute Cleveland Clinic
More informationIndicator Mild Moderate Severe
Indicator Mild Moderate Severe Jet velocity (m/s) 2.0-2.9 3.0-3.9 4.0 Mean gradient (mmhg) < 20 20-39 40 Valve area (cm 2 ) 1.0 Valve area index (cm 2 /m 2 ) 0.6 1 Abnormal AV with Reduced Systolic Opening
More informationTSDA Boot Camp September 13-16, Introduction to Aortic Valve Surgery. George L. Hicks, Jr., MD
TSDA Boot Camp September 13-16, 2018 Introduction to Aortic Valve Surgery George L. Hicks, Jr., MD Aortic Valve Pathology and Treatment Valvular Aortic Stenosis in Adults Average Course (Post mortem data)
More informationOutline. EuroScore II. Society of Thoracic Surgeons Score. EuroScore II
SURGICAL RISK IN VALVULAR HEART DISEASE: WHAT 2D AND 3D ECHO CAN TELL YOU AND WHAT THEY CAN'T Ernesto E Salcedo, MD Professor of Medicine University of Colorado School of Medicine Director of Echocardiography
More informationTAVR: Echo Measurements Pre, Post And Intra Procedure
2017 ASE Florida, Orlando, FL October 10, 2017 8:00 8:25 AM 25 min TAVR: Echo Measurements Pre, Post And Intra Procedure Muhamed Sarić MD, PhD, MPA Director of Noninvasive Cardiology Echo Lab Associate
More informationNew imaging modalities for assessment of TAVI procedure and results. R Dulgheru, MD Heart Valve Clinic CHU, Liege
New imaging modalities for assessment of TAVI procedure and results R Dulgheru, MD Heart Valve Clinic CHU, Liege Disclosure of Interest I, Raluca Dulgheru, DO NOT HAVE a financial interest/arrangement
More informationCardiac Perioperative Risk Assessment American Heart Association Guidelines
Cardiac Perioperative Risk Assessment American Heart Association Guidelines Dr Gary Liew, MBBS, PhD, FRACP US Board Certified in Cardiovascular CT Executive Committee, Cardiac Institute, Epworth Healthcare
More informationValvular Intervention
Valvular Intervention Outline Introduction Aortic Stenosis Mitral Regurgitation Conclusion Calcific Aortic Stenosis Deformed Eccentric Calcified Nodular Rigid HOSTILE TARGET difficult to displace prone
More informationRVOTO adult and post-op
Right ventricular outflow tract obstruction in the adult: native and post-op Helmut Baumgartner Westfälische Wilhelms-Universität Münster Adult Congenital and Valvular Heart Disease Center University of
More informationValvular Heart Disease
Valvular Heart Disease B K Singh, MD, FACC Disclosures: None 1 CARDIAC CYCLE S2 S2=A2P2 S1=M1T1 S4 S1 S3 2 JVP Carotid S1 Slitting of S2 S3 S4 Ejection click Opening snap Dynamic Auscultation What is the
More informationStress Testing in Valvular Disease
2017 ASE Florida Orlando, FL October 10, 2017 2:40 2:50 PM 10 min Grand Harbor Ballroom South Stress Testing in Valvular Disease Muhamed Sarić MD, PhD, MPA Director of Noninvasive Cardiology Echo Lab Associate
More informationICE: Echo Core Lab-CRF
APPENDIX 1 ICE: Echo Core Lab-CRF Study #: - Pt Initials: 1. Date of study: / / D D M M M Y Y Y Y 2. Type of Study: TTE TEE 3. Quality of Study: Poor Moderate Excellent Ejection Fraction 4. Ejection Fraction
More informationRisk Stratification for CAD for the Primary Care Provider
Risk Stratification for CAD for the Primary Care Provider Shimoli Shah MD Assistant Professor of Medicine Directory, Ambulatory Cardiology Clinic Knight Cardiovascular Institute Oregon Health & Sciences
More informationStress Echocardiography: Illustrative Cases Sunil Mankad, MD, FACC, FCCP, FASE Associate Professor of Medicine Mayo Clinic College of Medicine Director, Transesophageal Echocardiography Associate Director,
More informationManagement of Difficult Aortic Root, Old and New solutions
Management of Difficult Aortic Root, Old and New solutions Hani K. Najm MD, Msc, FRCSC,, FACC, FESC Chairman, Pediatric and Congenital Heart Surgery Cleveland Clinic Conflict of Interest None Difficult
More informationMAKING SENSE OF MODERATE GRADIENTS IN PATIENTS WITH SYMPTOMATIC AORTIC STENOSIS
MAKING SENSE OF MODERATE GRADIENTS IN PATIENTS WITH SYMPTOMATIC AORTIC STENOSIS David A. Orsinelli, MD, FACC, FASE Professor, Internal Medicine Director, Structural Heart Imaging The Ohio State University
