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Acute aortic injury

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https://www.readbyqxmd.com/read/28797584/long-term-outcomes-of-frozen-elephant-trunk-for-type-a-aortic-dissection-in-patients-with-marfan-syndrome
#1
Wei-Guo Ma, Wei Zhang, Jun-Ming Zhu, Bulat A Ziganshin, Ai-Hua Zhi, Jun Zheng, Yong-Min Liu, John A Elefteriades, Li-Zhong Sun
OBJECTIVE: The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. METHODS: The early and long-term outcomes were analyzed for 106 patients with MFS (mean age, 34.5 ± 9.7 years) undergoing FET + TAR for TAAD. RESULTS: Operative mortality was 6.6% (7 of 106)...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28795480/hospital-teaching-status-and-trascatheter-aortic-valve-replacement-outcomes-in-the-united-states-analysis-of-the-national-inpatient-sample
#2
Tesfaye Telila, Emmanuel Akintoye, Tomo Ando, Obsinet Merid, Mohan Palla, Sagar Mallikethi-Reddy, Alexandros Briasoulis, Cindy Grines, Luis Afonso
BACKGROUND: Evidence suggests that medical service offerings vary by hospital teaching status. However, little is known about how these translate to patient outcomes. We therefore sought to evaluate this gap in knowledge in patients undergoing Transcatheter aortic valve replacement (TAVR) in the United States. METHODS: This study was conducted using the National Inpatient Sample (NIS) in the United States from 2011 to 2014. Teaching status was classified, as teaching vs...
August 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28790276/-acute-leg-ischemia-at-acute-aortic-dissection
#3
Yukio Kuniyoshi
Legs ischemia might be associated with acute aortic dissection, in acute phase or even in subacute phase. In general, immediate central repair for acute aortic dissection is mandatory prior to intervention of leg ischemia because central repair might improve leg ischemia. Depending on condition of leg ischemia, revascularization of occluded artery should be considered. The perfusion to ischemic leg during central repair is useful to diminish leg injury. There are some useful modalities for revascularization such as some route of extra-anatomical bypass, placing of stent graft for closing entry site of dissected aortic wall...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28782492/impact-of-pre-existing-kidney-dysfuntion-on-outcomes-following-transcatheter-aortic-valve-replacement
#4
Ikechukwu A Ifedili, Oluwaseyi Bolorunduro, Tamunoinemi Bob-Manuel, Mark R Heckle, Ellis Christian, Saibal Kar, Uzoma N Ibebuogu
BACKGROUND: Pre-existing chronic kidney disease (CKD) portends adverse outcomes following heart valve surgery. However, only limited and conflicting evidence is available on the impact of CKD on outcomes following transcatheter aortic valve replacement (TAVR). The objective of this review was to evaluate the effect of pre-existing CKD on TAVR outcomes. METHODS: We performed a systematic electronic search using the PRISMA statement to identify all randomized controlled trials and observational studies investigating the effect of pre-existing CKD on outcomes following TAVR...
