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https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#1
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#2
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29705366/permanent-pacemaker-implantation-following-rapid-deployment-aortic-valve-replacement
#3
Matthew A Romano, Michael Koeckert, Mubashir A Mumtaz, Frank N Slachman, Himanshu J Patel, W Randolph Chitwood, Glenn R Barnhart, Eugene A Grossi
BACKGROUND: Expandable, rapid deployment aortic valves may interfere with the cardiac conduction system, which can lead to permanent pacemaker implantation (PPI). We sought to characterize PPI following rapid deployment aortic valve replacement (RDAVR) with the EDWARDS INTUITY valve system and investigate associated factors. METHODS: We analyzed 708 patients from 29 centers in the TRANSFORM trial undergoing RDAVR ± CABG without pre-existing pacemakers. Intrinsic conduction status was recorded as well as PPI incidence through one year...
April 26, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29701394/ascending-aorta-aneyrysms-over-70mm
#4
Jorge Pinheiro Santos, Álvaro Laranjeira, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Current guidelines suggest that patients with aortic diameter over 55-60 mm should undergo ascending aorta replacement, depending on associated valve pathology and other comorbidities. Studies show that the risk of aortic rupture over 60 mm is over 30%. Even though, we still receive in our practice patients that present with aneurysms of greater dimensions. The aim of our study is to evaluate the surgical outcomes of patients presenting with ascending aorta with diameter larger than 70 mm...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701390/ascending-aorta-aneurysms-in-octogenarians
#5
Jorge Pinheiro Santos, Álvaro Laranjeira, António Cruz Tomás, Daniela Varela-Afonso, José Fragata
INTRODUCTION: Older age is often regarded as a relative contraindication for open surgery for aortic aneurysms. These individuals often have a greater comorbidity burden that predispose them for development of postoperative complications. The aim of our study is to evaluate the surgical outcomes of selected octogenarians after open aortic surgery. METHODS: We performed a retrospective observational study. We collected data from patients operated on by our team between January of 2012 to September of 2017...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701355/aortic-valve-replacement-with-perceval%C3%A2-bioprosthesis-initial-single-center-experience
#6
Diogo Rijo, Sara Simões Costa, João Pedro Monteiro, Fátima Neves, Luís Vouga, Paulo Neves, Paulo Ponce, Miguel Guerra
INTRODUCTION: Aortic valve replacement (AVR) is the gold standard for the treatment of severe or symptomatic aortic valve stenosis. Less invasive procedures have been developed as an alternative to the conventional technique of full sternotomy approach with stented prosthesis. The Perceval® aortic valve (LivaNova, Milan, Italy) is a sutureless bioprosthesis, of which several reports have shown promising results in terms of mortality, morbidity and hemodynamic performance, especially with a less invasive approach...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29643130/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-prior-coronary-artery-bypass-grafting-trends-in-utilization-and-propensity-matched-analysis-of-in-hospital-outcomes
#7
Tanush Gupta, Sahil Khera, Dhaval Kolte, Kashish Goel, Ankur Kalra, Pedro A Villablanca, Herbert D Aronow, J Dawn Abbott, Gregg C Fonarow, Cynthia C Taub, Neal S Kleiman, Giora Weisz, Ignacio Inglessis, Sammy Elmariah, Charanjit S Rihal, Mario J Garcia, Deepak L Bhatt
BACKGROUND: A significant proportion of patients requiring aortic valve replacement (AVR) have undergone prior coronary artery bypass grafting (CABG). Reoperative heart surgery is associated with increased risk. Data on relative utilization and comparative outcomes of transcatheter (TAVR) versus surgical AVR (SAVR) in patients with prior CABG are limited. METHODS AND RESULTS: We queried the 2012 to 2014 National Inpatient Sample databases to identify isolated AVR hospitalizations in adults with prior CABG...
April 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29573404/correlation-of-natural-autoantibodies-and-cardiovascular-disease-related-antibacterial-antibodies-in-pericardial-fluid-of-cardiac-surgery-patients
#8
D Simon, O Gilicze, N Farkas, J Najbauer, P Németh, L Lénárd, T Berki
Our previous studies showed that anti-citrate synthase (a-CS) IgM natural autoantibodies are present in healthy individuals without previous antigen stimulation, but no studies have investigated their presence in the pericardial fluid (PF). Therefore we detected the natural anti-CS IgG/M autoantibody levels in plasma and PF of cardiac surgery patients and investigated their relationship with cardiovascular disease-associated bacterial pathogens. PF and blood samples of 22 coronary artery bypass graft (CABG) and 10 aortic valve replacement (AVR) patients were tested for total Ig levels, natural autoantibodies and infection-related antibodies using ELISA and Luminex methods...
