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https://www.readbyqxmd.com/read/28431442/-aortic-valve-stenosis-when-to-treat-interventionally-when%C3%A2-surgically
#1
Won-Keun Kim, Christian W Hamm
The mainstay for the current treatment of severe aortic stenosis includes surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). In patients with high operative risk TAVI is established as first line therapy. New data on intermediate and low risk groups demonstrate at least non-inferiority of TAVI against SAVR, and in the near future a consistently rising number of transcatheter procedures may be anticipated. The purpose of this review is to outline the decision making process, hence to illustrate the diagnostic algorithm and to provide criteria for a differentiated approach against the background of recent data...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28431214/interferon-%C3%AE-released-by-activated-cd8-t-lymphocytes-impairs-the-calcium-resorption-potential-of-osteoclasts-in-calcified-human-aortic-valves
#2
Edit Nagy, Yang Lei, Eduardo Martínez-Martínez, Simon C Body, Florian Schlotter, Michael Creager, Alexander Assmann, Kamal Khabbaz, Peter Libby, Göran K Hansson, Elena Aikawa
Calcium content in patients with calcific aortic valve disease (CAVD) correlates with the severity of stenosis. In CAVD, activated T lymphocytes localize with osteoclast regions; however, the functional consequences of this association remain unknown. We hypothesized that CD8(+) T cells modulate calcification in CAVD. Explanted CAVD valves (n = 52) dissected into noncalcified and calcified portions were subjected to mRNA extraction, real-time quantitative PCR, enzyme-linked immunosorbent assay, and immunohistochemical analyses...
April 18, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28431180/collagenosis-of-the-deep-medullary-veins-an-underrecognized-pathologic-correlate-of-white-matter-hyperintensities-and-periventricular-infarction
#3
Julia Keith, Fu-Qiang Gao, Raza Noor, Alex Kiss, Gayathiri Balasubramaniam, Kelvin Au, Ekaterina Rogaeva, Mario Masellis, Sandra E Black
White matter hyperintensities (WMH) are prevalent. Although arteriolar disease has been implicated in their pathogenesis, venous pathology warrants consideration. We investigated relationships of WMH with histologic venous, arteriolar and white matter abnormalities and correlated findings with premortem neuroimaging. Three regions of periventricular white matter were sampled from archived autopsy brains of 24 pathologically confirmed Alzheimer disease (AD) and 18 age-matched nonAD patients. Using trichrome staining, venous collagenosis (VC) of periventricular veins (<150 µm in diameter) was scored for severity of wall thickening and occlusion; percent stenosis by collagenosis of large caliber (>200 µm) veins (laVS) was measured...
April 1, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28431144/effect-of-body-mass-index-on-venous-sinus-pressures-in-idiopathic-intracranial-hypertension-patients-before-and-after-endovascular-stenting
#4
Daniel M S Raper, Dale Ding, Thomas J Buell, R Webster Crowley, Robert M Starke, Kenneth C Liu
BACKGROUND: Elevated body mass index (BMI) has been correlated with worse outcomes after treatment for idiopathic intracranial hypertension (IIH). Venous sinus stenting (VSS) has emerged as a safe and effective treatment for a subset of patients with IIH and evidence of venous sinus stenosis. However, the association between BMI and the efficacy of VSS remains poorly characterized. OBJECTIVE: To determine, in a retrospective cohort study, the effect of BMI on preoperative mean intracranial venous pressure (MVP) and post-VSS outcomes...
April 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#5
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28430541/a-comprehensive-approach-to-hepatic-vascular-disease
#6
Khaled M Elsayes, Akram M Shaaban, Sarah M Rothan, Sanaz Javadi, Beatrice L Madrazo, Rosa P Castillo, Victor J Casillas, Christine O Menias
The liver has a complex vascular supply, which involves the inflow of oxygenated blood through the hepatic artery (systemic circulation) and deoxygenated blood through the portal vein (portal circulation), as well as the outflow of deoxygenated blood through the hepatic veins to the inferior vena cava. A spectrum of vascular variants can involve the liver. Some of these variants may result in areas of enhancement that can mimic more serious pathologic conditions. In this article, the authors discuss a spectrum of variants and pathologic conditions that may involve the liver vasculature...
