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Lead avr

Konstadinos Plestis, Oleg Orlov, Vishal N Shah, Joshua Wong, Matthew Thomas, Alon Aharon, Cinthia Orlov, Georgia Panagopoulos, Scott Goldman
OBJECTIVES: Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS: A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Thomas Walther, Ganesh Manoharan, Axel Linke, Helge Möllmann, David Holzhey, Stephen G Worthley, Won-Keun Kim, Ulrich Schäfer
OBJECTIVES: To examine the incidence and timing of new-onset left bundle branch block (LBBB) and new permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve implantation (TAVI) using the repositionable, self-expanding Portico™ TAVI system (St. Jude Medical, St Paul, MN, USA). Clinical impact and periprocedural factors associated with new PPI were also assessed. METHODS: A total of 198 high-risk patients without pre-existing pacemaker [83...
March 9, 2018: European Journal of Cardio-thoracic Surgery
Derek Leong, Ali A Sovari, Ashkan Ehdaie, Tarun Chakravarty, Qiang Liu, Hasan Jilaihawi, Rajendra Makkar, Xunzhang Wang, Eugenio Cingolani, Michael Shehata
BACKGROUND: Damage to the cardiac conduction system requiring permanent pacemaker (PPM) implantation is a known adverse outcome of transcatheter aortic valve replacement (TAVR). A permanent-temporary pacemaker (PTPM) is a device that involves an active-fixation lead attached to an external pulse generator taped to the skin. We reviewed the utility of PTPMs as a temporary bridge measure after TAVR in patients with conduction abnormalities that do not meet conventional criteria for PPM placement...
March 12, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Mark Webster, Sanjeevan Pasupati, Nigel Lever, Martin Stiles
OBJECTIVE: This first-in-human study evaluated the safety and technical feasibility of the Tempo temporary cardiac pacing lead (BioTrace Medical), which includes a novel fixation mechanism and soft tip. BACKGROUND: Complications of temporary pacing leads include dislodgment, arrhythmias, and ventricular perforation. Temporary pacing applications have increased with transcatheter aortic valve replacement (TAVR) growth, for rapid pacing during balloon valvuloplasty (BAV) and valve deployment, and for periprocedural bradyarrhythmia support...
February 15, 2018: Journal of Invasive Cardiology
Erich Gygax, Hans-Ulrich Kaeser, Mario Stalder, Brigitta Gahl, Robert Rieben, Thierry Carrel, Gabor Erdoes
Extracorporeal circulation triggers systemic inflammatory response and coagulation disorders which may lead to unfavorable clinical outcome. A type II minimally-invasive extracorporeal circuit (MiECC) is a closed system with markedly reduced artificial surface as compared to conventional extracorporeal circuits (CECC). The aim of this study was to investigate and compare inflammatory responses, complement activation and selected clinical end-points in isolated surgical aortic valve replacement (SAVR) performed with a type II MiECC circuit or a CECC...
February 12, 2018: Artificial Organs
Stephen H Little, Jeffrey J Popma, Neal S Kleiman, G Michael Deeb, Thomas G Gleason, Steven J Yakubov, Stan Checuti, Daniel O'Hair, Tanvir Bajwa, Mubashir Mumtaz, Brijeshwar Maini, Alan Hartman, Stanley Katz, Newell Robinson, George Petrossian, John Heiser, William Merhi, B Jane Moore, Shuzhen Li, David H Adams, Michael J Reardon
OBJECTIVES: Patients with symptomatic severe aortic stenosis and severe mitral regurgitation or severe tricuspid regurgitation were excluded from the major transcatheter aortic valve replacement trials. We studied these 2 subgroups in patients at extreme risk for surgery in the prospective, nonrandomized, single-arm CoreValve US Expanded Use Study. METHODS: The primary end point was all-cause mortality or major stroke at 1 year. A favorable medical benefit was defined as a Kansas City Cardiomyopathy Questionnaire overall summary score greater than 45 at 6 months and greater than 60 at 1 year and with a less than 10-point decrease from baseline...
January 31, 2018: Journal of Thoracic and Cardiovascular Surgery
Chekrallah Chamandi, Marco Barbanti, Antonio Munoz-Garcia, Azeem Latib, Luis Nombela-Franco, Enrique Gutiérrez-Ibanez, Gabriela Veiga-Fernandez, Asim N Cheema, Ignacio Cruz-Gonzalez, Vicenç Serra, Corrado Tamburino, Antonio Mangieri, Antonio Colombo, Pilar Jiménez-Quevedo, Jaime Elizaga, Gerard Laughlin, Dae-Hyun Lee, Bruno Garcia Del Blanco, Tania Rodriguez-Gabella, Josep-Ramon Marsal, Mélanie Côté, François Philippon, Josep Rodés-Cabau
OBJECTIVES: This study sought to evaluate the long-term clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Conduction disturbances leading to PPI are common following TAVR. However, no data exist regarding the impact of PPI on long-term outcomes post-TAVR. METHODS: This was a multicenter study including a total of 1,629 patients without prior PPI undergoing TAVR (balloon- and self-expandable valves in 45% and 55% of patients, respectively)...
