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Valve replacement status

Muhammet Onur Hanedan, Mehmet Ali Yuruk, Ali Ihsan Parlar, Ugur Ziyrek, Ali Kemal Arslan, Ufuk Sayar, Ilker Mataraci
In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32)...
February 2018: Texas Heart Institute Journal
Simone A Huygens, Lucas M A Goossens, Judith A van Erkelens, Johanna J M Takkenberg, Maureen P M H Rutten-van Mölken
Objective: In the era of limited healthcare budgets, healthcare costs of heart valve implantations need to be considered to inform cost-effectiveness analyses. We aimed to provide age group-specific costs estimates of heart valve implantations, related complications and other healthcare utilisation following the intervention. Methods: We performed retrospective analyses of healthcare costs of patients who had undergone heart valve implantations in 2010-2013 and controls using claims data from Dutch health insurers...
2018: Open Heart
Robert B Hawkins, J Hunter Mehaffey, Eric J Charles, John A Kern, D Scott Lim, Nicholas R Teman, Gorav Ailawadi
BACKGROUND: Frailty is an important predictor of outcomes after cardiac surgery, but utility is limited by difficult assessment and quantification. We hypothesize that sarcopenia defined as psoas muscle cross-sectional area is a useful predictor of surgical aortic valve replacement (SAVR) outcomes in moderate to high-risk patients. METHODS: Moderate to high-risk (predicted risk of mortality [PROM] >3%) patients who underwent SAVR with or without coronary bypass were extracted from an institutional database (2009-2016)...
March 9, 2018: Annals of Thoracic Surgery
María Elena Arnáiz-García, Jose María González-Santos, Javier López-Rodríguez, Ana María Arnáiz-García, Javier Arnáiz
Postoperative bleeding with its important socioeconomic cost is associated with an increased morbidity and mortality. It causes hemodynamic instability, increases blood loss, and multiplies the number of transfusions required. Especially in vascular or aortic surgery, postoperative bleeding can become a life-threatening complication due to anticoagulant or antiaggregation preoperative status or postoperative coagulation dysfunction after a high level of heparinization. Presently described is the case of a patient who underwent an aortic valve and ascending aorta replacement...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Edyta Wernio, Dariusz Jagielak, Jolanta Anna Dardzińska, Ewa Aleksandrowicz-Wrona, Jan Rogowski, Agnieszka Gruszecka, Sylwia Małgorzewicz
Severe aortic stenosis (AS) is associated with the reduction of muscle mass and may be associated with deterioration of nutritional status. Furthermore, malnourished cardiac patients are characterized by a higher risk of postoperative complications and mortality. The aim of this study was the evaluation and comparison of nutritional status, appetite and body composition in older people with severe aortic stenosis before aortic valve replacement and healthy elderly volunteers. One hundred and one patients, aged >65 years old with severe AS were included in the study...
March 5, 2018: Nutrients
Anat Berkovitch, Victor Guetta, Israel M Barbash, Noam Fink, Ehud Regev, Elad Maor, Yotam Vered, Yoni Grossman, Arwa Younis, Rafael Kuperstein, Micha Feinberg, Elad Asher, Amit Segev, Paul Fefer
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is now the treatment of choice for high-surgical risk patients with symptomatic aortic stenosis. Little is known regarding the outcome of TAVR in patients with previous malignancy. METHODS: We investigated 477 patients who underwent TAVR in a tertiary medical center. Subjects were divided into two groups according to malignancy status: no history of malignancy (n = 386) and positive history of malignancy (n = 91)...
March 2018: Journal of Invasive Cardiology
Jawad Salman, Felix Fleißner, Jamshid Naqizadah, Murat Avsar, Malakh Shrestha, Gregor Warnecke, Issam Ismail, Stefan Rümke, Serghei Cebotari, Axel Haverich, Igor Tudorache
BACKGROUND:  Minimally invasive mitral valve surgery (MIMVS) is superior to "classical" mitral valve surgery via a sternotomy regarding wound healing and postoperative pain. It is however a more challenging procedure. Patients' preference is leading clearly toward minimally invasive approaches, and surgeons are driven by upcoming new technologies in interventional procedures such as the MitraClip. Especially in re-do cases, the access via right mini-thoracotomy, as previously non-operated situs, is a possible advantage over a re-sternotomy...