August 4, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28768757/optimized-screening-of-coronary-artery-disease-with-invasive-coronary-angiography-and-ad-hoc-percutaneous-coronary-intervention-during-transcatheter-aortic-valve-replacement
#5
Marco Barbanti, Denise Todaro, Giuliano Costa, Gerlando Pilato, Andrea Picci, Simona Gulino, Piera Capranzano, Ketty La Spina, Emanuela Di Simone, Paolo D'Arrigo, Wanda Deste, Antonino Indelicato, Stefano Cannata, Daniela Giannazzo, Sebastiano Immè, Claudia Tamburino, Martina Patanè, Sergio Buccheri, Davide Capodanno, Carmelo Sgroi, Corrado Tamburino
BACKGROUND: We sought to describe an optimized approach to coronary artery disease (CAD) screening and management in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: When invasive coronary angiography showed CAD, the treatment strategy and completeness of revascularization was determined based on coronary anatomy. TAVR was performed in the same setting if percutaneous coronary intervention (PCI) was uncomplicated; otherwise TAVR was postponed...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28766839/techniques-and-outcomes-of-paravalvular-leak-repair-after-transcatheter-aortic-valve-replacement
#6
Thomas M Waterbury, Guy S Reeder, Sorin V Pislaru, Allison K Cabalka, Charanjit S Rihal, Mackram F Eleid
OBJECTIVES: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). BACKGROUND: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. METHODS: This is a single center retrospective review of PVL closure after TAVR...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#7
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28761674/risk-factors-for-worsening-renal-function-and-their-association-with-long-term-mortality-following-transcatheter-aortic-valve-implantation-data-from-the-swedeheart-registry
#8
Georgios Vavilis, Marie Evans, Tomas Jernberg, Andreas Rück, Karolina Szummer
BACKGROUND: The occurrence of persistent acute kidney injury (pAKI) following transcatheter aortic valve implantation (TAVI) has serious implications. METHODS: There were 1540 patients undergoing and surviving TAVI included in the nationwide SWEDEHEART registry between 2008 and 2015. Creatinine was measured at baseline and discharge, and those with baseline estimated glomerular filtration rate (eGFR) <15 mL/min/1.73 m(2) or dialysis were excluded. pAKI was defined by and encompassing theValve Academic Research Consortium-2 (VARC-2) criteria: increase in serum creatinine concentration ≥26...
2017: Open Heart
https://www.readbyqxmd.com/read/28760721/transcatheter-aortic-valve-implantation-versus-re-do-surgery-for-failing-surgical-aortic-bioprosthesis-a-multi-centre-propensity-score-analysis
#9
Marco Spaziano, Darren Mylotte, Pascal Thériault-Lauzier, Ole De Backer, Lars Søndergaard, Johan Bosmans, Nicolas Debry, Thomas Modine, Marco Barbanti, Corrado Tamburino, Jan-Malte Sinning, Eberhard Grube, Georg Nickenig, Fritz Mellert, Sabine Bleiziffer, Rüdiger Lange, Benoit de Varennes, Kevin Lachapelle, Giuseppe Martucci, Nicolo Piazza
AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV- in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aims to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching. METHODS AND RESULTS: Patients from 7 centres in Europe and Canada who had undergone either TAV- in-SAV (n=79) or redo-SAVR (n=126) were identified...
August 1, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28759604/a-web-based-tool-to-predict-acute-kidney-injury-in-patients-with-st-elevation-myocardial-infarction-development-internal-validation-and-comparison
#10
Benjamin R Zambetti, Fridtjof Thomas, Inyong Hwang, Allen C Brown, Mason Chumpia, Robert T Ellis, Darshan Naik, Rami N Khouzam, Uzoma N Ibebuogu, Guy L Reed
BACKGROUND: In ST-elevation myocardial infarction (STEMI), acute kidney injury (AKI) may increase subsequent morbidity and mortality. Still, it remains difficult to predict AKI risk in these patients. We sought to 1) determine the frequency and clinical outcomes of AKI and, 2) develop, validate and compare a web-based tool for predicting AKI. METHODS & FINDINGS: In a racially diverse series of 1144 consecutive STEMI patients, Stage 1 or greater AKI occurred in 12...
2017: PloS One
https://www.readbyqxmd.com/read/28759544/minimally-invasive-access-aortic-arch-surgery
#11
Nora Goebel, Daniel Bonte, Schahriar Salehi-Gilani, Ragi Nagib, Adrian Ursulescu, Ulrich F W Franke
OBJECTIVE: Median sternotomy is still the standard approach for aortic arch surgery. Minimally invasive techniques promise faster recovery with shorter hospital stay due to thoracic stability, reduced pain, and superior cosmetic results. However, safety is a concern in complex aortic surgery. The aim of our study was to demonstrate that aortic arch surgery via partial upper sternotomy is viable, safe, and equivalent to standard procedure both in terms of its safety and the risk of major adverse cardiac and cerebrovascular events...
