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Acute aortic injury

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https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#1
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#2
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#3
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#4
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#5
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28076620/intraperitoneal-administration-of-silymarin-protects-end-organs-from-multivisceral-ischemia-reperfusion-injury-in-a-rat-model
#6
Aydemir Koçarslan, Sezen Koçarslan, Mehmet Salih Aydin, Şamil Gunay, Mahmut Alp Karahan, Abdullah Taşkın, Murat Üstunel, Nurten Aksoy
Objective: To determine whether intraperitoneal silymarin administration has favorable effects on the heart, lungs, kidney, and liver and on oxidative stress in a rat model of supraceliac aorta ischemia/reperfusion injury. Methods: Thirty male Wistar albino rats were divided equally into three groups: sham, control, and silymarin. The control and silymarin groups underwent supraceliac aortic occlusion for 45 min, followed by a 60 min period of reperfusion under terminal anesthesia...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28074790/incidence-and-progression-of-cardiac-surgery-associated-acute-kidney-injury-and-its-relationship-with-bypass-and-cross-clamp-time
#7
Habib Md Reazaul Karim, Mohd Yunus, Manuj Kumar Saikia, Jyoti Prasad Kalita, Mrinal Mandal
INTRODUCTION: Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. MATERIALS AND METHODS: Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074703/early-surgery-after-angiography-in-patients-scheduled-for-valve-replacement
#8
Victor Dayan, Roberto Stanham, Gerardo Soca, Fernando Genta, Jorge Mariño, Alvaro Lorenzo
Background There are limited data regarding the risks of cardiac surgery early after coronary angiography in patients scheduled for isolated aortic and/or mitral valve replacement. Our aim was to evaluate the risk of early surgery after coronary angiography in these patients. Methods We retrospectively analyzed data of 1044 patients who underwent isolated aortic and/or mitral valve replacement from 2006 to 2014. Baseline, operative, and postoperative variables were collected. The patients were divided into 3 groups based on the interval between coronary angiography and surgery: ≤3 days ( n = 216), 4-7 days ( n = 109), and ≥8 days ( n = 719)...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28067195/combined-erythropoietin-and-iron-therapy-for-anemic-patients-undergoing-transcatheter-aortic-valve-replacement-the-epicure-randomized-clinical-trial
#9
Marina Urena, Maria Del Trigo, Omar Abdul-Jawad Altisent, Francisco Campelo-Prada, Ander Regueiro, Robert DeLarochellière, Daniel Doyle, Siamak Mohammadi, Jean-Michel Paradis, François Dagenais, Eric Dumont, Rishi Puri, Vincent Laroche, Josep Rodés-Cabau
AIMS: The aim of this study was to evaluate, in anemic patients, the efficacy of erythropoietin (EPO) in reducing red-cell (RC) transfusion rates post-TAVI. METHODS AND RESULTS: This was a randomized double-blind trial. Patients with severe symptomatic aortic stenosis and concomitant anemia with an indication for TAVI were randomized (1:1) to receive 2 weight-based doses of EPO (darbepoetin alfa) + iron or placebo at days 10 (±4 days) and 1 (±1 day) pre- TAVI...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28061996/comparative-outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-for-aortic-stenosis-in-nonagenarians
#10
Chad J Zack, Fahad Al-Qahtani, Akram Kawsara, Mohammed Al-Hijji, Ali Hama Amin, Mohamad Alkhouli
Transcatheter aortic valve replacement (TAVR) emerged as a promising alternative to surgical aortic valve replacement (SAVR) in extreme-aged patients with severe aortic stenosis (AS). Data on the outcomes of TAVR or SAVR in nonagenarians are limited. The Nationwide Inpatient Sample was used to identify patients aged 90 years or older who underwent TAVR or SAVR from 2004 to 2013. In-hospital morbidity and mortality were assessed. From 2004 to 2013, 9,066 (national estimate) nonagenarians underwent aortic valve replacement...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28039285/patients-views-of-consent-in-clinical-trials-for-acute-myocardial-infarction-impact-of-trial-design
#11
Neal W Dickert, Kristopher A Hendershot, Candace D Speight, Alexandra E Fehr
OBJECTIVE: Seeking prospective informed consent is difficult in clinical trials for emergent conditions such as acute myocardial infarction (AMI). Prior data suggest that enrolment decisions of patients are often poorly informed in AMI trials but that patients prefer to be asked permission before enrolment. It is unknown whether this is true across trial designs or in comparative effectiveness research (CER) with approved treatments. METHODS: Structured interviews were conducted with 30 patients with AMI...
