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https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#1
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29756640/aortic-valve-hemodynamics-in-atrial-fibrillation-should-the-highest-doppler-signal-be-used-to-estimate-severity-of-aortic-stenosis
#2
Said Alsidawi, Sana Khan, Sorin V Pislaru, Vuyisile T Nkomo
Grading severity of AS in AF is complicated by varying stroke volumes associated with fluctuating maximum velocities and pressure gradients across the aortic valve. Current guidelines recommend averaging five continuous-wave peak velocity and mean gradient (MG) Doppler signals across the aortic valve when estimating severity of AS in AF. However, it is unknown when grading severity of AS how the average of multiple Doppler signals vs the highest Doppler signal in AF compares to the Doppler signals when the patient is in normal sinus rhythm...
May 14, 2018: Echocardiography
https://www.readbyqxmd.com/read/29735221/a-review-of-the-2017-american-society-of-echocardiography-guidelines-for-evaluation-of-aortic-stenosis-considerations-for-perioperative-echocardiography
#3
REVIEW
Rohesh J Fernando, Chandrika Garner, Thomas F Slaughter
No abstract text is available yet for this article.
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29721704/workup-and-management-of-patients-with-paradoxical-low-flow-low-gradient-aortic-stenosis
#4
REVIEW
Mohamed-Salah Annabi, Marine Clisson, Marie-Annick Clavel, Philippe Pibarot
About 60% of patients with paradoxical low-flow, low-gradient (PLF-LG) aortic stenosis (AS) have a severe disease that justifies aortic valve replacement (AVR). The first step in patients with symptomatic PLF AS should be to rule out measurement errors and treat hypertension. The second step is to distinguish pseudo-severe from true severe AS (TSAS). The third step is to select the optimal treatment modality at the right time. Regarding the second step, projected aortic valve area calculated using stress echocardiography is superior to traditional severity criteria (AVA < 1...
May 2, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29701358/carotid-stenosis-in-cardiac-surgery-patients
#5
Pedro Pinto Sousa, Gabriela Teixeira, João Gonçalves, Carlos Veiga, Pedro Sá Pinto, Pedro Brandão, Alexandra Canedo, Luis Vouga, Rui Almeida
INTRODUCTION: Ischemic stroke is a potential perioperative complication after an open heart surgery (OHS). Whether a carotid stenosis or occlusion is associated with an increased risk of perioperative stroke in patients or just a risk factor has been a concern of intense debate in the literature. METHODS: We retrospectively analyzed patients submitted to OHS between January and December2016 with known asymptomatic carotid disease. The data from 85 consecutive patients undergoing coronary artery bypass grafting, valve replacement, or both was collected...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29663506/new-classification-of-geometric-ventricular-patterns-in-severe-aortic-stenosis-could-it-be-clinically-useful
#6
Concetta Di Nora, Eugenio Cervesato, Iulian Cosei, Andreea Ravasel, Bogdan A Popescu, Concetta Zito, Scipione Carerj, Francesco Antonini-Canterin, Andreea C Popescu
BACKGROUND: In severe aortic stenosis, different left ventricle (LV) remodeling patterns as a response to pressure overload have distinct hemodynamic profiles, cardiac function, and outcomes. The most common classification considers LV relative wall thickness and LV mass index to create 4 different groups. A new classification including also end-diastolic volume index has been recently proposed. AIM: To describe the prevalence of the newly identified remodeling patterns in patients with severe aortic stenosis and to evaluate their clinical relevance according to symptoms...
April 16, 2018: Echocardiography
https://www.readbyqxmd.com/read/29655505/midterm-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-controlled-trials
#7
Yanwei Wang, Yijiang Zhou, Li Zhang, Jianhua Zhu
BACKGROUND: Current guidelines recommend transcatheter aortic valve replacement (TAVR) in patients with severe symptomatic aortic stenosis (AS) who are not suitable for conventional surgical aortic valve replacement (SAVR). In light of the recent trend in performing TAVR in patients with lower risk profile, we assessed the midterm outcome comparing TAVR and SAVR for the treatment of patients with severe AS at low to intermediate risk. METHODS: PubMed, EBSCO, and Cochrane CENTRAL were systematically searched for randomized controlled trials that reported the clinical outcomes of TAVR versus SAVR in patients at low to intermediate surgical risk with at least 2 years of follow-up...
June 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29625742/appropriate-use-criteria-for-aortic-stenosis-guidelines-or-opinion
#8
EDITORIAL
Hersh S Maniar, Marc R Moon
No abstract text is available yet for this article.