February 12, 2018: JACC. Cardiovascular Interventions
Alfredo Giuseppe Cerillo, Francesca Amoretti, Massimiliano Mariani, Emanuele Cigala, Michele Murzi, Tommaso Gasbarri, Marco Solinas, Dante Chiappino
BACKGROUND: Significant underexpansion or distortion of valved stents may be associated with altered leaflet function, leading to increased transprosthetic gradients and, possibly, early structural degeneration. We investigated the relationship between a computed tomography (CT) measure of the degree of oversizing and the early haemodynamic and clinical outcomes in patients undergoing aortic valve replacement with the Perceval sutureless aortic valve. METHODS: The degree of oversizing of the implanted prosthesis was calculated as the ratio between the patients' aortic annulus cross-sectional area (CSA) and the ex-vivo CSA of the implanted prosthesis in 151 perceval patients that had a preoperative cardiac CT...
February 2, 2018: Annals of Thoracic Surgery
Laura M Seese, Faisal G Bakaeen, Ibrahim Sultan, Danny Chu
Incompletely seated knots (air knots) during surgical aortic valve replacement can be potentially difficult to repair in anatomically challenging areas around the aortic root. This is especially true with mechanical protheses as subvalvular areas are inaccessble once the valve is seated. In this report, we present a novel and simple technique of tightening air knots from within the aortic root without removing the prosthesis. The definitive surgical therapy for aortic valve disease has been in evolution since the advent of cardiopulmonary bypass and the development of aortic valve prostheses...
February 2, 2018: Annals of Thoracic Surgery
Samuel Latham, Tamunoinemi Bob-Manuel, Arindam Sharma, Amit Nanda, Devareshi Ardeshna, Rami N Khouzam
Aortic stenosis (AS) is a common cause of valvular heart disease with heavy disease burden in elderly patients. It is present in almost 7% of patients older than 65. The mortality rate increases significantly once it becomes symptomatic with average life expectancy of around 1-year. Symptoms include angina, syncope, or heart failure. This requires either surgical or transcutaneous replacement. Transcutaneous aortic valve replacement (TAVR) use has increased in recent years from high risk patients to now even including intermediate risk patients...
January 2018: Annals of Translational Medicine
Yun-Tao Zhao, Hang Zhou, Ruiqi Shi, Bin Wang
An ECG pattern of widespread ST depression in six or more precordial and inferior leads, accompanied by ST-segment elevation in the aVR and/or V1 leads, is typical of the non-ST-segment elevation myocardial infarction (NSTEMI) pattern associated left main (LM) artery occlusion, but this ECG pattern is really associated with a subocclusion of the LM, or in the case that the LM was occluded with the presence of collateral circulation. There are few reports of ST-elevation myocardial infarction (STEMI) due to acute total LM occlusion...
February 2, 2018: Journal of Electrocardiology
André B de Souza, Renan P S Rodrigues, Gerson T Pessoa, Andrezza Bs da Silva, Laecio S Moura, Francisco Ca Sousa, Elzivânia G da Silva, Anaemilia N Diniz, Maria Aps Barbosa, Jefferson R Araújo, Igor C Santos, Porfirio C Guerra, Jacyara Jrp Alves, Kássio V Macedo, Bruno Lm Diniz, Danielle C Marques, Flávio R Alves
Capuchin monkeys are a species of arboreal primate found in all South American countries. These monkeys have been highlighted for their potential for biomedical research due to their anatomic and physiologic similarities and genetic homology with humans. Here we characterized the electrocardiographic tracings from 12 healthy, young capuchin monkeys that were restrained with ketamine and midazolam. All 12 monkeys had normal sinus rhythms. Neither P-wave duration, PR interval, QT interval, nor P- or R-wave amplitude (in millivolts) differed between males and females...
January 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Jess L Thompson, Alan M Speir, Douglas J Mathisen, Keith S Naunheim, Richard L Prager, Stephen J Lahey
In the late 1990s, several federal government health policy decisions threatened the viability of thoracic surgery as a specialty. To respond to such decisions, active participation in political processes was given extremely high priority by the Executive Committee of The Society of Thoracic Surgeons (STS). Creation of the STS Political Action Committee (STS-PAC) in 1997 was a part of the platform of participation. The purpose of the STS-PAC is to enhance the Society's voice and stature in health care policymaking...
January 31, 2018: Annals of Thoracic Surgery
Sandeep Banga, Marco A Barzallo, Casey L Nighswonger, Sudhir Mungee
We report a challenging case of a 81-year-old male with history of severe calcific aortic valve stenosis and aneurysmal membranous interventricular septum. The presence of anomalies in the sub-annular area can lead to valve malpositioning and its consequences. transcatheter aortic valve implantation (TAVR) in patients with aneurysm of the perimembranous interventricular septum extending into the left ventricular outflow tract has not been previously reported. This case describes a successful transfemoral TAVR with an Edwards SAPIEN XT valve (Edwards Lifesciences, Irvine, CA, United States) with such anomaly...
