Reported cases of coronary obstruction after TAVI occurred more frequently in women, in patients receiving a balloon-expandable valve, and the LCA was the most commonly involved artery. Percutaneous coronary intervention was a feasible and successful treatment in most cases. Continuous efforts should be made to identify the factors associated with this life-threatening complication to implement the appropriate measures for its prevention.

Significant mitral regurgitation (MR) is frequent in patients with severe aortic stenosis (AS). In these cases, concomitant mitral valve repair or replacement is usually performed at the time of surgical aortic valve replacement (SAVR). Transcatheter aortic valve replacement (TAVR) has recently been considered as an alternative for patients at high or prohibitive surgical risk. However, concomitant significant MR in this setting is typically left untreated. Moderate to severe MR after aortic valve replacement is therefore a relevant entity in the TAVR era. The purpose of this review is to present the current knowledge on the clinical impact and post-procedural evolution of concomitant significant MR in patients with severe AS who have undergone aortic valve replacement (SAVR and TAVR). This information could contribute to improving both the clinical decision-making process in and management of this challenging group of patients.

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Twenty-four crossbred beef cows were used to investigate the concentration of alpha-tocopherol in plasma and tissues following oral administration of four tocopherol sources. Animals were allotted to the following treatments: DL-alpha-tocopherol, D-alpha-tocopherol, DL-tocopheryl acetate and D-alpha-tocopheryl acetate. Animals received a daily oral dose of 1,000 IU of the respective tocopherol treatment for 28 d and then were slaughtered. Blood samples were collected on d 0, 1, 7, 14 and 28 for tocopherol concentration assays, and samples from 10 different tissues were collected from slaughtered cows. Identification of alpha-tocopherol in tissues was confirmed by HPLC retention times and by comparison of mass spectra with that of alpha-tocopherol standards. The D-alpha-tocopherol and its acetate ester increased plasma tocopherol concentration faster than the racemic products, the greatest response occurring with D-alpha-tocopherol. Across all treatments, the highest alpha-tocopherol concentrations were noted in the adrenal gland and liver, the lowest in muscle and thyroid tissue. Tissue analyses confirmed that in adrenal gland, kidney, liver and lung, alpha-tocopherol concentrations were higher following D-alpha than DL-alpha-tocopherol supplementation.

No abstract