April 21, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28430317/treatment-of-central-venous-in-stent-restenosis-with-repeat-stent-deployment-in-hemodialysis-patients
#7
James Ronald, Bradley Davis, Carlos J Guevara, Waleska M Pabon-Ramos, Tony P Smith, Charles Y Kim
PURPOSE: To report patency rates for stent deployment for treatment of in-stent stenosis of the central veins of the chest in hemodialysis patients. MATERIALS AND METHODS: A retrospective analysis was performed on 29 patients who underwent 35 secondary percutaneous transluminal stent (PTS) deployments for in-stent stenosis within the central veins that were refractory to angioplasty and ipsilateral to a functioning hemodialysis access (in-stent PTS group). For comparison, patency data were acquired for 47 patients who underwent 78 successful percutaneous transluminal angioplasty (PTA) procedures for in-stent stenosis (in-stent PTA group) and 55 patients who underwent 55 stent deployments within native central vein stenosis refractory to angioplasty (native vein PTS group)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430315/adding-access-blood-flow-surveillance-reduces-thrombosis-and-improves-arteriovenous-fistula-patency-a-randomized-controlled-trial
#8
Inés Aragoncillo, Soraya Abad, Silvia Caldés, Yésika Amézquita, Almudena Vega, Antonio Cirugeda, Cristina Moratilla, José Ibeas, Ramón Roca-Tey, Cristina Fernández, Nicolás Macías, Borja Quiroga, Ana Blanco, Maite Villaverde, Caridad Ruiz, Belén Martín, Asunción M Ruiz, Jara Ampuero, Fernando de Alvaro, Juan M López-Gómez
PURPOSE: Stenosis is the main cause of arteriovenous fistula (AVF) failure. It is still unclear whether surveillance based on vascular access blood flow (QA) enhances AVF function and longevity. METHODS: We conducted a three-year follow-up randomized, controlled, multicenter, open-label trial to compare QA-based surveillance and pre-emptive repair of subclinical stenosis with standard monitoring/surveillance techniques in prevalent mature AVFs. AVFs were randomized to either the control group (surveillance based on classic alarm criteria; n = 104) or to the QA group (QA measured quarterly using Doppler ultrasound [M-Turbo®] and ultrasound dilution [Transonic®] added to classic surveillance; n = 103)...
April 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28430083/hydrocephalus-treatment-in-children-long-term-outcome-in-975-consecutive-patients
#9
Pierre-Aurelien Beuriat, Stephanie Puget, Giuseppe Cinalli, Thomas Blauwblomme, Kevin Beccaria, Michel Zerah, Christian Sainte-Rose
OBJECTIVE Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgical units. Endoscopic third ventriculostomy (ETV) has an advantage over ventriculoperitoneal shunting as it enables patients to remain device free. Multiple shunt devices with various valve designs exist, with no one valve proven to be superior to another. The aim of this study was to describe the management of hydrocephalus and its long-term outcome. METHODS The authors retrospectively reviewed the medical records of all patients who had been treated for hydrocephalus at the Hôpital Necker-Enfants Malades in the period from 1985 to 1995...
April 21, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28429704/case-images-huge-multicavitated-left-atrial-mass-mimicking-mitral-stenosis
#10
Sefa Ünal, Burak Açar, Ahmet Göktuğ Ertem, Çağrı Yayla, Omaç Tüfekçioğlu
No abstract text is available yet for this article.
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429698/coronary-microvascular-dysfunction-equivalent-to-left-main-coronary-artery-disease
#11
Cafer Panç, Mehmet Kocaağa, Onur Erdoğan, Remzi Sarıkaya, Sabahattin Umman
Coronary microvascular dysfunction, also known as cardiac syndrome X, is a clinical syndrome presenting with typical angina and evidence of myocardial ischemia in the absence of flow-limiting stenosis on coronary angiography. Of patients undergoing coronary angiography due to suspected myocardial ischemia, 50% are found to have normal or near-normal coronary arteries. Described in this case report is a patient who developed hypotension and ST segment depressions during treadmill exercise test. Left main coronary artery or multivessel disease was suspected...
April 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28429599/lipoprotein-associated-phospholipase-a2-and-risk-of-carotid-atherosclerosis-and-cardiovascular-events-in-community-based-older-adults-in-china
#12
Chunxiu Wang, Xianghua Fang, Yang Hua, Yutong Liu, Zhongying Zhang, Xiang Gu, Xiaoguang Wu, Zhe Tang, Shaochen Guan, Hongjun Liu, Beibei Liu, Xiuhai Guo, Xunming Ji
We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#13
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28429278/-trans-hepatico-cystic-coledochostomy-for-the-opening-hydatid-cyst-in-the-biliary-tract-indications-and-outcome-evaluation-of-25-cases
#14
S Daldoul, G H El Kebir, I Messoudi, A Mabrouk, M Tahar Bouzidi, M Ben Moussa
The treatment of hydatid cysts of the liver opened in the bile ducts is sometimes difficult and complex. The trans-hepaticocystic coledochostomy (CTHK) is one of these processes. We conducted a review of the indications for this surgical procedure and its perioperative outcomes through a series of 25 patients and then we analyzed predictor factors of complications. During the period's study, 909 patients with liver hydatid cyst went under the surgery. Ninety two (92, i.e. 10.1%) of them had an opening in the bile ducts through a large fistula...
