An 80-year-old woman was admitted to our institution because of shortness of breath (New York Heart Association grade III) and stable angina pectoris (Canadian Cardiovascular Society [CCS] grade II). Two years ago, the patient had a posterior wall infarction successfully treated by percutaneous coronary intervention and stent implantation. A low-gradient aortic stenosis with an aortic valve are...

AIMS Because the elderly are increasingly referred for operation, we reviewed the results of cardiac surgery in patients of 80 years or older. METHODS AND RESULTS Records of 182 consecutive octogenarians who had had cardiac operations between 1992 and 1998 were reviewed. Follow-up was 100% complete. Seventy patients had coronary grafting (CABG), 70 aortic valve replacement, 30 aortic valve re...

We report a rare case of progressive left ventricular outflow tract (LVOT) obstruction after percutaneous device closure of a mechanical prosthetic mitral valve (MV) paravalvular leak (PVL) in the region of aortomitral curtain in a patient who also had small mechanical aortic valve prosthesis with patient-prosthesis mismatch.

Transcatheter aortic valve replacement emerged ≈20 years ago and changed the landscape of structural interventional cardiology. The first experiments in animal models provided proofs of the concept and the substrate for the first percutaneous valve implantation in patients. The initial promising results in a clinical setting drew the attention of the industry and of the scientific community, an...

Asymptomatic women with mild aortic stenosis (AS) and normal left ventricular functions can successfully carry pregnancy to term and have vaginal deliveries. However, severe AS (valve area <1.0 cm2) can result in rapid clinical deterioration and maternal and fetal mortality. So, these patients require treatment of AS before conception or during pregnancy preferably in the second trimester. In s...

Transcatheter Aortic Valve Replacement (TAVR) is performed in patients who are poor surgical candidates. Many patients have inadequate femoral access, and alternative access sites have been used such as the transapical approach discussed in this paper. We present an elderly and fragile patient not suitable for surgery for unacceptable high risk, including poor ventricular function, previous myo...

the bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. a 22-year-old man p...

Transcaval, or caval-aortic, access is a promising approach for fully percutaneous transcatheter aortic valve implantation in patients without good conventional access options. This tutorial review provides step-by-step guidance to planning and executing the procedure, along with approaches to remedy complications.

A 75 year old man with severe angina caused by aortic stenosis and coronary artery disease was considered to be unsuitable for cardiac surgery after the recent removal of a bronchial carcinoma. Combined percutaneous balloon dilatation of the aortic valve and right coronary angioplasty considerably ameliorated the patient's angina.

pulmonary valve stenosis. N Engl J Med 1982;307:540. 6. Cribber A, Saoudi N, Beriand J, Savin T, Rocha P, Letae B. Percutaneous tr~sluminal v~~lopl~ty of acquired sortie stenosis in elderly patientsz An alternative to valve replacement? Lancet 1986;1:63. 7: Carver JM, Goldstein J, Jones EL, Knapp WA, Hatcher CR. Clinical hem~~amic and operative descriptors affecting the outcome of aortic valve ...