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https://www.readbyqxmd.com/read/29348386/st-elevation-in-lead-avr-and-its-association-with-clinical-outcomes
#1
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
https://www.readbyqxmd.com/read/29347958/correlation-of-structural-defects-in-the-ascending-aortic-wall-to-ultrasound-parameters-benefits-for-decision-making-process-in-aortic-valve-surgery
#2
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
https://www.readbyqxmd.com/read/29332374/transcatheter-aortic-valve-replacement-in-bicuspid-aortic-valve-stenosis-where-do-we-stand
#3
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
https://www.readbyqxmd.com/read/29326128/idiopathic-ventricular-arrhythmias-originating-from-the-vicinity-of-the-communicating-vein-of-cardiac-venous-systems-at-the-left-ventricular-summit
#4
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
https://www.readbyqxmd.com/read/29326113/acute-heart-failure-with-new-onset-continuous-murmur-in-a-26-year-old-man
#5
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
CLINICAL INTRODUCTION: A 26-year-old man with an unremarkable medical history sensed a momentary retrosternal 'pop' followed by overwhelming dyspnoea, without reporting any prodromal symptoms. At the emergency department, he had a significant tachycardia (170 bpm) and an extreme low diastolic blood pressure (<30 mm Hg). A loud, harsh and continuous murmur could be maximally auscultated at the right lower sternal border. ECG revealed global ST depression with ST elevation in lead aVR...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29305147/repair-of-a-quadricuspid-autograft
#6
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/29297188/primary-safety-and-effectiveness-feasibility-study-after-surgical-aortic-valve-replacement-with-a-new-generation-bioprosthesis-one-year-outcomes
#7
Krzysztof Bartus, Radosław Litwinowicz, Mariusz Kusmierczyk, Agata Bilewska, Maciej Bochenek, Maciej Stapor, Sebastian Wozniak, Jacek Rozanski, Jerzy Sadowski, Boguslaw Kapelak
BACKGROUND: Structural valve deterioration (SVD) is a major obstacle to lifetime durability for bioprosthetic heart valves. Bioprosthetic valve created with RESILIA™ tissue was designed to produce long-term resistance to SVD. AIM: The objective of this study was to evaluate the safety and performance of this new class of RESILIA™ tissue aortic bioprosthesis. METHODS: A nonrandomized, prospective, multi-center, single-arm, observational study was performed in 133 patients who underwent surgical aortic valve replacement between July 2011 and February 2013...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29245315/st-segment-change-and-t-wave-amplitude-ratio-in-lead-avr-associated-with-coronary-artery-disease-severity-in-patients-with-non-st-elevation-myocardial-infarction-a-retrospective-study
#8
Yahya Kemal İçen, Mevlüt Koç
Non-ST elevation myocardial infarction (NSTEMI) severity is difficult only with electrocardiogram (ECG). In most cases, NSTEMI patients are followed with cardiac enzymes without early invasive intervention if no severe chest pain exists in the emergency department (ED) or coronary intensive care unit (CICU).Our aim was to evaluate association between CAD severity and ST segment change in lead aVR (STaVR)/T wave amplitude in lead aVR (TAaVR) ratio in patients with NSTEMI.We included 306 patients with NSTEMI in the ED between 2015 and 2016...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29223434/durability-of-quality-of-life-benefits-of-transcatheter-aortic-valve-replacement-long-term-results-from-the-corevalve-us-extreme-risk-trial
#9
MULTICENTER STUDY
Suzanne J Baron, Suzanne V Arnold, Matthew R Reynolds, Kaijun Wang, Michael Deeb, Michael J Reardon, James Hermiller, Steven J Yakubov, David H Adams, Jeffrey J Popma, David J Cohen
BACKGROUND: For patients with severe aortic stenosis (AS) at extreme surgical risk, transcatheter aortic valve replacement (TAVR) leads to improved survival and health status when compared with medical therapy. Whether the early health status benefits of TAVR in these patients are sustained beyond 1 year of follow-up is unknown. METHODS AND RESULTS: Six hundred thirty-nine patients with severe AS at extreme surgical risk underwent TAVR in the CoreValve US Extreme Risk Pivotal trial...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29201955/the-relationship-of-st-segment-changes-in-lead-avr-with-outcomes-after-myocardial-infarction-a-cross-sectional-study
#10
Mohammad Reza Beyranvand, Mohammad Assadpour Piranfar, Mohammadreza Mobini, Mehdi Pishgahi
