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https://www.readbyqxmd.com/read/29455964/polytetrafluoroethylene-conduits-versus-homografts-for-right-ventricular-outflow-tract-reconstruction-in-infants-and-young-children-an-institutional-experience
#1
Christopher W Mercer, Shawn C West, Mahesh S Sharma, Masahiro Yoshida, Victor O Morell
OBJECTIVE: Our institution uses a valved polytetrafluoroethylene conduit as an alternative to homografts. The objective of this study was to investigate the performance of bicuspid valved polytetrafluoroethylene conduits used for right ventricular outflow tract reconstruction in children aged less than 2 years and to evaluate risk factors for earlier conduit explant. METHODS: We performed an Institutional Review Board-approved retrospective chart review of all patients aged less than 2 years who underwent surgical right ventricular outflow tract reconstruction with a bicuspid valved polytetrafluoroethylene conduit or homograft conduit from July 2004 to December 2014...
January 31, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29455823/sequential-melody-valve-insertion-after-repair-of-tetralogy-of-fallot-atrioventricular-septal-defect
#2
Damien Kenny, Terence Prendiville, Kevin P Walsh, Jonathan McGuinness
Repair of tetralogy of Fallot with atrioventricular septal defect may be associated with hemodynamic challenges in the postoperative period particularly as left atrial hypertension secondary to left atrioventricular valve dysfunction may exacerbate pulmonary regurgitation and augment low cardiac output. We present a case describing hybrid strategies to treat severe left atrioventricular and pulmonary valve regurgitation with modified balloon expandable stent valves to counter low cardiac output secondary to valve dysfunction...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455804/step-by-step-aortic-valve-replacement-with-a-new-rapid-deployment-valve
#3
Kevin D Accola, W Randolph Chitwood, Mubashir A Mumtaz, Glenn R Barnhart
PURPOSE: Rapid deployment/sutureless aortic valve replacement is aimed at minimizing the invasiveness of surgical aortic valve replacement. We describe the implantation techniques of a new rapid deployment aortic valve, focusing on its unique and challenging features. DESCRIPTION: The EDWARDS INTUITY Elite aortic valve (Edwards Lifesciences, Irvine, CA) represents a hybrid between the surgical PERIMOUNT Magna Ease (Edwards Lifesciences) pericardial valve, but with advanced features of the percutaneous SAPIEN valve system (Edwards Lifesciences)...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455034/preoperative-risk-factors-for-unexpected-postoperative-intensive-care-unit-admission-a-retrospective-case-analysis
#4
Joshua B Knight, Evan E Lebovitz, Theresa A Gelzinis, Ibtesam A Hilmi
INTRODUCTION: The purpose of this retrospective case-control study was to investigate preoperative risk factors for unexpected postoperative intensive care unit (ICU) admissions in patients undergoing non-emergent surgical procedures in a tertiary medical centre. METHODS: A medical record review of adult patients undergoing elective non-cardiac and non-transplant major surgical procedures during the period of January 2011 through December 2015 in the operating rooms of a large university hospital was carried out...
February 15, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29454583/post-operative-ventricular-flow-dynamics-following-atrioventricular-valve-surgical-and-device-therapies-a-review
#5
REVIEW
Yen Ngoc Nguyen, Munirah Ismail, Foad Kabinejadian, Edgar Lik Wui Tay, Hwa Liang Leo
Intra-ventricular flow dynamics has recently emerged as an important evaluation and diagnosis tool in different cardiovascular conditions. The formation of vortex pattern during the cardiac cycle has been suggested to play important epigenetic and energy-modulation roles in cardiac remodelling, adaptations and mal-adaptations. In this new perspective, flow alterations due to different cardiovascular procedures can affect the long-term outcome of those procedures. Especially, repairs and replacements performed on atrioventricular valves are likely to exert direct impact on intra-ventricular flow pattern...
