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Aortic valve repair

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https://www.readbyqxmd.com/read/29342427/reconstructive-aortic-valve-surgery-in-the-elderly-techniques-and-outcomes
#1
Paul P Urbanski, Atanas Jankulovski, Kiril Doldurov, Xiaochun Zhan, Ayman Sodah, Michael Zacher, Anno Diegeler
OBJECTIVES: The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. METHODS: Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29334508/practical-valvular-issues-in-patients-requiring-ventricular-assist-devices
#2
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29325012/systematic-review-of-the-cost-effectiveness-of-transcatheter-interventions-for-valvular-heart-disease
#3
Gialama Fotini, Prezerakos Panagiotis, Apostolopoulos Vasilis, Nikolaos Maniadakis
Objectives: Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. Methods: The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29317120/preoperative-invasive-hemodynamic-determinants-of-survival-among-patients-undergoing-aortic-or-mitral-valve-surgery
#4
David X Zhuo, Kenneth C Bilchick, Sula Mazimba
OBJECTIVES: To evaluate the association of preoperative invasive hemodynamic parameters with mortality in valvular heart surgery. DESIGN: Retrospective cohort study. SETTING: Single tertiary academic medical center. PARTICIPANTS: A total of 382 patients who underwent preoperative right and/or left heart catheterization before open aortic valve replacement (AVR), open mitral valve repair/replacement (MVR), or combined AVR and MVR, from July 2009 to December 2014...
September 29, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29312717/predictors-of-ventricular-tachyarrhythmia-occurring-late-after-intracardiac-repair-of-tetralogy-of-fallot-combination-of-qrs-duration-change-rate-and-tricuspid-regurgitation-pressure-gradient
#5
Shuichi Shiraishi, Masashi Takahashi, Ai Sugimoto, Masanori Tsuchida
Background: To determine potential predictors of ventricular tachyarrhythmia and sudden cardiac death (SCD) occurring late after repair of tetralogy of Fallot (TOF). Methods: Since 1964, 415 patients had undergone total repair for TOF at Niigata University Hospital. Of these, 89 patients who were followed for more than 10 years at our institute were retrospectively reviewed. Results: The mean follow-up period was 24.3 years. During the study period, one patient died of cerebral bleeding, and two patients had SCD...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310563/evaluation-of-factors-associated-with-achievement-of-biventricular-repair-after-bilateral-pulmonary-artery-banding-in-patients-with-interrupted-aortic-arch
#6
Yasuhiro Hirano, Noboru Inamura, Yukiko Kawazu, Hisaaki Aoki, Futoshi Kayatani, Shigemitsu Iwai, Hiroaki Kawata
BACKGROUND: At our institution, we perform bilateral pulmonary artery banding (BPAB) as the first-stage palliation for interrupted aortic arch (IAA) with low birth weight or severe subaortic stenosis (SAS). The present study aimed to identify factors that may influence the decision regarding the type of second-stage operation, that is, univentricular palliation or biventricular repair, in these patients. METHODS: Cardiac catheterization and angiographic data of nine patients with IAA who underwent initial BPAB and subsequent univentricular or biventricular repair were retrospectively analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29309319/tranexamic-acid-dosing-for-cardiac-surgical-patients-with-chronic-renal-dysfunction-a-new-dosing-regimen
#7
Angela Jerath, Qi Joy Yang, K Sandy Pang, Nikita Looby, Nathaly Reyes-Garces, Tijana Vasiljevic, Barbara Bojko, Janusz Pawliszyn, Duminda Wijeysundera, W Scott Beattie, Terrence M Yau, Marcin Wąsowicz
BACKGROUND: Tranexamic acid (TXA) is a common antifibrinolytic agent used to minimize bleeding in cardiac surgery. Up to 50% cardiac surgical patients have chronic renal dysfunction (CRD). Optimal dosing of TXA in CRD remains poorly investigated. This is important as TXA is renally eliminated with accumulation in CRD. High TXA doses are associated with postoperative seizures. This study measures plasma TXA concentrations in CRD cardiac surgical patients for pharmacokinetic modeling and dose adjustment recommendations...
January 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29306337/partial-anomalous-pulmonary-venous-drainage-repair-concomitant-with-bilateral-semilunar-valve-replacements-and-pulmonary-artery-reconstruction-for-an-adult-female-20-years-after-initial-truncus-arteriosus-repair
#8
Toshiyuki Iwaya, Koichi Sughimoto, Kagami Miyaji
We describe the case of a 21-year-old patient who underwent repairs for multiple lesions including aortic and pulmonary valve replacements, right ventricular outflow tract reconstruction, revision of the right pulmonary artery route, and a repair of partial anomalous pulmonary venous drainage, which was diagnosed during this fourth sternotomy. For these patients with adult CHD, it is most important to address all underlying factors as much as possible at the redo surgery.
