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Cabg and avr

Francisco Leyva, Tian Qiu, David McNulty, Felicity Evison, Howard Marshall, Maurizio Gasparini
BACKGROUND: The risk of permanent pacemaker implantation (PPI) after cardiac valve replacement surgery is thought be highest in the post-operative period. Long-term risks are uncertain. OBJECTIVE: To determine rates and timing of PPI after valve replacement surgery. METHODS: We compared PPI rates patients undergoing aortic (AVR, n = 111,674), mitral (MVR, n = 18,402) valve replacement, AVR+MVR (n = 5,166) or AVR + MVR and tricuspid valve replacement (TVR, n = 114) or CABG without valve replacement (n=249,742)...
November 28, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Konstantinos V Voudris, S Chiu Wong, Ryan Kaple, Polydoros N Kampaktsis, Andreas R de Biasi, Jonathan S Weiss, Richard Devereux, Karl Krieger, Luke Kim, Rajesh V Swaminathan, Dmitriy N Feldman, Harsimran Singh, Nikolaos J Skubas, Robert M Minutello, Geoffrey Bergman, Arash Salemi
BACKGROUND: Transapical approach (TA) is an established access alternative to the transfemoral technique in patients undergoing transcatheter aortic valve replacement (TAVR) for treatment of symptomatic aortic valve stenosis. The impact of prior coronary artery bypass grafting (CABG) on clinical outcomes in patients undergoing TA-TAVR is not well defined. METHODS: A single center retrospective cohort analysis of 126 patients (male 41%, mean age 85.8 ± 6.1 years) who underwent TA balloon expandable TAVR (Edwards SAPIEN, SAPIEN XT or SAPIEN 3) was performed...
November 29, 2016: Journal of Cardiothoracic Surgery
Kizuku Yamashita, Tomoyuki Fujita, Hiroki Hata, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Junjiro Kobayashi
BACKGROUND: The best management strategy for patients with coronary disease and mild to moderate AS requires the clinician to consider the operative risks of isolated coronary artery bypass grafting (CABG) against the risks of untreated aortic stenosis (AS). METHODS: Between 2000 and 2014, isolated off-pump CABG (OPCAB) was performed in 2023 patients. Of these patients, 103 presented with mild or moderate AS (mean age 72.7±6.3 years; 23 females), 96 (93.2%) presented with mild AS and seven (6...
November 14, 2016: Journal of Cardiology
Jochen Reinöhl, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Manfred Zehender, Constantin von Zur Mühlen, Christoph Bode, Peter Stachon
OBJECTIVES: The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). BACKGROUND: A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. METHODS: In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013...
October 24, 2016: JACC. Cardiovascular Interventions
Tone Bull Enger, Hilde Pleym, Roar Stenseth, Guri Greiff, Alexander Wahba, Vibeke Videm
OBJECTIVES: To assess long-term survival and mortality in adult cardiac surgery patients. METHODS: 8,564 consecutive patients undergoing cardiac surgery in Trondheim, Norway from 2000 until censoring 31.12.2014 were prospectively followed. Observed long-term mortality following surgery was compared to the expected mortality in the Norwegian population, matched on gender, age and calendar year. This enabled assessment of relative survival (observed/expected survival rates) and relative mortality (observed/expected deaths)...
2016: PloS One
Harindra C Wijeysundera, Lindsay Li, Vevien Braga, Nandhaa Pazhaniappan, Anar M Pardhan, Dana Lian, Aric Leeksma, Ben Peterson, Eric A Cohen, Anne Forsey, Kori J Kingsbury
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) is generally more expensive than surgical aortic valve replacement (SAVR) due to the high cost of the device. Our objective was to understand the patient and procedural drivers of cumulative healthcare costs during the index hospitalisation for these procedures. DESIGN: All patients undergoing TAVI, isolated SAVR or combined SAVR+coronary artery bypass grafting (CABG) at 7 hospitals in Ontario, Canada were identified during the fiscal year 2012-2013...
2016: Open Heart
Andrew L Smith, William Y Shi, Alexander Rosalion, Michael Yii, Michael O'Keefe, Andrew E Newcomb, Philip Davis
BACKGROUND: The use of rapid-deployment aortic valve replacement (RD-AVR) has burgeoned in recent years. There are few studies comparing RD-AVR to conventional aortic valve replacement (cAVR) and no studies where both were inserted via full sternotomy. As such, we reviewed our experience and compared the two approaches. METHODS: From 2008 to 2015, 597 patients underwent isolated aortic valve replacement ± coronary artery bypass grafting (CABG) at a single centre...
