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Open Heart

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https://www.readbyqxmd.com/read/29387434/beating-heart-minimally-invasive-mitral-valve-surgery-in-patients-with-previous-sternotomy-the-operative-technique-and-early-outcomes
#1
Robert B Xu, Mohammad Rahnavardi, Mart Nadal, Fabiano Viana, Robert G Stuklis, Michael Worthington, James Edwards
Objective: Reoperative mitral valve surgery is increasingly required and can be associated with significant morbidity and mortality. The beating heart minimally invasive mitral valve surgery has a proposed benefit in avoiding the risks of repeat sternotomy, with reducing the need for adhesiolysis and cardioplegia reperfusion injury. We describe our experience with such a technique in patients with previous sternotomy. Methods: A retrospective study was performed and all patients undergoing surgery of mitral valve through a right limited thoracotomy without application of an aortic cross-clamp (beating heart) as a redo cardiac surgery between January 2006 and January 2015 were included (n=25)...
2018: Open Heart
https://www.readbyqxmd.com/read/29387433/optimal-antiplatelet-strategy-after-transcatheter-aortic-valve-implantation-a-meta-analysis
#2
Yousif Ahmad, Ozan Demir, Christopher Rajkumar, James P Howard, Matthew Shun-Shin, Christopher Cook, Ricardo Petraco, Richard Jabbour, Ahran Arnold, Angela Frame, Nilesh Sutaria, Ben Ariff, Gajen Kanaganayagam, Darrel Francis, Jamil Mayet, Ghada Mikhail, Iqbal Malik, Sayan Sen
Objective: International guidelines recommend the use of dual antiplatelet therapy (DAPT) after transcatheter aortic valve implantation (TAVI). The recommended duration of DAPT varies between guidelines. In this two-part study, we (1) performed a structured survey of 45 TAVI centres from around the world to determine if there is consensus among clinicians regarding antiplatelet therapy after TAVI; and then (2) performed a systematic review of all suitable studies (randomised controlled trials (RCTs) and registries) to determine if aspirin monotherapy can be used instead of DAPT...
2018: Open Heart
https://www.readbyqxmd.com/read/29387432/supar-predicts-postoperative-complications-and-mortality-in-patients-with-asymptomatic-aortic-stenosis
#3
Gethin W Hodges, Casper N Bang, Jesper Eugen-Olsen, Michael H Olsen, Kurt Boman, Simon Ray, Antero Y Kesäniemi, Jørgen L Jeppesen, Kristian Wachtell
Background: We evaluated whether early measurement of soluble urokinase plasminogen activator receptor (suPAR) could predict future risk of postoperative complications in initially asymptomatic patients with mild-moderate aortic stenosis (AS) undergoing aortic valve replacement (AVR) surgery. Methods: Baseline plasma suPAR levels were available in 411 patients who underwent AVR surgery during follow-up in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study...
2018: Open Heart
https://www.readbyqxmd.com/read/29387431/transcatheter-and-doppler-waveform-correlation-in-transcatheter-aortic-valve-replacement
#4
REVIEW
Ankur Kalra, Raj R Makkar, Deepak L Bhatt, Sahil Khera, Neal S Kleiman, Michael J Reardon, Morton J Kern
Transcatheter aortic valve replacement (TAVR) has become the preferred therapy for treatment of severe aortic stenosis in patients at intermediate to high risk of perioperative mortality following surgical aortic valve replacement. Haemodynamic assessment is an integral part of the procedure, and it is crucial for the operator to have an in-depth understanding of the haemodynamic alterations that occur during balloon aortic valvuloplasty and transcatheter valve deployment. Comprehension of the haemodynamic tracings is also pivotal for early recognition of periprocedural complications...
2018: Open Heart
https://www.readbyqxmd.com/read/29387430/body-mass-index-as-a-risk-factor-for-coronary-events-and-mortality-in-patients-with-type-1-diabetes
#5
Daniel Vestberg, Annika Rosengren, Katarina Eeg-Olofsson, Mervete Miftaraj, Stefan Franzen, Ann-Marie Svensson, Marcus Lind
Objective: To investigate the potential relationship between body mass index (BMI) and the risk for myocardial infarction and coronary death in patients with type 1 diabetes. Methods: We studied patients with type 1 diabetes included in the Swedish National Diabetes Registry during 2002-2004 and followed them until a discharge diagnosis for myocardial infarction, acute coronary event, death or until 31 December 2011. Cox regression was used to estimate relative risks...
