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https://www.readbyqxmd.com/read/28646501/progressive-aortic-root-dilatation-in-pediatric-heart-transplant-recipients
#1
Shagun Sachdeva, Liyun Zhang, Pippa Simpson, Peter C Frommelt
BACKGROUND: To determine prevalence, clinical implication, and risk factors for aortic root dilation (ARD) in pediatric heart transplant recipients. METHODS: Serial echocardiograms were reviewed in all pediatric heart transplant recipients from 1999 to 2014 to assess maximal systolic diameter at the aortic annulus, aortic sinus, aortic sino-tubular (ST) junction, and ascending aorta. ARD was defined by a sinus/annulus ratio >1.56, ST junction/annulus ratio >1...
June 23, 2017: Echocardiography
https://www.readbyqxmd.com/read/28646460/a-nationwide-survey-of-aortic-valve-surgery-in-japan-current-status-of-valve-preservation-in-cases-with-aortic-regurgitation
#2
REVIEW
Satoshi Arimura, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Minoru Matsuhama, Takashi Kunihara, Yutaka Okita, Shuichiro Takanashi, Tatsuhiko Komiya, Hitoshi Yaku, Hitoshi Okabayashi, Hirofumi Takemura, Hirokuni Arai, Masaru Sawazaki, Yoshiro Matsui, Norihiko Shiiya
OBJECTIVE: Although aortic valve-sparing operations are performed throughout Japan, the indications, specific repair techniques, and outcomes have not been reported in full. Thus, we conducted the first nationwide survey of aortic valve-sparing surgery. METHODS: We mailed a questionnaire to 508 institutions across Japan to obtain information on elective aortic valve and aortic root surgeries performed in 2014. Included in the mailing was a secondary questionnaire that sought further information from institutions reporting aortic valve-sparing surgeries...
June 23, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28643478/critical-role-of-tnf-inhibition-in-combination-therapy-for-elderly-mice-with-atherosclerosis
#3
Kyung-Yeon Park, Tae-Hwe Heo
We have previously shown that the combination of pravastatin and sarpogrelate is synergistically beneficial for atherosclerosis. In this study, we investigated whether the pravastatin-sarpogrelate combination was sufficient for treatment in an old mouse model of atherosclerosis or if additional intervention would be needed to address the newly included aging factor and its complex pathophysiological impact on the atherosclerogenic state. We added an anti-TNF biologic to the combination treatment cocktail because of the known pathologic roles of TNF in the aging process...
June 23, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28637586/soluble-lr11-associates-with-aortic-root-calcification-in-asymptomatic-treated-male-patients-with-familial-hypercholesterolemia
#4
Ranitha Vongpromek, Sven Bos, Gert-Jan R Ten Kate, Hideaki Bujo, Meizi Jiang, Koen Nieman, Wolfgang Schneider, Jeanine E Roeters van Lennep, Adrie J M Verhoeven, Eric J G Sijbrands, Monique T Mulder
BACKGROUND AND AIMS: Despite statin treatment, a high prevalence of severe vascular calcification is found in patients with familial hypercholesterolemia (FH). We assessed the relation between the circulating soluble form of low-density lipoprotein receptor relative with 11 ligand-binding repeats (sLR11), a risk factor for cardiovascular disease, and vascular calcification in asymptomatic statin-treated heterozygous FH patients. METHODS: In 123 asymptomatic heterozygous FH patients (age 40-69 years), aortic root (ARC), aortic valve (AVC) and coronary artery calcification (CAC) were determined with CT-based calcium scoring expressed in Agatston units...
June 9, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28637199/first-ex-vivo-and-preliminary-sheep-model-results-of-the-new-tribio-aortic-valve-bioprosthesis-in-small-aortic-annuli
#5
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: : Small aortic annuli are challenging in aortic valve replacement. Prosthesis-patient mismatch, accompanied by high transvalvular gradients and small orifice area, is an often faced problem impairing postoperative outcome. The new TRIBIO bioprosthesis aims to enable enhanced haemodynamics, being increasingly important with decreasing annular size. This study compares ex vivo hydrodynamics of TRIBIO with 2 established bioprostheses in small annuli at different stroke volumes, simulating 'rest' and 'exercise', and evaluates haemodynamics of TRIBIO in a sheep model...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28636844/clonal-hematopoiesis-and-risk-of-atherosclerotic-cardiovascular-disease
#6
Siddhartha Jaiswal, Pradeep Natarajan, Alexander J Silver, Christopher J Gibson, Alexander G Bick, Eugenia Shvartz, Marie McConkey, Namrata Gupta, Stacey Gabriel, Diego Ardissino, Usman Baber, Roxana Mehran, Valentin Fuster, John Danesh, Philippe Frossard, Danish Saleheen, Olle Melander, Galina K Sukhova, Donna Neuberg, Peter Libby, Sekar Kathiresan, Benjamin L Ebert
Background Clonal hematopoiesis of indeterminate potential (CHIP), which is defined as the presence of an expanded somatic blood-cell clone in persons without other hematologic abnormalities, is common among older persons and is associated with an increased risk of hematologic cancer. We previously found preliminary evidence for an association between CHIP and atherosclerotic cardiovascular disease, but the nature of this association was unclear. Methods We used whole-exome sequencing to detect the presence of CHIP in peripheral-blood cells and associated such presence with coronary heart disease using samples from four case-control studies that together enrolled 4726 participants with coronary heart disease and 3529 controls...
