MedStar Authors catalog › Details for: Impact of transapical aortic valve replacement on apical wall motion.
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Impact of transapical aortic valve replacement on apical wall motion.

by Barbash, Israel M; Ben-Dor, Itsik; Bond, Elizabeth; Corso, Paul J; Dvir, Danny; Goldstein, Steven A; Okubagzi, Petros; Pichard, Augusto D; Satler, Lowell F; Waksman, Ron; Wang, Zuyue.
Citation: Journal of the American Society of Echocardiography. 26(3):255-60, 2013 Mar..Journal: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography.ISSN: 0894-7317.Full author list: Barbash IM; Ben-Dor I; Bond E; Corso PJ; Dvir D; Goldstein SA; Okubagzi PG; Pichard AD; Satler LF; Waksman R; Wang Z.UI/PMID: 23298943.Subject(s): *Aortic Valve/pp [Physiopathology] | *Aortic Valve/su [Surgery] | *Cardiac Catheterization | *Echocardiography/mt [Methods] | *Heart Valve Prosthesis Implantation/mt [Methods] | Aged, 80 and over | Aortic Valve/us [Ultrasonography] | Female | Humans | Male | Retrospective Studies | Treatment Outcome | Ventricular Dysfunction, Left/pp [Physiopathology] | Ventricular Dysfunction, Left/us [Ultrasonography]Institution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: J Am Soc Echocardiogr. 26(3):255-60, 2013 Mar.Local Holdings: Available online from MWHC library: 1995 - present.Abstract: BACKGROUND: Recent reports indicate that the transapical approach for transcatheter aortic valve replacement may be associated with elevated cardiac enzymes, poor recovery of left ventricular function, and poor outcomes. The aim of this study was to evaluate whether transapical access is associated with apical dysfunction and to assess consequences on patient outcomes.Abstract: CONCLUSIONS: Myocardial injury during transapical access resulted in apical dysfunction early after the procedure in 28% of patients. This apical dysfunction was transient in half of the patients and was associated with a decrease in left ventricular function but did not affect mortality. Copyright 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.Abstract: METHODS: In patients undergoing transapical aortic valve replacement, apical regional function was retrospectively assessed using the three standard echocardiographic long-axis views. Patients with abnormal baseline apical motion were excluded. Apical regional wall motion abnormality was assessed on preprocedural (baseline), immediate postprocedural (early [6 +/- 2 days]), and late postprocedural (late [95 +/- 76 days]) examinations. Apical regional wall motion abnormalities were categorized as normal, hypokinesis, or akinesis.Abstract: RESULTS: A total of 58 patients undergoing transapical aortic valve replacement were included in the present analysis. Of those, 16 (28%) developed early apical dysfunction. There were no differences in baseline characteristics between the patients who developed early apical dysfunction and those who did not. Patients who received 26-mm valves were more likely to develop apical dysfunction (40% vs. 69%, P = .05). In total, 50% of patients with apical dysfunction (eight of 16) had complete recovery of apical function but tended to have lower ejection fractions (50% vs. 60%, P = .045) at long-term follow-up. No difference in short-term or long-term mortality was detected in these small patient cohorts.

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