April 20, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28429135/clinical-characteristics-of-patients-with-suspected-cardiac-chest-pain-and-angiographically-normal-coronary-arteries-in-a%C3%A2-secondary-care-hospital
#15
T S de Lange, R Y G Tijssen, P Damman, P F M M van Bergen
BACKGROUND: An important number of patients with suspected cardiac chest pain have non-obstructive coronary artery disease. Our purpose was to describe the clinical characteristics of patients with normal or near-normal coronary arteries in routine cardiological practice in a secondary care hospital. METHODS: In 2013, consecutive patients referred for invasive coronary angiography with suspected cardiac chest pain were analysed at a single-centre (Westfriesgasthuis, Hoorn, the Netherlands)...
April 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28428693/the-association-between-small-dense-low-density-lipoprotein-and-coronary-artery-disease-in-north-indian-patients
#16
Pravin K Goel, Fauzia Ashfaq, Roopali Khanna, V Ramesh, Chandra Mohan Pandey
Pathogenesis of coronary artery disease (CAD) is multi-factorial and several conventional risk factors have been ascribed; LDL-C being one of the important risk factor. However Indian population studies with established CAD often show LDL levels within normal range in patients with proven CAD. We hypothesized that Small dense low density lipoprotein (sdLDL) being more atherogenic might correlate more strongly to the occurrence and severity of CAD. The aim of the study was to evaluate the association between serum small dense LDL level and angiographically documented coronary artery disease...
June 2017: Indian Journal of Clinical Biochemistry: IJCB
https://www.readbyqxmd.com/read/28428518/-a-case-of-malignant-lymphoma-of-the-jejunum-that-developed-stenosis-and-perforation-after-a-complete-response-to-chemotherapy
#17
Atsushi Sugimoto, Masaharu Tada, Tomoe Taji, Yudai Houjo, Yu Kanokogi, Masaaki Hirata, Yusuke Fujita, Yusuke Kawasaki, Takashi Sakamoto, Junichi Yoshikawa, Hideaki Iwama, Shinichiro Usuki, Yoshiharu Shirakata, Jun Tamura, Atsuhiko Maki
A 57-year-old woman was admitted owing to epigastric pain.Abdominal computed tomography demonstrated a tumor in the origin of the jejunum.After an endoscopic biopsy, we diagnosed diffuse large B-cell lymphoma.We treated her with CHOP chemotherapy because pancreaticoduodenectomy is highly invasive.After 1 course of chemotherapy, the tumor was reduced.However, she developed a jejunal stenosis; therefore, we performed laparoscopic gastrojejunostomy.Furthermore, she developed perforated peritonitis on the sixth day after the surgery, and therefore, an emergency partial jejunum resection was performed...
April 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28428080/the-effect-of-preoperative-lumbar-epidural-corticosteroid-injection-on-post-operative-infection-rate-in-patients-undergoing-single-level-lumbar-decompression
#18
Jonathan G Seavey, George C Balazs, Theodore Steelman, Melvin Helgeson, David E Gwinn, Scott C Wagner
BACKGROUND CONTEXT: Lumbar epidural corticosteroid injections (LECI) are frequently used in the treatment of lumbar intervertebral disc herniation with radiculopathy and lumbar spinal stenosis. Although widely utilized, their effect on the outcomes and complications of subsequent surgery is unclear. Post-operative infection can be a morbid complication following spine surgery, and recent literature has suggested that the risk may be increased in patients undergoing lumbar spinal surgery who had previously received LECI...
April 17, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28427985/ureter-injury-as-a-complication-of-oblique-lumbar-interbody-fusion-a-case-report
#19
Hyeong-Jin Lee, Jin-Sung Kim, Kyeong-Sik Ryu, Choon Keun Park
BACKGROUND: Oblique lumbar interbody fusion is a commonly used surgical method of achieving lumbar interbody fusion. There have been some reports about complications of oblique lumbar interbody fusion at the L2-3 level. But to our knowledge, there have been no reports about ureter injury during oblique lumbar interbody fusion. We report a case of ureter injury during oblique lumbar interbody fusion to share our experience. CASE DESCRIPTION: A 78-year-old male patient presented with a history of lower back pain and neurogenic intermittent claudication...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427972/endovascular-treatment-of-complex-distal-posterior-cerebral-artery-aneurysms-with-the-pipeline-embolization-device
#20
Paul Mazaris, Tapan Mehta, Mohammed Hussain, Violiza Inoa, Justin Singer, Gary Spiegel, Inam Kureshi, Martin Ollenschleger
INTRODUCTION: The purpose of our study is to assess the safety and efficacy of the Pipeline Embolization Device (PED) for endovascular treatment of complex, distal posterior cerebral artery (PCA) aneurysms. METHODS: We conducted a retrospective review of patients who underwent endovascular treatment of complex PCA aneurysms with PED from November 2012 to December 2015. A total of 4 patients were identified and treated. 12 month angiographic and clinical follow-up was available for all patients...
April 17, 2017: World Neurosurgery
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