Introduction: Among the 12 leads studied in electrocardiography (ECG), lead aVR can be considered as the most forgotten part of it since no attention is paid to it as the mirror image of other leads. Therefore, the present study has been designed with the aim of evaluating the prevalence of ST segment changes in lead aVR and its relationship with the outcome of these patients. Methods: In this retrospective cross sectional study medical profiles of patients who had presented to emergency department with the final diagnosis of myocardial infarction (MI) in a 4-year period were evaluated regarding changes of ST segment in lead aVR and its relationship with in-hospital mortality, the number of vessels involved, infarct location and cardiac ejection fraction...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/29174248/electrocardiographic-characteristics-in-young-male-patients-with-left-primary-spontaneous-pneumothorax-estimated-by-the-collins-equation
#11
Pang-Yen Liu, Yen-Po Lin, Yi-Hwei Li, Zhi-Wei Su, Chih-Lu Han, Shih-Chung Huang, Chin-Sheng Lin, Fan-Chun Meng, Hsien-Tsai Wu, Gen-Min Lin
OBJECTIVE: To investigate the 12-lead surface electrocardiographic (ECG) findings in young male patients with left primary spontaneous pneumothorax (PSP) estimated by the Collins equation. METHODS: From 2003 through 2008, 60 young male patients who had left PSP and 61 age-matched unaffected males were included for 12-lead ECG analyses. The PSP size was estimated by the Collins equation. Those with left PSP were divided into two groups: 1) large PSP ≥30% (n=37), and 2) small PSP <30% (n=23)...
November 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29170843/the-impact-of-waiting-for-intervention-on-costs-and-effectiveness-the-case-of-transcatheter-aortic-valve-replacement
#12
Aida Ribera, John Slof, Ignacio Ferreira-González, Vicente Serra, Bruno García-Del Blanco, Purificació Cascant, Rut Andrea, Carlos Falces, Enrique Gutiérrez, Raquel Del Valle-Fernández, César Morís-de laTassa, Pedro Mota, Juan Francisco Oteo, Pilar Tornos, David García-Dorado
OBJECTIVES: The economic crisis in Europe might have limited access to some innovative technologies implying an increase of waiting time. The purpose of the study is to evaluate the impact of waiting time on the costs and benefits of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis. METHODS: This is a cost-utility analysis from the perspective of the Spanish National Health Service. Results of two prospective hospital registries (158 and 273 consecutive patients) were incorporated into a probabilistic Markov model to compare quality adjusted life years (QALYs) and costs for TAVR after waiting for 3-12 months, relative to immediate TAVR...
November 23, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/29129350/evaluation-of-ecg-algorithms-designed-to-improve-detect-of-transient-myocardial-ischemia-to-minimize-false-alarms-in-patients-with-suspected-acute-coronary-syndrome
#13
Michele M Pelter, Yuan Xu, Richard Fidler, Ran Xiao, David W Mortara, Hu Xiao
BACKGROUND: Patients hospitalized for suspected acute coronary syndrome (ACS) are at risk for transient myocardial ischemia. During the "rule-out" phase, continuous ECG ST-segment monitoring can identify transient myocardial ischemia, even when asymptomatic. However, current ST-segment monitoring software is vastly underutilized due to false positive alarms, with resultant alarm fatigue. Current ST algorithms may contribute to alarm fatigue because; (1) they are not designed with a delay (minutes), rather alarm to brief spikes (i...
October 24, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29108790/the-association-between-electrocardiographic-r-wave-peak-time-and-coronary-artery-disease-severity-in-patients-with-non-st-segment-elevation-myocardial-infarction-and-unstable-angina-pectoris
#14
İbrahim Rencüzoğulları, Metin Çağdaş, Süleyman Karakoyun, Yavuz Karabağ, Mahmut Yesin, İnanç Artaç, Doğan İliş, Murat Selçuk, Mesut Öterkuş, Halil İbrahim Tanboğa
BACKGROUND: We aimed to evaluate possible association between QRS duration (QRSD), R wave peak time (RWPT), and coronary artery disease severity identified using the SYNTAX score (SS) in patients with unstable angina pectoris (USAP) or non-ST segment elevation myocardial infarction (NSTEMI). METHOD: A total of 176 USAP/NSTEMI patients were enrolled in the study. RESULTS: The high SS group (>22, n:45) patients had a higher prevalence of diabetes mellitus (DM); presence of ST segment depression ≥0...
