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https://www.readbyqxmd.com/read/28728688/transcatheter-versus-surgical-aortic%C3%A2-valve%C3%A2-replacement-propensity-matched-comparison
#1
J Matthew Brennan, Laine Thomas, David J Cohen, David Shahian, Alice Wang, Michael J Mack, David R Holmes, Fred H Edwards, Naftali Z Frankel, Suzanne J Baron, John Carroll, Vinod Thourani, E Murat Tuzcu, Suzanne V Arnold, Roberta Cohn, Todd Maser, Brenda Schawe, Susan Strong, Allen Stickfort, Elizabeth Patrick-Lake, Felicia L Graham, Dadi Dai, Fan Li, Roland A Matsouaka, Sean O'Brien, Fan Li, Michael J Pencina, Eric D Peterson
BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. OBJECTIVES: The aim of this study was to determine the safety and effectiveness of TAVR versus surgical aortic valve replacement (SAVR), particularly in intermediate- and high-risk patients, in a nationally representative real-world cohort...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28728656/the-prognostic-effects-of-coronary-disease-severity-and-completeness-of-revascularization-on-mortality-in-patients-undergoing-transcatheter-aortic-valve-replacement
#2
Guy Witberg, Ehud Regev, Shmuel Chen, Abbid Assali, Israel M Barbash, David Planer, Hana Vaknin-Assa, Victor Guetta, Vojislav Vukasinovic, Katia Orvin, Haim D Danenberg, Amit Segev, Ran Kornowski
OBJECTIVES: The study sought to examine the effect of coronary artery disease (CAD) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: CAD is common in the TAVR population. However, there are conflicting data on the prognostic significance of CAD and its treatment in this population. METHODS: The authors analyzed 1,270 consecutive patients with severe aortic stenosis (AS) undergoing TAVR at 3 Israeli centers...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28714522/factors-associated-with-safe-early-discharge-after-trans-catheter-aortic-valve-implantation
#3
Omar Aldalati, Friedon Keshavarzi, Amit Kaura, Jonathan Byrne, Mehdi Eskandari, Ranjit Deshpande, Mark Monaghan, Olaf Wendler, Rafal Dworakowski, Philip Maccarthy
BACKGROUND: As transcatheter aortic valve replacement (TAVI) becomes more straightforward, a larger proportion of patients will be well enough to be discharged early. This study sought to characterise the clinical features that allowed patients to be discharged early after TAVI and to evaluate the safety of an early discharge policy. METHODS: All patients undergoing TAVI at the above cited centre from August 2007 to March 2015 were included in this study. Baseline characteristics, in-hospital outcomes, re-admissions and mortality were compared...
July 17, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#4
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28703280/the-oregonheart-total-artificial-heart-design-and-performance-on-a-mock-circulatory-loop
#5
Jeremy Glynn, Howard Song, Bryan Hull, Stanley Withers, Jill Gelow, James Mudd, Albert Starr, Richard Wampler
Widespread use of heart transplantation is limited by the scarcity of donor organs. Total artificial heart (TAH) development has been pursued to address this shortage, especially to treat patients who require biventricular support. We have developed a novel TAH that utilizes a continuously spinning rotor that shuttles between two positions to provide pulsatile, alternating blood flow to the systemic and pulmonary circulations without artificial valves. Flow rates and pressures generated by the TAH are controlled by adjusting rotor speed, cycle frequency, and the proportion of each cycle spent pumping to either circulation...
