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https://www.readbyqxmd.com/read/28821336/a-randomized-clinical-trial-of-red-blood-cell-transfusion-triggers-in-cardiac-surgery
#1
Colleen G Koch, Daniel I Sessler, Edward J Mascha, Joseph F Sabik, Liang Li, Andra I Duncan, Nicole M Zimmerman, Eugene H Blackstone
BACKGROUND: Class I evidence supporting a threshold for transfusion in the cardiac surgical setting is scarce. We randomly allocated patients to a transfusion hematocrit trigger of 24% versus 28% to compare morbidity, mortality, and resource use. METHODS: From March 2007 to August 2014, two centers randomly assigned 722 adults undergoing coronary artery bypass graft surgery or valve procedures to a 24% hematocrit trigger (n = 363, low group) or 28% trigger (n = 354, high group)...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28820560/severe-valvular-aortic-stenosis-and-fixed-subvalvular-aortic-stenosis-a-rare-and-challenging-combination
#2
Ayman Elbadawi, Marwan Saad, Islam Y Elgendy, Basarat Baig, Farhad Abtahian
A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820556/unusual-locations-for-cardiac-papillary-fibroelastomas
#3
Davide Carino, Francesco Nicolini, Alberto Molardi, Clara Indira Dadamo, Tiziano Gherli
Papillary fibroelastomas (PFEs) are rare and benign cardiac tumors which usually are localized on the valves (mostly on the aortic valve), though they may originate also from the ventricles or atrial walls. Whilst, in the large majority of cases, these lesions are asymptomatic they may cause serious complications such as thromboembolic events, or more rarely valvular dysfunctions. Surgical excision is necessary for a symptomatic lesion. The management of asymptomatic lesions is not defined. Herein are reported the details of a miniseries of six cases operated on at the authors' institution between 2005 and 2015...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820553/is-transcatheter-tricuspid-valve-in-valve-implantation-feasible-in-the-presence-of-right-atrial-thrombus
#4
Jan Henzel, Zofia Dzielińska, Marek Konka, Maciej Dąbrowski, Marcin Protasiewicz, Adam Witkowski, Marcin Demkow
The case is reported of a successful transcatheter implantation of an Edwards SAPIEN 3 valve (29 mm) into a failing tricuspid bioprosthesis (Sorin Pericarbon, 31 mm). The procedure was performed in a 69-year-old woman with post-rheumatic mitral and tricuspid valve disease. Multiple previous cardiac surgeries precluded the use of another surgical approach. A large, organized, two-piece thrombus in the enlarged right atrium was not considered an absolute contraindication to the procedure. The SAPIEN 3 valve was implanted under general anesthesia, via a femoral venous access, under three-dimensional transesophageal echocardiography guidance...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#5
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820543/minimally-invasive-versus-transcatheter-and-surgical-aortic-valve-replacement-a-propensity-matched-study
#6
Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Prakash Balan, Catalin Loghin, Daniel Ocazionez, Anthony Estrera, Carson T Hoffmann, Vasilis C Babaliaros, Joseph Lamelas, Tom C Nguyen
BACKGROUND: An increasing number of options exist for the treatment of severe symptomatic aortic stenosis. The study aim was to compare short-term outcomes in patients undergoing surgical aortic valve replacement (SAVR), minimally invasive aortic valve replacement (MIAVR), and transcatheter aortic valve replacement (TAVR). METHODS: A multi-institutional retrospective review of 2,571 patients undergoing SAVR (n = 842), MIAVR via right anterior thoracotomy (n = 699) and TAVR (n = 1,030) between 2011 and 2014 was conducted...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820540/endoscopic-port-access-surgery-for-late-orthotopic-cardiac-transplantation-atrioventricular-valve-disease
#7
Johan van der Merwe, Filip Casselman, Bernard Stockman, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
