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Acute aortic injury

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https://www.readbyqxmd.com/read/28342840/the-ratio-of-contrast-volume-to-glomerular-filtration-rate-predicts-acute-kidney-injury-and-mortality-after-transcatheter-aortic-valve-implantation
#1
Francesco Giannini, Azeem Latib, Richard J Jabbour, Massimo Slavich, Susanna Benincasa, Alaide Chieffo, Matteo Montorfano, Stefano Stella, Nicola Buzzatti, Ottavio Alfieri, Antonio Colombo
OBJECTIVE: The aim of this study was to assess the impact of the ratio of volume of contrast medium to the glomerular filtration rate (V/GFR) on acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) and its impact on long-term mortality. METHODS: We retrospectively calculated V/GFR in 397 patients undergoing TAVI. AKI was defined as VARC-modified Risk, Injury, Failure, Loss and End-stage (RIFLE) kidney disease score≥2. RESULTS: The incidence of AKI was 17...
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28330439/impact-of-preoperative-anemia-and-postoperative-hemoglobin-drop-on-the-incidence-of-acute-kidney-injury-and-in-hospital-mortality-in-patients-with-type-b-acute-aortic-syndromes-undergoing-thoracic-endovascular-aortic-repair
#2
Riccardo Gorla, Konstantinos Tsagakis, Michael Horacek, Amir-Abbas Mahabadi, Philipp Kahlert, Heinz Jakob, Eduardo Bossone, Raimund Erbel, Rolf Alexander Jánosi
BACKGROUND: The impact of preoperative anemia and postoperative hemoglobin (Hb) drop on the incidence of acute kidney injury (AKI) after thoracic endovascular aortic repair (TEVAR) for type B acute aortic syndromes (AAS) as well as their prognostic value is unknown. METHODS: This retrospective study included 144 patients with type B AAS undergoing TEVAR at our center. Preoperative anemia was classified as no/mild (Hb ≥ 12.0 g/dL in men; ≥11.3 g/dL in women), moderate (Hb 10...
April 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28320577/pre-operative-functional-cardiovascular-reserve-is-associated-with-acute-kidney-injury-after-intervention
#3
A Saratzis, J Shakespeare, O Jones, M J Bown, A Mahmood, C H E Imray
BACKGROUND: Acute kidney injury (AKI) is a common complication after endovascular intervention, associated with poor short and long-term outcomes. However, the mechanisms underlying AKI development remain poorly understood. The impact of pre-existing cardiovascular disease and low cardiovascular reserve (CVR) in AKI is unclear; it remains unknown whether AKI is primarily related to pre-existing comorbidity or to procedural parameters. The association between CVR and AKI after EVAR was therefore assessed...
March 17, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28318632/endovascular-aneurysm-repair-evar-and-transcatheter-aortic-valve-replacement-tavr-associated-acute-kidney-injury
#4
REVIEW
Kenar D Jhaveri, Athanasios N Saratzis, Rimda J Wanchoo, Pantelis A Sarafidis
Acute kidney injury (AKI) after surgery or intervention is an important complication that may impact mortality, morbidity, and health care costs. Endovascular procedures are now performed routinely for a variety of pathologies that were traditionally treated with open surgery because randomized trials comparing endovascular and open surgery have shown at least equally good results and reduced complication and hospitalization rates with endovascular techniques. However, endovascular procedures have been associated with an increased risk for postoperative AKI, predominantly owing to contrast nephrotoxicity...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28304219/surgical-or-transcatheter-aortic-valve-replacement-in-intermediate-risk-patients
#5
Michael J Reardon, Nicolas M Van Mieghem, Jeffrey J Popma, Neal S Kleiman, Lars Søndergaard, Mubashir Mumtaz, David H Adams, G Michael Deeb, Brijeshwar Maini, Hemal Gada, Stanley Chetcuti, Thomas Gleason, John Heiser, Rüdiger Lange, William Merhi, Jae K Oh, Peter S Olsen, Nicolo Piazza, Mathew Williams, Stephan Windecker, Steven J Yakubov, Eberhard Grube, Raj Makkar, Joon S Lee, John Conte, Eric Vang, Hang Nguyen, Yanping Chang, Andrew S Mugglin, Patrick W J C Serruys, Arie P Kappetein
Background Although transcatheter aortic-valve replacement (TAVR) is an accepted alternative to surgery in patients with severe aortic stenosis who are at high surgical risk, less is known about comparative outcomes among patients with aortic stenosis who are at intermediate surgical risk. Methods We evaluated the clinical outcomes in intermediate-risk patients with severe, symptomatic aortic stenosis in a randomized trial comparing TAVR (performed with the use of a self-expanding prosthesis) with surgical aortic-valve replacement...
