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Structural heart disease encompasses a wide range of abnormalities involving noncoronary structures like the heart's valves, walls, and chambers. The last decade emphasized the burden of the disease and revolutionized the treatment strategies. The number of percutaneous structural heart interventions constantly increases worldwide. While some parts of the world acquire experience with various intervention treatments, techniques, and devices, others are paving their first steps. Complex Cases in Structural Heart Interventions provide a descriptive and highly illustrative insight into unique clinical situations managed by one of the world's most experienced and innovative teams. Each case study contains a clinical presentation, imaging analysis, procedural dilemmas, and resulting outcome. A detailed explanation of the technique used, key points and tips were highlighted, and a literature review covered broad knowledge on each topic. The authors shared their knowledge and distinctive solutions from over a decade of experience to ensure an educational adventure for the medical community and a roadmap for interventional heart teams.
Heart --- Diseases --- Treatment. --- Transcatheter Aortic Valve Replacement --- Heart Valve Diseases --- Balloon Valvuloplasty --- surgery --- Balloon Valvotomy --- Balloon Valvotomies --- Balloon Valvuloplasties --- Valvotomies, Balloon --- Valvotomy, Balloon --- Valvuloplasties, Balloon --- Valvuloplasty, Balloon --- Transcatheter Aortic Valve Implantation --- Transcatheter Aortic Valve Replacement. --- Balloon Valvuloplasty.
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"With the dramatic reduction of rheumatic disease and the increase in life expectancy, valvular diseases are now mostly degenerative in industrialized countries(1). Calcific aortic stenosis (AS) is the most common heart valve anomaly, with a largely age-dependent prevalence, a calculated annual incidence rate in the range of 4-5% in general populations and a marked increase up to 6% in patients greater than or equal to 75 years of age(2,3). Surgical aortic valve replacement (SAVR) was previously the only option available to patients with symptomatic, severe aortic stenosis, without which a median survival of 2 years was to be expected(4). After the first-in-human transcatheter aortic valve implantation (TAVI) performed by Alain Cribier in 2002(5), the treatment strategy for patients with symptomatic aortic stenosis has been revolutionized. In over 15 years, penetration of TAVI has grown exponentially, as a result of accruing evidence demonstrating safety and efficacy, and reduced invasiveness compared with SAVR"--
Aortic valve --- Cardiac catheterization --- Aortic Valve Stenosis --- Transcatheter Aortic Valve Replacement --- Intraoperative Complications --- Stenosis --- Surgery. --- Complications --- surgery --- adverse effects --- prevention & control --- therapy
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This reprint focuses on the transcatheter treatment of the main structural heart diseases covering the latest innovations and hot topics on this subject. All the technological developments witnessed in recent decades have made structural heart disease interventions a growing field and have contributed to offering patients less invasive, more effective, and safe alternative approaches.
Medicine --- Cardiovascular medicine --- cerebral protection device --- transcatheter aortic valve replacement --- stroke --- cerebrovascular events --- bovine aortic arch --- TAVR --- percutaneous access --- vascular complications --- surgical cut-down --- transfemoral approach --- aortic stenosis --- transcatheter aortic valve implantation --- valvular heart disease --- congestion --- plasma volume --- risk stratification --- TAVI --- SAVR --- young --- balloon aortic valvuloplasty --- bridge therapy --- destination therapy --- heart failure --- transradial coronaro-angiography --- single-catheter technique --- coronary artery disease --- futility --- transfemoral --- transcatheter --- aortic valve --- vascular --- complications --- BASILICA --- coronary artery obstruction --- structural heart intervention --- transcatheter mitral valve replacement --- mitral regurgitation --- transoesophageal echocardiography --- cardiac computed tomography --- TAVI degeneration --- SAVR after TAVI --- long-term outcome of TAVI --- tricuspid regurgitation --- atrial functional tricuspid regurgitation --- transcatheter tricuspid valve interventions --- echocardiography --- three-dimensional echocardiography --- multimodality imaging --- sizing --- planning --- MDCT --- 3D echocardiography --- MRI --- n/a
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Hereditary hemorrhagic telangiectasia (HHT) is an inherited disease that affects the blood vessels, and is characterized by direct connections between arteries and veins with no intervening capillaries. These abnormal vessels may appear in the skin as tiny red dilated blood vessels in the mouth, lips, fingers and toes. The presence of these vascular lesions in the mucosa can lead to spontaneous and recurrent nose bleeding, typically beginning in mid-childhood, and this is the most common clinical manifestation of HHT, occurring in over 90% of patients. Gastrointestinal bleeding, derived from mucocutaneous vascular lesions, affects approximately 25% of patients, almost always presenting after the age of 50. Chronic nasal and gastrointestinal bleeding can cause iron-deficiency anemia, and current therapeutic strategies are trying to minimize iron and blood transfusions. HHT patients also present large vascular lesions, known as arteriovenous malformations, that occur in internal organs like lungs, liver, and brain, and may result in life-threatening complications often related to the shunting of blood. This book not only highlights the current knowledge regarding diagnosis and treatment of HHT, but also the newest insights in the molecular basis of HHT, the understanding of which is essential for the development of new medicines or therapeutic strategies.
Research & information: general --- hereditary hemorrhagic telangiectasia --- rare diseases --- telangiectasis --- transforming growth factor-beta (TGF-β) --- Smad pathway --- gastrointestinal bleeding --- epistaxis --- nosebleeds --- tacrolimus --- nasal ointment --- genetic disease --- rare disease --- hereditary hemorrhagic telangiectasia (HHT) --- telangiectases --- mechanical damage --- sun-induced trauma --- vascular malformations --- Endoglin --- activin-receptor-like kinase 1 --- Hereditary Hemorrhagic Telangiectasia --- antithrombotic therapy --- anticoagulants --- antiplatelets --- bleeding --- safety --- HHT --- ALK1 --- endoglin --- raloxifene --- bazedoxifene --- tranexamic acid --- propranolol --- FK506 --- etamsylate --- N-acetylcysteine --- pulmonary arteriovenous malformations --- transcatheter embolotherapy --- screening --- guidelines --- Hereditary hemorrhagic telangiectasia --- pediatrics --- genotype–phenotype correlation --- arteriovenous malformation --- ENG --- ACVRL1 --- SMAD4 --- microRNA --- biomarker --- plasma --- arteriovenous malformations (AVMs) --- angiogenesis --- activin receptor-like kinase 1 (ALK1) --- transforming growth factor beta (TGF-β) --- bone morphogenetic protein (BMP) --- propranolol gel --- epistaxis severity score --- nasal endoscopy --- antiangiogenic properties --- non-coding RNAs --- microRNAs --- long non-coding RNAs --- biomarkers --- endothelial cells --- hereditary hemorrhagic telangiectasia (HHT), second-hit --- arteriovenous malformation (AVM) --- Smad4 --- inflammation --- shear stress --- vascular injury --- somatic mutation --- cell adhesion --- vascular endothelial growth factor (VEGF) --- telangiectasia --- hereditary hemorrhagic --- survival --- life expectancy --- pulmonary arteriovenous malformation --- contrast enhanced magnetic resonance angiography --- liver --- MRI --- ultrasound --- AVM --- bevacizumab --- Osler–Weber–Rendu --- hereditary hemorrhagic telangiectasia/HHT/osler’s disease --- cerebral ischemic lesions --- catheter based embolization therapy
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