July 16, 2016: Heart, Lung & Circulation
Junjiro Kobayashi, Yusuke Shimahara, Tomoyuki Fujita, Hideaki Kanzaki, Makoto Amaki, Hiroki Hata, Yuta Kume, Kizuku Yamashita, Atsushi Okada
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become an alternative procedure for treating aortic stenosis (AS) in patients with advanced age and severe comorbidities. Ischemic heart disease (IHD) is present with AS in 40-50% of patients with typical angina. Considering the high operative mortality and morbidity rates in these patients, hybrid TAVI and off-pump CABG (OPCAB) have become realistic treatment options. METHODS AND RESULTS: Between August 2014 and November 2015, 12 patients were evaluated for simultaneous TAVI and OPCAB...
August 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Anjali Prasad, Meghana R Helder, Dwight A Brown, Hartzell V Schaff
BACKGROUND: The University HealthSystem Consortium (UHC) administrative database has been used increasingly as a quality indicator for hospitals and even individual surgeons. We aimed to determine the accuracy of cardiac surgical data in the administrative UHC database vs data in the clinical Society of Thoracic Surgeons database. STUDY DESIGN: We reviewed demographic and outcomes information of patients with aortic valve replacement (AVR), mitral valve replacement (MVR), and coronary artery bypass grafting (CABG) surgery between January 1, 2012, and December 31, 2013...
October 2016: Journal of the American College of Surgeons
Tom Kai Ming Wang, David Hm Choi, Tharumenthiran Ramanathan, Peter N Ruygrok
BACKGROUND: With the introduction of transcatheter aortic valve implantation (TAVI), there is increasing interest in evaluating outcomes of aortic valve replacement (AVR) with or without (+/-) concurrent coronary artery bypass grafting (CABG) particularly in high-risk patients. We reviewed the characteristics and outcomes of octogenarians undergoing isolated AVR and AVR+CABG. METHODS: All patients 80 years of age or older undergoing AVR+/-CABG at Auckland City Hospital during 2005-2012 were included, and their characteristics and outcomes analysed...
July 6, 2016: Heart, Lung & Circulation
Suguru Ohira, Hiroaki Miyata, Kiyoshi Doi, Noboru Motomura, Shinichi Takamoto, Hitoshi Yaku
OBJECTIVES: The aims of this study were to investigate early results of aortic valve replacement (AVR) after cardiovascular surgery and create a risk model using a national database in Japan. METHODS: We used the Japan Adult Cardiovascular Surgery Database. Between 2008 and 2013, 2157 patients who underwent AVR for aortic stenosis after cardiovascular surgery or redo AVR were retrospectively analysed. RESULTS: The background of prior surgery (including overlapping cases) was as follows: coronary artery bypass grafting (CABG), 31...
July 11, 2016: European Journal of Cardio-thoracic Surgery
Zubair A Khan, Janah Aji, Armaghan Soomro, Sara Malik, Wajeeha Saeed, M Rizwan Sardar
History of prior coronary artery bypass surgery (CABG) is a frequent scenario encountered in patients with severe symptomatic aortic stenosis deemed inoperable and referred for transcatheter aortic valve replacement (TAVR). Aside from indices of frailty and other comorbidities, these patients remain at higher risk for peri-operative mortality and morbidity compared to their counterparts without prior CABG. Presence of concomitant peripheral arterial disease and patent left internal mammary artery (LIMA) graft pose further access related challenges...
September 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Michael P Robich, Nicholas K Schiltz, Douglas R Johnston, Stephanie Mick, Amar Krishnaswamy, Rodrigo A Iglesias, Dustin Hang, Eric E Roselli, Edward G Soltesz
INTRODUCTION: The need for permanent pacemaker implantation (PCM) following surgical aortic valve replacement (SAVR) is uncommon but can lead to increased hospital resource utilization. Using nationwide data, we sought to (1) identify hospital, patient, and procedure-level risk factors for PCM after SAVR and (2) determine incremental resource utilization. METHODS: We identified 659,692 patients from the Nationwide Inpatient Sample database who underwent SAVR with or without coronary artery bypass grafting (CABG), mitral valvuloplasty (MVr), or mitral valve replacement (MVR) between 1998 and 2009...