2018: Open Heart
https://www.readbyqxmd.com/read/29387429/residual-cardiovascular-risk-in-individuals-on-lipid-lowering-treatment-quantifying-absolute-and-relative-risk-in-the-community
#6
Wolfgang Lieb, Danielle M Enserro, Martin G Larson, Ramachandran S Vasan
Objective: The residual cardiovascular disease (CVD) risk in individuals on long-term lipid-lowering treatment (LLT) in the general population is not well described. Methods: We estimated absolute CVD risks by age and sex for different categories of low-density lipoprotein cholesterol (LDL-C) levels, stratified by LLT status, and assessed subclinical carotid atherosclerosis in 3012 Framingham Study participants (mean age, 58.4 years; 55% women) free of CVD. Individuals were categorised into five groups: (1) LDL-C <100 mg/dL without LLT; (2) LDL-C ≥100 mg/dL to <130 mg/dL without LLT; (3) LDL-C <130 mg/dL on LLT; (4) LDL-C ≥130 mg/dL without LLT; and (5) LDL-C ≥130 mg/dL on LLT...
2018: Open Heart
https://www.readbyqxmd.com/read/29387428/-porcelain-aorta-a-proposed-definition-and-classification-of-ascending-aortic-calcification
#7
Thomas Snow, Thomas Semple, Alison Duncan, Sarah Barker, Michael Rubens, Carlo DiMario, Simon Davies, Neil Moat, Edward David Nicol
Introduction: 'Porcelain aorta' is listed in the second consensus document of the Valve Academic Research Consortium as a risk factor in aortic valve replacement. However, the extent of circumferential involvement is poorly defined with great variability in reported incidence. We present a simple, reproducible classification to describe the extent of aortic calcification and thus appropriately define 'porcelain aorta', aiding clinical decision-making and registry data collection. Methods: 175 consecutive CT aortograms were reviewed...
2018: Open Heart
https://www.readbyqxmd.com/read/29387427/early-versus-newer-generation-devices-for-transcatheter-aortic-valve-implantation-in-routine-clinical-practice-a-propensity-score-matched-analysis
#8
Thomas Pilgrim, Joe K T Lee, Crochan J O'Sullivan, Stefan Stortecky, Sara Ariotti, Anna Franzone, Jonas Lanz, Dik Heg, Masahiko Asami, Fabien Praz, George C M Siontis, René Vollenbroich, Lorenz Räber, Marco Valgimigli, Eva Roost, Stephan Windecker
Aim: Contemporary data comparing early versus newer generation transcatheter heart valve (THV) devices in routine clinical practice are lacking. We sought to compare the safety and efficacy of early versus newer generation THVs in unselected patients undergoing transcatheter aortic valve implantation (TAVI). Methods and results: We performed a propensity score matched analysis of patients undergoing transfemoral TAVI at a single centre with early versus newer generation devices between 2007 and 2016...
2018: Open Heart
https://www.readbyqxmd.com/read/29387426/subclinical-magnesium-deficiency-a-principal-driver-of-cardiovascular-disease-and-a-public-health-crisis
#9
REVIEW
James J DiNicolantonio, James H O'Keefe, William Wilson
Because serum magnesium does not reflect intracellular magnesium, the latter making up more than 99% of total body magnesium, most cases of magnesium deficiency are undiagnosed. Furthermore, because of chronic diseases, medications, decreases in food crop magnesium contents, and the availability of refined and processed foods, the vast majority of people in modern societies are at risk for magnesium deficiency. Certain individuals will need to supplement with magnesium in order to prevent suboptimal magnesium deficiency, especially if trying to obtain an optimal magnesium status to prevent chronic disease...
2018: Open Heart
https://www.readbyqxmd.com/read/29387425/comparison-of-tricuspid-annular-plane-systolic-excursion-with-fractional-area-change-for-the-evaluation-of-right-ventricular-systolic-function-a-meta-analysis
#10
Justin Z Lee, See-Wei Low, Ahmed K Pasha, Carol L Howe, Kwan S Lee, Prakash G Suryanarayana
Background: Accurate determination of right ventricular ejection fraction (RVEF) is challenging because of the unique geometry of the right ventricle. Tricuspidannular plane systolic excursion (TAPSE) and fractional area change (FAC) are commonly used echocardiographic quantitative estimates of RV function. Cardiac MRI (CMRI) has emerged as the gold standard for assessment of RVEF. We sought to summarise the available data on correlation of TAPSE and FAC with CMRI-derived RVEF and to compare their accuracy...