March 17, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28302346/postoperative-acute-kidney-injury-and-blood-product-transfusion-after-synthetic-colloid-use-during-cardiac-surgery
#6
Rajika Tobey, Hao Cheng, Mei Gao, Zhongmin Li, J Nilas Young, W Douglas Boyd, Fuhai Ji, Hong Liu
OBJECTIVES: This study assessed the effect of 2 types of hydroxyethyl starches (HES) on renal integrity and blood transfusion in cardiac surgery patients. DESIGN: Retrospective investigation. SETTING: Patients from a single tertiary medical center. PARTICIPANTS: Inclusion criteria included coronary artery bypass graft (CABG) and/or valve surgery that included cardiopulmonary bypass with aortic cross-clamping. INTERVENTIONS: Intraoperative HES and blood product administration...
December 28, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28294662/-endovascular-treatment-of-blunt-thoracic-aortic-injuries
#7
Zsuzsanna Mihály, Péter Banga, Lilla Szatai, Árpád Simonffy, Daniele Mariastefano Fontanini, Judit Bélteki, Bianka Forgó, Zoltán Szeberin
INTRODUCTION: A new era has begun in the last two decades with the advent of endovascular methods in the therapy of blunt thoracic aorta injuries. Our experiences with the endovascular interventions of blunt aortic trauma in the Cardiovascular Center of Semmelweis University are summarised here. METHODS: We included those patients who underwent endovascular intervention due to blunt aortic trauma in a university hospital between 1998 and 2014. The statistical analysis was performed with the use of Excel...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28290162/tavr-in-intermediate-risk-patients-a-review-of-the-partner-2-trial-and-its-future-implications
#8
Sameer Arora, Cassandra J Ramm, Jacob A Misenheimer, John P Vavalle
BACKGROUND: Following publication of the results of the PARTNER trial, the American College of Cardiology/American Heart Association recognized the success of transcatheter aortic valve replacement (TAVR) by incorporating it as a feasible option in high-surgical risk patients, and recommending it as the standard of care for patients at prohibitive risk of surgery. Although this was recognized as a major success in the field of percutaneous valve replacement, surgical aortic valve replacement (SAVR) continued to be realized as the procedure of choice for low and intermediate surgical risk patients...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28285957/comparison-of-renal-outcomes-in-patients-treated-by-zenith-%C3%A2-fenestrated-and-zenith-%C3%A2-abdominal-aortic-aneurysm-stent-grafts-in-us-prospective-pivotal-trials
#9
L R de Souza, G S Oderich, M A Farber, S Haulon, P V Banga, A H Pereira, P Gloviczki, S C Textor, F Jia
OBJECTIVE/BACKGROUND: Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS: Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28259479/-management-of-mesenteric-ischemia-in-the-era-of-intestinal-stroke-centers-the-gut-and-lifesaving-strategy
#10
A Nuzzo, O Corcos
Mesenteric ischemia is a gut and life-threatening, medical and surgical, digestive and vascular emergency. Mesenteric ischemia is the result of an arterial or venous occlusion, a vasospasm secondary to low-flow states in intensive care patients, aortic clamping during vascular surgery or intestinal transplantation. Progression towards mesenteric infarction and its complications is unpredictable and correlates with high rates of mortality or a high risk of short bowel syndrome in case of survival. Thus, mesenteric ischemia should be diagnosed and treated at an early stage, when gut injury is still reversible...