March 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29614972/aortic-stenosis-is-a-risk-factor-for-all-cause-mortality-in-patients-on-dialysis-a-multicenter-prospective-cohort-analysis
#9
Daijo Inaguma, Yuji Sasakawa, Noriko Suzuki, Eri Ito, Kazuo Takahashi, Hiroki Hayashi, Shigehisa Koide, Midori Hasegawa, Yukio Yuzawa
BACKGROUND: Aortic stenosis (AS) is common in patients on dialysis as well as in the general population. AS leads to difficulty with dialysis therapy because of unstable conditions such as intradialytic hypotension due to low cardiac output. However, the precise morbidity rates and risk factors of AS in patients on dialysis are unknown. Moreover, there are no large-scale observational studies regarding the association between AS in patients on dialysis and mortality. Therefore, we will investigate whether morbidity of AS in patients on dialysis is associated with mortality...
April 3, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29588742/expert-opinion-guidelines-for-the-management-of-patients-with-aortic-stenosis-undergoing-non-cardiac-surgery-out-of-date-and-overly-prescriptive
#10
Simon Kennon, Andrew Archbold
Patients with severe aortic stenosis who require non-cardiac surgery present a difficult clinical problem. The most recent clinical practice guidelines from the American College of Cardiology/American Heart Association and the European Society of Cardiology for the perioperative cardiovascular assessment and management of patients undergoing noncardiac surgery were both published in 2014. These guidelines are reviewed in the light of recently published randomised controlled trial data regarding the efficacy of transcatheter aortic valve implantation to treat aortic stenosis...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29578921/updated-clinical-indications-for-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis-expert-opinion-of-the-italian-society-of-cardiology-and-gise
#11
Ciro Indolfi, Antonio L Bartorelli, Sergio Berti, Paolo Golino, Giovanni Esposito, Giuseppe Musumeci, Sonia Petronio, Corrado Tamburino, Giuseppe Tarantini, Gianpaolo Ussia, Corrado Vassanelli, Carmen Spaccarotella, Roberto Violini, Giuseppe Mercuro, Francesco Romeo
: The introduction of percutaneous treatment of severe aortic stenosis with transcatheter aortic valve implantation (TAVI) remains one of the greatest achievements of interventional cardiology. In fact, TAVI emerged as a better option than either medical therapy or balloon aortic valvuloplasty for patients who cannot undergo surgical aortic valve replacement (SAVR) or are at high surgical risk. Recently, increased operator experience and improved device systems have led to a worldwide trend toward the extension of TAVI to low-risk or intermediate-risk patients...
May 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29564333/surgery-for-young-adults-with-aortic-valve-disease-not-amenable-to-repair
#12
Mustafa Zakkar, Vito Domanico Bruno, Alexandru Ciprian Visan, Stephanie Curtis, Gianni Angelini, Emmanuel Lansac, Serban Stoica
Aortic valve replacement is the gold standard for the management of patients with severe aortic stenosis or mixed pathology that is not amenable to repair according to currently available guidelines. Such a simplified approach may be suitable for many patients, but it is far from ideal for young adults considering emerging evidence demonstrating that conventional valve replacement in this cohort of patients is associated with inferior long-term survival when compared to the general population. Moreover; the utilisation of mechanical and bioprosthetic valves can significantly impact on quality and is linked to increased rates of morbidities...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29551010/decision-support-system-for-the-planning-of-minimally-invasive-aortic-valve-replacement-surgery
#13
Hui Li, Miguel Castro, Pascal Haigron, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
PURPOSE: Minimally invasive aortic valve replacement (MIAVR) procedures remain more complex and technically challenging compared to conventional full sternotomy surgery. This technique involves a restricted surgical field and a limited workspace, which is, at present, strictly reserved for the most experienced surgeons. The MIAVR clinical outcomes are strongly dependent on the appropriate choice of the thoracic incision. This work presents a decision support system to optimize, through an interactive visualization interface, the exposure of the target structure in a limited field of view...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29546380/the-ross-procedure-in-adults-presenting-with-bicuspid-aortic-valve-and-pure-aortic-regurgitation-85-freedom-from-reoperation-at-20-years
#14
Chin L Poh, Edward Buratto, Marco Larobina, Rochelle Wynne, Michael O'Keefe, John Goldblatt, James Tatoulis, Peter D Skillington
OBJECTIVES: The Ross procedure has demonstrated excellent results when performed in patients with aortic stenosis or mixed aortic valve disease [aortic stenosis and aortic regurgitation (AR)]. However, due to its reported risk of late reoperation, it is not recommended under current guidelines for patients presenting with bicuspid aortic valve and pure AR. We have analysed our own results in light of this recommendation. METHODS: Between 1993 and 2016, 129 consecutive patients with a mean age of 34...