December 30, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28034845/thirty-day-readmissions-after-transcatheter-aortic-valve-replacement-in-the-united-states-insights-from-the-nationwide-readmissions-database
#12
Dhaval Kolte, Sahil Khera, M Rizwan Sardar, Neil Gheewala, Tanush Gupta, Saurav Chatterjee, Andrew Goldsweig, Wilbert S Aronow, Gregg C Fonarow, Deepak L Bhatt, Adam B Greenbaum, Paul C Gordon, Barry Sharaf, J Dawn Abbott
BACKGROUND: Readmissions after cardiac procedures are common and contribute to increased healthcare utilization and costs. Data on 30-day readmissions after transcatheter aortic valve replacement (TAVR) are limited. METHODS AND RESULTS: Patients undergoing TAVR (International Classification of Diseases-Ninth Revision-CM codes 35.05 and 35.06) between January and November 2013 who survived the index hospitalization were identified in the Nationwide Readmissions Database...
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28034631/emergency-endovascular-management-of-acute-thoracic-aortic-pathology-a-safe-and-feasible-option
#13
Z Ahmed, S M McHugh, A Elmallah, M P Colgan, A O'Callaghan, S M O'Neill, P Madhavan, Z Martin
Endovascular repair has revolutionised the emergency treatment of thoracic aortic disease. We report our 10 year experience using this treatment in emergency cases. A prospectively maintained vascular database was analysed. Patients' medical records and CT images stored on the hospital PACS system were also reviewed. Statistical analysis was done using IBM SPSS V21. There were a total of 59 thoracic aortic stenting procedures of which 33 (60% males with a mean age of 58 yrs) were performed for emergency thoracic pathologies: traumatic transection (n = 10), ruptured aneurysm (n = 6), non-traumatic dissection (n = 8) and penetrating aortic ulcer (n = 9)...
December 27, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/28029207/prospective-comparison-between-three-tavr-devices-acurate-neo-vs-corevalve-vs-sapien-xt-a-single-heart-team-experience-in-patients-with-severe-aortic-stenosis
#14
Tannas Jatene, Antonio Castro-Filho, Rafael A Meneguz-Moreno, Dimytri A Siqueira, Alexandre A C Abizaid, Auristela I O Ramos, Magaly Arrais, David C S Le Bihan, Rodrigo B M Barretto, Adriana C Moreira, Amanda G M R Sousa, J Eduardo Sousa
OBJECTIVE: We sought to compare the new transcatheter aortic valve replacement (TAVR) device ACURATE neo (ACT) with the already established CoreValve (MCV) and SAPIEN XT (SXT) for the treatment of severe aortic stenosis (AS). BACKGROUND: Very few data on TAVR devices are available beyond MCV and SAPIEN and there is no previous study comparing ACT with MCV and SXT. METHODS: We prospectively evaluated consecutive patients who underwent transfemoral TAVR for the treatment of severe AS...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28028070/ticagrelor-but-not-clopidogrel-reduces-arterial-thrombosis-via-endothelial-tissue-factor-suppression
#15
Martin F Reiner, Alexander Akhmedov, Simona Stivala, Stephan Keller, Daniel S Gaul, Nicole R Bonetti, Gianluigi Savarese, Martina Glanzmann, Cuicui Zhu, Wolfram Ruf, Zhihong Yang, Christian M Matter, Thomas F Lüscher, Giovanni G Camici, Juerg H Beer
AIMS: The P2Y12 antagonist ticagrelor reduces mortality in patients with acute coronary syndrome (ACS), compared with clopidogrel, and the mechanisms underlying this effect are not clearly understood. Arterial thrombosis is the key event in ACS; however, direct vascular effects of either ticagrelor or clopidogrel with focus on arterial thrombosis and its key trigger tissue factor have not been previously investigated. METHODS AND RESULTS: Human aortic endothelial cells were treated with ticagrelor or clopidogrel active metabolite (CAM) and stimulated with tumour necrosis factor-alpha (TNF-α); effects on procoagulant tissue factor (TF) expression and activity, its counter-player TF pathway inhibitor (TFPI) and the underlying mechanisms were determined...