February 14, 2018: Medical Engineering & Physics
https://www.readbyqxmd.com/read/29454487/a-cost-utility-analysis-of-transcatheter-versus-surgical-aortic-valve-replacement-for-the-treatment-of-aortic-stenosis-in-the-population-with-intermediate-surgical-risk
#6
Derrick Y Tam, Avery Hughes, Stephen E Fremes, Saerom Youn, Rebecca L Hancock-Howard, Peter C Coyte, Harindra C Wijeysundera
OBJECTIVE: Although transcatheter aortic valve implantation has been shown to be noninferior to surgical aortic valve replacement in patients with severe aortic stenosis at intermediate surgical risk, the cost-effectiveness of this strategy in this population is unknown. Our objective was to conduct a cost-utility analysis comparing transcatheter aortic valve implantation with surgical aortic valve replacement in the population with intermediate risk severe aortic stenosis. METHODS: A fully probabilistic Markov model with 30-day cycles was constructed from the Canadian third-party payer's perspective to estimate the difference in cost and effectiveness (measured as quality-adjusted life years) of transcatheter aortic valve implantation versus surgical aortic valve replacement for intermediate-risk patients over a lifetime time horizon, discounted at 1...
February 2, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29454380/quality-of-life-satisfaction-and-outcomes-after-ministernotomy-versus-full-sternotomy-isolated-aortic-valve-replacement-quality-avr-study-protocol-for-a-randomised-controlled-trial
#7
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29453309/sutureless-perceval-aortic-valve-versus-conventional-stented-bioprostheses-meta-analysis-of-postoperative-and-midterm-results-in-isolated-aortic-valve-replacement
#8
REVIEW
Massimo Meco, Andrea Montisci, Antonio Miceli, Paolo Panisi, Francesco Donatelli, Silvia Cirri, Matteo Ferrarini, Antonio Lio, Mattia Glauber
BACKGROUND: Aortic stenosis is the most common valvular disease and has a dismal prognosis without surgical treatment. The aim of this meta-analysis was to quantitatively assess the comparative effectiveness of the Perceval (LivaNova) valve versus conventional aortic bioprostheses. METHODS AND RESULTS: A total of 6 comparative studies were identified, including 639 and 760 patients who underwent, respectively, aortic valve replacement with the Perceval sutureless valve (P group) and with a conventional bioprosthesis (C group)...
February 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29453001/transmitral-septal-myectomy-for-hypertrophic-obstructive-cardiomyopathy
#9
Brody Wehman, Mehrdad Ghoreishi, Nathaniel Foster, Libin Wang, Michael N D'Ambra, Nathan Maassel, Sam Maghami, Rachael Quinn, Murtaza Dawood, Stacy Fisher, James S Gammie
BACKGROUND: Intrinsic abnormalities of the mitral valve are common in patients with hypertrophic cardiomyopathy and may need to be addressed at operation. METHODS: Consecutive patients undergoing transmitral septal myectomy were retrospectively reviewed. The ventricular septum was exposed through a left atriotomy, and the anterior leaflet of the mitral valve was detached from its annulus. An extended myectomy was performed to the base of the papillary muscles. After myectomy, the anterior leaflet was reattached and concomitant mitral valve repair or replacement was performed...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29452875/use-of-expanders-for-bowel-protection-in-pediatric-pelvic-tumor-radiation-therapy-15-years-of-tolerance-results
#10
Fernand Missohou
PURPOSE: Bowel is often the dose-limiting organ in curative pelvic irradiation because of radiation enteritis when dose exceeds 40 to 45 Gy. To limit radiation enteritis, a silicone tissue-expander prothesis (STEP) connected to a subcutaneous self-sealing valve was prospectively used in children undergoing pelvic or abdominal radiation therapy. This study reports the 15-year long-term outcomes of this prospective series. METHODS AND MATERIALS: Between 1987 and 2008, 29 children from 3 Paris institutions received pelvic radiation therapy after surgical placement of a STEP in the pelvis...