June 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28633398/a-novel-system-for-the-treatment-of-aortic-annular-dilation-an-ex-vivo-investigation
#7
Pallav Shah, Claudia Romagnoni, Michal Jaworek, Federico Lucherini, Monica Contino, Alan Menkis, Guido Gelpi, Gianfranco B Fiore, Carlo Antona, Riccardo Vismara
OBJECTIVES: The main reason for aortic repair failures is recurrent annular dilatation. The fibrous portion of left ventricular outflow tract dilates. A novel device was designed to tackle this problem. METHODS: The device consists of an internal ring applied at the aortic annulus plus an external flexible band at the level of the aortic root. The internal ring has a semi-rigid portion (40%, placed at ventriculo-arterial junction) and a flexible portion to allow it to conform along the curves of the non-coronary/right coronary leaflet and right coronary/left coronary leaflet commissures...
June 15, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28633278/radiopaque-marker-addition-during-aortic-root-replacement-with-the-use-of-a-freestyle-porcine-bioprosthesis
#8
Olivia M Crowley, John R Doty
Aortic root replacement is indicated for aortic root aneurysm, small aortic root, and most root abscesses. This report describes the placement of a radiopaque marker during aortic root replacement using a Freestyle porcine bioprosthesis. This marker is a useful landmark during fluoroscopy for transcatheter valve-in-valve aortic valve replacement in the event of bioprosthesis degeneration.
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28633264/rapidly-progressive-bioprosthetic-aortic-valve-stenosis-due-to-bartonella-species-endocarditis
#9
Kathy Schnitzer, Zafrir Or, Shtiwi Sawaed, Erez Sharoni, Naiel Bisharat
Rapid progression of valvular stenosis in the setting of infective endocarditis is extremely rare. Here we describe a patient with Bartonella endocarditis on a bioprosthetic aortic valve that caused rapidly progressive aortic stenosis without regurgitation. At operation the bioprosthetic valve was severely fibrotic and calcified, with markedly thickened and distorted leaflets and circular partial detachment from the aortic ring. The patient underwent aortic root replacement with aortic bioprosthesis and aortic grafting with reimplantation of the coronary ostia...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28633253/transforming-growth-factor-beta-2-mutations-in-barlow-s-disease-and-aortic-dilatation
#10
Kushtrim Disha, Solveig Schulz, Thomas Kuntze, Evaldas Girdauskas
We report on a patient operated on for degenerative myxomatous mitral and tricuspid valve disease (Barlow's disease) and aortic root dilatation. A valve repair operation and the postoperative course were uneventful. Multigenerational genetic analyses revealed two different mutations in the transforming growth factor beta-2 gene in the same patient. The two mutations in different exons were inherited from both parents each. None of the parents presented with either valve dysfunction or aortic root dilatation...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28629660/characterization-and-risk-factors-for-aortic-dilatation-in-pediatric-patients-with-bicuspid-aortic-valve
#11
Anna Sabaté-Rotés, Laura Sabidó Sanchez, Ferran Gran Ipiña, Dimpna Albert Brotons, Raúl F Abella, Ferran Rosés Noguer
INTRODUCTION AND OBJECTIVES: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. METHODS: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17)...
June 16, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28628659/wave-intensity-of-aortic-root-pressure-as-diagnostic-marker-of-left-ventricular-systolic-dysfunction
#12
Bernhard Hametner, Stephanie Parragh, Thomas Weber, Siegfried Wassertheurer
BACKGROUND: Systolic left ventricular function strongly influences the blood pressure waveform. Therefore, pressure-derived parameters might potentially be used as non-invasive, diagnostic markers of left ventricular impairment. The aim of this study was to investigate the performance of pressure-based parameters in combination with electrocardiography (ECG) for the detection of left ventricular systolic dysfunction defined as severely reduced ejection fraction (EF). METHODS AND RESULTS: Two populations, each comprising patients with reduced EF and pressure-matched controls, were included for the main analysis (51/102 patients) and model testing (44/88 patients)...