November 15, 2016: Cardiovascular Research
https://www.readbyqxmd.com/read/28009954/outcomes-of-minimally-invasive-valve-surgery-in-patients-with-multiple-previous-cardiac-operations
#16
Orlando Santana, Rama Krishna, Nisharahmed Kherada, Christos G Mihos
BACKGROUND: The study aim was to evaluate the outcomes of minimally invasive valve surgery, performed via a right anterior thoracotomy approach, in patients with a history of multiple (more than two) prior cardiac surgeries. METHODS: A retrospective review was conducted of all minimally invasive valve operations performed in patients with a prior history of two or more cardiac surgeries, including coronary artery bypass grafting (CABG) and/or valve surgery, at the authors' institution between January 2008 and November 2014...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28007879/transcatheter-versus-surgical-aortic-valve-replacement-in-moderate-and-high-risk-patients-a-meta-analysis
#17
Manuel Carnero-Alcázar, Luis Carlos Maroto, Javier Cobiella-Carnicer, Isidre Vilacosta, Luis Nombela-Franco, Ali Alswies, Enrique Villagrán-Medinilla, Carlos Macaya
OBJECTIVES: The evidence of the benefits of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) for patients of high or intermediate surgical risk is not consistent. We performed a meta-analysis to compare major adverse outcomes after TAVR or SAVR. METHODS: We searched propensity score matched studies or randomized clinical trials comparing the risks of mortality, stroke, major bleeding, acute renal injury, pacemaker implantation, vascular complications and prostheses haemodynamic performance between TAVR and SAVR in patients with moderate or high risk...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28004897/management-of-acute-aortic-thrombosis
#18
Mark Kaschwich, Christian A Behrendt, Nikolaos Tsilimparis, Tilo Kölbel, Sabine H Wipper, Eike S Debus
Acute aortic thrombosis (AAT) is a rare life threatening event that leads to a sudden occlusion of the aorta. The mortality and morbidity of AAT is still high despite modern surgical techniques. Usually it is the result of a large saddle embolus to the aortic bifurcation, in situ thrombosis of an atherosclerotic aorta or acute occlusion of an abdominal aortic aneurysm. Clinical symptoms depend on the level of the aortic occlusion and can be mistaken for a stroke or similar neurological disease. The combination of age and advanced cardiac disease seems to be significant risks factors for AAT...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27989077/favorable-survival-after-aortic-valve-replacement-compared-to-the-general-population
#19
Sindri A Viktorsson, Dadi Helgason, Andri W Orrason, Thor Aspelund, Martin Ingi Sigurdsson, Arnar Geirsson, Tomas Gudbjartsson
BACKGROUND: A comparison was made between the long-term survival of patients undergoing aortic valve replacement (AVR) for aortic stenosis and of the general Icelandic population, using centralized registries. METHODS: A total of 366 AVR patients (231 males, 135 females; mean age 70.1 years) operated on for aortic stenosis in Iceland between 2002 and 2011 was included in the study. Concomitant coronary artery bypass grafting was performed in 54% of cases. Short-term complications and 30-day mortality were analyzed...
January 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27986479/prospective-nonrandomized-study-to-evaluate-endovascular-repair-of-pararenal-and-thoracoabdominal-aortic-aneurysms-using-fenestrated-branched-endografts-based-on-supraceliac-sealing-zones
#20
Gustavo S Oderich, Mauricio Ribeiro, Jan Hofer, Jean Wigham, Stephen Cha, Julia Chini, Thanila A Macedo, Peter Gloviczki
PURPOSE: To investigate outcomes of manufactured fenestrated and branched endovascular aortic repair (F-BEVAR) endografts based on supraceliac sealing zones to treat pararenal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). METHODS: A total of 127 patients (91 male, mean age 75 ± 10 years old) were enrolled in a prospective, nonrandomized single-center study using manufactured F-BEVAR (November 2013-March 2015). Stent design was based on supraceliac sealing zone in all patients with ≥ four vessels in 111 (89%)...
December 13, 2016: Journal of Vascular Surgery
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