January 8, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29305147/repair-of-a-quadricuspid-autograft
#9
Irem Karliova, Andreas Hagendorff, Ahmad Shalabi, Ulrich Schneider, Hans-Joachim Schäfers
Aortic valve replacement using a pulmonary autograft is an accepted option in children and young patients. The use of a pulmonary valve with congenital anomaly as autograft is controversial. We describe a case in which a quadricuspid pulmonary valve was used as autograft in childhood. The patient presented with severe regurgitation 13 years later. Repair was performed with stabilization of the root and cusp prolapse correction, leading to normalized valve function. Despite concerns over the long term durability of an anomalous pulmonary valve as autograft good mid- to long-term results can be achieved...
January 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29304513/nonvitamin-k-antagonist-oral-anticoagulants-use-in-patients-with-atrial-fibrillation-and-bioprosthetic-heart-valves-prior-surgical-valve-repair-a-multicenter-clinical-practice-experience
#10
Vincenzo Russo, Emilio Attena, Carmine Mazzone, Francesca Esposito, Valentina Parisi, Ciro Bancone, Anna Rago, Gerardo Nigro, Raffaele Sangiuolo, Antonio D' Onofrio
This is an observational study to investigate the efficacy and safety of nonvitamin K antagonist oral anticoagulants (NOACs) in atrial fibrillation (AF) patients with bioprosthetic valves or prior surgical valve repair in clinical practice. A total of 122 patients (mean age: 74.1 ± 13.2; 54 females) with bioprosthetic heart valve or surgical valve repair and AF treated with NOACs were included in the analysis. The mean CHA2DS2-VASc (Congestive heart failure, Hypertension, Age >75 years, Diabetes mellitus, prior Stroke or transient ischemic attack, Vascular disease) and HAS-BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INR [international normalized ratio], Elderly, Drugs or alcohol) score values were 3...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302949/simultaneous-transcatheter-intervention-for-coarctation-of-the-aorta-and-bicuspid-aortic-valve
#11
Yukiko Mizutani, Norio Tada, Takahiko Masuda, Masaki Hata
Coarctation of the aorta (CoA) is a relatively common congenital heart anomaly, and bicuspid aortic valve (BAV) is a common congenital heart disease that coexists with CoA. In larger children and adults with CoA, transcatheter intervention has gained acceptance, but for surgical high-risk patients with aortic stenosis, the use of transcatheter aortic valve implantation (TAVI) has been established. Recently, although favorable data have been reported for TAVI when treating BAV, simultaneous transcatheter intervention for CoA and BAV will prove to be a challenge because of the unique anatomy involved requires multiple procedural steps and also has problems of site access...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302942/pathophysiological-factors-associated-with-left-ventricular-perforation-in-transcatheter-aortic-valve-implantation-by-transfemoral-approach
#12
Tamer Owais, Mohammad El Garhy, Jürgen Fuchs, Kushtrim Disha, Sameh Elkaffas, Martin Breuer, Bernward Lauer, Thomas Kuntze
BACKGROUND: Left ventricular (LV) perforation is one of the rare and most serious complications of transcatheter aortic valve implantation (TAVI). The study aim was to determine the pathophysiological factors associated with this serious complication. METHODS: A retrospective study was conducted of pathophysiological factors shown in echocardiograms and computed tomography angiograms performed preoperatively in patients who developed LV perforation during transfemoral TAVI (study group) with regards to anatomic and functional variables...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302119/teg-directed-transfusion-in-complex-cardiac-surgery-impact-on-blood-product-usage
#13
Kevin Fleming, Roberta E Redfern, Rebekah L March, Nathan Bobulski, Michael Kuehne, John T Chen, Michael Moront
Complex cardiac procedures often require blood transfusion because of surgical bleeding or coagulopathy. Thrombelastography (TEG) was introduced in our institution to direct transfusion management in cardiothoracic surgery. The goal of this study was to quantify the effect of TEG on transfusion rates peri- and postoperatively. All patients who underwent complex cardiac surgery, defined as open multiple valve repair/replacement, coronary artery bypass grafting with open valve repair/replacement, or aortic root/arch repair before and after implementation of TEG were identified and retrospectively analyzed...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29289366/comparison-of-endoaortic-and-transthoracic-aortic-clamping-in-less-invasive-mitral-valve-surgery
#14
Cristina Barbero, Ralph Krakor, Mohamed Bentala, Filip Casselman, Pascal Candolfi, Jacques Goldstein, Mauro Rinaldi
BACKGROUND: Less-invasive mitral valve surgery has become a widespread procedure in recent years, although mode of perfusion and aortic clamping are still debated questions. The aim of this study was to compare the results between transthoracic aortic clamping (TTC) and endoaortic clamping (EAC) in a multicenter, retrospective study. METHODS: Data from 3 centers experienced in both TTC and EAC were retrospectively analyzed. Five hundred consecutive patients undergoing less-invasive mitral valve surgery received either TTC (n = 250) or EAC (n = 250)...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29285347/patient-specific-simulations-for-planning-treatment-in-congenital-heart-disease
#15
Claudio Capelli, Emilie Sauvage, Giuliano Giusti, Giorgia M Bosi, Hopewell Ntsinjana, Mario Carminati, Graham Derrick, Jan Marek, Sachin Khambadkone, Andrew M Taylor, Silvia Schievano
Patient-specific computational models have been extensively developed over the last decades and applied to investigate a wide range of cardiovascular problems. However, translation of these technologies into clinical applications, such as planning of medical procedures, has been limited to a few single case reports. Hence, the use of patient-specific models is still far from becoming a standard of care in clinical practice. The aim of this study is to describe our experience with a modelling framework that allows patient-specific simulations to be used for prediction of clinical outcomes...