2017: PloS One
https://www.readbyqxmd.com/read/28620068/x-box-binding-protein-1-dependent-plasma-cell-responses-limit-the-development-of-atherosclerosis
#13
Andrew P Sage, Meritxell Nus, Jayashree Bagchi Chakraborty, Dimitrios Tsiantoulas, Stephen A Newland, Alison J Finigan, Leanne Masters, Christoph J Binder, Ziad Mallat
Rationale: Diverse B cell responses and functions may be involved in atherosclerosis. Protective antibody responses, such as those against oxidized lipid epitopes, are thought to mainly derive from T cell-independent innate B cell subsets. In contrast, both pathogenic and protective roles have been associated with T cell-dependent antibodies and their importance in both humans and mouse models is still unclear. Objective: To specifically target antibody production by plasma cells and determine the impact on atherosclerotic plaque development in mice with and without CD4+ T cells...
June 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28616920/-association-of-gh-and-igf-1-burden-with-cardiac-structural-and-functional-changes-in-acromegaly-patients
#14
Shuo Zhang, Yi-Lin Li, Xiao-Peng Guo, Lu Gao, Yong Yao, Ren-Zhi Wang, Bing Xing
OBJECTIVES: To investigate the association of growth hormone (GH) and insulin-like growth factor (IGF-1) burden with the cardiac structural and functional changes in acromegaly patients. METHODS: Ninety-nine acromegaly patients were enrolled in this study. According to the normal range of echocardiographic parameters of Peking Union Medical College Hospital, the patients were divided into parameter normal group and abnormal group. Correlation analyses were conducted between duration of disease, mean GH, mean IGF-1, GH burden, IGF-1 burden and echocardiography data retrospectively...
May 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28616353/double-pseudoaneurysm-recurrent-subvalvular-aortic-membrane-and-small-left-ventricular-outflow-tract-in-the-same-patient-who-dares
#15
Rocío Díaz, Daniel Hernandez-Vaquero, Rubén Álvarez-Cabo, Isaac Pascual, Cecilia Corros, Alberto Alperi, Jose Rozado, Jacobo Silva, César Morís
Patients with pseudoaneurysm in the left ventricular outflow tract (LVOT) commonly present vague and nonspecific symptoms making the diagnosis difficult. We present the case of a 37-year-old patient with two subvalvular pseudoaneurysms in whom a combined resection surgery, enlargement of the LVOT, aortic valve replacement (AVR) and aortic root replacement were performed using the technique of Cabrol.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616349/sparing-aortic-valve-techniques
#16
Rubén Álvarez-Cabo
Prosthetic valve implantation is the most widely used therapeutic option for aortic regurgitation (AR), but complications associated with prosthetic valves, with an incidence of 3-5% patient/year, and the need for anticoagulation in mechanical valves, force us to consider aortic valve repair as an alternative to the prosthetic implant, especially in young people with many potential years of life for these complications. Aortic valve repair techniques are not excessively complicated, but there is no standardization, so they are not reproducible in all medical centers...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616348/predictive-risk-models-for-proximal-aortic-surgery
#17
REVIEW
Daniel Hernandez-Vaquero, Rocío Díaz, Isaac Pascual, Rubén Álvarez, Alberto Alperi, Jose Rozado, Carlos Morales, Jacobo Silva, César Morís
Predictive risk models help improve decision making, information to our patients and quality control comparing results between surgeons and between institutions. The use of these models promotes competitiveness and led to increasingly better results. All these virtues are of utmost importance when the surgical operation entails high-risk. Although proximal aortic surgery is less frequent than other cardiac surgery operations, this procedure itself is more challenging and technically demanding than other common cardiac surgery techniques...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#18
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#19
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28606890/how-to-plan-an-overlap-free-projection-on-cta-or-fluoroscopy-to-facilitate-quantitative-analysis
#20
Justin Teng, Vincent Nijenhuis, Martin Swaans, Gerald Yong, Carl Schultz
AIMS: Assessment of para-valvular aortic regurgitation remains challenging. Quantitative video-densitometry is an effective technique however overlap of the aorta and left ventricle (LV) limits feasibility. We aimed to develop and validate a method to determine an 'Overlap Free Projection' (OFP). METHODS AND RESULTS: 65 computed tomography scans of patients referred for transcatheter aortic valve implantation were analysed using 3D reconstruction to evaluate the OFP...
June 13, 2017: EuroIntervention
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