December 14, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/29452395/mini-extracorporeal-circulation-technology-conventional-bypass-and-prime-displacement-in-isolated-coronary-and-aortic-valve-surgery-a-propensity-matched-in-hospital-and-survival-analysis
#11
Priyadharshanan Ariyaratnam, Lindsay A Mclean, Alexander Cale, Mubarak A Chaudhry, Ajith Vijayan, Neil Richards, Martin A Jarvis, Yama Haqzad, Dumbor Ngaage, Michael E Cowen, Mahmoud Loubani
OBJECTIVES: Conventional cardiopulmonary bypass is the most commonly used means of artificial circulation in cardiac surgery. However, it suffers from the effects of haemodilution and activation of inflammatory/coagulation cascades. Prime displacement (PD) can offset haemodilution and Mini-Extracorporeal Technology (MIECT) can offset both. So far, no study has compared all of these modalities together; hence, we compared the outcomes of these 3 modalities at our institution. METHODS: This was a retrospective analysis of our cardiac surgical database...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29450784/-a-challenging-decision-making-process-pro-or-con-surgical-heart-valve-replacement-in-a-case-of-long-term-non-adherence-a-case-report
#12
René Florian Oswald, H Christof Müller-Busch
A young, still multimorbid woman aquires infectious endocarditis. Anamnestically severe non-adherence concerning medical advice is reported. Complete cure may only be achieved by performing surgical heart valve replacement, which implies lifelong scrupulous oral anticoagulation postoperatively. Discussion evolves within medical staff, whether surgery should be indicated or not.
February 15, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29447771/topographical-distribution-of-perioperative-cerebral-infarction-associated-with-transcatheter-aortic-valve-implantation
#13
Jonathon P Fanning, Allan J Wesley, Darren L Walters, Andrew A Wong, Adrian G Barnett, Wendy E Strugnell, David G Platts, John F Fraser
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is associated with a high incidence of cerebrovascular injury. As these injuries are thought to be primarily embolic, neuroprotection strategies have focused on embolic protection devices. However, the topographical distribution of cerebral emboli and how this impacts on the effectiveness of these devices have not been thoroughly assessed. Here, we evaluated the anatomical characteristics of magnetic resonance imaging (MRI)-defined cerebral ischemic lesions occurring secondary to TAVI to enhance our understanding of the distribution of cardioembolic phenomena...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29445840/-serious-adverse-events-in-clinical-trials-with-tavr-and-savr
#14
U Barth
BACKGROUND: The expansion of the transcatheter aortic valve replacement (TAVR) indication towards patients with intermediate surgical risk (Ref. Society of Thoracic Surgeons, STS, score) was analyzed. The aim was to investigate if the complication rates particularly with respect to TAVR and surgical aortic valve replacement (SAVR) concerning patients with intermediate risk are comparable. METHODS: An analysis of serious adverse events (SAEs) and complication rates in clinical trials with TAVR and SAVR of these patients in comparison with high surgical risk patients was performed with the scientific literature and in the Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM) database (2012-2017)...
February 14, 2018: Herz
https://www.readbyqxmd.com/read/29445001/interventional-treatment-of-severe-tricuspid-regurgitation-early-clinical-experience-in-a-multicenter-observational-first-in-man-study
#15
Alexander Lauten, Hans R Figulla, Axel Unbehaun, Neil Fam, Joachim Schofer, Torsten Doenst, Joerg Hausleiter, Marcus Franz, Christian Jung, Henryk Dreger, David Leistner, Brunilda Alushi, Anja Stundl, Ulf Landmesser, Volkmar Falk, Karl Stangl, Michael Laule
BACKGROUND: Transcatheter caval valve implantation is under evaluation as a treatment option for inoperable patients with severe tricuspid regurgitation (TR). The procedure involves the catheter-based implantation of bioprosthetic valves in the inferior vena cava and superior vena cava to treat symptoms associated with TR. This study is the first to evaluate the feasibility, safety, and efficacy of this interventional concept. METHODS AND RESULTS: Twenty-five patients (mean age, 73...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29444694/reliability-and-construct-validity-of-the-ottawa-valve-collapse-scale-when-assessing-external-nasal-valve-collapse
#16
Hedyeh Ziai, James P Bonaparte
BACKGROUND: Nasal valve collapse is a common cause of nasal obstruction in otolaryngology practice. Common examination methods, such as the Cottle Maneuver and modified Cottle Maneuver are available. However, these methods are dichotomous and do not provide ordinal severity information. The Ottawa Valve Collapse Scale (OVCS) is a grading system for assessing and easily grading external nasal valve collapse in patients with a septal deviation. The primary objective was to assess the test-retest reliability and construct validity of the OVCS grading scale...
