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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
#1
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
#2
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 human population. AIM: The purpose of this study was to examine if age affects clinical presentation, intraoperative management and outcomes of patients that undergo simultaneous operations of aortic valve replacement (AVR) and coronary artery bypass grafting (CABG). METHODS: The study involved 452 consecutive patients with the age of 64...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29243687/sutureless-valves-and-the-quality-of-perfusion-towards-a-goal-directed-aortic-valve-replacement
#3
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 CABG, were compared to a contemporary cohort of 116 patients receiving conventional stented bioprostheses. Propensity score matching was used to reduce selection bias...
December 14, 2017: 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
#4
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%C3%A2-776-patients
#5
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...
November 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29132703/rapid-deployment-aortic-valve-replacement-excellent-results-and-increased-effective-orifice-areas
#6
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...
November 10, 2017: 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
#7
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...
November 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29104016/single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#8
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
OBJECTIVE: 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 del Nido cardioplegia versus standard blood cardioplegia (BC) in minimally invasive aortic valve surgery. METHODS: From 8/2011 to 5/2016, 178 patients underwent minimally invasive aortic valve replacement (AVR) with BC (n=101) or DC (n= 77)...
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
#9
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)...
October 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29016380/comparison-of-del-nido-cardioplegia-with-blood-cardioplegia-in-adult-combined-surgery
#10
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
September 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#11
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28712580/withdrawn-single-dose-del-nido-cardioplegia-in-minimally-invasive-aortic-valve-surgery
#12
Daniel Ziazadeh, Regina Mater, Ben Himelhoch, Andrew Borgman, Jessica L Parker, Charles L Willekes, Tomasz A Timek
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669501/surgical-ablation-of-atrial-fibrillation-in-the-united-states-trends-and-propensity-matched-outcomes
#13
MULTICENTER STUDY
Vinay Badhwar, J Scott Rankin, Niv Ad, Maria Grau-Sepulveda, Ralph J Damiano, A Marc Gillinov, Patrick M McCarthy, Vinod H Thourani, Rakesh M Suri, Jeffrey P Jacobs, James L Cox
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) effectively restores sinus rhythm. Incompletely defined risk has previously limited concomitant performance of SA during cardiac operations. The study goals were to define performance trends and risk-adjusted outcomes for contemporary SA. METHODS: From July 2011 to June 2014, 86,941 patients with AF, but without endocarditis, underwent primary nonemergent cardiac operations in The Society of Thoracic Surgeons (STS) database...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#14
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/28605428/the-commence-trial-2-year-outcomes-with-an-aortic-bioprosthesis-with-resilia-tissue
#15
John D Puskas, Joseph E Bavaria, Lars G Svensson, Eugene H Blackstone, Bartley Griffith, James S Gammie, David A Heimansohn, Jerzy Sadowski, Krzysztof Bartus, Douglas R Johnston, Jacek Rozanski, Todd Rosengart, Leonard N Girardi, Charles T Klodell, Mubashir A Mumtaz, Hiroo Takayama, Michael Halkos, Vaughn Starnes, Percy Boateng, Tomasz A Timek, William Ryan, Shuab Omer, Craig R Smith
OBJECTIVES: The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). METHODS: Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre (n = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28578622/modular-minimal-invasive-extracorporeal-circuits-another-step-toward-universal-applicability
#16
Aschraf El-Essawi, Mohammed Morjan, Ingo Breitenbach, Ahmed Bechri, Rene Brouwer, Wolfgang Harringer
INTRODUCTION: Safety concerns have been one of the main reasons opposing a wider acceptance of minimal invasive extracorporeal circuits (MiECC). Following an extensive experience and a multitude of modifications, we have set out to employ a modular MiECC as a universal extracorporeal circuit. METHODS: A total of 129 cardiac surgical procedures were performed by a single surgeon in 2013. Excluding procedures done under circulatory arrest or with the potential need of such, the MiECC was utilized in almost 90% of surgeries...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28515742/the-use-of-intraoperative-epiaortic-ultrasonography-in-monitoring-patients-over-75-years-old-treated-with-aortic-valve-replacement
#17
Tomasz Niklewski, Michał Zembala, Dariusz Puszczewicz, Paweł Nadziakiewicz, Wojciech Karolak, Marian Zembala
INTRODUCTION: Epiaortic ultrasound scanning (EAS) extended the use of ultrasound to the intraoperative diagnosis of aortic pathology. Surgical palpation of the ascending aorta underestimates the presence and severity of atherosclerotic plaques. Epiaortic ultrasound scanning has been used as an adjunct to transesophageal echocardiography (TEE) or as a primary direct diagnostic tool for imaging the ascending aorta as well as the aortic arch, which gained prominence as part of a multipronged intraoperative strategy to reduce atherosclerotic emboli...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28496079/-surgical-treatment-for-anomalous-aortic-origin-of-coronary-arteries
#18
Ryo Hirayama, Ryusuke Suzuki, Toshiaki Watanabe, Mai Matsukawa, Takeshi Sakaguchi, Kenta Uekihara, Yuki Yoshioka, Masaharu Mouri, Tomoya Miyamoto, Masamichi Nakajima
Anomalous aortic origin of coronary arteries is rare. We report 3 cases of surgical treatment for anomalous aortic origin of coronary arteries. Case 1 was a 38-year-old man who was saved by the use of an automated external defibrillator from cardiopulmonary arrest while exercising. The coronary angiogram showed the right coronary artery arising from the left coronary sinus of Valsalva and being located between the aorta and the pulmonary trunk. He underwent coronary artery bypass grafting (CABG) using the right internal thoracic artery with ligation of proximal part of right coronary artery to prevent sudden death...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28451388/myofilament-function-and-body-mass-index
#19
Constanze Bening, Khaled Hamouda, Christoph Schimmer, Rainier Leyh
Body mass is reported to influence myocardial performance. Recent studies have emphasised the importance of negative inotropic adipocyte-derived factors and their impact on cardiac contractile function. However, the underlying mechanisms remain unclear. We aimed to determine whether body mass impacts cardiac force development on the level of the contractile apparatus. We examined the influence of body mass index (BMI) (3 groups: group I >25, group II 25-30, group III >30) on the myocardial performance of skinned muscle fibres...
March 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28439849/aortic-valve-replacement-after-coronary-artery-bypass-grafting-with-the-in-situ-right-gastroepiploic-artery-to-the-occluded-right-coronary-artery-using-a-temporary-vein-graft-for-cardioplegia
#20
Yoshifumi Fuke, Toru Yasutsune, Masato Sakamoto
BACKGROUND: The operation of aortic valve replacement (AVR) after CABG is a technically challenging procedure in respect to dissection of living grafts from its surrounding tissue, myocardial protection, and so on, especially that procedure to patients with living in situ functional arterial grafts to occluded native coronary arteries has a special problem in regard to myocardial protection because myocardial blood supply originates from various arteries including the left internal thoracic artery (LITA), the right internal thoracic artery (RITA), and the right gastroepiploic artery (GEA); hence, adequate myocardial protection should be fastidiously considered...
December 2017: Surgical Case Reports
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