July 13, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28698288/impact-of-forward-stroke-volume-response-on-clinical-and-structural-outcomes-after-percutaneous-mitral-valve-repair-with-mitraclip
#6
Shunsuke Kubo, Mamoo Nakamura, Takahiro Shiota, Yuji Itabashi, Yukiko Mizutani, Yoshifumi Nakajima, Krissada Meemook, Asma Hussaini, Moody Makar, Robert J Siegel, Saibal Kar
BACKGROUND: An increase of systolic forward flow was frequently observed after successful MitraClip implantation in patients with significant mitral regurgitation. However, the impact of systolic forward flow improvement on post-MitraClip outcomes remains unknown. METHODS AND RESULTS: Study population included 160 patients who underwent successful MitraClip implantation. The systolic forward flow was noninvasively calculated as the forward stroke volume (FSV) at baseline before the MitraClip procedure and before discharge with pulse-wave Doppler using transthoracic echocardiography...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28691910/transcatheter-aortic-valve-implantation-for-mixed-versus-pure-stenotic-aortic-valve-disease
#7
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Jan G Tijssen, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
AIMS: In addition to patients with pure/predominant aortic stenosis (PAS), real-world transcatheter aortic valve implantation (TAVI) referrals include patients with mixed aortic valve disease (MAVD; severe stenosis + moderate-severe regurgitation). We sought to compare TAVI outcomes in patients with MAVD vs. PAS. METHODS AND RESULTS: Out of 793 consecutive patients undergoing TAVI, 106 (13.4%) had MAVD. Patients with MAVD were younger and had a higher operative risk, a severer adverse cardiac remodeling, and a worse functional status than patients with PAS...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28684438/five-year-follow-up-after-transcatheter-aortic-valve-implantation-for-symptomatic-aortic-stenosis
#8
Ralf Zahn, Nicolas Werner, Ulrich Gerckens, Axel Linke, Horst Sievert, Philipp Kahlert, Rainer Hambrecht, Stefan Sack, Mohamed Abdel-Wahab, Ellen Hoffmann, Uwe Zeymer, Steffen Schneider
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has been implemented into the care of elderly patients suffering from severe symptomatic aortic stenosis. However, data on long-term follow-up are sparse and predictors of long-term mortality need to be evaluated to better select patients. Therefore, we aimed to analyse predictors of 5-year mortality after TAVI. METHODS: We analysed data from the German Transcatheter Aortic Valve Interventions-Registry. Each of the 27 participating hospitals agreed to include all consecutive TAVI patients at their institution...
July 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28674631/liver-stiffness-assessed-by-fibrosis-4-index-predicts-mortality-in-patients-with-heart-failure
#9
Yu Sato, Akiomi Yoshihisa, Yuki Kanno, Shunsuke Watanabe, Tetsuro Yokokawa, Satoshi Abe, Tomofumi Misaka, Takamasa Sato, Satoshi Suzuki, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Shu-Ichi Saitoh, Yasuchika Takeishi
OBJECTIVE: Liver dysfunction due to heart failure (HF) is known as congestive hepatopathy. It has recently been reported that liver stiffness assessed by transient elastography reflects increased central venous pressure. The Fibrosis-4 (FIB4) index (age (years) × aspartate aminotransferase (IU/L)/platelet count (10(9)/L) × square root of alanine aminotransferase (IU/L)) is expected to be useful for evaluating liver stiffness in patients with non-alcoholic fatty liver disease. We aimed to investigate the impact of the FIB4 index on HF prognosis, with consideration for liver fibrosis markers and underlying cardiac function...
2017: Open Heart
https://www.readbyqxmd.com/read/28674629/morbidity-outcomes-after-surgical-aortic-valve-replacement
#10
Andreas Auensen, Amjad Iqbal Hussain, Bjørn Bendz, Lars Aaberge, Ragnhild Sørum Falk, Marte Meyer Walle-Hansen, Jorun Bye, Johanna Andreassen, Jan Otto Beitnes, Kjell Arne Rein, Kjell Ingar Pettersen, Lars Gullestad
OBJECTIVE: In patients with mild to moderate operative risk, surgical aortic valve replacement (SAVR) is still the preferred treatment for patients with severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of postsurgical outcomes, this study reports a broad set of morbidity outcomes following surgical intervention. METHODS: Our cohort comprised 442 patients referred for severe AS; 351 had undergone SAVR, with the remainder (91) not operated on...
2017: Open Heart
https://www.readbyqxmd.com/read/28673705/reoperative-aortic-root-replacement-outcome-in-a-contemporary-series
#11
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Vinod H Thourani, Edward P Chen
OBJECTIVES: Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. METHODS: From 2006 to 2015, 280 consecutive patients at an academic center underwent reoperative aortic root replacement after a variety of previous aortic or cardiac operations...
June 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#12
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28668555/the-obesity-paradox-an-analysis-of-pre-procedure-weight-trajectory-on-survival-outcomes-in-patients-undergoing-transcatheter-aortic-valve-implantation
#13
Rodney De Palma, John Ivarsson, Kari Feldt, Nawzad Saleh, Andreas Ruck, Rikard Linder, Magnus Settergren
INTRODUCTION: Increased mortality has been observed in those with cardiovascular diseases who are of normal body mass index (BMI) compared to the overweight and the obese. A similar association has been demonstrated in patients undergoing transcatheter aortic valve (TAVI) implantation. However, it still remains unclear whether low or normal BMI itself is unfavourable or whether this is merely a reflection of cardiac cachexia due to severe aortic stenosis. The hypothesis for the study was that weight change prior to TAVI may be associated with increased mortality following the procedure...