August 2016: Journal of Cardiac Surgery
Seyed Hossein Aalaei-Andabili, Negiin Pourafshar, Anthony A Bavry, Charles T Klodell, R David Anderson, Ashkan Karimi, John W Petersen, Thomas M Beaver
BACKGROUND: Acute kidney injury (AKI) during transcatheter aortic valve replacement (TAVR) increases morbidity and mortality. In this study, we investigated the incidence and risk factors for AKI in patients undergoing TAVR. METHODS: Two hundred ninety consecutive patients underwent TAVR. Valve Academic Research Consortium (VARC)-I criteria for AKI diagnosis at 72 hours, and VARC-II criteria at seven days were employed. RESULTS: Overall AKI incidence was 24...
July 2016: Journal of Cardiac Surgery
Tom Kai Ming Wang, David H M Choi, Tharumenthiran Ramanathan, Peter N Ruygrok
BACKGROUND: Aortic valve replacement (AVR) and/or coronary artery bypass grafting (CABG) make up the majority of cardiac surgery with increasing demand as the population ages. Accuracy of risk stratification is important, in predicting adverse outcomes and selecting modality of intervention, but has been rarely studied for the combined AVR+CABG operation. We compared the prognostic utility of EuroSCORE, EuroSCORE II and Society of Thoracic Surgeons' (STS) Score for AVR+CABG. METHODS: All patients (n=450) undergoing AVR+CABG at Auckland City Hospital during 2005-2012 with mean follow-up of 4...
April 20, 2016: Heart, Lung & Circulation
Tomo Ando, Alexandros Briasoulis, Anthony A Holmes, Luis Afonso, Theodore Schreiber, Ashok Kondur
BACKGROUND: Patients with severe aortic stenosis (AS) and previous coronary artery bypass graft (CABG) surgery have increased risk for aortic valve replacement. Whether surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) offers better outcomes in this population is unclear. We aimed to assess outcomes of TAVR and SAVR in patients with previous CABG. METHODS: A systematic literature search of Medline, EMBASE and Cochrane library was conducted...
July 15, 2016: International Journal of Cardiology
Mihriban Yalcin, Kaptan Derya Tayfur, Melih Urkmez
AIM: To determine whether concomitant surgery is a predictor of mortality in patients undergoing surgery for ascending aortic aneursym. METHODS: Ninety-nine patients who underwent ascending aortic aneursym surgery between January 2010 and January 2015 were included in this study. Nineteen patients underwent ascending aortic replacement (RAA) only, 36 underwent aortic valve replacement (AVR) and RAA, 25 underwent coronary artery bypass grafting (CABG) and RAA, 11 underwent the Bentall procedure, and eight underwent AVR, CABG and RAA...
April 12, 2016: Cardiovascular Journal of Africa
Gilbert H L Tang, Hasan Ahmad, Martin Cohen, Cenap Undemir, Steven L Lansman
Coronary obstruction during transcatheter aortic valve replacement (TAVR) is a rare yet life-threatening complication. Emergent resection of the obstructing calcium is a quick and simple method to restore coronary perfusion in TAVR over emergency CABG. doi: 10.1111/jocs.12752 (J Card Surg 2016;31:315-317).
May 2016: Journal of Cardiac Surgery
Mansour T A Sharabiani, Francesca Fiorentino, Gianni D Angelini, Nishith N Patel
OBJECTIVE: Surgical aortic valve replacement (AVR) remains the gold standard therapy for severe aortic stenosis. Long-term survival data following AVR is required. Our objective was to provide a detailed contemporary benchmark of long-term survival following AVR among elderly patients (≥65 years) in the UK. METHODS: We conducted a retrospective cohort study of 1815 adult patients undergoing surgical AVR± coronary artery bypass graft (CABG) surgery at a single UK centre between 1996 and 2011...
2016: Open Heart
Simone A Huygens, Mostafa M Mokhles, Milad Hanif, Jos A Bekkers, Ad J J C Bogers, Maureen P M H Rutten-van Mölken, Johanna J M Takkenberg
Many observational studies have reported outcomes after surgical aortic valve replacement (AVR), but there are no recent systematic reviews and meta-analyses including all available bioprostheses and allografts. The objective of this study is to provide a comprehensive and up-to-date overview of the outcomes after AVR with bioprostheses and allografts reported in the last 15 years. We conducted a systematic literature review (PROSPERO register: CRD42015017041) of studies published between 2000-15. Inclusion criteria were observational studies or randomized controlled trials reporting on outcomes of AVR with bioprostheses (stented or stentless) or allografts, with or without coronary artery bypass grafting (CABG) or valve repair procedure, with study population size n ≥ 30 and mean follow-up length ≥5 years...
October 2016: European Journal of Cardio-thoracic Surgery
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