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https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#1
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29455964/polytetrafluoroethylene-conduits-versus-homografts-for-right-ventricular-outflow-tract-reconstruction-in-infants-and-young-children-an-institutional-experience
#2
Christopher W Mercer, Shawn C West, Mahesh S Sharma, Masahiro Yoshida, Victor O Morell
OBJECTIVE: Our institution uses a valved polytetrafluoroethylene conduit as an alternative to homografts. The objective of this study was to investigate the performance of bicuspid valved polytetrafluoroethylene conduits used for right ventricular outflow tract reconstruction in children aged less than 2 years and to evaluate risk factors for earlier conduit explant. METHODS: We performed an Institutional Review Board-approved retrospective chart review of all patients aged less than 2 years who underwent surgical right ventricular outflow tract reconstruction with a bicuspid valved polytetrafluoroethylene conduit or homograft conduit from July 2004 to December 2014...
January 31, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29455849/relationship-between-proximal-aorta-morphology-and-progression-rate-of-aortic-stenosis
#3
Romain Capoulade, Jonathan G Teoh, Philipp E Bartko, Eliza Teo, Jan-Erik Scholtz, Lionel Tastet, Mylene Shen, Christos G Mihos, Yong H Park, Julio Garcia, Eric Larose, Eric M Isselbacher, Thoralf M Sundt, Thomas E MacGillivray, Serguei Melnitchouk, Brian B Ghoshhajra, Philippe Pibarot, Judy Hung
BACKGROUND: The aim of this study was to examine the association between abnormal morphology of the proximal aorta and aortic stenosis (AS) progression rate. The main hypothesis was that morphologic changes of the proximal aorta, such as effacement of the sinotubular junction (STJ), result in increased biomechanical stresses and contribute to calcification and progression of AS. METHODS: Between 2010 and 2012, 426 patients with mild to moderate AS were included in this study...
February 16, 2018: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29455818/mitral-regurgitation-exacerbation-due-to-sutureless-aortic-valve-replacement
#4
Timothy Lee, Alexander J C Mittnacht, Shinobu Itagaki, Allan Stewart
Sutureless aortic valves are increasingly used for aortic valve replacement (AVR) with excellent outcomes. Implantation requires device expansion in a subannular position within the native aortic root. We report a patient with severe aortic stenosis who received a Perceval sutureless AVR (LivaNova, London, United Kingdom), resulting in a competent prosthesis with an absence of paravalvular leak and aortic regurgitation. However, this implantation resulted in the exacerbation of mitral regurgitation. The sutureless valve required explantation, and a traditional sutured valve was subsequently implanted, which returned the mitral regurgitation to baseline...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29455791/criss-cross-heart-transthoracic-echocardiographic-features
#5
Devi Manuel, Gopal Ghosh, George Joseph, Anandaroop Lahiri, Paul V George
OBJECTIVE: To study the echocardiographic features of criss-cross heart (CCH), a congenital cardiac anomaly characterized by crossed ventricular inflow streams, in Indian patients. METHODS: In this retrospective observational study, all pediatric echocardiograms performed in a single tertiary care institution in South India over a three-year period were scrutinized for a diagnosis of CCH. Demographic, clinical and echocardiographic data were collected from patients' medical records and echocardiographic database...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455772/prenatal-diagnosis-of-congenital-heart-disease-a-review-of-current-knowledge
#6
REVIEW
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior
This article reviews important features to improve the diagnosis of congenital heart disease (CHD) by applying ultrasound in prenatal cardiac screening. As low and high-risk pregnancies for CHD are subject to routine obstetric ultrasound, the diagnosis of structural heart defects represents a challenge that involves a team of specialists and subspecialists on fetal ultrasonography. In this review, the images highlight normal anatomy of the heart as well as pathologic cases consistent with cardiac malposition and isomerism, septal defects, pulmonary stenosis/atresia, aortic malformations, hypoplastic left ventricle, conotruncal anomalies, tricuspid dysplasia, and Ebstein's anomaly, and univentricular heart, among other congenital cardiovascular defects...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455016/descending-aorta-rupture-after-transcatheter-aortic-valve-embolization
#7
África Duque Santos, Andrés Reyes Valdivia, Pablo Gallo González, Eduardo González Ferrer, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
PURPOSE: To report a case of rupture of the descending aorta after aortic migration during transcatheter aortic valve replacement (TAVR). CASE REPORT: An 85 year-old man with a severe and symptomatic aortic stenosis underwent elective TAVR, which complicated with embolization into the ascending aorta. While repositioning into the descending aorta the procedure complicated with aortic rupture. The patient required urgent thoracic intra-valve stent graft implantation (TEVAR)...
