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Serviceable heart valves

Kaushik Guha, Christopher J Allen, Sumir Chawla, Hayley Pryse-Hawkins, Laura Fallon, Vicki Chambers, Ali Vazir, Alex R Lyon, Martin R Cowie, Rakesh Sharma
The National Institute for Health and Care Excellence (NICE) updated its guidelines for chronic heart failure (HF) in 2010. This re-audit assessed interim improvement as compared with an audit in 2011. Patients with HF (preserved and reduced ejection fraction) attending a tertiary cardiac centre over a 2-year period (January 2013-December 2014) were audited. The data collected included demographics, HF aetiology, medications, clinical parameters and cardiac rehabilitation. In total, 513 patients were audited...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Steven R Messé, Pooja Khatri, Mathew J Reeves, Eric E Smith, Jeffrey L Saver, Deepak L Bhatt, Maria V Grau-Sepulveda, Margueritte Cox, Eric D Peterson, Gregg C Fonarow, Lee H Schwamm
OBJECTIVE: To determine patient and hospital characteristics associated with not providing IV tissue plasminogen activator (tPA) to eligible patients with acute ischemic stroke (AIS) in clinical practice. METHODS: We performed a retrospective cohort study of patients with AIS arriving within 2 hours of onset to hospitals participating in Get With The Guidelines-Stroke without documented contraindications to IV tPA from April 2003 through December 2011, comparing those who received tPA to those who did not...
October 11, 2016: Neurology
Andreas Beckmann, Anne-Katrin Funkat, Jana Lewandowski, Michael Frie, Markus Ernst, Khosro Hekmat, Wolfgang Schiller, Jan F Gummert, Armin Welz
On the basis of a long-standing voluntary registry, which was founded by the German Society for Thoracic and Cardiovascular Surgery (GSTCVS), well-defined data of all heart, thoracic, and vascular surgery procedures performed in 78 German heart surgery departments during 2015 are analyzed. In 2015, a total of 103,967 heart surgery procedures (implantable cardioverter defibrillator, pacemaker, and extracardiac procedures without ECC excluded) were submitted to the database. Approximately 14.8% of the patients were at least 80 years old, resulting in an increase of 0...
September 2016: Thoracic and Cardiovascular Surgeon
Barış Ata Borsa, Mehmet Ersoy Aldağ, Birsen Tunalı, Uğur Dinç, Zeynep Güngördü Dalar, Veli Cengiz Özalp
The high prevalence of Bacillus species in nature and the detection of these bacteria as contaminant in cultures may lead diagnostic dilemma, however they should still be considered as a pathogen particularly in case of repeated positive cultures from patients with risk factors. Bacillus pumilus is a bacteria, though rarely, been reported as the causative agent of various infections such as sepsis, endocarditis, skin infections and food poisoning in human. In this report, a sepsis case in an immunocompetent patient caused by B...
July 2016: Mikrobiyoloji Bülteni
David Watkins, Solomon J Lubinga, Bongani Mayosi, Joseph B Babigumira
BACKGROUND: Rheumatic heart disease (RHD) prevalence and mortality rates remain especially high in many parts of Africa. While effective prevention and treatment exist, coverage rates of the various interventions are low. Little is known about the comparative cost-effectiveness of different RHD interventions in limited resource settings. We developed an economic evaluation tool to assist ministries of health in allocating resources and planning RHD control programs. METHODOLOGY/PRINCIPAL FINDINGS: We constructed a Markov model of the natural history of acute rheumatic fever (ARF) and RHD, taking transition probabilities and intervention effectiveness data from previously published studies and expert opinion...
August 2016: PLoS Neglected Tropical Diseases
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller
BACKGROUND: The mechanisms behind the association of atrial fibrillation (AF) and dementia are unknown. We previously found a significantly increased risk of dementia in AF patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which AF itself increases dementia risk, in addition to long-term anticoagulation exposure. METHODS AND RESULTS: A total of 10 537 patients anticoagulated with warfarin (target INR 2-3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included...
July 2016: Journal of the American Heart Association
Jean-Sébastien Palerme, Ashley E Jones, Jessica L Ward, Nandhakumar Balakrishnan, Keith E Linder, Edward B Breitschwerdt, Bruce W Keene
INTRODUCTION: To describe the clinical presentation, clinicopathological abnormalities and outcomes of a series of cats diagnosed with infective endocarditis (IE) at two tertiary care referral institutions. ANIMALS: Thirteen client-owned cats presenting to the cardiology or emergency services of tertiary referral institutions with a diagnosis of endocarditis based on the modified Duke criteria. MATERIALS AND METHODS: Retrospective case series...
