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https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#1
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28302715/late-thrombosis-of-a-mitral-bioprosthetic-valve-with-associated-massive-left-atrial-thrombus
#2
Preetham Muskula, Rigoberto Ramirez, A Michael Borkon, Michael L Main
An 84-year-old man presented 5 years following bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg) was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (> 4 cm in diameter) (see Figures 1A-D, and video files 1-4)...
March 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28296050/a-heart-within-a-heart
#3
Edward T Carreras, Maya Barghash, Michael M Givertz, Deepak L Bhatt
A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc...
March 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28292589/tricuspid-valve-repair-and-pulmonary-valve-replacement-in-adults-with-repaired-tetralogy-of-fallot
#4
François Roubertie, Pierre-Emmanuel Séguéla, Zakaria Jalal, Xavier Iriart, Xavier Roques, Bernard Kreitmann, Mohammed Al-Yamani, Xavier Pillois, Jean-Benoît Thambo
BACKGROUND: Pulmonary valve replacement (PVR) often is performed in adults with repaired tetralogy of Fallot (TOF). For patients who have tricuspid regurgitation (TR), tricuspid valve (TV) repair associated to PVR is still debated. OBJECTIVE: We sought to evaluate perioperative factors related to TV repair when performed at the time of PVR in patients with repaired TOF. METHODS: We retrospectively reviewed 104 patients with repaired TOF (or its equivalent) who underwent PVR (2002-2014)...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283226/differential-impact-of-net-atrioventricular-compliance-on-clinical-outcomes-in-patients-with-mitral-stenosis-according-to-cardiac-rhythm
#5
In-Jeong Cho, Hyuk-Jae Chang, Soo Yeon Lee, Chi Young Shim, Geu-Ru Hong, Namsik Chung
BACKGROUND: Net atrioventricular compliance (Cn), a parameter for the net compliance of the left atrium and left ventricle, is known to be a useful predictor of outcomes in patients with mitral stenosis (MS). The present study aimed to evaluate whether the impact of Cn on symptom status and clinical outcomes, as well as its contribution toward systolic pulmonary artery pressure (SPAP), differed according to cardiac rhythm. METHODS: We retrospectively reviewed patients (N = 308) with rheumatic pure MS...
March 7, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28281857/engineering-challenges-and-the-future-prospects-of-transcatheter-mitral-valve-replacement-technologies-a-comprehensive-review-of-case-studies
#6
Ranjitha Rebecca Jeevan, Bhaskar Mohan Murari
Catheter based Interventional procedures have become an indispensable treatment option for patients contraindicated for surgical heart valve replacement . The broad spectrum of disease that affect the mitral valve have increased the need for a transcatheter mitral valve replacement (TMVR) device. As complex as the mitral valve anatomy is, so are challenges in the development of a TMVR device. Areas covered: This review article analyses the challenges in the development of the TMVR device from an engineering perspective of material and device design...
March 10, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28275558/myocardial-strain-and-symptom-severity-in-severe-aortic-stenosis-insights-from-cardiovascular-magnetic-resonance
#7
Tarique Al Musa, Akhlaque Uddin, Peter P Swoboda, Pankaj Garg, Timothy A Fairbairn, Laura E Dobson, Christopher D Steadman, Anvesha Singh, Bara Erhayiem, Sven Plein, Gerald P McCann, John P Greenwood
BACKGROUND: Symptomatic severe aortic stenosis (AS) is a class I indication for replacement in patients when left ventricular ejection fraction (LVEF) is preserved. However, symptom reporting is often equivocal and decision making can be challenging. We aimed to quantify myocardial deformation using cardiovascular magnetic resonance (CMR) in patients classified by symptom severity. METHODS: Forty-two patients with severe AS referred to heart valve clinic were studied using tagged CMR imaging...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28267085/hemolytic-anemia-due-to-right-ventricular-to-pulmonary-artery-conduit-stenosis
#8
Sudha Rao, Julie A Creaden, Shunyou Gong, Cynthia Rigsby, John M Costello
Hemolytic anemia is a well-recognized complication in patients with left-sided mechanical heart valves. It is rare to see hemolysis with a bioprosthetic valve in the right ventricular outflow tract. We report a 4-year-old-girl with history of truncus arteriosus status-post repair who developed hemolytic anemia as a result of a calcified and obstructed bioprosthetic right ventricular to pulmonary artery-valved conduit. The hemolysis was alleviated by replacing the obstructed conduit with a larger valved conduit...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28266162/short-term-results-of-alcohol-septal-ablation-as-a-bail-out-strategy-to-treat-severe-left-ventricular-outflow-tract-obstruction-after-transcatheter-mitral-valve-replacement-in-patients-with-severe-mitral-annular-calcification
#9
Mayra Guerrero, Dee Dee Wang, Dominique Himbert, Marina Urena, Amit Pursnani, Georges Kaddissi, Vijay Iyer, Michael Salinger, Tarun Chakravarty, Adam Greenbaum, Raj Makkar, Alec Vahanian, Ted Feldman, William O'Neill
OBJECTIVES: To evaluate the outcomes of the early experience of percutaneous alcohol septal ablation in patients with severe left ventricular outflow tract (LVOT) obstruction post transcatheter mitral valve replacement (TMVR). BACKGROUND: Severe LVOT obstruction with hemodynamic compromise is a complication of TMVR associated with high mortality. Percutaneous alcohol septal ablation has recently been described as a therapeutic option in this setting. METHODS: Multicenter retrospective review of clinical outcomes of patients undergoing alcohol septal ablation to treat LVOT obstruction after TMVR for severe mitral stenosis with severe mitral annular calcification...