February 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29454487/a-cost-utility-analysis-of-transcatheter-versus-surgical-aortic-valve-replacement-for-the-treatment-of-aortic-stenosis-in-the-population-with-intermediate-surgical-risk
#8
Derrick Y Tam, Avery Hughes, Stephen E Fremes, Saerom Youn, Rebecca L Hancock-Howard, Peter C Coyte, Harindra C Wijeysundera
OBJECTIVE: Although transcatheter aortic valve implantation has been shown to be noninferior to surgical aortic valve replacement in patients with severe aortic stenosis at intermediate surgical risk, the cost-effectiveness of this strategy in this population is unknown. Our objective was to conduct a cost-utility analysis comparing transcatheter aortic valve implantation with surgical aortic valve replacement in the population with intermediate risk severe aortic stenosis. METHODS: A fully probabilistic Markov model with 30-day cycles was constructed from the Canadian third-party payer's perspective to estimate the difference in cost and effectiveness (measured as quality-adjusted life years) of transcatheter aortic valve implantation versus surgical aortic valve replacement for intermediate-risk patients over a lifetime time horizon, discounted at 1...
February 2, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29454380/quality-of-life-satisfaction-and-outcomes-after-ministernotomy-versus-full-sternotomy-isolated-aortic-valve-replacement-quality-avr-study-protocol-for-a-randomised-controlled-trial
#9
Emiliano A Rodríguez-Caulo, Ana Guijarro-Contreras, Juan Otero-Forero, María José Mataró, Gemma Sánchez-Espín, Arantza Guzón, Carlos Porras, Miguel Such, Antonio Ordóñez, José María Melero-Tejedor, Manuel Jiménez-Navarro
BACKGROUND: During the last decade, the use of ministernotomy in cardiac surgery has increased. Quality of life and patient satisfaction after ministernotomy have never been compared to conventional full sternotomy in randomised trials. The aim of the study is to determine if this minimally invasive approach improves quality of life, satisfaction and clinical morbimortality outcomes. METHODS/DESIGN: The QUALITY-AVR trial is a single-blind, single-centre, independent, and pragmatic randomised clinical trial comparing ministernotomy ("J" shaped upper hemisternotomy toward right 4th intercostal space) to full sternotomy in patients with isolated severe aortic stenosis scheduled for elective aortic valve replacement...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29453394/experimental-modelling-of-cardiac-pressure-overload-hypertrophy-modified-technique-for-precise-reproducible-safe-and-easy-aortic-arch-banding-debanding-in-mice
#10
David Merino, Aritz Gil, Jenny Gómez, Luis Ruiz, Miguel Llano, Raquel García, María A Hurlé, J Francisco Nistal
Pressure overload left ventricular hypertrophy is a known precursor of heart failure with ominous prognosis. The development of experimental models that reproduce this phenomenon is instrumental for the advancement in our understanding of its pathophysiology. The gold standard of these models is the controlled constriction of the mid aortic arch in mice according to Rockman's technique (RT). We developed a modified technique that allows individualized and fully controlled constriction of the aorta, improves efficiency and generates a reproducible stenosis that is technically easy to perform and release...
February 16, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29453309/sutureless-perceval-aortic-valve-versus-conventional-stented-bioprostheses-meta-analysis-of-postoperative-and-midterm-results-in-isolated-aortic-valve-replacement
#11
REVIEW
Massimo Meco, Andrea Montisci, Antonio Miceli, Paolo Panisi, Francesco Donatelli, Silvia Cirri, Matteo Ferrarini, Antonio Lio, Mattia Glauber
BACKGROUND: Aortic stenosis is the most common valvular disease and has a dismal prognosis without surgical treatment. The aim of this meta-analysis was to quantitatively assess the comparative effectiveness of the Perceval (LivaNova) valve versus conventional aortic bioprostheses. METHODS AND RESULTS: A total of 6 comparative studies were identified, including 639 and 760 patients who underwent, respectively, aortic valve replacement with the Perceval sutureless valve (P group) and with a conventional bioprosthesis (C group)...