September 2016: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
Sandra B Lauck, Jennifer A Gibson, Jennifer Baumbusch, Sandra L Carroll, Leslie Achtem, Gil Kimel, Cindy Nordquist, Anson Cheung, Robert H Boone, Jian Ye, David A Wood, John G Webb
PURPOSE OF REVIEW: Transcatheter aortic valve implantation (TAVI) is the recommended treatment for most patients with symptomatic aortic stenosis at high surgical risk. However, TAVI may be clinically futile for patients who have multiple comorbidities and excessive frailty. This group benefits from transition to palliative care to maximize quality of life, improve symptoms, and ensure continuity of health services. We discuss the clinical determination of utility and futility, explore the current evidence guiding the integration of palliative care in procedure-focused cardiac programs, and outline recommendations for TAVI programs...
March 2016: Current Opinion in Supportive and Palliative Care
Clovis Nkoke, Alain Menanga, Jerome Boombhi, David Chelo, Samuel Kingue
BACKGROUND: Acquired heart diseases (AHD) in children cause significant morbidity and mortality especially in low resource settings. There is limited description of acquired childhood heart diseases in Cameroon, making it difficult to estimate its current contribution to childhood morbidity and mortality. Echocardiography is the main diagnostic modality in low resource settings and has a key role in the characterization and management of these disorders. We aimed to determine the prevalence and spectrum of AHD in children in Yaoundé-Cameroon, in an era of echocardiography...
December 2015: Cardiovascular Diagnosis and Therapy
Gonzalo Latorre S, Josefina Almeida Z, Santiago Besa B, Samuel Córdova A, Ricardo Zalaquett S
BACKGROUND: The 2014 Guidelines for the Management of Patients with Valvular Heart Disease require to know the probability of success and operative mortality of Mitral Valve Repair (MVR) for Degenerative Mitral Insufficiency (DMI) at a given institution. AIM: To assess the probability of success, operative mortality and long-term results of MVR for DMI. PATIENTS AND METHODS: The database of the Cardiovascular Surgery Service was reviewed for the period December 1991 to December 2013...
October 2015: Revista Médica de Chile
N C Edwards, M Yuan, O Nolan, T A Pawade, T Oelofse, H Singh, H Mehrzad, Z Zia, J I Geh, D H Palmer, C J H May, J Ayuk, T Shah, S J Rooney, R P Steeds
CONTEXT: Carcinoid heart disease (NET-CHD) is associated with the development of symptom-limited exercise capacity and high rates of morbidity and mortality. OBJECTIVE: This study sought to determine the survival, cardiac function, and functional class following surgery. DESIGN AND SETTING, AND PATIENTS: This was a retrospective observational cohort study between 2005 and 2015 at a European Centre of Excellence for Neuroendocrine Tumours, Queen Elizabeth Hospital Birmingham...
January 2016: Journal of Clinical Endocrinology and Metabolism
Adrian Ionescu, Charlie McKenzie, John B Chambers
BACKGROUND: Valve disease is using up an important, growing proportion of the resources allocated for healthcare. Clinical care is often suboptimal and while multidisciplinary clinics are the 'gold standard', their adoption has been patchy and inhomogeneous. METHODS: We hypothesised that adoption of valve clinics can deliver financial savings and set out to estimate differences in cost between a standard model in which the cardiologist sees every case and a multidisciplinary model in which some cases are devolved to sonographer-led or nurse-led clinics, assuming usage of various tests in accordance with practice at our institutions and to published data...
2015: Open Heart
Zipu Yu, Shengjun Wu, Chengchen Li, Yu Zou, Liang Ma
OBJECTIVES: To validate ascending aorta-lower abdominal aorta bypass grafting treatment for patients with descending aortic coarctation and an aortic valve disease. METHODS: The three patients in whom a descending atypical aortic coarctation was associated with an aortic valve disease were treated with one stage surgical treatment with aortic bypass grafting through the diaphragm and aortic valve replacement in our heart center. Operative technique consisted of performing ascending aorta-lower abdominal aorta bypass grafting through diaphragm muscle and implementing aortic valve replacement...