March 24, 2018: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29479385/transcatheter-aortic-valve-replacement-after-coronary-artery-bypass-graft-is-associated-with-increased-pacemaker-implantation-but-not-reduced-overall-survival
#9
Brent Klinkhammer
Background: A history of coronary artery bypass graft (CABG) is a common compelling indication for transcatheter aortic valve replacement (TAVR). However, there is little data on how these patients compare to other TAVR patients. In this study, the short and long-term outcomes of these TAVR patients after CABG are defined. Methods: A retrospective chart review case-control study of 337 consecutive patients who underwent a TAVR for severe aortic stenosis at Sanford Health in Fargo ND was performed to determine if a history of prior CABG was associated with worse outcomes after TAVR as compared to a TAVR cohort without a history of CABG...
February 2018: Cardiology Research
https://www.readbyqxmd.com/read/29462406/long-term-non-institutionalized-survival-and-rehospitalization-after-surgical-aortic-and-mitral-valve-replacements-in-a-large-provincial-cardiac-surgery-centre
#10
Weiang Yan, Pallav Shah, Brett Hiebert, Zlatko Pozeg, Nitin Ghorpade, Rohit K Singal, Rizwan A Manji, Rakesh C Arora
OBJECTIVES: Long-term quality of life following open surgical valve replacement is an increasingly important outcome to patients and their caregivers. This study examines non-institutionalized survival and rehospitalization within our surgical aortic valve replacement (AVR) and mitral valve replacement (MVR) populations. METHODS: A retrospective single-centre study of all consecutive open surgical valve replacements between 1995 and 2014 was undertaken. Clinical data were linked to provincial administrative data for 3219 patients who underwent AVR, MVR or double (aortic and mitral) valve replacement with or without concomitant coronary artery bypass grafting (CABG)...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29382508/good-at-one-or-good-at-all-variability-of-coronary-and-valve-operation-outcomes-within-centers
#11
Lily E Johnston, Emily A Downs, Robert Hawkins, Mohamed Quader, Alan Speir, Jeff Rich, Leora Yarboro, Gorav Ailawadi
BACKGROUND: The technical expertise required for treatment of coronary and structural heart valve disease differs. Correlation between center-specific mortality after coronary artery bypass grafting (CABG) and valve operations has not been demonstrated. This study tested the hypothesis that risk-adjusted outcomes between coronary and valve procedures do not correlate within centers. METHODS: Records of patients undergoing isolated CABG, isolated aortic valve (AVR), or isolated mitral valve (MVR) procedures from 2008-2015 in a multi-institutional STS database were used to generate observed-to-expected (OE) ratios for morbidity and mortality...
January 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29316204/outcomes-of-intermediate-risk-patients-treated-with-transcatheter-and-surgical-aortic-valve-replacement-in-the-veterans-affairs-healthcare-system-a-single-center-20-year-experience
#12
Santiago Garcia, Rosemary Kelly, Mackenzie Mbai, Sergey Gurevich, Brett Oestreich, Demetris Yannopoulos, Selcuk Adabag
BACKGROUND: Transfemoral transcatheter aortic valve replacement (TAVR) was superior to surgical aortic valve replacement (SAVR) in the placement of aortic transcatheter valves (PARTNER) 2A trial (P2). The generalizability of the trial results to the broader population of patients with intermediate surgical risk remains unknown. OBJECTIVE: To compare the outcomes of SAVR and TAVR among patients with intermediate surgical risk treated in the VA Healthcare System. METHODS: We retrospectively analyzed the clinical characteristics and outcomes on all SAVR (1987-2014) and TAVR procedures (2015-2017) performed at the Minneapolis VA Healthcare System...
January 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29313564/clinical-presentation-surgical-management-and-outcomes-of-patients-treated-for-aortic-stenosis-and-coronary-artery-disease-does-age-matter
#13
Bartłomiej Perek, Veronica Casadei, Mateusz Puślecki, Sebastian Stefaniak, Dawid Maison, Adrian Gwizdała, Anna Perek, Łukasz Szarpak, Marek Jemielity
BACKGROUND: Aortic stenosis and coronary artery disease (CAD) sharing similar risk factors are associated with aging of the human population. AIM: The purpose of this study was to examine whether age affects clinical presentation, intraoperative management, and outcomes of patients who undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). METHODS: The study involved 452 consecutive patients aged 64...
