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https://www.readbyqxmd.com/read/28545062/association-of-frailty-status-with-acute-kidney-injury-and-mortality-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#1
Charat Thongprayoon, Wisit Cheungpasitporn, Natanong Thamcharoen, Patompong Ungprasert, Wonngarm Kittanamongkolchai, Michael A Mao, Ankit Sakhuja, Kevin L Greason, Kianoush Kashani
OBJECTIVE: Frailty is a common condition in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). The aim of this systematic review was to assess the impact of frailty status on acute kidney injury (AKI) and mortality after TAVR. METHODS: A systematic literature search was conducted using MEDLINE, EMBASE, and Cochrane databases from the inception through November 2016. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no...
2017: PloS One
https://www.readbyqxmd.com/read/28544841/transcatheter-valve-in-valve-implantation-failing-tricuspid-bioprosthesis-in-a-patient-with-ebstein%C3%A2-s-anomaly
#2
Pedro A Villablanca, Aman M Shah, David F Briceno, Ali N Zaidi, Mei Chau, Mario J Garcia, David Slovut, Cynthia Taub
Transcatheter valve-in-valve (VIV) implantation has been recently proposed as an alternative to surgical reoperative aortic valve replacement in patients with a failing aortic bioprosthesis. Experience with transcatheter VIV implantation at other valve positions is very limited. Herein is reported the case of an 18-year-old man with Ebstein's anomaly and severe tricuspid valve (TV) regurgitation status after bioprosthetic valve replacement, who developed new dyspnea on exertion three years after the initial valve replacement...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#3
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28536224/impella-percutaneous-left-ventricular-assist-device-for-severe-acute-ischaemic-mitral-regurgitation-as-a-bridge-to-surgery
#4
Bilal Jalil, Karim El-Kersh, Jarrod Frizzell, Shozab Ahmed
Ischaemic papillary muscle rupture causing acute severe mitral regurgitation (MR) has a dramatic presentation and a very high mortality. Emergent surgical repair improves outcomes, which necessitates robust preoperative stabilisation. Here we discuss a patient with cardiogenic shock with an acute severe MR that was deemed very high risk for emergent valve replacement due to haemodynamic instability and respiratory failure. A percutaneous left ventricular assist device Impella 2.5 (Abiomed, Danvers, MA) drastically improved clinical status, and the patient underwent a successful surgical mitral valve replacement soon after placement of the temporary assist device...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#5
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28527771/aspirin-versus-aspirin-plus-clopidogrel-as-antithrombotic-treatment-following-transcatheter-aortic-valve-replacement-with-a-balloon-expandable-valve-the-arte-aspirin-versus-aspirin%C3%A2-clopidogrel-following%C3%A2-transcatheter-aortic-valve-implantation-randomized%C3%A2
#6
Josep Rodés-Cabau, Jean-Bernard Masson, Robert C Welsh, Bruno Garcia Del Blanco, Marc Pelletier, John G Webb, Faisal Al-Qoofi, Philippe Généreux, Gabriel Maluenda, Martin Thoenes, Jean-Michel Paradis, Chekrallah Chamandi, Vicenç Serra, Eric Dumont, Mélanie Côté
OBJECTIVE: The aim of this study was to compare aspirin plus clopidogrel with aspirin alone as antithrombotic treatment following transcatheter aortic valve replacement (TAVR) for the prevention of ischemic events, bleeding events, and death. BACKGROUND: Few data exist on the optimal antithrombotic therapy following TAVR. METHODS: This was a randomized controlled trial comparing aspirin (80 to 100 mg/day) plus clopidogrel (75 mg/day) (dual-antiplatelet therapy [DAPT]) versus aspirin alone (single-antiplatelet therapy [SAPT]) in patients undergoing TAVR with a balloon-expandable valve...