March 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28265210/transcatheter-aortic-valve-replacement-comprehensive-review-and-present-status
#10
REVIEW
Sameer Arora, Jacob A Misenheimer, Radhakrishnan Ramaraj
Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28179592/five-year-clinical-outcome-of-asymptomatic-vs-symptomatic-severe-aortic-stenosis-after-aortic-valve-replacement
#11
Shinichi Shirai, Tomohiko Taniguchi, Takeshi Morimoto, Kenji Ando, Kengo Korai, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Tsukasa Inada, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Katsuhisa Ishii, Naritatsu Saito, Kazuo Yamanaka, Noboru Nishiwaki, Hiroyuki Nakajima, Toshihiko Saga, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Hitoshi Kitayama, Ryuzo Sakata, Takeshi Kimura
BACKGROUND: There is discordance regarding the effect of symptom status before aortic valve replacement (AVR) on long-term outcome after AVR in severe aortic stenosis (AS).Methods and Results:The CURRENT AS registry is a multicenter retrospective registry enrolling 3,815 consecutive patients with severe AS. Among 1,196 patients managed with the initial AVR strategy, long-term clinical outcomes were compared between the symptomatic patients (n=905), and asymptomatic patients (n=291)...
February 9, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28151531/-cognitive-and-quality-of-life-trajectory-after-either-surgical-or-transcatheter-aortic-valve-replacement-in-high-risk-patients
#12
Cristina Ciuca, Daniela Fortuna, Susy Ferrari, Stefano Salizzoni, Enrica Grisoglio, Giuseppe Punta, Stefano Del Ponte, Tiziana Claudia Aranzulla, Davide Gabbieri, Caterina Gandolfo, Flavia Dispensa, Lavinia Vecchio Verderame, Corrado Tamburino, Cinzia Caruso, Claudio Grossi, Elisa Mikus, Vincenzo Guiducci, Roberto Violini, Silvia Rongoni, Claudia Pandolfi, Carolina Moretti, Rossana De Palma, Rabih Chattat, Carlo Savini, Antonio Marzocchi, Francesco Saia
RATIONALE: The impact of transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (AVR) on cognitive status and quality of life in high-risk patients has been incompletely investigated. METHODS: We conducted a prospective, multicenter study including all patients treated with TAVI and high-risk patients undergoing AVR (age ≥80 years or logistic EuroSCORE ≥15%) at participating centers. Multidimensional geriatric evaluation including Mini Mental State Examination (MMSE), EuroQol 5D (EQ5D) and Minnesota Living With Heart Failure Questionnaire (MLHFQ) were performed at baseline and at 3- and 12-month follow-up...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28151530/-quality-of-life-after-transcatheter-aortic-valve-implantation-a-comprehensive-literature-review-and-critical-appraisal
#13
Susy Ferrari, Cristina Ciuca, Enrica Grisoglio, Tiziana Claudia Aranzulla, Davide Gabbieri, Lavinia Vecchio Verderame, Flavia Dispensa, Cinzia Caruso, Alda Carmela Di Mauro, Omar Di Gregorio, Claudia Pandolfi, Silvia Rongoni, Giovanni Ottoboni, Carolina Moretti, Rossana De Palma, Antonio Marzocchi, Rabih Chattat, Francesco Saia
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a very effective treatment option for patients with severe aortic stenosis who are either not suitable candidates or at high risk for surgical aortic valve replacement (AVR). Patients undergoing TAVI are often very elderly and their clinical status is burdened with multiple comorbidities, therefore evaluation of quality of life (QoL) might be challenging. We sought to provide an overview of available data on QoL changes after TAVI and critical insights on the instruments used to detect these changes...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28146260/quality-of-life-outcomes-after-transcatheter-aortic-valve-replacement-in-an-unselected-population-a-report-from-the-sts-acc-transcatheter-valve-therapy-registry
#14
Suzanne V Arnold, John A Spertus, Sreekanth Vemulapalli, Zhuokai Li, Roland A Matsouaka, Suzanne J Baron, Amit N Vora, Michael J Mack, Matthew R Reynolds, John S Rumsfeld, David J Cohen
Importance: In clinical trials, transcatheter aortic valve replacement (TAVR) has been shown to improve symptoms and quality of life. As this technology moves into general clinical practice, evaluation of the health status outcomes among unselected patients treated with TAVR is of critical importance. Objective: To examine the short- and long-term health status outcomes of surviving patients after TAVR in the context of an unselected population. Design, Setting, and Participants: This observational cohort study included patients with severe aortic stenosis who underwent TAVR in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry from November 1, 2011, to March 31, 2016, at more than 450 clinical sites...