March 12, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29527552/perioperative-airway-management-for-aortic-valve-replacement-in-an-adult-with-mucopolysaccharidosis-type-ii-hunter-syndrome
#15
Kazuchika Suzuki, Hiroaki Sakai, Kenji Takahashi
We herein report anesthetic management during aortic valve replacement for aortic valve regurgitation in a patient with adult mucopolysaccharidosis type II (MPS type 2) (Hunter syndrome). This disorder is rare and related to the accumulation of a mucopolysaccharide in lysosomes. It affects various organs, including the airways, heart, and central nerves. In children with MPS type 2, the risk of airway obstruction during anesthesia/sedation is high, and the degree of difficulty increases with aging. The patient described herein was a 33-year-old male without mental retardation...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29501544/the-impact-of-left-ventricular-diastolic-dysfunction-on-clinical-outcomes-after-transcatheter-aortic-valve-replacement
#16
Masahiko Asami, Jonas Lanz, Stefan Stortecky, Lorenz Räber, Anna Franzone, Dik Heg, Lukas Hunziker, Eva Roost, George Cm Siontis, Marco Valgimigli, Stephan Windecker, Thomas Pilgrim
OBJECTIVES: This study sought to determine the impact of left ventricular diastolic dysfunction (LVDD) on clinical outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Left ventricular (LV) hypertrophy in response to afterload increase promotes the development of LVDD and represents an early stage in the progression to valvular heart failure. METHODS: In a consecutive cohort of 777 aortic stenosis patients undergoing TAVR, LVDD was categorized according to the latest guidelines...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29468829/disease-progression-and-variation-in-clinical-practice-for-isolated-bicuspid-aortic-valve-in-children
#17
Melissa S W Yamauchi, Michael D Puchalski, Hsin Ti Weng, Nelangi M Pinto, Susan P Etheridge, Angela P Presson, Lloyd Y Tani, L LuAnn Minich, Richard V Williams
BACKGROUND: Disease progression of an isolated bicuspid aortic valve (BAV) in children is poorly understood and adult management guidelines may not be applicable. Thus, we sought to evaluate disease progression of pediatric isolated BAV and its relationship to current management practices. METHODS: Children with a BAV and ≤mild aortic stenosis (AS) and/or aortic regurgitation (AR) at the time of initial evaluation were included in this retrospective cohort study (1/2005-12/2014)...
February 21, 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29440154/outcomes-comparison-of-different-surgical-strategies-for-the-management-of-severe-aortic-valve-stenosis-study-protocol-of-a-prospective-multicentre-european-registry-e-avr-registry
#18
Francesco Onorati, Riccardo Gherli, Giovanni Mariscalco, Evaldas Girdauskas, Eduardo Quintana, Francesco Santini, Marisa De Feo, Sandro Sponga, Piergiorgio Tozzi, Mohamad Bashir, Andrea Perrotti, Aniello Pappalardo, Vito Giovanni Ruggieri, Giuseppe Santarpino, Mauro Rinaldi, Silva Ronaldo, Francesco Nicolini
INTRODUCTION: Traditional and transcatheter surgical treatments of severe aortic valve stenosis (SAVS) are increasing in parallel with the improved life expectancy. Recent randomised controlled trials (RCTs) reported comparable or non-inferior mortality with transcatheter treatments compared with traditional surgery. However, RCTs have the limitation of being a mirror of the predefined inclusion/exclusion criteria, without reflecting the 'real clinical world'. Technological improvements have recently allowed the development of minimally invasive surgical accesses and the use of sutureless valves, but their impact on the clinical scenario is difficult to assess because of the monocentric design of published studies and limited sample size...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29407076/the-prognostic-value-of-coronary-endothelial-and-microvascular-dysfunction-in-subjects-with-normal-or-non-obstructive-coronary-artery-disease-a-systematic-review-and-meta-analysis
#19
Philip Brainin, Daria Frestad, Eva Prescott
AIMS: Coronary vascular dysfunction is linked with poor cardiovascular prognosis in patients without obstructive coronary artery disease (CAD) but a critical appraisal of the literature is lacking. METHODS AND RESULTS: We performed a systematic review and meta-analysis to quantify the cardiovascular risk associated with endothelial dependent and non-endothelial dependent coronary vascular dysfunction in patients with normal or non-obstructive CAD (epicardial stenosis <50%)...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29406851/dobutamine-stress-echocardiography-for-management-of-low-flow-low-gradient-aortic-stenosis
#20
Mohamed-Salah Annabi, Eden Touboul, Abdellaziz Dahou, Ian G Burwash, Jutta Bergler-Klein, Maurice Enriquez-Sarano, Stefan Orwat, Helmut Baumgartner, Julia Mascherbauer, Gerald Mundigler, João L Cavalcante, Éric Larose, Philippe Pibarot, Marie-Annick Clavel
BACKGROUND: In the American College of Cardiology/American Heart Association guidelines, patients are considered to have true-severe stenosis when the mean gradient (MG) is ≥40 mm Hg with an aortic valve area (AVA) ≤1 cm2 during dobutamine stress echocardiography (DSE). However, these criteria have not been previously validated. OBJECTIVES: The aim of this study was to assess the value of these criteria to predict the presence of true-severe AS and the occurrence of death in patients with low-flow, low-gradient aortic stenosis (LF-LG AS)...
February 6, 2018: Journal of the American College of Cardiology
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