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Heart Valve Surgery: Repair or Replacement?
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Heart Valve Surgery: Repair or Replacement?

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (20 January 2024) | Viewed by 7646

Special Issue Editor

Dr. Ilias P. Doulamis

E-Mail Website
Guest Editor
Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA
Interests: cardiac surgery; diabetes; ischemia-reperfusion injury; mitochondria; surgery; vascular surgery

Special Issue Information

Dear Colleagues,

Aortic valve disease—congenital or acquired—represents a big cluster of the cardiac surgery procedures performed in everyday practice. Different approaches have been suggested for fixing a diseased aortic valve, mainly divided into replacement with a mechanical or bioprosthetic valve and repair of the valve leaflets. The disease pathophysiology, surgical approach, patient population, and intervention criteria are some of the determining factors for choosing the optimal surgical intervention for aortic valve disease. Despite the implementation of new guidelines and the conduction of multiple clinical studies over the years, there is still controversy regarding the optimal approach in terms of short-term and long-term outcomes for aortic valve surgery.

Thus, the aim of this Special Issue is to unveil the role of surgical repair and replacement of the aortic valve in advanced valvular disease and highlight all the aspects of different approaches currently in practice.

We therefore welcome the submission of original articles or review articles focused on the novel findings and latest developments dealing with:

  • Aortic valve repair;
  • Aortic valve replacement;
  • Mechanical vs. bioprosthetic aortic valve replacement;
  • Robotic aortic valve surgery;
  • Ross procedure;
  • Bicuspid aortic valve;
  • Transcatheter aortic valve replacement;
  • Aortic valve and root disease;
  • Post-TAVR aortic valve replacement.

Authors are encouraged to focus or underscore the impact of novel findings/innovations on the surgical management of aortic valve disease.

Dr. Ilias P. Doulamis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aortic valve repair
  • aortic valve replacement
  • robotic aortic valve surgery
  • Ross procedure
  • bicuspid aortic valve
  • mechanical aortic valve
  • bioprosthetic aortic valve

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Published Papers (3 papers)

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Editorial

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3 pages, 160 KiB  
Editorial
Aortic Valve Surgery: Fix the Valve or Use a New One?
by Ilias P. Doulamis, Athanasios Rempakos, Eric W. Etchill and Alexandros Briasoulis
J. Clin. Med. 2022, 11(16), 4844; https://doi.org/10.3390/jcm11164844 - 18 Aug 2022
Viewed by 1183
Abstract
Surgical replacement of the diseased aortic valve (SAVR) has been implemented for over half a century as the surgery of choice to prolong the lifespan of this population of patients [...] Full article
(This article belongs to the Special Issue Heart Valve Surgery: Repair or Replacement?)

Research

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13 pages, 1860 KiB  
Article
Mechanosensitive Stem-Cell Genes and Klotho in Atherosclerotic Aortas: Regulating Spatially Deranged Expression Patterns Using Colchicine Regimens
by Konstantinos S. Mylonas, Panagiotis Sarantis, Alkistis Kapelouzou, Michalis V. Karamouzis, Emmanouil I. Kapetanakis, Konstantinos Kontzoglou, Dimitrios C. Iliopoulos, Nikolaos Nikiteas and Dimitrios Schizas
J. Clin. Med. 2022, 11(21), 6465; https://doi.org/10.3390/jcm11216465 - 31 Oct 2022
Cited by 7 | Viewed by 1625
Abstract
Aims: Inflammatory dysregulation of mechanosensitive developmental genes may be central to atherogenesis. In the present seven-week model, we utilized colchicine regimens to curtail aortic atherogenesis in New Zealand White rabbits. We also explored the effect of colchicine regimens on atheroprotective (Klotho, [...] Read more.
Aims: Inflammatory dysregulation of mechanosensitive developmental genes may be central to atherogenesis. In the present seven-week model, we utilized colchicine regimens to curtail aortic atherogenesis in New Zealand White rabbits. We also explored the effect of colchicine regimens on atheroprotective (Klotho, HOXA5, NOTCH1, and OCT4) and proatherogenic (HIF1a, SOX2, BMP4, and NANOG) genes. Methods: The control (n = 6) and group A (n = 6) received standard and cholesterol-enriched chow, respectively. Groups B (n = 8) and C (n = 8) were fed hypercholesterolemic diet and were treated with colchicine plus fenofibrate or N-acetylcysteine (NAC), respectively. Results: Group A developed significantly greater thoracic and abdominal aortic atherosclerosis compared to groups B (p < 0.001) and C (p < 0.001). Combining colchicine with NAC resulted in stronger atheroprotection both in the thoracic and the abdominal aorta. In group A thoracic aortas, Klotho was downregulated compared to controls (95% CI: 1.82–15.76). Both colchicine regimens upregulated Klotho back to baseline levels (p < 0.001). Colchicine/fenofibrate also significantly upregulated thoracic NOTCH1 compared to controls (95% CI: −8.09 to −0.48). Colchicine/NAC significantly reduced thoracic NANOG expression compared to hyperlipidemic diet alone (95% CI: 0.37–8.29). In the abdominal aorta, hypercholesterolemic diet resulted in significant downregulation of HOXA5 (95% CI: 0.03–2.74) which was reversed with colchicine/NAC back to baseline (95% CI: −1.19 to 1.51). Colchicine/fenofibrate downregulated HIF1a compared to baseline (95% CI: 0.83–6.44). No significant differences were noted in terms of BMP4, SOX2, and OCT4. Conclusions: Overall, the aortic expression pattern of mechanosensitive genes seems to be spatially influenced by a hyperlipidemic diet and can be modified using colchicine-based therapy. Full article
(This article belongs to the Special Issue Heart Valve Surgery: Repair or Replacement?)
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Other