February 6, 2018: Interface Focus
https://www.readbyqxmd.com/read/29284867/short-term-outcome-of-patients-with-infective-endocarditis-a-single-center-prospective-study
#16
Kianoush Saberi, Mehrdad Salehi, Ali Reza Bakhshandeh, Shahnaz Sharifi, Mehrzad Rahmanian, Roya Sattarzadeh, Anahita Tavoosi
Objectives: To investigate the short-term outcome of patients with infective endocarditis (IE). Patients and Methods: We analyzed data from 42 patients with active endocarditis which underwent different cardiac surgeries. An active endocarditis was considered due to urine analysis and/or blood culture and acute inflammation Gram stains of sample tissue and/or blood culture and acute inflammation Gram stains of sample tissue. Design: Collecting data of 42 patients prospectively...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29275952/late-onset-of-atrial-fibrillation-in-patients-undergoing-mitral-valve-repair-for-type-ii-dysfunction
#17
Naonori Kawamoto, Tomoyuki Fujita, Satsuki Fukushima, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Kizuku Yamashita, Junjiro Kobayashi
BACKGROUND: There are few reports regarding factors related to late-onset of atrial fibrillation (Af) after mitral valve repair, which can compromise long-term outcome. We analyzed the risk factors for late Af after mitral valve repair. METHODS AND RESULTS: Between 2001 and 2015, 318 patients (214 males; median, 57.7 years) underwent mitral valve repair for degenerative mitral insufficiency (MI) without concomitant aortic valve disease in our institute. Patients with a history of paroxysmal or chronic Af preoperatively were excluded...
December 21, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#18
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29273323/durability-of-aortic-valve-cusp-repair-with-and-without-annular-support
#19
Ahmad Zeeshan, Jay J Idrees, Douglas R Johnston, Jeevanantham Rajeswaran, Eric E Roselli, Edward G Soltesz, A Marc Gillinov, Brian Griffin, Richard Grimm, Donald F Hammer, Gösta B Pettersson, Eugene H Blackstone, Joseph F Sabik, Lars G Svensson
BACKGROUND: To determine the value of aortic valve repair rather than replacement for valve dysfunction, we assessed late outcomes of various repair techniques in the contemporary era. METHODS: From January 2001 to January 2011, aortic valve repair was planned in 1,124 patients. Techniques involved commissural figure-of-8 suspension sutures (n = 63 [6.2%]), cusp repair with commissuroplasty (n = 481 [48%]), debridement (n = 174 [17%]), free-margin plication (n = 271 [27%]) or resection (n = 75) or both, or annulus repair with resuspension (n = 230 [23%]), root reimplantation (n = 252 [25%]), or remodeling (n = 35 [3...
December 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29249501/predictors-of-survival-in-octogenarians-after-mitral-valve-surgery-for-degenerative-disease-the-mitral-surgery-in-octogenarians-study
#20
Pierpaolo Chivasso, Vito D Bruno, Shakil Farid, Pietro Giorgio Malvindi, Amit Modi, Umberto Benedetto, Franco Ciulli, Yasir Abu-Omar, Massimo Caputo, Gianni D Angelini, Steve Livesey, Hunaid A Vohra
OBJECTIVES: An increasing number of octogenarians are referred to undergo mitral valve surgery for degenerative disease, and percutaneous approaches are being increasingly used in this subgroup of patients. We sought to determine the survival and its predictors after Mitral valve Surgery in Octogenarians (MiSO) in a multicenter UK study of high-volume specialized centers. METHODS: Pooled data from 3 centers were collected retrospectively. To identify the predictors of short-term composite outcome of 30 days mortality, acute kidney injury, and cerebrovascular accident, a multivariable logistic regression model was developed...
November 20, 2017: Journal of Thoracic and Cardiovascular Surgery
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