May 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#7
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#8
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28510272/diabetes-mellitus-is-associated-with-increased-acute-kidney-injury-and-1-year-mortality-after-transcatheter-aortic-valve-replacement-a-meta-analysis
#9
George S Mina, Priyanka Gill, Demiana Soliman, Pratap Reddy, Paari Dominic
BACKGROUND: Diabetes mellitus (DM) is associated with adverse outcomes after surgical aortic valve replacement. However, there are conflicting data on the impact of DM on outcomes of transcatheter aortic valve replacement (TAVR). HYPOTHESIS: DM is associated with poor outcomes after different cardiac procedures. Therefore, DM can also be associated with poor outcomes after TAVR. METHODS: We searched PubMed and Cochrane Central Register of Controlled Trials for studies that evaluated outcomes after TAVR and stratified at least 1 of the studied endpoints by DM status...
May 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28493641/impact-of-pre-existing-or-new-onset-atrial-fibrillation-on-30-day-clinical-outcomes-following-transcatheter-aortic-valve-replacement-results-from-the-bravo-3-randomized-trial
#10
Christian Hengstenberg, Jaya Chandrasekhar, Samantha Sartori, Thierry Lefevre, Ghada Mikhail, Nicolas Meneveau, Christophe Tron, Raban Jeger, Christian Kupatt, Birgit Vogel, Serdar Farhan, Sabato Sorrentino, Madhav Sharma, Clayton Snyder, Oliver Husser, Peter Boekstegers, Rainer Hambrecht, Julian Widder, David Hildick-Smith, Marco De Carlo, Peter Wijngaard, Efthymios Deliargyris, Debra Bernstein, Usman Baber, Roxana Mehran, Prodromos Anthopoulos, George Dangas
BACKGROUND: Prior studies have suggested that patients with atrial fibrillation (AF) undergoing transcatheter aortic valve replacement (TAVR) are at higher risk for adverse cardiovascular events. Whether procedural bivalirudin compared to unfractionated heparin (UFH) has a beneficial effect on early outcomes in these patients is unknown. We examined for the effect of baseline or new-onset AF within 30 days of TAVR and explored for the effect of bivalirudin vs. UFH by AF status, on 30-day outcomes from the BRAVO 3 trial...
May 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28485110/the-role-of-neo-sinus-reconstruction-in-aortic-valve-sparing-surgery
#11
Mario Gaudino, Antonino Di Franco, Luca Weltert, Umberto Benedetto, Christopher Lau, Ivancarmine Gambardella, Ruggero De Paulis, Leonard N Girardi
AIMS: The aim of this study was to evaluate the clinical and echocardiographic results and the predictors of outcomes in patients undergoing valve-sparing operation (VSO) at two aortic centers. In addition, we sought to evaluate the potential effect of recreation of the sinuses of Valsalva (SV) on the outcome of valve-sparing procedures. METHODS: During a 14-year period, 328 patients underwent aortic valve-sparing root replacement at two institutions. Clinical and echo evaluation was performed 6 months after surgery and every year thereafter or in case of clinical symptoms...
May 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28468272/clinical-correlates-and-prognostic-value-of-plasma-galectin-3-levels-in-degenerative-aortic-stenosis-a-single-center-prospective-study-of-patients-referred-for-invasive-treatment
#12
Beata Bobrowska, Ewa Wieczorek-Surdacka, Olga Kruszelnicka, Bernadeta Chyrchel, Andrzej Surdacki, Dariusz Dudek
Galectin-3 (Gal-3), a β-galactoside-binding lectin, has been implicated in myocardial fibrosis, development of left ventricular (LV) dysfunction and transition from compensated LV hypertrophy to overt heart failure (HF), being a novel prognostic marker in HF. Risk stratification is crucial for the choice of the optimal therapy in degenerative aortic stenosis (AS), affecting elderly subjects with coexistent diseases. Our aim was to assess correlates and prognostic value of circulating Gal-3 in real-world patients with degenerative AS referred for invasive treatment...