February 14, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29442998/acute-kidney-injury-following-percutaneous-edge-to-edge-vs-minimally-invasive-surgical-mitral-valve-repair-incidence-predictors-and-prognostic-value
#17
Maria Isabel Körber, Maximilian Scherner, Kathrin Kuhr, Hugai Kasisada, Svenja Ney, Roman Pfister, Parwis Rahmanian, Jens Wippermann, Thorsten Wahlers, Stephan Baldus, Volker Rudolph
AIMS: This study sought to determine the incidence and identify predictors of acute kidney injury (AKI) following percutaneous edge-to-edge mitral valve repair (PMVR) and compare the risk of AKI between PMVR and surgical mitral valve repair (SMVR). METHODS AND RESULTS: We performed a single-centre analysis of 378 patients receiving treatment for mitral regurgitation (196 consecutive patients undergoing PMVR and 182 patients undergoing SMVR). The incidence of AKI (any stage according to KDIGO) following PMVR was 17...
October 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29440878/functionality-and-outcome-in-older-patients-with-severe-aortic-stenosis-foopas-an-interdisciplinary-study-concept-for-a-prospective-trial
#18
Ferdinand Vogt, Susanne Wicklein, Markus Gosch, Jürgen Jessl, Wolfgang Hitzl, Theodor Fischlein, Matthias Pauschinger, Steffen Pfeiffer, Dennis Eckner
Background: Frailty is a geriatric syndrome that can influence mortality and functional recovery after treatment of severe aortic stenosis (AS). The integration of standardized geriatric assessment (GA) in clinical practice is limited by a lack of consensus on how to measure it. Objectives: This study aims to compare the incremental predictive value of different frailty scales to predict the outcomes following surgical aortic valve replacement, transcatheter aortic valve implantation, and conservative treatment of severe AS...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29440218/impact-of-renin-angiotensin-system-inhibitors-on-clinical-outcomes-and-ventricular-remodelling-after-transcatheter-aortic-valve-implantation-rationale-and-design-of-the-rastavi-randomised-multicentre-study
#19
Ignacio J Amat-Santos, Pablo Catalá, Felipe Diez Del Hoyo, Jose A Fernandez-Diaz, Juan H Alonso-Briales, María Del Trigo, Ander Regueiro, Pablo Juan-Salvadores, Vicenç Serra, Enrique Gutierrez-Ibanes, Antonio J Muñoz-García, Luis Nombela-Franco, Manel Sabate, Victor A Jimenez-Diaz, Bruno García Del Blanco, Javier López, Luis H Varela-Falcón, Teresa Sevilla, Roman Arnold, Ana Revilla, J Alberto San Roman
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement. METHODS AND ANALYSIS: The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure...
February 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29440154/outcomes-comparison-of-different-surgical-strategies-for-the-management-of-severe-aortic-valve-stenosis-study-protocol-of-a-prospective-multicentre-european-registry-e-avr-registry
#20
Francesco Onorati, Riccardo Gherli, Giovanni Mariscalco, Evaldas Girdauskas, Eduardo Quintana, Francesco Santini, Marisa De Feo, Sandro Sponga, Piergiorgio Tozzi, Mohamad Bashir, Andrea Perrotti, Aniello Pappalardo, Vito Ruggieri, Giuseppe Santarpino, Mauro Rinaldi, Silva Ronaldo, Francesco Nicolini
INTRODUCTION: Traditional and transcatheter surgical treatments of severe aortic valve stenosis (SAVS) are increasing in parallel with the improved life expectancy. Recent randomised controlled trials (RCTs) reported comparable or non-inferior mortality with transcatheter treatments compared with traditional surgery. However, RCTs have the limitation of being a mirror of the predefined inclusion/exclusion criteria, without reflecting the 'real clinical world'. Technological improvements have recently allowed the development of minimally invasive surgical accesses and the use of sutureless valves, but their impact on the clinical scenario is difficult to assess because of the monocentric design of published studies and limited sample size...
February 10, 2018: BMJ Open
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