March 1, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28247569/transcatheter-aortic-valve-implantation-in-the-united-states-predictors-of-early-hospital-discharge
#11
Sagar Mallikethi-Reddy, Emmanuel Akintoye, Tesfaye Telila, Rajeev Sudhakar, Kavyashri Jagadeesh, Alexandros Briasoulis, Melvyn Rubenfire, Luis Afonso, Cindy L Grines
BACKGROUND: There is a concerted push for adopting a minimalist strategy with emphasis on early hospital discharge for patients undergoing Transcatheter aortic valve implantation (TAVI). However, studies on discharge patterns and predictors of early discharge (≤3 days post-TAVI) are sparse, in the United States. METHODS: We analyzed using Healthcare Utilization Project, Nationwide Inpatient Sample database, 2011-2012. A total of 7321 TAVI procedures were identified...
March 1, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28229254/the-impact-of-post-procedural-complications-on-reimbursement-length-of-stay-and-mechanical-ventilation-among-patients-undergoing-transcatheter-aortic-valve-implantation-in-germany
#12
Klaus Kaier, Holger Reinecke, Huseyin Naci, Lutz Frankenstein, Martin Bode, Werner Vach, Philip Hehn, Andreas Zirlik, Manfred Zehender, Jochen Reinöhl
BACKGROUND: The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified. METHODS: In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses...
February 22, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28216353/left-subclavian-artery-revascularization-in-zone-2-thoracic-endovascular-aortic-repair-is-associated-with-lower-stroke-risk-across-all-aortic-diseases
#13
Rhiannon J Bradshaw, S Sadie Ahanchi, Obie Powell, Sebastian Larion, Colin Brandt, Michael C Soult, Jean M Panneton
BACKGROUND: The best management strategy for the left subclavian artery (LSA) in pathologic processes of the aorta requiring zone 2 thoracic endovascular aortic repair (TEVAR) remains controversial. We compared LSA coverage with or without revascularization as well as the different means of LSA revascularization. METHODS: A retrospective chart review was conducted of patients with any aortic diseases who underwent zone 2 TEVAR deployment from 2007 to 2014. Primary end points included 30-day stroke and 30-day spinal cord injury (SCI)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216344/perioperative-outcome-of-endovascular-repair-for-complex-abdominal-aortic-aneurysms
#14
Klaas H J Ultee, Sara L Zettervall, Peter A Soden, Jeremy Darling, Hence J M Verhagen, Marc L Schermerhorn
BACKGROUND: As endovascular aneurysm repair (EVAR) continues to advance, eligibility of patients with anatomically complex abdominal aortic aneurysms (AAAs) for EVAR is increasing. However, whether complex EVAR is associated with favorable outcome over conventional open repair and how outcomes compare with infrarenal EVAR remains unclear. This study examined perioperative outcomes of patients undergoing complex EVAR, focusing on differences with complex open repair and standard infrarenal EVAR...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28203019/-investigation-of-risk-factors-of-acute-kidney-injury-after-off-pump-coronary-artery-bypass-grafting-and-3-years-follow-up
#15
X H Li, F Xiao, S Y Zhang
OBJECTIVE: To investigate the incidence rate and risk factors of acute kidney injury (AKI) after off-pump coronary artery bypass grafting (CABG),and to compare the effects of AKI on complications after operation and major adverse cardiovascular and cerebrovascular events (MACCE) after 3 years' follow-up. METHODS: In the study, 299 consecutive patients who underwent scheduled off-pump CABG from January 2010 to March 2012 were included. The patients were divided into AKI group with AKI and control group without AKI after operation...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28183467/initial-experience-of-a-second-generation-self-expanding-transcatheter-aortic-valve-the-uk%C3%A2-ireland-evolut-r-implanters-registry
#16
