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Heart, Lung & Circulation

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https://www.readbyqxmd.com/read/29217391/percutaneous-transvenous-mitral-valve-in-valve-implantation-using-commercially-available-transcatheter-valve-first-australian-experience
#1
Anthony Putrino, Gregory Scalia, Sarvesh Natani, Swaroop Margale, Ivan Rapchuk, Simon Binny, Catherine Lau, Myo Lwin, Andrew Clarke, Christopher Raffel, Darren L Walters
In patients with a degenerative mitral bioprosthesis and prohibitive surgical risk there is emerging evidence for the feasibility of valve-in-valve procedures via a percutaneous transvenous transseptal approach. This paper describes the first time this procedure has been performed in Australia.
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29198572/acute-myocardial-infarction-as-the-initial-manifestation-of-delayed-bioprosthesis-thrombosis-after-transcatheter-aortic-valve-replacement
#2
Yi-Jian Li, Yan-Biao Liao, Xin Wei, Yuan Feng, Mao Chen
Bioprosthesis thrombosis after transcatheter aortic valve replacement (TAVR) raised concerns about further clinical events. We report the case of a patient who suffered acute myocardial infarction (AMI) after TAVR for 3 years. Thrombosis was confirmed in the right coronary sinus of Valsalva by transthoracic echocardiography. Coronary angiography demonstrated the ostium of the right coronary artery was occluded. As an attempt to perform percutaneous coronary intervention (PCI) was unsuccessful, long-term therapeutic anticoagulation with warfarin was undertaken...
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29191505/predictors-of-frequent-readmissions-in-patients-with-heart-failure
#3
Nelson Wang, Robyn Gallagher, David Sze, Susan Hales, Geoffrey Tofler
BACKGROUND: Patients with heart failure (HF) have a high incidence of hospital readmissions. However risk models that explore predictors of a single readmission may be less useful at identifying the patients with frequent readmissions who contribute to a disproportionately large proportion of morbidity and health care costs. METHODS: A total of 6252 patients enrolled in the Management of Cardiac Failure Program (MACARF) in Northern Sydney Area Hospitals between 1998 and 2015 were randomly divided into derivation and validation cohorts to create and test a risk model for predictors of ≥2 readmissions or death within 1year of initial hospitalisation for HF...
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29191504/predictors-of-in-hospital-mortality-in-patients-with-st-segment-elevation-myocardial-infarction-complicated-with-cardiogenic-shock
#4
Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Okan Uzun, Duygu İlke Yıldırım, Adnan Kaya, Göksel Çinier, Emrah Bozbeyoğlu, Özlem Yıldırımtürk, Ömer Kozan, Seçkin Pehlivanoğlu
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS) remains as an unresolved condition causing high morbidity and mortality despite advances in medical treatment and coronary intervention procedures. In the current study, we evaluated the predictors of in-hospital mortality of STEMI complicated with CS. METHODS: In this retrospective study, we evaluated the predictive value of baseline characteristics, angiographic, echocardiographic and laboratory parameters on in-hospital mortality of 319 patients with STEMI complicated with CS who were treated with primary percutaneous coronary intervention...
November 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29191503/management-of-adults-with-congenital-heart-disease-and-pulmonary-arterial-hypertension-in-the-uk-survey-of-current-practice-unmet-needs-and-expert-commentary
#5
Robert Tulloh, Kostas Dimopoulos, Robin Condliffe, Paul Clift
BACKGROUND: Pulmonary arterial hypertension (PAH) is a well-recognised complication of adult congenital heart disease (CHD). However, management is not currently standardised between centres and specific guidelines are lacking. In order to identify and understand the unmet needs related to PAH associated with CHD (PAH-CHD), a survey of physicians was performed. METHODS: An electronic survey was sent to two physician groups: (1) cardiologists registered in a UK cardiology directory; (2) specialist pulmonary hypertension (PH) physicians known to manage patients with adult PAH-CHD...
November 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29150159/diagnostic-performance-of-pulmonary-capacitance-at-rest-and-during-exercise-in-idiopathic-pulmonary-arterial-hypertension
#6
Pankaj Jain, Sriram Rao, Peter Macdonald, Eugene Kotlyar, Andrew Jabbour, Christopher Hayward, Anne Keogh
BACKGROUND: Reliable markers of early disease are needed in pulmonary arterial hypertension (PAH). As measures of the contribution of abnormal vascular compliance to overall vascular resistance, resting and exercise pulmonary capacitance-defined as the stroke volume divided by the change in pulmonary pulse pressure-may be sensitive markers of early disease. METHODS: We examined all patients in our pulmonary hypertension database with idiopathic PAH, who had undergone rest and exercise right heart catheterisation in one sitting...