BACKGROUND: The study aim was to present details of the perioperative and long-term outcomes of redo-endoscopic port access surgery (REPAS) for late atrioventricular valve disease (AVVD) in orthotopic cardiac transplant (OCT) patients. METHODS: Between February 2004 and October 2015, REPAS was performed for late AVVD in seven consecutive OCT patients (mean age 57.9 ± 17.2 years; EuroSCORE II 21.2 ± 14.7%) at the authors' institution. The mean OCT-REPAS time interval was 7...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820034/the-value-of-adding-sub-valvular-procedures-for-chronic-ischemic-mitral-regurgitation-surgery-a-meta-analysis
#8
Marco Moscarelli, Thanos Athanasiou, Giuseppe Speziale, Prakash P Punjabi, George Malietzis, Patrizio Lancellotti, Khalil Fattouch
BACKGROUND: The most performed repair technique for the treatment of chronic ischemic mitral regurgitation in patients referred for bypass grafting remains restricted annuloplasty. However, it is associated with a high rate of failure, especially if severe tenting exists. OBJECTIVES: To understand if adjunctive sub-valvular mitral procedures may provide better repair performance. METHODS: A systematic literature review identified six studies of which five fulfilled the criteria for meta-analysis...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28819828/-patio-repair-for-urethrocutaneous-fistulae-results-of-a-multicentre-retrospective-study
#9
REVIEW
J Kranz, O A Brinkmann, B Brinkmann, J Steffens, P Malone
BACKGROUND: Urethrocutaneous (UC) fistulae are common complications after hypospadias surgery and they have been a serious problem for surgeons since the repair was first attempted. We present the results of our multicentre retrospective study for repairing UC fistulae using the Patio ("preserve the tract and turn it inside out") repair described by Malone. MATERIALS AND METHODS: A total of 16 boys (Eschweiler 2, Lingen 4, Reading 10) at the ages of 1-10 years were treated for UC fistulae...
August 17, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28818562/conduction-recovery-and-avoidance-of-permanent-pacing-after-transcatheter-aortic-valve-implantation
#10
Corinne Marzahn, Cornel Koban, Martin Seifert, Akihiro Isotani, Michael Neuß, Frank Hölschermann, Christian Butter
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established treatment option for patients with severe aortic stenosis and high surgical risk. Currently, various prosthesis types are available. Atrioventricular block (AVB) requiring pacemaker (PM) implantation is a typical complication after TAVI. This study investigated the recovery of AV node conduction and mid-term outcome of patients with or without PM implantation after TAVI according to prosthesis type. METHODS: From July 2008 to May 2015, 856 transcatheter heart valves were implanted at our center (age: 80...
August 14, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28818190/aortic-bioprosthetic-valve-durability-incidence-mechanisms-predictors-and-management-of-surgical%C3%A2-and-transcatheter-valve-degeneration
#11
REVIEW
Tania Rodriguez-Gabella, Pierre Voisine, Rishi Puri, Philippe Pibarot, Josep Rodés-Cabau
In recent times, there has been a considerable increase in the use of aortic bioprostheses (vs. mechanical prostheses) for treating aortic valve disease, and this tendency is likely to continue in the near future. However, the occurrence of structural valve degeneration, limiting valve durability, remains an important drawback of surgical and transcatheter bioprostheses. In this paper, we provide an overview of bioprosthetic valve durability, focusing on the definition, incidence, mechanisms, predictive factors, and management of structural degeneration of aortic bioprostheses...
August 22, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28818088/assessment-of-the-effect-of-left-atrial-cryoablation-enhanced-by-ganglionated-plexi-ablation-in-the-treatment-of-atrial-fibrillation-in-patients-undergoing-open-heart-surgery
#12
Jiří Bárta, Radim Brát
BACKGROUND: The aim of our study was to investigate, whether enhancement of left atrial cryoablation by ablation of the autonomic nervous system of left atrium leads to influencing the outcomes of surgical treatment of atrial fibrillation in patients with structural heart disease undergoing open-heart surgery. METHODS: The observed patient file consisted of 100 patients, who have undergone a combined open-heart surgery at our department between July 2012 and December 2014...
