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https://www.readbyqxmd.com/read/28805039/unnatural-milieu-thrombus-after-transcatheter-mitral-valve-replacement
#1
EDITORIAL
Jaffar M Khan, Robert J Lederman
What the article teaches Transcatheter heart valve thrombosis in the mitral position causes increased valve gradients, valve dysfunction, and symptoms, and may be associated with lack of therapeutic anticoagulation. How it will impact practice Anticoagulation with a vitamin K antagonist should be considered in all patients undergoing transcatheter mitral valve replacement. What new research/study would help answer the question posed Efficacy, optimal duration, and safety of anticoagulation therapy, balancing reduced thrombosis against increased bleeding risk, needs to be assessed in larger cohort studies and prospective trials...
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28804824/laboratory-testing-for-activated-protein-c-resistance-apcr
#2
Soma Mohammed, Emmanuel J Favaloro
Activated protein C resistance (APCR) describes a hemostatic disorder characterized by a poor anticoagulant response to activated protein C (APC). This results in an increased risk of venous thrombosis, including deep vein thrombosis and pulmonary embolism. Protein C is a natural anticoagulant that is synthesized in the liver and is activated to APC via proteolysis. APC then degrades Factors Va and VIIIa. APCR describes the reduced inability of APC to cleave Factors Va and VIIIa, which therefore promotes increased thrombin generation and potentially leads to a prothrombotic state...
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/28799521/transcatheter-mitral-valve-replacement-long-term-outcomes-of-first-in-man-experience-with-an-apically-tethered-device-a-case-series-from-a-single-centre
#3
Alison Duncan, Anan Daqa, James Yeh, Simon Davies, Anselm Uebing, Cesare Quarto, Neil Moat
AIMS: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/2-year outcomes of the 5 first-in-man patients undergoing chronic TMVR with the Tendyne device. METHODS AND RESULTS: Five patients (STS score 14%-23%) underwent TMVR using a Tendyne system under compassionate use at a single centre. 1 patient (who was noncompliant with anti-coagulation) died 9 months after TMVR following a cerebrovascular accident...
August 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28796273/role-of-replacement-therapy-in-the-evaluation-of-thrombosis-occurring-in-congenital-bleeding-conditions
#4
Antonio Girolami, Silvia Ferrari, Elisabetta Cosi, Bruno Girolami
No abstract text is available yet for this article.
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28795676/-design-and-application-of-medical-electric-leg-raising-machine
#5
Jintang Liang, Jinyuan Chen, Zixian Zhao, Jinfeng Lin, Juanhong Li, Jingliang Zhong
Passive leg raising is widely used in clinic, but it lacks of specialized mechanical raise equipment. It requires medical staff to raise leg by hand or requires a multi-functional bed to raise leg, which takes time and effort. Therefore we have developed a new medical electric leg-raising machine. The equipment has the following characteristics: simple structure, stable performance, easy operation, fast and effective, safe and comfortable. The height range of the lifter is 50-120 cm, the range of the angle of raising leg is 10degree angle-80degree angle, the maximum supporting weight is 40 kg...
August 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28777390/thrombosis-in-left-ventricular-assistance-device-with-centrifugal-technology-is-early-thrombolysis-a-better-solution
#6
Paolo Centofanti, Andrea Baronetto, Matteo Attisani, Davide Ricci, Erika Simonato, Michele W La Torre, Massimo Boffini, Mauro Rinaldi
BACKGROUND: Continuous flow left ventricular assistance devices (CF-LVADs) have revolutionized the treatment of advanced heart failure. Pump replacement for thrombosis is a high-risk procedure with a high perioperative mortality rate with possible recurrence. We aim to summarize our experience using a conservative approach with medical therapy. METHODS: We retrospectively reviewed records of patients who experienced pump thrombosis after LVAD implantation with HeartWare HVAD at our institution, from November 2010 to March 2016...
July 27, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28765007/combined-intravenous-topical-and-oral-tranexamic-acid-administration-in-total-knee-replacement-evaluation-of-safety-in-patients-with-previous-thromboembolism-and-effect-on-hemoglobin-level-and-transfusion-rate
#7
Joris A Jansen, Joost R C Lameijer, Barbara A M Snoeker
BACKGROUND: The aims of this study were to investigate the safety of combined intravenous, oral and topical tranexamic acid (TXA) in primary total knee replacement. We assessed dose-related efficacy on hemoglobin level, transfusion, length of stay and thromboembolic complications. In addition, TXA safety in patients with previous history of thromboembolism >12months ago was monitored specifically. METHODS: From January 2013 until January 2016, 922 patients were included who received TXA after primary total knee replacement...