February 28, 2018: Thoracic and Cardiovascular Surgeon
Johan Ljungberg, Mikael Janiec, Ingvar A Bergdahl, Anders Holmgren, Johan Hultdin, Bengt Johansson, Ulf Näslund, Agneta Siegbahn, Tove Fall, Stefan Söderberg
Background -Aortic valve stenosis (AS) is the most common indication for cardiac valve surgery; untreated AS is linked to high mortality. The aetiological background of AS is unknown. Previous human studies were typically based on case-control studies. Biomarkers identified in prospective studies could lead to novel mechanistic insights. Methods -Within a large population survey with blood samples obtained at baseline, 334 patients were identified that later underwent surgery for AS (median age (interquartile range) 59...
February 27, 2018: Circulation
Zhen Meng, Er-Li Zhang, Yong-Jian Wu
No abstract text is available yet for this article.
March 5, 2018: Chinese Medical Journal
Nicholas S Clarke, Howaida El-Said, John J Lamberti, Raghav A Murthy
Percutaneous therapies for congenital heart disease have been evolving rapidly despite limited investment from industry. The Melody transcatheter pulmonary valve (Medtronic, Inc, Minneapolis, MN USA) replacement therapy represents an important advancement in this arena. It has been approved in the United States for use in the pulmonary position, on a Humanitarian Device Exemption status. Off-label use of the Melody transcatheter pulmonary valve has extended to the mitral, pulmonary, and aortic valves, especially in previously implanted valves with prosthetic valve degeneration...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Damien J LaPar, Donald S Likosky, Min Zhang, Patty Theurer, C Edwin Fonner, John A Kern, Stephen F Bolling, Daniel H Drake, Alan M Speir, Jeffrey B Rich, Irving L Kron, Richard L Prager, Gorav Ailawadi
BACKGROUND: While tricuspid valve (TV) operations remain associated with high mortality (∼8-10%), no robust prediction models exist to support clinical decision-making. We developed a preoperative clinical risk model with an easily calculable clinical risk score (CRS) to predict mortality and major morbidity after isolated TV surgery. METHODS: Multi-state Society of Thoracic Surgeons database records were evaluated for 2,050 isolated TV repair and replacement operations for any etiology performed at 50 hospitals (2002-2014)...
February 1, 2018: Annals of Thoracic Surgery
Yuki Obayashi, Chisato Izumi, Yoshihisa Nakagawa
CLINICAL INTRODUCTION: A man in his 50s with sudden-onset chest pain and dyspnoea was transferred to the emergency room. He had a history of aortic valve replacement due to aortic regurgitation with a mechanical valve 6 years previously. Heart rate was 90 bpm, and blood pressure was too low to measure. In the emergency room, he presented with severe dyspnoea and a chest X-ray showed severe lung congestion (figure 1A). ECG showed complete left bundle branch block. His respiratory status rapidly worsened, and he went into cardiopulmonary arrest...
January 30, 2018: Heart: Official Journal of the British Cardiac Society
Nicola Straiton, Kai Jin, Ravinay Bhindi, Robyn Gallagher
Background: transcatheter aortic valve replacement (TAVR) provides prognostic benefit for high surgical-risk patients with severe aortic stenosis (AS), yet the impact to patient outcomes is far less understood. Method: we performed a systematic review and meta-analysis to evaluate functional capacity and health-related quality of life (HRQoL) outcomes for patients up to 12 months post TAVR. A total of 20 eligible publications, comprising randomised-controlled trials, observational studies and a registry study were identified from electronic databases, including MEDLINE, EMBASE, Cochrane Library and others (inception to February 2017)...
January 25, 2018: Age and Ageing
Monica Dobrovie, Ricardo A Spampinato, Elena Efimova, Jaqueline G da Rocha E Silva, Julia Fischer, Michael Kuehl, Jens-Uwe Voigt, Ann Belmans, Agnieszka Ciarka, Fernanda Bonamigo Thome, Valerie Schloma, Yaroslava Dmitrieva, Sven Lehmann, Jochen Hahn, Elfriede Strotdrees, Friedrich-Wilhelm Mohr, Jens Garbade, Anna L Meyer
OBJECTIVES: This study evaluates the impact of untreated preoperative severe mitral valve regurgitation (MR) on outcomes after left ventricular assist device (LVAD) implantation. METHODS: Of the 234 patients who received LVAD therapy in our centre during a 6-year period, we selected those who had echocardiographic images of good quality and excluded those who underwent mitral valve replacement prior to or mitral valve repair during LVAD placement. The 128 patients selected were divided into 2 groups: Group A with severe MR (n = 65) and Group B with none to moderate MR (n = 63, 28 with moderate MR)...