August 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28818015/bioglue-associated-loss-of-aortic-valve-leaflet-motility-sonographically-masked-by-both-newly-replaced-mechanical-aortic-and-mitral-valves
#13
Alan Matthew Smeltz, Thomas G Caranasos, Emily G Teeter
BioGlue is a surgical adhesive widely used to help reinforce complex cardiac and vascular repairs. Since its introduction, several case reports have emerged revealing complications that all providers should be mindful of whenever the product is used. This report considers a unique situation where BioGlue was used after double cardiac valve repair that resulted in adhesion of the new mechanical aortic valve leaflets and was difficult to visualize with transesophageal echocardiography.
August 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28816817/a-novel-surgical-technique-for-ahmed-valves-in-refractory-glaucoma-with-silicone-oil-endotamponade
#14
Juan Maria Davo-Cabrera, Aitor Lanzagorta-Aresti, Pablo Alcocer Yuste
PURPOSE: The purpose of the study is to describe a novel technique to implant Ahmed valves in patients with refractory glaucoma because of silicone oil (SO) endotamponade PATIENTS:: Three patients with glaucoma without SO removal were used as an example for this technique. METHODS: Technique report. RESULTS AND CONCLUSIONS: We introduce a standard technique modification for Ahmed valves in patients with SO. This modification consists on locating the Ahmed valve more tangential to the limbus curvature instead of the usual perpendicular position and inserting the tube in the posterior chamber...
August 14, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28814237/statins-in-aortic-stenosis
#15
Karl Norrington, Emmanuel Androulakis, Evangelos Oikonomou, Georgia Vogiatzi, Dimitris Tousoulis
Calcific aortic stenosis (AS) is the most common form of valvular heart disease in Europe and North America. It is a progressive disease with a prolonged period of asymptomatic latency which eventually leads to critical left ventricular outflow tract obstruction necessitating surgical replacement of the valve. Statins are lipid-lowering drugs with a robust evidence base demonstrating clinical benefit in atherosclerotic coronary artery disease. There has therefore been significant interest in the potential benefit of statins in AS...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28812435/transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-patients-with-anaemia
#16
Paola D'Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco, Fulvia Seccareccia
OBJECTIVES: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. METHODS: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. RESULTS: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1...
August 16, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28811002/in-debakey-type-i-aortic-dissection-bovine-aortic-arch-is-associated-with-arch-tears-and-stroke
#17
Julia Dumfarth, Sven Peterss, Markus Kofler, Michaela Plaikner, Bulat A Ziganshin, Thomas Schachner, Maryann Tranquilli, Michael Grimm, John A Elefteriades
BACKGROUND: The study sought to evaluate if a bovine aortic arch (BAA) influences the location of the entry site in acute aortic dissection type A (AADA) and to identify the impact of BAA on postoperative outcome, especially stroke. METHODS: A total of 315 patients underwent surgery due to AADA DeBakey type I (72.1% men, mean age 59.5 ± 13.4 years) between 2002 and 2015. Imaging studies and operative reports were screened for presence of BAA and location of the entry site...
August 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#18
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#19
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28805033/balloon-aortic-valvuloplasty-in-the-tavr-era-not-so-new-but-definitely-improved
#20
EDITORIAL
Ted Feldman, Mayra Guerrero
BAV in the TAVR era is not well studied BAV resulted in improvements in aortic valve area and transvalvular pressure gradient, and in patients with impaired left ventricle function, ejection fraction improved. These improvements diminished over time, but at one year were still improved compared to baseline. BAV resulted in changes of planned therapy more than half of the patients treated as bridge for TAVR did not ultimately undergo TAVR twice as many planned as bridge for surgical valve replacement actually had surgical valve replacement...
August 1, 2017: Catheterization and Cardiovascular Interventions
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