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https://www.readbyqxmd.com/read/27913738/extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-replacement
#1
Elena Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
BACKGROUND: Patients undergoing transcatheter aortic valve replacement can experience severe perioperative complications leading to hemodynamic instability and death. Venoarterial extracorporeal membrane oxygenation can be used to provide cardiorespiratory support during this time. METHODS: From 2012 to 2015, of 247 patients who underwent transcatheter aortic valve replacement, 6 (2.42%) required extracorporeal membrane oxygenation support. Their mean age was 82 ± 7...
December 2, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27911025/effect-of-balloon-expandable-transcatheter-aortic-valve-replacement-positioning-a-patient-specific-numerical-model
#2
Matteo Bianchi, Gil Marom, Ram P Ghosh, Harold A Fernandez, James R Taylor, Marvin J Slepian, Danny Bluestein
Transcatheter aortic valve replacement (TAVR) has emerged as a life-saving and effective alternative to surgical valve replacement in high-risk, elderly patients with severe calcific aortic stenosis. Despite its early promise, certain limitations and adverse events, such as suboptimal placement and valve migration, have been reported. In the present study, it was aimed to evaluate the effect of various TAVR deployment locations on the procedural outcome by assessing the risk for valve migration. The deployment of a balloon-expandable Edwards SAPIEN valve was simulated via finite element analysis in a patient-specific calcified aortic root, which was reconstructed from CT scans of a retrospective case of valve migration...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27908807/incomplete-expansion-of-chimney-stent-graft-during-chimney-thoracic-endovascular-aneurysm-repair-ch-tevar
#3
Athanasios Katsargyris, Domenico Spinelli, Kyriakos Oikonomou, Hozan Mufty, Eric Lg Verhoeven
PURPOSE: To report a technical complication during a chimney-thoracic endovascular aneurysm repair (Ch-TEVAR) procedure. CASE REPORT: A 77 year-old female patient underwent Ch-TEVAR for a symptomatic thoracic aortic aneurysm (TAA) with a short and angulated proximal neck. Deployment of the aortic stent-graft over the left subclavian artery (LSA) was followed by placement of a balloon expandable covered stent as a chimney for the LSA. Chimney deployment failed due to balloon perforation...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903575/early-severe-coronary-artery-disease-and-aortic-coarctation-in-a-child-with-familial-hypercholesterolaemia
#4
Dina Labib, Haytham Soliman, Kareem Said, Khaled Sorour
An 11-year-old boy presented with easy fatigability, multiple xanthomas, and absent pedal pulsations. Laboratory workup showed severe hypercholesterolaemia and non-invasive imaging revealed 'normally functioning' bicuspid aortic valve and tight aortic coarctation. Coronary angiography showed severe right coronary artery (RCA) stenosis. Medical treatment resulted in significant improvement of dyslipidaemia. We successfully performed balloon dilation and stenting of his coarctation, as well as percutaneous coronary intervention for RCA lesion...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27899140/transapical-transcatheter-aortic-valve-replacement-in-patients-with-or-without-prior-coronary-artery-bypass-graft-operation
#5
Konstantinos V Voudris, S Chiu Wong, Ryan Kaple, Polydoros N Kampaktsis, Andreas R de Biasi, Jonathan S Weiss, Richard Devereux, Karl Krieger, Luke Kim, Rajesh V Swaminathan, Dmitriy N Feldman, Harsimran Singh, Nikolaos J Skubas, Robert M Minutello, Geoffrey Bergman, Arash Salemi
BACKGROUND: Transapical approach (TA) is an established access alternative to the transfemoral technique in patients undergoing transcatheter aortic valve replacement (TAVR) for treatment of symptomatic aortic valve stenosis. The impact of prior coronary artery bypass grafting (CABG) on clinical outcomes in patients undergoing TA-TAVR is not well defined. METHODS: A single center retrospective cohort analysis of 126 patients (male 41%, mean age 85.8 ± 6.1 years) who underwent TA balloon expandable TAVR (Edwards SAPIEN, SAPIEN XT or SAPIEN 3) was performed...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27896912/balloon-valvuloplasty-to-predict-x-ray-projection-angles-that-are-perpendicular-to-cardiovascular-structures-a-tavi-patient-feasibility-study
#6
Kenneth Fetterly, Kevin Greason, Verghese Mathew
OBJECTIVES: The purpose of this work is to describe methods to measure the 3D angular orientation of cardiovascular structures based on a planar image of a valvuloplasty balloon. These methods facilitate X-ray beam alignment with respect to the anatomy of interest. BACKGROUND: X-ray beam projections which are perpendicular to the long axis of cardiovascular structures are required to support interventional procedures, including transcatheter aortic valve implant (TAVI)...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27895344/peri-operative-determinants-of-prolonged-cicu-stay-after-coronary-artery-bypass-graft-surgery-in-elderly-at-a-private-tertiary-care-hospital-a-case-control-study
#7
Fazal Wahab Khan, Shiraz Hashmi, Syed Saeed Naeem, Benish Fatima, Hashim Hanif, Mubashir Zareen, Saulat Hasnain Fatimi
OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894326/preserved-autoregulation-of-coronary-flow-after-off-pump-coronary-artery-bypass-grafting-retrospective-assessment-of-intraoperative-transit-time-flowmetry-with-and-without-intra-aortic-balloon-counterpulsation
#8
Hiroyuki Nakajima, Atsushi Iguchi, Mimiko Tabata, Masaru Kambe, Masahiro Ikeda, Kazuhiko Uwabe, Toshihisa Asakura, Hiroshi Niinami
BACKGROUND: Intra-aortic balloon pumping (IABP) markedly increases graft flow after coronary artery bypass grafting (CABG) with cardiopulmonary bypass. We sought to delineate the effects of IABP on graft flow after off-pump CABG (OPCAB). METHODS: The clinical records of 32 patients (25 male, 7 female; mean age: 70 ± 9 years) who underwent OPCAB with IABP between January 2011 and May 2015 were retrospectively reviewed. Thirteen patients (41%) had a history of myocardial infarction, and 13 patients (41%) had a history of percutaneous coronary intervention...