September 27, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29107324/daytime-variation-of-perioperative-myocardial-injury-in-cardiac-surgery-and-its-prevention-by-rev-erb%C3%AE-antagonism-a-single-centre-propensity-matched-cohort-study-and-a-randomised-study
#15
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
https://www.readbyqxmd.com/read/29102453/timing-of-conduction-abnormalities-leading-to-permanent-pacemaker-insertion-after-transcatheter-aortic-valve-implantation-a-single-centre-review
#16
Daniel Ozier, Nevena Zivkovic, Gabby Elbaz-Greener, Sheldon M Singh, Harindra C Wijeysundera
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is the preferred alternative to traditional surgical aortic valve replacement; however, it remains expensive. One potential driver of cost is the need for postprocedural monitoring for conduction abnormalities after TAVI. Given the paucity of literature on the optimal length of monitoring, we aimed to determine when clinically significant conduction abnormalities leading to permanent pacemaker (PPM) insertion after TAVI were first identified...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29050623/death-and-dialysis-after-transcatheter-aortic-valve-replacement-an-analysis-of-the-sts-acc-tvt-registry
#17
James W Hansen, Andrew Foy, Pradeep Yadav, Ian C Gilchrist, Mark Kozak, Amanda Stebbins, Roland Matsouaka, Sreekanth Vemulapalli, Alice Wang, Dee Dee Wang, Marvin H Eng, Adam B Greenbaum, William O O'Neill
OBJECTIVES: The authors sought to elucidate the true incidence of renal replacement therapy (RRT) after transcatheter aortic valve replacement (TAVR). BACKGROUND: There is a wide discrepancy in the reported rate of RRT after TAVR (1.4% to 40%). The true incidence of RRT after TAVR is unknown. METHODS: The STS/ACC TVT (Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy) registry was linked to the Centers for Medicare & Medicaid database to identify all patients that underwent TAVR from November 2011 through September 2015 and their outcomes...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29027810/electrocardiographic-characteristics-associated-with-in-hospital-outcome-in-patients-with-left-main-acute-coronary-syndrome-for-contriving-a-new-risk-stratification-score
#18
Takayuki Iida, Fumito Tanimura, Kyoko Takahashi, Hideki Nakamura, Satoshi Nakajima, Motoyuki Nakamura, Yoshihiro Morino, Tomonori Itoh
AIM: The aim of this study was to evaluate electrocardiographic characteristics associated with in-hospital prognosis in patients with left main acute coronary syndrome. METHODS AND RESULTS: A total of 89 left main acute coronary syndrome subjects were selected from 3357 consecutive acute coronary syndrome patients (2.7%). Patients of this study were divided into two groups; those who survived and those who died. Patients' characteristics and electrocardiogram on admission were then retrospectively analyzed between the two groups...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28980129/rupture-of-the-aortic-root-a%C3%A2-rare-but-life-threatening-complication-of-transcatheter-aortic-valve-replacement
#19
Christian Reiter, Michael Grund, Alexander Nahler, Clemens Steinwender, Thomas Lambert
Transcatheter aortic valve replacement (TAVR) has been shown to be a valid treatment option for patients with significant symptomatic aortic valve stenosis and high surgical risk. Rupture of the aortic root is a rare but life-threatening complication that occurs in approximately 1% of procedures and usually manifests as an acute complication at the time of valve implantation; however, physicians should be aware of a potentially subacute onset, since early recognition and immediate management are crucial...
October 4, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28964778/predictors-and-prognostic-impact-of-new-left-bundle-branch-block-after-surgical-aortic-valve-replacement
#20
Moukda Khounlaboud, Erwan Flécher, Maxime Fournet, Hervé Le Breton, Erwan Donal, Christophe Leclercq, Philippe Mabo, Alain Leguerrier, Claude Daubert
BACKGROUND: Left bundle branch block (LBBB) induces mechanical dyssynchrony that may lead to left ventricular systolic dysfunction. AIMS: To evaluate the incidence, predictors and clinical impact of new LBBB in patients undergoing surgical aortic valve replacement (SAVR). METHODS: After exclusion of patients with pre-existing LBBB, a previous pacemaker or a paced rhythm at hospital discharge, 547 consecutive patients undergoing SAVR were included...
December 2017: Archives of Cardiovascular Diseases
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