November 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29150158/peripheral-arterial-disease
#7
REVIEW
Sean M Conte, Peter R Vale
Peripheral arterial disease (PAD) affects 15% of the Australian population and is a powerful and serious predictor of cardiovascular mortality yet continues to be under-recognised and undertreated. Diagnosis is simple and management is centred upon symptom relief and risk minimisation. While novel and specialised therapies play a role, the bulk of management is approachable and feasible. In this review, we cover the epidemiology, risk factors, associated conditions, classification, and natural history of PAD...
November 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29150157/all-cause-mortality-following-an-acute-coronary-syndrome-12-year-follow-up-of-the-comprehensive-2002-new-zealand-acute-coronary-syndrome-audit
#8
Chris J Ellis, Greg D Gamble, Michael J A Williams, Phil Matsis, John M Elliott, Gerry Devlin, Stewart Mann, John K French, Harvey D White
BACKGROUND: To describe the long-term mortality of a complete national cohort of acute coronary syndrome (ACS) patients enrolled in 2002, to compare this with a national age, sex and Māori ethnicity matched population, and to assess the influence of baseline factors on the 12-year mortality. METHODS: We reviewed 721 patients with a discharge diagnosis of an ACS who were enrolled in the first New Zealand ACS audit group cohort over 14days in May 2002. We matched the cohort to the national mortality database using each patient's unique national identity number...
November 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29150156/the-efficacy-of-danshen-injection-as-adjunctive-therapy-in-treating-angina-pectoris-a-systematic-review-and-meta-analysis
#9
REVIEW
Huikai Shao, Mengsi Li, Fuchao Chen, Lianghua Chen, Zhengjin Jiang, Lingguo Zhao
BACKGROUND: During the last 40 years, Danshen injection has been widely used as an adjunctive therapy for angina pectoris in China, but its efficacy is not yet well defined. The objective of this study was to verify the efficacy of Danshen injection as adjunctive therapy in treating angina pectoris. METHODS: The major databases including PubMed, Cochrane Library, Sino-Med, Medline, Embase, Google Scholar, China National Knowledge Infrastructure, Wanfang Databases, Chinese Scientific Journal Database, Chinese Biomedical Literature Database and the Chinese Science Citation Database were systematically searched for the published randomised controlled trials (RCTs) on Danshen injection until April 2016...
November 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29133025/perivalvular-mitral-abscess-fistulised-to-the-pericardial-cavity-revealing-staphylococcal-endocarditis
#10
Paul Desaint, Anthony Chauvat, Thomas Garaud, Olivier Andremont, Gaëtan Plantefève, Hervé Mentec, Damien Contou
BACKGROUND: Fistula to the pericardial cavity is a very rare complication of perivalvular abscess during infective endocarditis, with Staphylococcus aureus being the most commonly associated microorganism. METHODS: We report a fatal septic shock due to a mitral endocarditis revealed by a myocardial abscess fistulised toward the pericardial cavity. RESULTS: A 66-year-old female without previous valvular disease was admitted to intensive care for severe sepsis...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29128166/right-ventricle-dysfunction-and-pre-implantation-vasopressors-in-refractory-ards-supported-by-vv-ecmo
#11
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Cristiana Guetti, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Acute respiratory distress syndrome (ARDS) has been shown to be frequently associated with haemodynamic instability requiring the use of vasopressors. To date, there is still some uncertainty in the use of veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) in haemodynamically unstable ARDS patients. METHODS: We therefore assessed whether patients receiving pre ECMO vasopressors had a worse prognosis and, furthermore, we reviewed the factors associated with the use of pre ECMO vasopressors in 92 consecutive patients with refractory ARDS treated with VV-ECMO...
October 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29126818/composite-y-grafts-from-the-left-internal-mammary-artery-current-considerations
#12
EDITORIAL
Hugh S Paterson, Paul G Bannon
The use of composite coronary artery bypass grafts from the left internal mammary artery (LIMA) has increased over the last 20 years. Total arterial revascularisation can be achieved with two arterial conduits and is associated with a reduced risk of stroke. However, the traditional coronary bypass graft configurations of the in situ LIMA and aorto-coronary saphenous vein grafts remain as the mainstay of coronary bypass surgery in most centres. Concerns regarding composite Y grafts relate to (1) the adequacy of a single inflow for all coronary bypass grafts; (2) the risk of compromising the LIMA flow to the left anterior descending coronary artery; (3) the effects of competitive flow on graft patency; and (4) the use of sequential coronary anastomoses...
October 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29103675/heart-valve-surgery-performed-by-trainee-surgeons-meta-analysis-of-clinical-outcomes
#13
REVIEW
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
October 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29102472/update-on-the-diagnosis-and-management-of-hypertrophic-cardiomyopathy
#14
LETTER
Christopher Semsarian
No abstract text is available yet for this article.