January 26, 2018: World Journal of Cardiology
Stefanie Samietz, Clemens Jürgens, Till Ittermann, Birte Holtfreter, Christiane Pink, Sabine Schipf, Reiner Biffar, Henry Völzke, Thomas Kocher, Frank Tost
AIM: To investigate the relation between oral health status and microcirculation we analyzed the association between periodontitis and number of teeth with retinal vessel diameters. METHODS: We analyzed data from 4420 subjects from the Study-of-Health-in-Pomerania-TREND (SHIP-TREND). All subjects (3183 for number of teeth, 3013 for mean probing depth, 2894 for mean attachment level) underwent nonmydriatic funduscopy and dental examination. We measured central retinal arteriolar (CRAE), venular (CRVE) vessel diameters and calculated arterio-venous-ratio (AVR) from static-vessel-analysis...
January 31, 2018: Journal of Clinical Periodontology
Marco Di Eusanio, Walter Vessella, Roberto Carozza, Filippo Capestro, Alessandro D'Alfonso, Carlo Zingaro, Christopher Munch, Paolo Berretta
Aortic valve replacement (AVR) via a median sternotomy approach has been largely reported to be safe and long-term efficacious, and currently represents the 'gold standard' approach for aortic stenosis treatment. However, aortic valve surgery has undergone continuous development over the last years, involving less invasive techniques and new technologies to reduce the traumatic impact of the intervention and extend the operability toward increasingly high-risk patients. Indeed, minimally invasive AVR and transcatheter aortic valve replacement caseload have steadily increased leading to a paradigm shift in the treatment of aortic valve disease...
January 23, 2018: European Journal of Cardio-thoracic Surgery
Eka Ginanjar, Yulianto Yulianto
The purpose of this case repots are to evaluate the role of ST elevation in aVR lead and to make analysis between both cases. There are some atypical electrocardiogram (ECG) presentations which need prompt management in patient with ischemic clinical manifestation such as ST elevation in aVR lead. In this case study, we report a 68-year old woman with chief symptoms of shortness of breath and chest discomfort. She was diagnosed with cardiogenic shock, with Killip class IV, and TIMI score of 8. The second case is a 57-year-old man with typical chest pain at rest which could not be relieved with nitrate treatment...
October 2017: Acta Medica Indonesiana
Saša D Borović, Milica M Labudović Borović, Ivan V Zaletel, Vera N Todorović, Petar A Dabić, Jelena T Rakočević, Jelena M Marinković-Erić, Predrag S Milojević
BACKGROUND: Histopathological changes in the ascending aorta wall in patients with severe tricuspid aortic valve (TAV) stenosis were graded and correlated to echocardiographic parameters. Objective was to associate threshold echocardiographic values with structural defects in the ascending aorta providing a tool to improve decision-making process in cases when simultaneous aortic valve replacement (AVR) and ascending aorta replacement is considered. METHODS: Biopsies from 108 TAV stenosis patients subjected to AVR were graded into three grades according to severity of aortic wall changes...
January 18, 2018: Journal of Cardiothoracic Surgery
Sung-Han Yoon, Rahul Sharma, Tarun Chakravarty, Masaki Miyasaka, Tomoki Ochiai, Takahiro Nomura, Norman Gellada, Shadi Nemanpour, Mamoo Nakamura, Wen Chen, Raj Makkar
Bicuspid aortic valve is the most common congenital cardiac defect in adults, and symptom typically develops in adulthood. In the majority of cases, bicuspid aortic valve disease progress with ages and surgical aortic valve replacement is performed with excellent operative outcomes. However, with the relatively slow progression of disease, surgical aortic valve replacement is required in elderly patients but the surgical risk often deemed extremely high due to old age and multiple comorbidities. Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for intermediate- and high-risk patients with symptomatic severe aortic valve stenosis (AS)...
January 11, 2018: Journal of Cardiovascular Surgery
Yuki Komatsu, Akihiko Nogami, Yasutoshi Shinoda, Keita Masuda, Takeshi Machino, Kenji Kuroki, Hiro Yamasaki, Yukio Sekiguchi, Kazutaka Aonuma
BACKGROUND: The communicating vein (CV) between the great cardiac vein and small cardiac venous systems passes between the aortic and pulmonary annulus and is located in close association with the left ventricular summit (summit CV). METHODS AND RESULTS: Thirty-one patients with idiopathic ventricular arrhythmias (VAs) underwent mapping of the left ventricular summit by using a 2F microcatheter introduced into the summit CV with coronary sinus venographic guidance...
January 2018: Circulation. Arrhythmia and Electrophysiology
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