July 29, 2017: Knee
https://www.readbyqxmd.com/read/28756546/thromboprophylaxis-with-enoxaparin-and-direct-oral-anticoagulants-in-major-orthopedic-surgery-and-acutely-ill-medical-patients-a-meta-analysis
#8
Claudio Cimminiello, Paolo Prandoni, Giancarlo Agnelli, Giovanni Di Minno, Hernan Polo Friz, Francesco Scaglione, Patrizia Boracchi, Giuseppe Marano, Job Harenberg
Subjects undergoing major orthopedic surgery and acutely ill hospitalized medical patients represent a population at medium-high risk for venous thromboembolism (VTE). They are treated with low molecular weight heparin (LMWH) and direct oral anticoagulants [DOACs] for VTE prevention. We conducted a meta-analysis of phase III randomized clinical trials evaluating LMWH enoxaparin versus DOACs for prophylaxis of VTE by combining studies including patients undergoing elective total hip and knee replacement surgery, and acutely ill hospitalized medical subjects...
July 29, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28747619/comparison-of-commercially-available-blood-collection-tubes-containing-sodium-citrate-and-hirudin-in-platelet-aggregation-testing
#9
Walter J Janse van Rensburg, Patricia van der Merwe
BACKGROUND Platelet reactivity assessment is an important tool in both the causal determination of bleeding diathesis as well as in the evaluation of the efficacy of anti-platelet therapy in patients at risk of thrombosis. Sodium citrate is the most widely used anticoagulant for hemostasis investigations. However, some doubt exists over the suitability of sodium citrate in platelet function testing. Hirudin has been suggested as a superior replacement. Nevertheless, only 1 study compared citrated and hirudin treated samples with light transmission aggregometry...
July 27, 2017: Medical Science Monitor Basic Research
https://www.readbyqxmd.com/read/28740586/mechanical-valve-thrombosis-on-rivaroxaban-are-novel-anticoagulants-really-an-option
#10
Vishesh Kumar, Shawn Kelly, Amol Raizada, Jimmy Yee, Amornpol Anuwatworn, Adam Stys, Maria Stys
This is a case of a 54-year-old female with a history of mechanical aortic valve replacement who presented in cardiogenic shock. Her primary care provider started her on rivaroxaban for anticoagulation therapy. An urgent transesophageal echocardiogram revealed a significant gradient and thrombosis on one leaflet of the valve that was immobile. Given that she was not a surgical candidate, she underwent thrombolysis. However, she later died due to complications from the thrombotic valve. The utility of target-specific oral anticoagulants has yet to be established in clinical practice...
April 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28725275/ash-meeting-2016-developments-in-hemostaseology
#11
REVIEW
Clemens Feistritzer, Birgit Mosheimer
During the annual meeting of the American Society of Hematology (ASH) in San Diego/California, novel developments in the field of hemostaseology were presented. Alternative treatment strategies besides factor replacement were discussed for patients with hemophilia. One of the highlights of the meeting in this year's plenary session was the presentation of successful adeno-associated virus mediated gene transfer in patients with hemophilia B leading to sustained elevation of factor IX:C (FIX:c). Other alternative treatment approaches in patients with hemophilia A may include bispecific antibodies mimicking factor VIIIa (FVIIIa) activity or disrupting anticoagulant proteins...
2017: Memo
https://www.readbyqxmd.com/read/28724752/the-fluid-mechanics-of-transcatheter-heart-valve-leaflet-thrombosis-in-the-neo-sinus
#12
Prem A Midha, Vrishank Raghav, Rahul Sharma, Jose F Condado, Ikechukwu U Okafor, Tanya Rami, Gautam Kumar, Vinod H Thourani, Hasan Jilaihawi, Vasilis Babaliaros, Raj R Makkar, Ajit P Yoganathan
Background -Transcatheter heart valve (THV) thrombosis has been increasingly reported. In these studies, thrombus quantification has been based on 2D assessment of a 3D phenomenon. Methods -Post-procedural four-dimensional, volume-rendered CT (4DCT) data of CoreValve, Evolut R, and SAPIEN 3 transcatheter aortic valve replacement (TAVR) patients enrolled in the RESOLVE trial were included in this analysis. Patients on anticoagulation were excluded. SAPIEN 3 and CoreValve/Evolut R patients with and without hypo-attenuated leaflet thickening (HALT) were included in order to study differences between groups...
July 19, 2017: Circulation
https://www.readbyqxmd.com/read/28704111/incomplete-dabigatran-reversal-with-idarucizumab
#13
Aaron P Steele, Jin A Lee, William E Dager
CONTEXT: With increasing use of direct oral anticoagulants (DOACs), urgent reversal of these agents becomes a growing concern. Idarucizumab is a humanized monoclonal antibody fragment that specifically binds to dabigatran with higher affinity than thrombin, rapidly neutralizing its anticoagulant effect without increased risk of thrombosis. CASE DETAILS: We describe two cases in which the recommended dose of idarucizumab was unsuccessful in completely reversing the anticoagulant effects of dabigatran...