Sundeep S Kalra, Sami Firoozi, James Yeh, Daniel J Blackman, Shabnam Rashid, Simon Davies, Neil Moat, Miles Dalby, Tito Kabir, Saib S Khogali, Richard A Anderson, Peter H Groves, Darren Mylotte, David Hildick-Smith, Rajiv Rampat, Jan Kovac, Ashan Gunarathne, Jean-Claude Laborde, Stephen J Brecker
OBJECTIVES: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve. BACKGROUND: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications. METHODS: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28180096/the-frozen-elephant-trunk-technique-european-association-for-cardio-thoracic-surgery-position-and-bologna-experience
#17
REVIEW
Luca Di Marco, Antonio Pantaleo, Alessandro Leone, Giacomo Murana, Roberto Di Bartolomeo, Davide Pacini
Complex lesions of the thoracic aorta are traditionally treated in 2 surgical steps with the elephant trunk technique. A relatively new approach is the frozen elephant trunk (FET) technique, which potentially allows combined lesions of the thoracic aorta to be treated in a 1-stage procedure combining endovascular treatment with conventional surgery using a hybrid prosthesis. These are very complex and time-consuming operations, and good results can be obtained only if appropriate strategies for myocardial, cerebral, and visceral protection are adopted...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28176909/outcomes-of-renal-function-in-elderly-patients-with-acute-kidney-injury
#18
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: The aim of this study was to explore the prognostic impact of clinical factors on the short-term outcomes of renal function (RF) in very elderly patients with acute kidney injury (AKI). PATIENTS AND METHODS: We carried out a retrospective cohort study of only very elderly patients who developed AKI at the geriatric department of a tertiary medical center during the period 2007-2015. All patients with AKI were followed up for 90 days after AKI diagnosis or until death...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28169084/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-lower-surgical-risk-scores-a-systematic-review-and-meta-analysis-of-early-outcomes
#19
Sameer Arora, Paula D Strassle, Cassandra J Ramm, Jeremy A Rhodes, Satyanarayana R Vaidya, Thomas G Caranasos, John P Vavalle
BACKGROUND: The results from the PARTNER 2 trial showed the feasibility of transcatheter aortic valve replacement (TAVR) in intermediate surgical risk patients. Although low risk clinical trials will take time to conclude, some data has emerged comparing TAVR with surgical aortic valve replacement (SAVR) in lower risk patients. METHODS: A Medline search was conducted using standard methodology to search for studies reporting results comparing TAVR and SAVR. Studies were included if the overall mean Society of Thoracic Surgeons Score was less than 4% (or equivalent Euroscore)...
January 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28162223/impact-of-subclinical-vascular-complications-detected-by-systematic-postprocedural-multidetector-computed-tomography-after-transcatheter-aortic-valve-implantation-using-balloon-expandable-edwards-sapien-xt-heart-valve
#20
Yuki Kakefuda, Kentaro Hayashida, Yoshitake Yamada, Fumiaki Yashima, Taku Inohara, Ryo Yanagisawa, Makoto Tanaka, Takahide Arai, Takashi Kawakami, Yuichiro Maekawa, Hikaru Tsuruta, Yuji Itabashi, Mitsushige Murata, Motoaki Sano, Kazuma Okamoto, Akihiro Yoshitake, Hideyuki Shimizu, Masahiro Jinzaki, Keiichi Fukuda
Complications after transcatheter aortic valve implantation (TAVI) remain an important issue. This study aimed to evaluate the impact of systematic postprocedural multidetector computed tomography (MDCT) to detect subclinical complications after TAVI. From October 2013 to August 2015, a total of 135 patients who underwent transfemoral TAVI (n = 116) or transapical TAVI (n = 19) with Sapien XT and MDCT preprocedure and postprocedure were enrolled. Postprocedural MDCT findings were compared with the preprocedural MDCT findings...
April 1, 2017: American Journal of Cardiology
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