2018: Open Heart
https://www.readbyqxmd.com/read/29387424/effects-of-disease-severity-distribution-on-the-performance-of-quantitative-diagnostic-methods-and-proposal-of-a-novel-v-plot-methodology-to-display-accuracy-values
#11
Ricardo Petraco, Hakim-Moulay Dehbi, James P Howard, Matthew J Shun-Shin, Sayan Sen, Sukhjinder S Nijjer, Jamil Mayet, Justin E Davies, Darrel P Francis
Background: Diagnostic accuracy is widely accepted by researchers and clinicians as an optimal expression of a test's performance. The aim of this study was to evaluate the effects of disease severity distribution on values of diagnostic accuracy as well as propose a sample-independent methodology to calculate and display accuracy of diagnostic tests. Methods and findings: We evaluated the diagnostic relationship between two hypothetical methods to measure serum cholesterol (Cholrapid and Cholgold) by generating samples with statistical software and (1) keeping the numerical relationship between methods unchanged and (2) changing the distribution of cholesterol values...
2018: Open Heart
https://www.readbyqxmd.com/read/29344384/blood-pressure-target-achievement-and-antihypertensive-medication-use-in-women-and-men-after-first-ever-myocardial-infarction-the-troms%C3%A3-study-1994-2016
#12
Laila A Hopstock, Anne Elise Eggen, Maja-Lisa Løchen, Ellisiv B Mathiesen, Amalie Nilsen, Inger Njølstad, Tom Wilsgaard
Background: Recurrent cardiovascular events after myocardial infarction (MI) are frequent, and gender differences in blood pressure treatment have been reported. Despite increased focus on secondary prevention, recent reports indicate that treatment targets are not achieved. There is a need for gender-specific analyses of post-MI blood pressure treatment target achievement and antihypertensive medication adherence. Design: We investigated the change in systolic and diastolic blood pressure and antihypertensive drug use after first-ever MI over two time periods in a Norwegian population-based study...
2018: Open Heart
https://www.readbyqxmd.com/read/29344383/prognosis-of-patients-with-secondary-mitral-regurgitation-and-reduced-ejection-fraction
#13
Samer Mowakeaa, Aeshita Dwivedi, Jason R Grossman, Gaurav Parikh, Zelmira Curillova, Krishna G Aragam, Sammy Elmariah, Scott Kinlay, Jayashri Aragam
Objective: The impact of the severity of secondary mitral regurgitation (MR) on the risk of death and heart failure (HF) hospitalisations in patients with reduced left ventricular (LV) systolic function is poorly defined. The study sought to identify the incremental risk of secondary MR in patients with reduced LV systolic function. Methods: We studied 615 consecutive patients with LV ejection fraction ≤35% by transthoracic echocardiography at a single medical centre...
2018: Open Heart
https://www.readbyqxmd.com/read/29344382/advanced-therapies-for-the-management-of-adults-with-pulmonary-arterial-hypertension-due-to-congenital-heart-disease-a-systematic-review
#14
Daniel L Varela, Mohamed Teleb, Wael El-Mallah
Pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) is the third most common cause of PAH, and it is becoming increasingly common as improvements in the management of CHD have led to increased life expectancy for these patients. The medical management of PAH due to CHD (PAH-CHD) is largely the same as what has been used for the treatment of idiopathic PAH, though the body of literature supporting this management decision is very small. There are currently few studies available which specifically focus on the treatment of PAH-CHD...
2018: Open Heart
https://www.readbyqxmd.com/read/29344381/impact-of-nutritional-indices-on-mortality-in-patients-with-heart-failure
#15
Akiomi Yoshihisa, Yuki Kanno, Shunsuke Watanabe, Tetsuro Yokokawa, Satoshi Abe, Makiko Miyata, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Takafumi Ishida, Yasuchika Takeishi
Background: Malnutrition is a common condition that is associated with adverse prognosis in patients with heart failure (HF). The Prognostic Nutritional Index (PNI), Geriatric Nutritional Risk Index (GNRI) and controlling nutritional status (CONUT) have all been used as objective indices for evaluating nutritional status. We aimed to clarify the relationship between these nutritional indices and the parameters of inflammatory markers, cardiac function and exercise capacity, as well as to compare the ability of these indexes for predicting mortality...