July 28, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28740713/outcomes-of-minimally-invasive-double-valve-surgery
#12
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Frederick Hasty, Esteban Escolar, Christos G Mihos
BACKGROUND: Double valve surgery is associated with an increased peri-operative morbidity and mortality. A less invasive right thoracotomy approach may be a viable alternative to median sternotomy surgery in these higher-risk patients. METHODS: We retrospectively analyzed the baseline demographics, operative characteristics, and post-operative outcomes of patients who underwent minimally invasive double valve surgery between January 2009 and December 2011 at our institution...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740709/outcomes-of-a-hybrid-approach-of-percutaneous-coronary-intervention-followed-by-minimally-invasive-aortic-valve-replacement
#13
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Gerald P Rosen, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients requiring coronary revascularization and aortic valve replacement, a combined approach of percutaneous coronary intervention followed by minimally invasive aortic valve replacement may be a viable treatment strategy. METHODS: The outcomes of 123 consecutive patients with significant coronary artery and aortic valve disease, who underwent percutaneous coronary intervention followed by elective minimally invasive aortic valve replacement between February 2009 and April 2014, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#14
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28736373/-relationship-between-hyperuricemia-and-adverse-events-in-patients-aged-40-years-or-older-receiving-rheumatic-aortic-valve-replacement
#15
Ying Wu, Zu-Hui Ke, Ying-Jie Huang, Jie-Leng Huang, Dan-Qing Yu, Xue-Biao Wei, Xiao-Lan Chen
OBJECTIVE: To explore the prognostic value of hyperuricemia for adverse events in patients >40 years old receiving valve replacement surgery for rheumatic aortic valve disease. METHDS: Consecutive middle-aged and elderly patients receiving aortic valve replacement surgery for rheumatic aortic valve disease between March, 2009 and July, 2013 were recruited in this study. The patients were divided into hyperuricemic group and normouricemic group based on their serum levels of uric acid, and the clinical data and adverse events within 1 year after the surgery were compared between the 2 groups...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28721029/the-impact-of-transient-and-persistent-acute-kidney-injury-on-short-term-outcomes-in-very-elderly-patients
#16
Qinglin Li, Meng Zhao, Xiaodan Wang
OBJECTIVES: Acute kidney injury (AKI) is a common complication in elderly patients and is associated with poor outcomes. However, the effect of transient and persistent geriatric AKI on short-term mortality is unclear. We aimed to study the incidence, clinical characteristics, and prognostic impact of transient and persistent AKI in such patients. METHODS: We retrospectively enrolled very elderly patients (≥75 years) from the geriatric department of the Chinese PLA General Hospital between 2007 and 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#17
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#18
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28706126/transfemoral-transcatheter-aortic-valve-in-valve-implantation-for-aortic-valve-bioprosthesis-failure-with-the-fully-repositionable-and-retrievable-lotus-valve-a-single-center-experience
#19
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
OBJECTIVE: To report a first case series of the Lotus valve (Boston Scientific) for the treatment of surgical aortic bioprosthesis failure. BACKGROUND: Valve-in-valve (VIV) transcatheter aortic valve implantation (TAVI) is an established management option for surgical aortic bioprosthesis failure. Although TAVI has proven efficacious, complications relating to suboptimal valve implantation have been reported in approximately 5% of patients. The Lotus valve is fully repositionable and retrievable, and therefore enables complete assessment of valve function prior to definitive deployment...
July 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28705072/short-and-long-term-results-after-endovascular-management-of-vascular-complications-during-transfemoral-aortic-valve-implantation
#20
Thomas Heger, Stefanie Strauß, Erwin Blessing, Martin Andrassy, Christian Erbel, Oliver J Müller, Emmanuel Chorianopoulos, Sven Pleger, Florian Leuschner, Grigorios Korosoglou, Raffi Bekeredjian, Hugo A Katus, Britta Vogel
Background Vascular injury and access site complications in the contemporary setting of transcatheter aortic valve implantation (TAVI) are known to be associated with increased mortality and morbidity. The aim of our study was to analyse the feasibility and safety of percutaneous treatment of such vascular complications using a stent graft. Methods Between January 2010 and April 2013, 36 TAVI patients developed severe access site complications and underwent subsequent interventional treatment with a covered stent...
July 14, 2017: Acta Cardiologica
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