February 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#15
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28073791/rapid-deployment-aortic-replacement-radar-registry-in-spain-a-protocol
#16
Victor Bautista-Hernandez, Natalia Cal-Purriños, Jose M Arribas-Leal, Manuel Carnero-Alcazar, Jose F Gutierrez-Diez, Jose J Cuenca-Castillo
INTRODUCTION: Rapid deployment valves (RDV) represent a newly introduced approach to aortic valve replacement which facilitates surgical implantation and minimally invasive techniques, shortens surgical times and shows excellent haemodynamic performance. However, evidence on their safety, efficacy and potential complications is mostly fitted with small-volume and retrospective studies. Moreover, no current guidelines exist. To improve our knowledge on this technology, The Rapid Deployment Aortic Replacement (RADAR) Registry will be established across Spain with the aim of assessing RDV outcomes in the real-world setting...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28052455/echocardiographic-follow-up-after-transcatheter-aortic-valve-replacement
#17
REVIEW
Vladislavs Sokalskis, Denisa Muraru, Chiara Fraccaro, Massimo Napodano, Augusto D'Onofrio, Giuseppe Tarantini, Luigi Paolo Badano
The use of transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis has rapidly increased during the past years. Accordingly, more and more patients are referred for a follow-up echocardiographic study after TAVR. However, the echocardiographic evaluation of patients who underwent TAVR places specific demands on echocardiographers. Furthermore, TAVR may be associated with new types of complications, which are frequently unrecognized or underestimated due to lack of familiarity with the normal and pathological appearance of TAVR...
January 3, 2017: Echocardiography
https://www.readbyqxmd.com/read/28043468/outcomes-of-truncus-arteriosus-repair-in-children-35-years-of-experience-from-a-single-institution
#18
Phillip S Naimo, Tyson A Fricke, Matthew S Yong, Yves d'Udekem, Andrew Kelly, Dorothy J Radford, Andrew Bullock, Robert G Weintraub, Christian P Brizard, Igor E Konstantinov
We evaluated the long-term outcomes following repair of truncus arteriosus (TA) from a single institution. We conducted a retrospective review of children (n = 171) who underwent TA repair between 1979 and 2014. Early mortality rate was 11.7% (20/171). There were 19 late deaths. Most deaths (74%, 29/39) occurred within the first year following surgery. The 1-year mortality rate in 1979-2004 was 18% (25/136) and decreased to 11% (4/35) in 2005-2014. The overall survival rate was 73.6% at 30 years. Multivariate analysis identified postoperative extracorporeal membrane oxygenation (P = 0...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28039604/socioeconomic-and-racial-disparities-a-case-control-study-of-patients-receiving-transcatheter-aortic-valve-replacement-for-severe-aortic-stenosis
#19
Anna Sleder, Shiloh Tackett, Matthew Cerasale, Chetan Mittal, Iyad Isseh, Ryhm Radjef, Andrew Taylor, Rashad Farha, Oleksandra Lupak, Dana Larkin, Lois Lamerato, George Divine, Kimberlydawn Wisdom, Kimberly Baker-Genaw, William O'Neill
BACKGROUND: We sought to quantify socioeconomic disparities in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) at an urban, tertiary referral center. METHODS: This retrospective case-control study identified 67 patients with severe AS (aortic valve [AV] area ≤1 cm(2) or AV area index ≤0.60 cm(2)/m(2) or AV velocity ≥40 mmHg) who underwent TAVR from November 5, 2013 to June 10, 2014. Study subjects were matched to controls with severe AS without TAVR in a 4:1 age-frequency match...
December 30, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28007203/quality-of-life-after-transcatheter-aortic%C3%A2-valve-replacement-prospective-data-from-gary-german-aortic-valve-registry
#20
Rüdiger Lange, Andreas Beckmann, Till Neumann, Markus Krane, Marcus-André Deutsch, Sandra Landwehr, Joachim Kötting, Armin Welz, Ralf Zahn, Jochen Cremer, Hans R Figulla, Gerhard Schuler, David M Holzhey, Anne-Kathrin Funkat, Gerd Heusch, Stefan Sack, Miralem Pasic, Thomas Meinertz, Thomas Walther, Karl-Heinz Kuck, Friedhelm Beyersdorf, Michael Böhm, Helge Möllmann, Christian W Hamm, Friedrich W Mohr
OBJECTIVES: This study sought to analyze health-related quality-of-life (HrQoL) outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) based on data from GARY (German Aortic Valve Registry). BACKGROUND: Typically, patients currently referred for and treated by TAVR are elderly with a concomitant variable spectrum of multiple comorbidities, disabilities, and limited life expectancy. Beyond mortality and morbidity, the assessment of HrQoL is of paramount importance not only to guide patient-centered clinical decision-making but also to judge this new treatment modality in this high-risk patient population...
December 26, 2016: JACC. Cardiovascular Interventions
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