2018: Open Heart
https://www.readbyqxmd.com/read/29344380/sex-stratified-analysis-of-national-trends-and-outcomes-in-isolated-tricuspid-valve-surgery
#16
Pranav Chandrashekar, Erin Amanda Fender, Chad J Zack, Yogesh N V Reddy, Courtney E Bennett, Megha Prasad, Mohammed A Al-Hijji, John M Stulak, Virginia M Miller
Objective: Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery. Methods: Patients aged >18 who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample...
2018: Open Heart
https://www.readbyqxmd.com/read/29344379/changes-in-contractile-protein-expression-are-linked-to-ventricular-stiffness-in-infants-with-pulmonary-hypertension-or-right-ventricular-hypertrophy-due-to-congenital-heart-disease
#17
Andrew R Bond, Dominga Iacobazzi, Safa Abdul-Ghani, Mohammed Ghorbel, Kate Heesom, Mariangela Wilson, Christopher Gillett, Sarah J George, Massimo Caputo, Saadeh Suleiman, Robert M R Tulloh
Background: The right ventricle (RV) is not designed to sustain high pressure leading to failure. There are no current medications to help RV contraction, so further information is required on adaption of the RV to such hypertension. Methods: The Right Ventricle in Children (RVENCH) study assessed infants with congenital heart disease undergoing cardiac surgery with hypertensive RV. Clinical and echocardiographic data were recorded, and samples of RV were taken from matched infants, analysed for proteomics and compared between pathologies and with clinical and echocardiographic outcome data...
2018: Open Heart
https://www.readbyqxmd.com/read/29344378/clinical-outcomes-and-costs-of-cardiac-revascularisation-in-england-and-new-york-state
#18
Francisco Leyva, Tian Qiu, Felicity Evison, Christopher Christoforou, David McNulty, Peter Ludman, Daniel Ray
Objectives: Healthcare expenditure per-capita in the USA is higher than in England. We hypothesised that clinical outcomes after cardiac revascularisation are better in the USA. We compared costs and outcomes of patients undergoing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in England and New York State (NYS). Methods: Costs and total mortality were assessed using the Hospital Episode Statistics for England and the Statewide Planning and Research Cooperative System for NYS...
2018: Open Heart
https://www.readbyqxmd.com/read/29344377/major-adverse-cardiac-and-cerebrovascular-event-and-patients-quality-of-life-after-endoscopic-vein-harvesting-as-compared-with-open-vein-harvest-maqeh-a-pilot-study
#19
Heyman Luckraz, Carly Cartwright, Kumaresan Nagarajan, Prabhjeet Kaur, Alan Nevill
Background: This is a prospective, comparative, pilot and follow-up (2-year postoperatively) study in patients undergoing coronary artery bypass graft surgery where the long saphenous vein was harvested either by the endoscopic vein harvest (EVH) technique or open vein harvest (OVH) technique. Quality of life (QOL) and major adverse cardiac and cerebrovascular events (MACCE) were assessed. Methods: Alive patients who were initially part of a pilot study when EVH was introduced in our institution were included (n=48 EVH, n=49 OVH)...
2018: Open Heart
https://www.readbyqxmd.com/read/29344376/effectiveness-of-pharmacist-s-intervention-in-the-management-of-cardiovascular-diseases
#20
REVIEW
Stefano Omboni, Marina Caserini
The pharmacist may play a relevant role in primary and secondary prevention of cardiovascular diseases, mainly through patient education and counselling, drug safety management, medication review, monitoring and reconciliation, detection and control of specific cardiovascular risk factors (eg, blood pressure, blood glucose, serum lipids) and clinical outcomes. Systematic reviews of randomised controlled and observational studies have documented an improved control of hypertension, dyslipidaemia or diabetes, smoking cessation and reduced hospitalisation in patients with heart failure, following a pharmacist's intervention...
2018: Open Heart
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