April 29, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#13
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
May 3, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28463403/the-impact-of-frailty-status-on-clinical-and-functional-outcomes-after-transcatheter-aortic-valve-replacement-in-nonagenarians-with-severe-aortic-stenosis
#14
Alexis K Okoh, Dhaval Chauhan, Nathan Kang, Nicky Haik, Aurelie Merlo, Mark Cohen, Bruce Haik, Chunguang Chen, Mark J Russo
BACKGROUND: The impact of frailty status on TAVR outcomes in nonagenarians is unknown. The present study aims to investigate the impact of frailty status on procedural outcomes and overall survival in nonagenarians after TAVR. METHODS: A frailty score (FS) was derived by using preoperative grip strength, gait speed, serum albumin, and daily activities. Patients were divided into two groups: Frail (FS ≥ 3/4) and Non-Frail (FS <3/4). Health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ)...
May 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#15
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28444455/prevalence-predictors-and-prognostic-implications-of-residual-impairment-of-functional-capacity-after-transcatheter-aortic-valve-implantation
#16
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
BACKGROUND: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We sought to investigate the prevalence, the predictors, and the prognostic impact of residual impairment of functional capacity after TAVI. METHODS AND RESULTS: Out of 790 patients undergoing TAVI with impaired functional capacity (NYHA II-IV) at baseline, NYHA functional class improved in 592 (86...
April 25, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28418954/aortic-root-abscess-clearly-shown-on-111in-leukocyte-scan-but-less-obvious-on-transesophageal-echocardiogram
#17
Harleen Kaur, John Seitz, Mitchel Muhleman, David Cragg, Feng Qing
A 79-year-old man with history of aortic stenosis, status post bioprosthetic aortic valve replacement, episodes of bacteremia, and endocarditis presented to hospital with fever. Clinical assessment led to suspicion of possible endocarditis. Initial interpretation of transesophageal echocardiogram was inconclusive without vegetation in mitral/aortic valve. An In-leukocyte scan demonstrated increased uptake in the area of aortic valve, suggestive of infection. Further review of the transesophageal echocardiogram showed signs of annular abscess...
April 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28412115/outcome-of-isolated-aortic-valve-replacement-in-patients-with-classic-and-paradoxical-low-flow-low-gradient-aortic-stenosis
#18
Ana Lopez-Marco, Harriet Miller, Pankaj Kumar, Saeed Ashraf, Afzal Zaidi, Farah Bhatti, Adrian Ionescu, Aprim Youhana
OBJECTIVE: To analyze operative outcomes and mid-term results after isolated aortic valve replacement (AVR) in low-flow, low-gradient aortic stenosis (LFLG AS) by comparing the 2 subcategories (classic low-flow, low-gradient aortic stenosis [CLFLG] and paradoxical low-flow, low-gradient aortic stenosis [PLFLG]). METHODS: This was a retrospective analysis of prospectively collected data for all isolated AVR in LFLG AS performed in our center during the last 13 years (n = 198; CLFLG AS, n = 66, 33% and PLFLG AS, n = 132, 67%)...
March 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28386460/reversal-of-abnormal-cardiac-parameters-following-mitral-valve-replacement-for-severe-mitral-stenosis-in-relation-to-pulmonary-artery-pressure-a-retrospective-study-of-noninvasive-parameters-early-and-late-pattern
#19
REVIEW
Usha T Parvathy, Rajesh Rajan, Alexander Georgevich Faybushevich
BACKGROUND AND OBJECTIVES: Although the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods. METHODS: The preoperative, early, and 1-year postoperative data - functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) - of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson's), and their change (t-test), in relation to that in PAP...
June 1, 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28380656/early-results-of-surgical-simultaneous-therapy-for-significant-carotid-artery-stenosis-and-heart-disease
#20
Marc Irqsusi, Alessandro Vannucchi, Julius Beckers, Stefan Kasseckert, Stefan Waldhans, Sebastian Vogt, Rainer G H Moosdorf
Background The purpose of this single-center, retrospective study was to review the early outcome with defined endpoints of myocardial infarction, brain injury, and death after coronary bypass grafting and simultaneous carotid endarterectomy with or without combined valve replacement. Methods During the preoperative investigation 52 (44 males, 8 females) patients were examined by cardiac catheterization within the scope of their coronary status. In addition, all patients underwent echocardiography, CT angiography of the supra-aortic vessels, and full description of their neurologic status...
April 5, 2017: Thoracic and Cardiovascular Surgeon
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