February 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29451963/aortic-valve-stenosis-and-aortic-diameters-determine-the-extent-of-increased-wall-shear-stress-in-bicuspid-aortic-valve-disease
#12
Emile S Farag, Pim van Ooij, R Nils Planken, Kayleigh C P Dukker, Frederiek de Heer, Berto J Bouma, Danielle Robbers-Visser, Maarten Groenink, Aart J Nederveen, Bas A J M de Mol, Jolanda Kluin, S Matthijs Boekholdt
BACKGROUND: Use of 4-dimensional flow magnetic resonance imaging (4D-flow MRI) derived wall shear stress (WSS) heat maps enables identification of regions in the ascending aorta with increased WSS. These regions are subject to dysregulation of the extracellular matrix and elastic fiber degeneration, which is associated with aortic dilatation and dissection. PURPOSE: To evaluate the effect of the presence of aortic valve stenosis and the aortic diameter on the peak WSS and surface area of increased WSS in the ascending aorta...
February 16, 2018: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/29448010/improved-outcomes-in-management-of-hypoplastic-left-heart-syndrome-associated-with-congenital-diaphragmatic-hernia-an-algorithmic-approach
#13
Kaitlin Balduf, T K Susheel Kumar, Umar Boston, Shyam Sathanandam, Marc V Lee, Tim Jancelewicz, Christopher J Knott-Craig
BACKGROUND: Hypoplastic left heart syndrome (HLHS) is the second most common congenital heart disease associated with congenital diaphragmatic hernia (CDH). The reported survival of neonates with CDH and HLHS is only 1-5%. We review our experience with CDH and HLHS and compare our outcomes to published literature. METHODS: Retrospective review of all neonates with CDH and HLHS at our institution over a 10 year period was performed. The morphology of cardiac and diaphragm defects, clinical course, treatment strategies and outcomes were reviewed and an algorithmic approach is proposed...
February 12, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29444998/treatment-of-aortic-stenosis-with-a-self-expanding-resheathable-transcatheter-valve-one-year-results-of-the-international-multicenter-portico-transcatheter-aortic-valve-implantation-system-study
#14
Axel Linke, David Holzhey, Helge Möllmann, Ganesh Manoharan, Ulrich Schäfer, Christian Frerker, Stephen G Worthley, A J van Boven, Simon Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Thomas Walther
BACKGROUND: The aim of the Portico TAVI (transcatheter aortic valve implantation) system study was to evaluate outcomes ≤1 year after implantation of a novel resheathable, self-expanding TAVI system in a multicenter patient population with severe aortic stenosis (AS). METHODS AND RESULTS: High-risk patients (n=222) with symptomatic severe AS (mean age, 83.0±4.6 years; 74.3% women) were enrolled across 12 centers in Europe and Australia. The study's primary end point was all-cause mortality at 30 days...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29444227/the-ross-konno-procedure-in-neonates-and-infants-less-than-3-months-of-age
#15
Eva Sames-Dolzer, Elisabeth Wickenhauser, Michaela Kreuzer, Peter Benedikt, Roland Gitter, Christoph Prandstetter, Gregor Gierlinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Patients with severe left ventricular outflow tract obstruction often suffer from impaired left ventricular function, endocardial fibroelastosis and borderline-sized structures. The early Ross-Konno operation can offer complete repair due to outflow tract stenosis and enable the functional recovery and growth of small structures. METHODS: Between 2008 and March 2017, 44 early Ross-Konno procedures were performed at our centre. Thirty-five patients were neonates, and 9 were infants less than 3 months of age...