More informationPrince Sultan Cardiac Center Experience Riyadh, Saudi Arabia
Transcatheter Transapical Aortic Valve Implantation Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia Ahmed Elwatidy, MD,PhD, FRCS S Kassab, MD,S Ahmari, MD, H Amri, MD, H Ismail, MD, A Calafiori,
More informationVinod H. Thourani, MD
Triggers for Aortic Stenosis and Regurgitation Vinod H. Thourani, MD Professor of Surgery Chair, Department of Cardiac Surgery MedStar Heart and Vascular Institute Georgetown University Washington, DC,
More informationLow Gradient Severe AS: Who Qualifies for TAVR? Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor
Low Gradient Severe AS: Who Qualifies for TAVR? Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central Michigan University
More informationHow to Assess and Treat Obstructive Lesions
How to Assess and Treat Obstructive Lesions Erwin Oechslin, MD, FESC, FRCPC, Director, Congenital Cardiac Centre for Adults Peter Munk Cardiac Centre University Health Network/Toronto General Hospital
More informationSevere left ventricular dysfunction and valvular heart disease: should we operate?
Severe left ventricular dysfunction and valvular heart disease: should we operate? Laurie SOULAT DUFOUR Hôpital Saint Antoine Service de cardiologie Pr A. COHEN JESFC 16 janvier 2016 Disclosure : No conflict
More informationMechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling. What is the pathophysiology at presentation?
Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling What is the pathophysiology at presentation? Ventricular-arterial coupling elastance Central arterial pressure
More informationAortic Valvular Stenosis
Aortic Valvular Stenosis How to Assess the Four Variables for Management Low Flow / Low Gradient / Normal EF / Low EF Patrick T. O Gara, MD, MACC Brigham and Women s Hospital Harvard Medical School No
More informationStructural Heart Disease Transcatheter Aortic Valve Replacement (TAVR)
Structural Heart Disease Transcatheter Aortic Valve Replacement (TAVR) Kathleen Harper DO FACC FACP 87 Chief, Cardiology Section VA Maine Healthcare Kathleen.Harper@va.gov Prevalence of Aortic Stenosis
More informationEdwards Transcatheter AVR: Have the Outcomes Changed after CE Approval?
Edwards Transcatheter AVR: Have the Outcomes Changed after CE Approval? Update from PARTNER EU and SOURCE Registries T. Lefèvre Disclosure Statement Cardiologist Interventional cardiologist 1 st PABV in
More informationThe use of Cardiac CT and MRI in Clinical Practice
The use of Cardiac CT and MRI in Clinical Practice Matthew W. Martinez, MD Assistant Professor of Medicine LVPG - Lehigh Valley Heart Specialists Lehigh Valley Health Network Oct. 3, 2009 DISCLOSURE Relevant
More informationWelcome 17 Michigan TAVR Participating Hospitals!
Welcome 17 Michigan TAVR Participating Hospitals! 1 MICHIGAN TAVR BRIEF OVERVIEW HOW AND WHY PRE-TAVR IMAGING EVALUATION AND THE TVT Michael Grossman, MD Co-Director, BMC2 Coordinating Center Why Michigan
More informationWhat the Cardiologist needs to know from Medical Images
What the Cardiologist needs to know from Medical Images Gerald Maurer Department of Cardiology Medical University of Vienna What kinds of Cardiologists Plumbers Electricians Photographers And then there
More informationA Health Care Professional s Guide Aortic Stenosis in Seniors
A Health Care Professional s Guide Aortic Stenosis in Seniors With highlights from the 2014 ACC/AHA practice guidelines for valve disease Aortic stenosis (AS) is primarily caused by calcification of the
More informationPolicy #: 222 Latest Review Date: March 2009
Name of Policy: MRI Phase-Contrast Flow Measurement Policy #: 222 Latest Review Date: March 2009 Category: Radiology Policy Grade: Active Policy but no longer scheduled for regular literature reviews and
More informationProf. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM
The Patient with Aortic Stenosis and Mitral Regurgitation Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM Aortic Stenosis + Mitral Regurgitation?