October 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29191506/a-practical-guide-for-fractional-flow-reserve-guided-revascularisation
#15
REVIEW
Abdul Rahman Ihdayhid, Andy Yong, Richard Harper, Jamie Rankin, Christopher Wong, Adam J Brown, Michael Leung, Brian Ko
The presence and extent of myocardial ischaemia is a major determinant of prognosis and benefit from revascularisation in patients with stable coronary artery disease. Fractional Flow Reserve (FFR) is accepted as the reference standard for invasive assessment of ischaemia. Its ability to detect lesion specific ischaemia makes it a useful test in a wide range of patient and lesion subsets, with FFR guided intervention improving clinical outcomes and reducing health care costs compared to assessment with coronary angiography alone...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29129560/the-role-of-holter-monitoring-in-the-diagnosis-of-early-repolarisation-pattern
#16
Cheng-Cheng Ji, Xu-Miao Chen, Yun-Jiu Cheng, Li-Juan Liu, Kai Tang, Wei-Qi Zhu, Ying Huang, Wei-Ying Chen, Su-Hua Wu
BACKGROUND: A slower heart rate can exaggerate J-point elevation in a 12-lead ECG. This study examined the role of Holter monitoring in the diagnosis of early repolarisation pattern (ERP). METHODS: We examined 24-hour Holter recordings of 4000 consecutive patients seen at an outpatient clinic, and found 500 patients (12.5%) with ERP (based on J-point elevation magnitude maximum value≥0.1mV on the Holter recording). The highest magnitude of J-point elevation, R wave amplitude, the ratio between J-point elevation magnitude and R-wave amplitude on the same ECG lead (J/R ratio), QRS interval, and QT/QTc interval were measured on the Holter recording and on a surface 12-lead ECG of the 500 patients with ERP...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29102471/left-heart-disease-and-pulmonary-hypertension-are-we-seeing-the-full-picture
#17
REVIEW
Kevin Chung, Geoff Strange, Jim Codde, David Celermajer, Gregory M Scalia, David Playford
Pulmonary hypertension (PH) is common, under diagnosed and associated with a high mortality. There are significant delays in the diagnosis of pulmonary hypertension leading to increased morbidity and delays in the initiation of treatment. Once PH is diagnosed, establishing the degree of pulmonary vascular resistance (PVR) enables clinicians to broadly divide the underlying pathology into pre-capillary or post-capillary causes, a crucial step in tailoring management. Pulmonary hypertension is most commonly due to left heart disease (PH-LHD) and echocardiography (echo) is the most widely accessible investigation in its diagnosis...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29100841/choice-of-health-options-in-prevention-of-cardiovascular-events-choice-replication-study
#18
Lis Neubeck, Ben Freedman, Nicole Lowres, Karice Hyun, Jessica Orchard, Tom Briffa, Adrian Bauman, Kris Rogers, Julie Redfern
BACKGROUND: Globally, attendance at cardiac rehabilitation (CR) is between 15 and 30%. Alternative models of individualised care are recommended to promote participation in CR, however there has been no prospective testing of different durations of such models. We aimed to replicate the previously proven Choice of Health Options In prevention of Cardiovascular Events (CHOICE) intervention, and to determine if an extended version (CHOICEplus) would confer additional benefits. METHODS: Acute coronary syndrome (ACS) survivors not accessing centre-based CR (n=203) were randomised to CHOICE for 3 months (n=100) or CHOICEplus for 24 months (n=103) at four urban hospitals...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29097068/evaluation-of-cognitive-function-following-transcatheter-aortic-valve-replacement
#19
Masieh Abawi, Rehana de Vries, Pieter R Stella, Pierfrancesco Agostoni, Dirk H M Boelens, Romy C van Jaarsveld, Charlotte S van Dongen, Pieter A F M Doevendans, Mariëlle H Emmelot-Vonk
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is associated with procedural-related neurological events and acute cognitive decline. However, data on the effect of TAVR on mid-term cognitive outcome are scarce. Therefore, we aimed to assess the impact of TAVR on mid-term cognitive outcome using different neurocognitive test batteries. METHODS: Patients with severe aortic valve stenosis scheduled for TAVR were enrolled. Cognitive assessment was performed at baseline and 4 months post-TAVR using an eight-word verbal-learning test ("Immediate Recall Memory Test" [IRMT], "Delayed Recall Memory Test" [DRMT], "Recognition of Verbal Information Test" [RVIT]), global cognitive function ("Mini Mental State Examination" [MMSE]), and executive function ("Trail Making Test" [TMT], "Clock-Drawing Test" [CDT])...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29129562/preoperative-use-of-oral-beta-adrenergic-blocking-agents-and-the-incidence-of-new-onset-atrial-fibrillation-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#20
REVIEW
Paul Min Thein, Kyle White, Khyati Banker, Carole Lunny, Sam Mirzaee, Arthur Nasis
BACKGROUND: Current epidemiological data suggests that postoperative atrial fibrillation or atrial flutter (POAF) causes significant morbidity and mortality after cardiac surgery. The literature for prophylactic management of POAF is limited, resulting in the lack of clear guidelines on management recommendations. AIM: To examine the efficacy of prophylactic rate control agents in reducing the incidence of new-onset POAF in patients undergoing elective cardiac surgery...
October 19, 2017: Heart, Lung & Circulation
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