2015: Journal of Cardiothoracic Surgery
Vinod H Thourani, Hanna A Jensen, Vasilis Babaliaros, Rakesh Suri, Sreekanth Vemulapalli, David Dai, J Matthew Brennan, John Rumsfeld, Fred Edwards, E Murat Tuzcu, Lars Svensson, Wilson Y Szeto, Howard Herrmann, Ajay J Kirtane, Susheel Kodali, David J Cohen, Stamatios Lerakis, Chandan Devireddy, Eric Sarin, John Carroll, David Holmes, Frederick L Grover, Mathew Williams, Hersh Maniar, David Shahian, Michael Mack
BACKGROUND: When transcatheter aortic valve replacement (TAVR) cannot be carried out through transfemoral access, alternative access TAVR is indicated. The purpose of this study was to explore inhospital and 1-year outcomes of patients undergoing alternative access TAVR through the transapical (TA) or transaortic (TAo) techniques in the United States. METHODS: Clinical records of 4,953 patients undergoing TA (n = 4,085) or TAo (n = 868) TAVR from 2011 to 2014 in The Society of Thoracic Surgeons (STS)/American College of Cardiology Transcatheter Valve Therapy Registry were linked to Centers for Medicare and Medicaid Services hospital claims...
November 2015: Annals of Thoracic Surgery
Pawana Sharma, Graham Scotland, Moira Cruickshank, Emma Tassie, Cynthia Fraser, Chris Burton, Bernard Croal, Craig R Ramsay, Miriam Brazzelli
BACKGROUND: Self-monitoring (self-testing and self-management) could be a valid option for oral anticoagulation therapy monitoring in the NHS, but current evidence on its clinical effectiveness or cost-effectiveness is limited. OBJECTIVES: We investigated the clinical effectiveness and cost-effectiveness of point-of-care coagulometers for the self-monitoring of coagulation status in people receiving long-term vitamin K antagonist therapy, compared with standard clinic monitoring...
June 2015: Health Technology Assessment: HTA
Madalina Garbi, John Chambers, Mani A Vannan, Patrizio Lancellotti
Valve stress echocardiography (VSE) is increasingly used both within specialist valve clinics and within dedicated VSE services, mandating practical guidance for referral, procedure, reporting, and clinical implementation of results. Therefore, a didactic VSE guide was compiled based on current European Society of Cardiology and American College of Cardiology/American Heart Association valve disease management guidelines, review of existing evidence, and the authors' extensive experience with VSE. The VSE indications were grouped into 3 categories: symptoms despite nonsevere valve disease, asymptomatic severe valve disease, and valve disease with reduced left ventricular systolic function...
June 2015: JACC. Cardiovascular Imaging
Andrew McLachlan, Tim Sutton, Patricia Ding, Andrew Kerr
BACKGROUND: Valvular heart disease is an important healthcare issue and its impacts are increasing. Following valve surgery, traditional models of care involve medical personnel, however, significant gaps in guideline adherence and delays in follow-up have been reported. Internationally, there is increasing evidence that specialist nurses can function in a variety of clinical settings and improve patient management. METHODS: In 2009, a nurse practitioner clinic to support patients following valve surgery was established...
November 2015: Heart, Lung & Circulation
Nguyenvu Nguyen, Anjali Sharathkumar
OBJECTIVE: This study investigated the clinician practices on perioperative anticoagulation in children with prosthetic mechanical heart valves who undergo elective surgeries. DESIGN: An online survey was administered to members of PediHeartNet. The survey consisted of multiple choice questions and clinical scenarios. OUTCOME MEASURES: The study described clinical practice patterns and variables that influence the clinicians' bridging anticoagulation decisions...
September 2015: Congenital Heart Disease
Eliane Roseli Winkelmann, Fernanda Dallazen, Angela Beerbaum Steinke Bronzatti, Juliara Cristina Werner Lorenzoni, Pollyana Windmöller
OBJECTIVE: To analyze a cardiac rehabilitation adapted protocol in physical therapy during the postoperative hospital phase of cardiac surgery in a service of high complexity, in aspects regarded to complications and mortality prevalence and hospitalization days. METHODS: This is an observational cross-sectional, retrospective and analytical study performed by investigating 99 patients who underwent cardiac surgery for coronary artery bypass graft, heart valve replacement or a combination of both...
January 2015: Revista Brasileira de Cirurgia Cardiovascular
P Choudhary, C Canniffe, D J Jackson, D Tanous, K Walsh, D S Celermajer
AIMS: Previous cohort studies of patients with coarctation of the aorta (CoA) demonstrate reduced long-term survival. Improved surgical outcomes in children and evolution of adult congenital heart disease (ACHD) services have resulted in improved survival in patients with other CHDs. We hypothesise that for young adult patients with CoA long-term outcomes have improved in the contemporary era. METHODS: 151 patients (58% men) with simple CoA followed up at a tertiary ACHD service in Sydney, Australia, from 1993 to 2013 were included...
August 2015: Heart: Official Journal of the British Cardiac Society
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