More information42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim
42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim Current Guideline for AR s/p TOF Surgery is reasonable in adults with prior repair of
More informationDobutamine Stress testing In Low Flow, Low EF, Low Gradient Aortic Stenosis Case Studies
Dobutamine Stress testing In Low Flow, Low EF, Low Gradient Aortic Stenosis Case Studies Mitral Regurgitation The New ASE Guidelines: Role of 2D/3D and CMR William A. Zoghbi MD, FASE, MACC Professor and
More informationValve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection
More informationImaging in TAVI. Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013
Imaging in TAVI Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013 Research grants: Medtronic, Biotronik, Boston Scientific, St Jude, BMS imaging, GE Healthcare,
More information3D Printing & Echocardiography
Echo Hawaii Jan 18, 2018 3D Printing & Echocardiography Stephen H. Little, MD John S. Dunn Chair in Cardiovascular Research and Education, Associate professor, Weill Cornell Medicine Rapid Prototyping
More informationAortic valve implantation using the femoral and apical access: a single center experience.
Aortic valve implantation using the femoral and apical access: a single center experience. R. Hoffmann, K. Brehmer, R. Koos, R. Autschbach, N. Marx, G. Dohmen Rainer Hoffmann, University Aachen, Germany
More informationAortic Valve Stenosis and TAVR: Putting it all together.
Aortic Valve Stenosis and TAVR: Putting it all together. Maria L. Held, MSN CNS Valve Clinic Coordinator at The Cleveland Clinic Alliance of Cardiovascular Professionals April 14 th, 2018 Brief Anatomy
More information2/28/2010. Speakers s name: Paul Chiam. I have the following potential conflicts of interest to report: NONE. Antegrade transvenous transseptal route
Transcatheter Aortic Valve Implantation Asian perspective Speakers s name: Paul Chiam Paul TL Chiam MBBS, MRCP, FACC I have the following potential conflicts of interest to report: NONE Consultant National
More informationReverse left atrium and left ventricle remodeling after aortic valve interventions
Reverse left atrium and left ventricle remodeling after aortic valve interventions Alexandra Gonçalves, Cristina Gavina, Carlos Almeria, Pedro Marcos-Alberca, Gisela Feltes, Rosanna Hernández-Antolín,
More informationValvular heart disease : Role of medication ( drug and intervention ) Pol.Col.Dr.Kasem Ratanasumawong
Valvular heart disease : Role of medication ( drug and intervention ) Pol.Col.Dr.Kasem Ratanasumawong Management of valvular heart disease Accurate diagnosis and disease severity Prevention and treatment
More informationEmbolic Protection Devices for Transcatheter Aortic Valve Replacement
Embolic Protection Devices for Transcatheter Aortic Valve Replacement James M. McCabe, MD Medical Director, Cardiac Cath Lab University of Washington Seattle, WA Disclosures Proctoring and honoraria for
More informationPrimary Mitral Valve Disease: Natural History & Triggers for Intervention ACC Latin American Conference 2017
Disclosures: GE stock, Primary Mitral Valve Disease: Natural History & Triggers for Intervention ACC Latin American Conference 2017 Athena Poppas, MD FACC Past ACC Scientific Sessions Chair, ACC Board
More informationThe Bicuspid Aortic Valve: New Frontiers in Genetics and Interventions
The Bicuspid Aortic Valve: New Frontiers in Genetics and Interventions Westfälische Wilhelms-Universität Münster Helmut Baumgartner Adult Congenital and Valvular Heart Disease Center Dept. of Cardiology
More informationA new option for the Diagnosis and Management of Valvular Heart Disease. Oregon Comprehensive Valve Center
A new option for the Diagnosis and Management of Valvular Heart Disease Oregon Comprehensive Valve Center I have no disclosures Oregon Comprehensive Valve Center Weekly multidisciplinary case conferences
More information