February 12, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29443370/beneficial-effects-of-high-density-lipoproteins-on-acquired-von-willebrand-syndrome-in-aortic-valve-stenosis
#16
C Gebhard, F Maafi, B E Stähli, A Bonnefoy, C E Gebhard, W Nachar, A Benjamim de Oliveira Moraes, M Mecteau, T Mihalache-Avram, V Lavoie, A E Kernaleguen, Y Shi, D Busseuil, M Chabot-Blanchet, L P Perrault, D Rhainds, E Rhéaume, J C Tardif
BACKGROUND: Infusions of apolipoprotein A-I (apoA-I), the major protein component of high-density lipoproteins (HDL), result in aortic valve stenosis (AVS) regression in experimental models. Severe AVS can be complicated by acquired von Willebrand syndrome, a haemorrhagic disorder associated with loss of high-molecular-weight von Willebrand factor (vWF) multimers (HMWM), the latter being a consequence of increased shear stress and enhanced vWF-cleaving protease (ADAMTS-13) activity. Although antithrombotic actions of HDL have been described, its effects on ADAMTS-13 and vWF in AVS are unknown...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29443065/balloon-based-injury-to-induce-myointimal-hyperplasia-in-the-mouse-abdominal-aorta
#17
Grigol Tediashvili, Dong Wang, Hermann Reichenspurner, Tobias Deuse, Sonja Schrepfer
The use of animal models is essential for a better understanding of MH, one major cause for arterial stenosis.In this article, we demonstrate a murine balloon denudation model, which is comparable with established vessel injury models in large animals. The aorta denudation model with balloon catheters mimics the clinical setting and leads to comparable pathobiological and physiological changes. Briefly, after performing a horizontal incision in the aorta abdominalis, a balloon catheter will be inserted into the vessel, inflated, and introduced retrogradely...
February 7, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29442340/aortic-valve-replacement-using-autologous-pericardium-single-centre-experience-with-the-ozaki-technique
#18
Oliver Reuthebuch, Luca Koechlin, Ulrich Schurr, Martin Grapow, Jens Fassl, Friedrich S Eckstein
OBJECTIVE: To assess the clinical implementation and report preliminary results of a novel technique called the Ozaki procedure for stentless aortic valve replacement through reconstruction of the valve leaflets from autologous pericardium. METHOD: Between September 2015 and May 2017 30 patients (20 males, mean ± standard deviation age 66.83 ± 10.55 years) suffering from aortic stenosis (AS, n = 7), aortic regurgitation (AR, n = 12), or a combination of both (AS/AR, n = 11) were assigned for an Ozaki procedure...
February 14, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29440878/functionality-and-outcome-in-older-patients-with-severe-aortic-stenosis-foopas-an-interdisciplinary-study-concept-for-a-prospective-trial
#19
Ferdinand Vogt, Susanne Wicklein, Markus Gosch, Jürgen Jessl, Wolfgang Hitzl, Theodor Fischlein, Matthias Pauschinger, Steffen Pfeiffer, Dennis Eckner
Background: Frailty is a geriatric syndrome that can influence mortality and functional recovery after treatment of severe aortic stenosis (AS). The integration of standardized geriatric assessment (GA) in clinical practice is limited by a lack of consensus on how to measure it. Objectives: This study aims to compare the incremental predictive value of different frailty scales to predict the outcomes following surgical aortic valve replacement, transcatheter aortic valve implantation, and conservative treatment of severe AS...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29440218/impact-of-renin-angiotensin-system-inhibitors-on-clinical-outcomes-and-ventricular-remodelling-after-transcatheter-aortic-valve-implantation-rationale-and-design-of-the-rastavi-randomised-multicentre-study
#20
Ignacio J Amat-Santos, Pablo Catalá, Felipe Diez Del Hoyo, Jose A Fernandez-Diaz, Juan H Alonso-Briales, María Del Trigo, Ander Regueiro, Pablo Juan-Salvadores, Vicenç Serra, Enrique Gutierrez-Ibanes, Antonio J Muñoz-García, Luis Nombela-Franco, Manel Sabate, Victor A Jimenez-Diaz, Bruno García Del Blanco, Javier López, Luis H Varela-Falcón, Teresa Sevilla, Roman Arnold, Ana Revilla, J Alberto San Roman
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement. METHODS AND ANALYSIS: The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure...
February 13, 2018: BMJ Open
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