January 16, 2018: European Journal of Cardio-thoracic Surgery
Sammy Elmariah, Laurie A Farrell, Deborah Furman, Brian R Lindman, Xu Shi, Jordan E Morningstar, Eugene P Rhee, Robert E Gerszten
Importance: Clinical practice guidelines currently endorse a reliance on clinical symptoms of overt left ventricular (LV) failure to time aortic valve replacement for severe aortic stenosis; however, delayed aortic valve replacement can result in irreversible LV injury and adverse outcomes. Blood metabolomic signatures possess prognostic value in heart failure; this study assesses whether they are informative in aortic stenosis. Objective: To evaluate the value of metabolomic signatures in reflecting the extent of maladaptive LV remodeling in patients with end-stage aortic stenosis undergoing transcatheter aortic valve replacement, and to assess whether this procedure reverses metabolomic aberrations...
January 3, 2018: JAMA Cardiology
Mani Arsalan, Samir Khan, Jake Golman, Molly Szerlip, Cecile Mahoney, Morley Herbert, David Brown, Michael Mack, Elizabeth M Holper
OBJECTIVES: Evaluate the role of balloon aortic valvuloplasty (BAV) in improving candidacy of patients for transcatheter aortic valve replacement (TAVR). BACKGROUND: Patients who are not candidates for TAVR may undergo BAV to improve functional and clinical status. METHODS: 117 inoperable or high-risk patients with critical aortic stenosis underwent BAV as a bridge-to-decision for TAVR. Frailty measures including gait speed, serum albumin, hand grip, activities of daily living (ADL); and NYHA functional class before and after BAV were compared...
December 28, 2017: Journal of Interventional Cardiology
Etienne Puymirat, Romain Didier, Hélène Eltchaninoff, Bernard Lung, Jean-Philippe Collet, Dominique Himbert, Eric Durand, Alain Leguerrier, Pascal Leprince, Jean Fajadet, Emmanuel Teiger, Karine Chevreul, Michel Lièvre, Didier Tchetché, Florence Leclercq, Stéphan Chassaing, Hervé Le Breton, Patrick Donzeau-Gouge, Thierry Lefèvre, Didier Carrié, Martine Gillard, Didier Blanchard
BACKGROUND: Coronary artery disease (CAD) is common in patients undergoing transcatheter aortic valve replacement (TAVR). However, the impact of CAD distribution before TAVR on short- and long-term prognosis remains unclear. HYPOTHESIS: We hypothesized that the long-term clinical impact differs according to CAD distribution in patients undergoing TAVR using the FRench Aortic National CoreValve and Edwards (FRANCE-2) registry. METHODS: FRANCE-2 is a national French registry including all consecutive TAVR performed between 2010 and 2012 in 34 centers...
December 16, 2017: Clinical Cardiology
Suzanne J Baron, Suzanne V Arnold, Matthew R Reynolds, Kaijun Wang, Michael Deeb, Michael J Reardon, James Hermiller, Steven J Yakubov, David H Adams, Jeffrey J Popma, David J Cohen
BACKGROUND: For patients with severe aortic stenosis (AS) at extreme surgical risk, transcatheter aortic valve replacement (TAVR) leads to improved survival and health status when compared with medical therapy. Whether the early health status benefits of TAVR in these patients are sustained beyond 1 year of follow-up is unknown. METHODS AND RESULTS: Six hundred thirty-nine patients with severe AS at extreme surgical risk underwent TAVR in the CoreValve US Extreme Risk Pivotal trial...
December 2017: American Heart Journal
Sammy Elmariah, William F Fearon, Ignacio Inglessis, Gus J Vlahakes, Brian R Lindman, Maria C Alu, Aaron Crowley, Susheel Kodali, Martin B Leon, Lars Svensson, Philippe Pibarot, Rebecca T Hahn, Vinod H Thourani, Igor F Palacios, D Craig Miller, Pamela S Douglas, Jonathan J Passeri
OBJECTIVES: The authors sought to evaluate the impact of transapical (TA) transcatheter aortic valve replacement (TAVR) on mortality, left ventricular (LV) ejection fraction (LVEF) improvement, and functional recovery in patients with LV dysfunction. BACKGROUND: LV injury inherent to TA access for structural heart disease interventions may be particularly detrimental to the LV, functional recovery, and survival in patients with LV dysfunction. METHODS: The study included patients enrolled within the PARTNER I (Placement of Aortic Transcatheter Valves) trial that underwent transfemoral (TF) or TA TAVR...
December 11, 2017: JACC. Cardiovascular Interventions
L F Miles, S A Kunz, L H Na, S Braat, K Burbury, D A Story
Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre-operative non-anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron-deficient group of patients undergoing cardiac surgery with an iron-replete group. Consecutive non-anaemic patients undergoing elective coronary artery bypass grafting or single valve replacement in our institution between January 2013 and December 2015 were considered for inclusion...
December 2, 2017: Anaesthesia
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