November 28, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27890552/combined-use-of-intra-aortic-balloon-pump-and-venoarterial-extracorporeal-membrane-oxygenation-support-with-femoral-arterial-cannulation-impairs-cerebral-microcirculation-evaluation-with-laser-speckle-flowgraphy
#9
Hirotsugu Kanda, Fumiaki Kimura, Takafumi Iida, Megumi Kanao-Kanda, Takayuki Kunisawa, Taiji Nagaoka, Akitoshi Yoshida, Hiroyuki Kamiya
No abstract text is available yet for this article.
September 15, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27889349/acquired-aseptic-intracardiac-shunts-following-transcatheter-aortic-valve%C3%A2-replacement-a%C3%A2-systematic-review
#10
Paol Rojas, Ignacio J Amat-Santos, Carlos Cortés, Javier Castrodeza, Javier Tobar, Rishi Puri, Teresa Sevilla, Silvio Vera, Luis H Varela-Falcón, Jose Luis Zunzunegui, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: The aim of this study was to describe the incidence, mechanisms, features, and management of aseptic intracardiac shunts (AICS). BACKGROUND: AICS following transcatheter aortic valve replacement (TAVR) are an uncommon and barely described complication. METHODS: A systematic review was performed of all published cases of AICS following TAVR, and the incidence, predictors, main features, management, and related outcomes were analyzed...
November 17, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27884411/celsior-versus-microplegia-analysis-of-myocardial-protection-in-elective-aortic-valve-replacement
#11
Jose López-Menéndez, Javier Miguelena, Carlos Morales, Carmen L Díaz, Francisco Callejo, Juan Carlos Llosa, Jacobo Silva
BACKGROUND: Previous studies have analyzed the efficacy of crystalloid cardioplegic solutions, but the use of Celsior (Genzyme Corp, Boston, MA) as a crystalloid cardioplegic solution has not been evaluated. METHODS: In this observational retrospective study, Celsior crystalloid solution was compared with an all-blood continuous myocardial protection (microplegia). The study included all patients who underwent elective aortic valve replacement operations in whom the myocardial protection was Celsior or microplegia...
November 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27884356/direct-comparison-of-feasibility-and-safety-of-transfemoral-versus-transaortic%C3%A2-versus-transapical-transcatheter-aortic%C3%A2-valve-replacement
#12
Takahide Arai, Mauro Romano, Thierry Lefèvre, Thomas Hovasse, Arnaud Farge, Daniel Le Houerou, Kentaro Hayashida, Yusuke Watanabe, Philippe Garot, Hakim Benamer, Thierry Unterseeh, Erik Bouvier, Marie-Claude Morice, Bernard Chevalier
OBJECTIVES: The aim of this study was to compare outcomes among transfemoral (TF), transaortic (TAo), and transapical (TA) transcatheter aortic valve replacement (TAVR). BACKGROUND: Very few studies have investigated the differences among TF, TAo, and TA TAVR in terms of safety and feasibility. METHODS: Between January 2011 and December 2014, 467 consecutive cases of TF TAVR, 289 cases of TAo TAVR, and 42 cases of TA TAVR were analyzed. Baseline characteristics, procedural characteristics, and outcomes were compared between TF and TAo and between TAo and TA approaches...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27883977/age-related-changes-of-thoracic-aorta-geometry-used-to-predict-the-risk-for-acute-type-b-dissection
#13
Damian Craiem, Salma El Batti, Mariano E Casciaro, Elie Mousseaux, Marie-Emmanuelle Sirieix, Alain Simon, Jean-Marc Alsac
AIMS: Risk models that use a single aortic diameter threshold have failed to successfully predict acute type B aortic dissection (TBAD). We sought to identify meaningful age-indexed anatomical variables to predict TBAD risk. METHODS AND RESULTS: A geometric deformable model, consisting of virtual elastic balloons that inflate inside a vessel lumen, was developed to quantify thoracic aorta geometry. In the presence of TBAD, true and total artery lumen morphology were assessed...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27882604/the-dog-bone-technique-a-novel-easy-and-safe-catheter-maneuver-for-aortic-arch-and-coarctation-stenting
#14
Marinos Kantzis, Anja Lehner, Kai Thorsten Laser, Anca Racolta, Radka Vcasna, Marcus Fischer, Deniz Kececioglu, Nikolaus A Haas
BACKGROUND: Various techniques are described to facilitate stable stent implantation in aortic arch stenosis or coarctation. We describe an alternative technique, which due to its unique appearance during stent implantation, we have named "Dog Bone Technique" (DBT). TECHNIQUE: The stent/balloon assembly is placed across the stenosis, the long sheath is retrieved to uncover the distal 20-50% of the stent. The balloon is inflated with the pressure inflator just to expand slightly the stent...