June 28, 2017: Obesity Research & Clinical Practice
https://www.readbyqxmd.com/read/28652531/long-term-outcome-of-aortic-root-remodeling-for-patients-with-and-without-acute-aortic-dissection
#14
Takashi Kunihara, Niklas Neumann, Steffen Daniel Kriechbaum, Ryota Nomura, Hans-Joachim Schäfers
BACKGROUND: Valve-preserving aortic surgery is increasingly used in acute aortic dissection type A (AADA). The object of this study was to compare the long-term results of aortic root remodeling (remodeling) for patients with and without AADA.Methods and Results:Between October 1995 and December 2013, 776 patients underwent valve-preserving root replacement, of whom 59 patients with AADA (<2 weeks from onset, 56±16 years, 48 male) underwent remodeling (the remodeling-group); 7 patients had bicuspid anatomy (12%), 3 had Marfan syndrome (5%), and 1 had undergone previous cardiac surgery (2%)...
June 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28645241/long-term-outcome-after-right-ventricle-to-pulmonary-artery-conduit-surgery-and-reintervention
#15
Kristofer Skoglund, Gunnar Svensson, Ulf Thilén, Mikael Dellborg, Peter Eriksson
BACKGROUND: Reconstruction of the right ventricular outflow tract with a conduit is an established surgical procedure in congenital heart disease and reinterventions are common. OBJECTIVE: An increasing number of patients have a conduit, but there are few population-based studies of long-term outcomes after conduit surgery, reoperations, and transcatheter pulmonary valve replacement. METHODS: In April 2015, all adult patients with a conduit were identified in the Swedish National Registry for Congenital Heart Disease (SWEDCON)...
June 23, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#16
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28618423/long-term-clinical-outcomes-of-the-carpentier-edwards-perimount-pericardial-bioprosthesis-in-chinese-patients-with-single-or-multiple-valve-replacement-in-aortic-mitral-or-tricuspid-positions
#17
Huiming Guo, Cong Lu, Huanlei Huang, Bin Xie, Jian Liu, Shaoyi Zheng, Ruixin Fan, Jimei Chen, Jian Zhuang
OBJECTIVES: To report the safety and efficacy results of a 9- to 15-year follow-up investigation among patients who had received Carpentier-Edwards Perimount (CE-P) bovine pericardial bioprostheses (Edwards Lifesciences, Irvine, CA, USA) for valve replacement. METHODS: This retrospective study investigated freedom from structural valve deterioration (SVD) as well as survival and reoperation among different age and etiology groups in patients who were implanted with a CE-P bioprosthesis at Guangdong General Hospital between 2001 and 2007...
June 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28618323/a-systematic-review-of-trends-in-the-selective-exclusion-of-older-participant-from-randomised-clinical-trials
#18
REVIEW
Miriam Thake, Andrew Lowry
INTRODUCTION: The unjustified exclusion of older participants from clinical trials creates research populations that are non-representative, in turn creating difficulties applying research to the target populations. The aim of this study was to assess the proportion of randomised control trials (RCTs) that have unexplained upper age limits and review whether this proportion is reducing over time. METHODS: All RCTs in BMJ, Lancet, JAMA and NEJM from 1998 to 2015 were reviewed to identify any specified upper-age cut off and, if so, whether this exclusion criterion had an explanation in the text...
June 7, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28616273/mid-to-long-term-outcomes-of-bovine-jugular-vein-conduit-implantation-in-chinese-children
#19
Hui-Feng Zhang, Gang Chen, Ming Ye, Xian-Gang Yan, Qi-Lin Tao, Bing Jia
BACKGROUND: Bovine jugular vein (BJV) conduits are widely applied for surgical reconstruction of the right ventricular outflow tract (RVOT). However, relevant studies of valve failure rates and the related risk factors are limited in China. The aim of this study was to assess the BJV prognosis after medium- to long-term follow-up. METHODS: Fifty-three hospital patients implanted with BJV conduits from January 2002 to December 2013 were recruited. Patient information and follow-up prognosis were reviewed retrospectively...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28606890/how-to-plan-an-overlap-free-projection-on-cta-or-fluoroscopy-to-facilitate-quantitative-analysis
#20
Justin Teng, Vincent Nijenhuis, Martin Swaans, Gerald Yong, Carl Schultz
AIMS: Assessment of para-valvular aortic regurgitation remains challenging. Quantitative video-densitometry is an effective technique however overlap of the aorta and left ventricle (LV) limits feasibility. We aimed to develop and validate a method to determine an 'Overlap Free Projection' (OFP). METHODS AND RESULTS: 65 computed tomography scans of patients referred for transcatheter aortic valve implantation were analysed using 3D reconstruction to evaluate the OFP...
June 13, 2017: EuroIntervention
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