July 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#14
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28697893/mechanical-valves-in-the-pulmonary-position-an-international-retrospective-analysis
#15
Hanna Pragt, Joost P van Melle, Hoda Javadikasgari, Dong Man Seo, John M Stulak, Igor Knez, Jürgen Hörer, Christian Muñoz-Guijosa, Mahyar G Dehaki, Hong Ju Shin, Joseph A Dearani, Maziar G Dehaki, Petronella G Pieper, Christine Eulenburg, Laura Dos, Tjark Ebels
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014...
May 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28689963/development-of-expanded-polytetrafluoroethylene-cardiovascular-graft-platform-based-on-immobilization-of-poly-lactic-co-glycolic-acid-nanoparticles-using-a-wet-chemical-modification-technique
#16
Bassam M Al Meslmani, Gihan F Mahmoud, Udo Bakowsky
Expanded polytetrafluoroethylene ePTFE grafts are mostly employed to replace damaged blood vessels and to restore normal blood flow. However, the dilemma of early thrombosis, inflammation, and development of biofilms after implantation limit ePTFE long-term patency and restrict the patient's life quality. In this study, poly lactic-co-glycolic acid (PLGA) nanoparticles were covalently immobilized on ePTFE surface for local therapeutic purposes. First, the ePTFE surface was primarily oxidized by H2O2/H2SO4 solution to create hydroxyl groups...
July 6, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28685204/time-course-of-the-antiplatelet-effect-after-switching-to-clopidogrel-from-initial-prasugrel-therapy-in-patients-with-acute-coronary-syndrome
#17
Erito Furuse, Hitoshi Takano, Takeshi Yamamoto, Yoshiaki Kubota, Takashi Yoshizane, Mitsunobu Kitamura, Hideki Miyachi, Yusuke Hosokawa, Wataru Shimizu
Prasugrel is often replaced with clopidogrel after a certain period of time following coronary stenting. However, the time course of platelet aggregation during this replacement is unknown. We performed a prospective, single-arm study to monitor platelet reactivity before and after the replacement. Forty-five patients (mean age 62.6 ± 13 years, 40 male) who received coronary stenting for acute coronary syndrome were initially treated with the loading dose (20 mg) of prasugrel followed by the maintenance dose (3...
July 6, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28684004/tavr-vs-savr-rising-expectations-and-changing-indications-for-surgery-in-response-to-partner-ii
#18
Cristiano Spadaccio, Francesco Nappi, Jean-Louis Sablayrolles, Fraser W H Sutherland
Despite the criticisms and concerns raised on the data published in the PARTNER II trial and related analyses, we are undeniably witnessing a revolution in the management of aortic valve disease, in which conventional full sternotomy surgical aortic valve replacement (SAVR), with all related complications and clinical burden, will soon become a nonviable option. Several of the findings described in the PARTNER II trial, although considerable as points of incongruence and study biases in comparison with SAVR, could be taken as lessons to found a new course in SAVR and redesign the respective roles of surgery and interventional procedures in aortic disease...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28680011/bioresorbable-vascular-scaffolds%C3%A3-are-we-facing-a-time-of-crisis-or-one-of-breakthrough
#19
Jeehoon Kang, Jung-Kyu Han, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim
Current 2nd-generation drug-eluting stents (DES) have dramatically improved clinical outcomes after percutaneous coronary intervention for coronary artery disease. However, DES implantation has major long-term limitations related to the permanent presence of foreign material in the coronary artery. Bioresorbable vascular scaffolds (BVS) were designed to overcome this limitation of permanent metal-based DES. However, because of immature manufacturing technology, BVS have several drawbacks, such as the thicker strut, poor deliverability, poor radio-opacity, poor radial strength, and cumbersome procedure to meet the principle of PSP (Preparation, Sizing, and Post-dilatation)...
July 6, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28678604/a-post-marketing-assessment-of-major-bleeding-in-total-hip-and-total-knee-replacement-surgery-patients-receiving-rivaroxaban
#20
Louis M Kwong, Alexander G G Turpie, Capt Sally Tamayo, W Frank Peacock, Zhong Yuan, Nicholas Sicignano, Kathleen Pillsbury Hopf, Manesh Patel
BACKGROUND: Rivaroxaban is a novel oral anticoagulant indicated for prophylaxis against deep vein thrombosis and pulmonary embolism in patients undergoing total hip replacement (THR) or total knee replacement (TKR) surgery. OBJECTIVE: To evaluate major bleeding (MB) in THR/TKR patients receiving post-operative rivaroxaban. METHODS: Electronic medical records of nearly 10 million U.S. Department of Defense (DoD) beneficiaries were queried from January 1, 2013 through June 30, 2015...
July 5, 2017: Current Medical Research and Opinion
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