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13 pages, 1329 KiB  
Systematic Review
Edge-to-Edge Transcatheter Mitral Valve Repair Using PASCAL vs. MitraClip: A Systematic Review and Meta-Analysis
by Kaveh Hosseini, Hamidreza Soleimani, Amir Nasrollahizadeh, Yaser Jenab, Angelos Karlas, Dimitrios V. Avgerinos, Alexandros Briasoulis, Toshiki Kuno, Ilias Doulamis and Polydoros N. Kampaktsis
J. Clin. Med. 2023, 12(10), 3579; https://doi.org/10.3390/jcm12103579 - 20 May 2023
Cited by 3 | Viewed by 3906
Abstract
Background: Transcatheter edge-to-edge repair (TEER) of the mitral valve (MV) can be performed using the PASCAL or MitraClip devices. Few studies offer a head-to-head outcome comparison of these two devices. Material and Methods: PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov and WHO’s International Clinical Trials [...] Read more.
Background: Transcatheter edge-to-edge repair (TEER) of the mitral valve (MV) can be performed using the PASCAL or MitraClip devices. Few studies offer a head-to-head outcome comparison of these two devices. Material and Methods: PubMed, EMBASE, Cochrane Library, Clinicaltrials.gov and WHO’s International Clinical Trials Registry Platform, from 1 January 2000 until 1 March 2023, were searched. Study protocol details were registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42023405400). Randomized Controlled Trials and observational studies reporting head-to-head clinical comparison of PASCAL and MitraClip devices were eligible for selection. Patients with severe functional or degenerative mitral regurgitation (MR) who had undergone TEER of the MV with either PASCAL or MitraClip devices were included in the meta-analysis. Data from six studies (five observational and one randomized clinical trial) were extracted and analyzed. The main outcomes were a reduction in MR to 2+ or less, improvement of New York Heart Association (NYHA) and 30-day all-cause mortality. Peri-procedural mortality, success rate and adverse events were also compared. Results: Data from 785 and 796 patients that underwent TEER using PASCAL and MitraClip, respectively, were analyzed. Thirty-day all-cause mortality (Risk ratio [RR] = 1.51, 95% CI 0.79–2.89), MR reduction to maximum 2+ (RR = 1.00, 95% CI 0.98–1.02) and NYHA improvement (RR = 0.98, 95% CI 0.84–1.15) were similar in both device groups. Both devices had high and similar success rates (96.9% and 96.7% for the PASCAL and MitraClip group, respectively, p value = 0.91). MR reduction to 1+ or less at discharge was similar in both device groups (RR = 1.06, 95% CI 0.95–1.19). Composite peri-procedural and in-hospital mortality was 0.64% and 1.66% in the PASCAL and MitraClip groups, respectively (p value = 0.094). Rates of peri-procedural cerebrovascular accidents were 0.26% in PASCAL and 1.01% in MitraClip (p value = 0.108). Conclusions: Both PASCAL and MitraClip devices have high success and low complication rates for TEER of the MV. PASCAL was not inferior to MitraClip in reducing the MR level at discharge. Full article
(This article belongs to the Special Issue Heart Valve Surgery: Repair or Replacement?)
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