2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29243687/sutureless-valves-and-the-quality-of-perfusion-towards-a-goal-directed-aortic-valve-replacement
#14
Antonino S Rubino, Carmelo Mignosa
BACKGROUND: Aim of this study was to assess the potential differences in respecting the principles of goal-directed perfusion between aortic valve replacement with sutureless vs. conventional stented bioprostheses. METHODS: Data from 94 consecutive patients undergoing aortic valve replacement with Perceval sutureless valve, with or without concomitant coronary artery bypass grafting, were compared to a contemporary cohort of 116 patients receiving conventional stented bioprostheses...
April 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29214718/coronary-artery-disease-revascularization-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-real-world-results-from-the-east-denmark-heart-registry
#15
Oscar Millan-Iturbe, Fadi J Sawaya, Jacob Lønborg, Danny H F Chow, Gintautas Bieliauskas, Thomas Engstrøm, Lars Søndergaard, Ole De Backer
Transcatheter aortic valve replacement (TAVR) has become an established therapeutic option for patients with symptomatic, severe aortic stenosis. The optimal treatment strategy for concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. This study aimed to describe the degree of CAD, revascularization strategies, and long-term clinical outcomes in a large-scale all-comers TAVR-population. Nine hundred and forty-four consecutive patients underwent TAVR. Obstructive CAD was reported in 224 patients (23...
December 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29190355/trends-in-practice-and-outcomes-from-2011-to-2015-for-surgical-aortic-valve-replacement-an-update-from-the-german-aortic-valve-registry-on-42-776-patients
#16
Buntaro Fujita, Stephan Ensminger, Timm Bauer, Helge Möllmann, Andreas Beckmann, Raffi Bekeredjian, Sabine Bleiziffer, Elke Schäfer, Christian W Hamm, Friedrich W Mohr, Hugo A Katus, Wolfgang Harringer, Thomas Walther, Christian Frerker
OBJECTIVES: Surgical aortic valve replacement (sAVR) is coming under close scrutiny with the recent upswing in the use of less invasive approaches. The aim of this analysis was to identify current trends in patient selection, procedural characteristics and outcomes after sAVR in Germany. METHODS: We analysed data from 42 776 patients included in the German Aortic Valve Registry who underwent sAVR with and without coronary artery bypass surgery (CABG) between 2011 and 2015...
March 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29132703/rapid-deployment-aortic-valve-replacement-excellent-results-and-increased-effective-orifice-areas
#17
Parwis B Rahmanian, Süreyya Kaya, Kaveh Eghbalzadeh, Hruy Menghesha, Navid Madershahian, Thorsten Wahlers
BACKGROUND: The aim of this study was to evaluate the effects of rapid deployment aortic valve replacement (RDAVR) on surgical outcome and hemodynamics compared with standard aortic valve replacement (AVR). METHODS: One hundred sixty-three RDAVR patients (isolated, n = 67; combined with coronary artery bypass graft surgery [CABG], n = 96) were compared with a propensity matched control group (n = 163). Primary endpoints included association between valve type and procedure times, prosthesis size, transvalvular gradient, and indexed effective orifice area...
January 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29117319/role-of-hospital-volumes-in-identifying-low-performing-and-high-performing-aortic-and-mitral-valve-surgical-centers-in-the-united-states
#18
Rohan Khera, Ambarish Pandey, Thomas Koshy, Colby Ayers, Brahmajee K Nallamothu, Sandeep R Das, Mark H Drazner, Michael E Jessen, Ajay J Kirtane, Timothy J Gardner, James A de Lemos, Deepak L Bhatt, Dharam J Kumbhani
Importance: Identifying high-performing surgical valve centers with the best surgical outcomes is challenging. Hospital surgical volume is a frequently used surrogate for outcomes. However, its ability to distinguish low-performing and high-performing hospitals remains unknown. Objective: To examine the association of hospital procedure volume with hospital performance for aortic and mitral valve (MV) surgical procedures. Design, Setting, and Participants: Within an all-payer nationally representative data set of inpatient hospitalizations, this study identified 682 unique hospitals performing surgical aortic valve replacement (SAVR) and MV replacement and repair with or without coronary artery bypass grafting (CABG) between 2007 and 2011...
December 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29104016/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#19
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
del Nido cardioplegia (DC) offers prolonged cardiac protection with single-dose administration and has been shown to be safe in adult CABG surgery. We set out to evaluate the efficacy of cardiac protection and clinical outcomes of DC versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. From August 2011 to May 2016, 178 patients underwent minimally invasive aortic valve replacement (mini-AVR) with BC (n = 101) or DC (n = 77). Ministernotomy or right minithoracotomy was utilized for surgical access...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29103675/heart-valve-surgery-performed-by-trainee-surgeons-meta-analysis-of-clinical-outcomes
#20
REVIEW
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
April 2018: Heart, Lung & Circulation
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