November 24, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#15
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#16
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867460/percutaneous-dual-valve-intervention-in-a-high-risk-patient-with-severe-aortic-and-mitral-stenosis
#17
Blaz Mrevlje, Mohamad Aboukura, Christoph A Nienaber
Aortic stenosis is the most frequent and mitral stenosis is the least frequent native single-sided valve disease in Europe. Patients with the combination of severe symptomatic degenerative aortic and mitral stenosis are very rare. Guidelines for the treatment of heart valve diseases are clear for single-valve situations. However, there is no common agreement or recommendation for the best treatment strategy in patients with multiple valve disease and severe concomitant comorbidities. A 76-year-old female patient with the combination of severe degenerative symptomatic aortic and mitral stenosis and several comorbidities including severe obesity, who was found unsuitable surgical candidate by the heart team and unsuitable for two-time general anesthesia in the case of two-step single-valve percutaneous approach by anesthesiologists, underwent successful percutaneous dual-valve single-intervention (transcatheter aortic valve implantation and percutaneous mitral balloon commissurotomy)...
July 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27864477/is-visceral-flow-during-intra-aortic-balloon-pumping-size-or-volume-dependent
#18
Sandro Gelsomino, Pieter W J Lozekoot, Monique M J de Jong, Fabiana Lucà, Orlando Parise, Francesco Matteucci, Mario Romano, Abdullrazak Hossien, Mark La Meir, Niccolò Marchionni, Jos G Maessen, Roberto Lorusso
AIM: We evaluated the influence of intra-aortic balloon size and volume on mesenteric and renal flows. METHODS: Thirty healthy swine underwent 120-minute ligation of the left anterior descending coronary artery followed by 6 hours of reperfusion. Then, they were randomly assigned to the following five groups of animals, with six animals in each group: no intra-aortic balloon pump (IABP), a short 35-mL IABP, a short 40-mL IABP, a long 35-mL IABP and a long 40-mL IABP...
November 17, 2016: Perfusion
https://www.readbyqxmd.com/read/27864460/use-of-the-octopus-endograft-technique-to-reconstruct-renovisceral-arteries-arising-from-the-false-lumen-of-a-rapidly-expanding-type-b-aortic-dissection-after-endovascular-repair
#19
Jiang Xiong, Yangyang Ge, Xiaoping Liu, Lijun Wang, Wei Guo
PURPOSE: To describe the use and 6-month outcomes of the octopus endograft technique to reconstruct renovisceral arteries arising from the false lumen (FL) of a type B aortic dissection after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 46-year-old man post TEVAR for type B aortic dissection was admitted with persistent back pain and a rapidly expanding residual dissection. The celiac and left renal arteries arose from the FL and the superior mesenteric artery from both lumens, with the FL as its main supply...
November 17, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27861423/influence-of-iabp-induced-abdominal-occlusions-on-aortic-hemodynamics-a-patient-specific-computational-evaluation
#20
Maria Vittoria Caruso, Attilio Renzuli, Gionata Fragomeni
Intra-aortic balloon pump (IABP) is used as temporary mechanical assistance in case of cardiovascular diseases, even if different hemodynamic problems and, so, clinical complications may happen, such as the decrease of visceral perfusion. A computational fluid dynamic (CFD) study was carried out in order to investigate the effects of different IABP-induced abdominal occlusions on patient-specific aortic flow. Two possible sizes (25 cm3 and 34 cm3) and two locations (2 cm and 3 cm) of the balloon were compared, modelling four abdominal occlusions and numerically reproducing IAB inflation/deflation behaviour...
November 16, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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