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https://www.readbyqxmd.com/read/27833782/telescoping-technique-to-engage-left-main-coronary-artery-in-a-case-of-giant-aortic-aneurysm-in-a-geriatric-patient
#1
Priyank Shah, Rahul Vasudev, Mahesh Bikkina, Hartaj Virk
We present a case of a geriatric male with giant ascending aortic aneurysm (AAA) who underwent successful coronary angiography using telescoping technique for evaluation his coronary arteries before surgery for AAA. Since the ascending aorta and root were extremely dilated, we knew it would not have been possible to engage the coronaries using regular catheters and standard technique. Hence, telescopic technique was used. Amplatz left 3 (AL3) 7F (French) guide catheter (90 cm) was initially used, and nonselective injection of contrast was done to see the coronary ostium...
2016: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#2
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
November 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27780804/how-i-treat-anticoagulation-in-atrial-fibrillation
#3
Benjamin A Steinberg
Atrial fibrillation (AF) is the most common cardiac arrhythmia, and conveys a significant risk of morbidity and mortality due to related stroke and systemic embolism. Oral anticoagulation (OAC) is the mainstay of thromboembolism prevention and management of anticoagulation can be challenging. For patients without significant valvular disease, decisions around anticoagulation therapy are first based on the presence of additional stroke risk factors, as measured by the CHA2DS2-VASc score. Patients with increased CHA2DS2-VASc scores (by regional guidelines) should next be evaluated to determine if they are candidates for non-vitamin K antagonist oral anticoagulant (NOAC) therapy...
October 25, 2016: Blood
https://www.readbyqxmd.com/read/27449459/first-north-american-experience-with-the-engager-self-expanding-transcatheter-aortic-valve-insights-from-the-london-health-sciences-centre-heart-team
#4
Rodrigo Bagur, Bob Kiaii, Patrick J Teefy, Pantelis Diamantouros, Ronit Lavi, Christopher Harle, Mauro Cassese, Michael W A Chu
The Engager aortic bioprosthesis consists of bovine pericardial leaflets mounted on a self-expandable frame with unique anatomic orientation capabilities to engage the aortic valve cusps. We report the initial North American transcatheter aortic valve implantation (TAVI) experience with the Engager device. Transapical TAVI was performed in 4 patients (mean age 80 ± 6 years, Society of Thoracic Surgeons score 5 ± 1%). The valve was anatomically oriented and successfully implanted in all patients. There were no conversions to open operation or major procedure-related adverse events...
August 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27265643/transcatheter-aortic-valve-replacement-a-solution-for-the-young-inoperable-and-regurgitant
#5
Kamran Majeed, Andrew J Lucking, Ross L Roberts-Thomson, Adam J Nelson, Joseph K Montarello, Stephen G Worthley
Transcatheter aortic valve replacement (TAVR) has become an established treatment for patients with severe aortic stenosis and high surgical risk. Ten years of technological advances in valve structure and delivery systems alongside growing operator and centre experience has opened TAVR implantation to an increasingly broad range of patients. The extension to off-label use however needs careful consideration and monitoring. Through discussion of our case involving an inoperable 24-year-old male with severe aortic regurgitation (AR), we highlight the need for an experienced and multidisciplinary team, together with early and extensive patient and family disclosure and engagement, prior to considering any off-label application of TAVR...
October 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27242354/the-jupiter-registry-1-year-results-of-transapical-aortic-valve-implantation-using-a-second-generation-transcatheter-heart-valve-in-patients-with-aortic-stenosis
#6
Miriam Silaschi, Hendrik Treede, Ardawan J Rastan, Hardy Baumbach, Friedhelm Beyersdorf, Utz Kappert, Walter Eichinger, Florian Rüter, Thomas L de Kroon, Rüdiger Lange, Stephan Ensminger, Olaf Wendler
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with aortic stenosis (AS) at high surgical risk. The JenaValve™ is a second-generation, self-expanding transcatheter heart valve (THV), implanted through transapical access (TA). During stent deployment, a specific 'clipping-mechanism' engages native aortic valve cusps for fixation. We present 1-year outcomes of the JUPITER registry, a post-market registry of the JenaValve for TA-TAVR. METHODS: The JUPITER registry is a prospective, multicentre, uncontrolled and observational European study to evaluate the long-term safety and effectiveness of the Conformité Européenne-marked JenaValve THV...
May 30, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27231335/cardiovascular-diseases-in-paralympic-athletes
#7
Antonio Pelliccia, Filippo M Quattrini, Maria Rosaria Squeo, Stefano Caselli, Franco Culasso, Mark S Link, Antonio Spataro, Marco Bernardi
BACKGROUND: Sport participation (SP) of individuals with impairments has recently grown exponentially. Scarce scientific data, however, exist regarding cardiovascular (CV) risk associated with competitive SP. OBJECTIVE: Assessing the prevalence of CV abnormalities and the risk for SP in Paralympic athletes (PA). METHODS: PA (n=267; 76% men), aged 35±9 years, engaged in 18 sport disciplines, with a spectrum of lesions including: spinal cord injury (paraplegia and spina bifida) (n=116); amputation, poliomyelitis, cerebral palsy and other neuromuscular and/or skeletal disorders (Les autres) or visual impairment (n=151) entered the study...
September 2016: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/27005292/hiatal-hernia-and-gastroesophageal-reflux-study-of-collagen-in-the-phrenoesophageal-ligament
#8
V von Diemen, E N Trindade, M R M Trindade
BACKGROUND: Gastroesophageal reflux disease (GERD) is defined by the intensity and/or quality of the reflux of gastric or duodenal contents into the esophagus. Surgical treatment of GERD has shown conflicting results and unacceptable recurrence rates, mainly due to herniation of the antireflux valve into the chest. A variety of techniques has been proposed to reduce GERD recurrence, including routine use of prosthesis in cruroplasty. The prevalence of GERD in patients with hiatal hernia (HH) can reach 94 %...
March 22, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26948037/quality-of-care-for-transcatheter-aortic-valve-implantation-development-of-canadian-cardiovascular-society-quality-indicators
#9
Anita W Asgar, Sandra Lauck, Dennis Ko, Faisal Alqoofi, Eric Cohen, Anne Forsey, Laurie J Lambert, Garth H Oakes, Marc Pelletier, John G Webb
Transcatheter aortic valve implantation (TAVI) is a relatively new procedure to treat aortic stenosis in patients at high surgical risk, and it is becoming increasingly available in Canada. Variation exists in the clinical care, program coordination, evaluation, and funding across provinces and centres. As a part of the Canadian Cardiovascular Society (CCS) quality initiative, the TAVI Quality Indicator (QI) Working Group was established in 2014 to develop a set of indicators to measure quality of care for Canadians undergoing TAVI for aortic stenosis...
August 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/26924674/transapical-implantation-in-the-catheterization-laboratory-of-the-second-generation-engager-aortic-valve
#10
LETTER
Raquel Del Valle, Isaac Pascual, Jacobo Silva, Pablo Avanzas, Félix Ezequiel Fernández-Suárez, César Morís
No abstract text is available yet for this article.
April 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/26403870/transcatheter-valve-in-valve-therapy-using-6-different-devices-in-4-anatomic-positions-clinical-outcomes-and-technical-considerations
#11
Lenard Conradi, Miriam Silaschi, Moritz Seiffert, Edith Lubos, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Hendrik Treede
OBJECTIVES: Transcatheter valve-in-valve implantation (ViV) is emerging as a novel treatment option for patients with deteriorated bioprostheses. We report our cumulative experience using 6 types of transcatheter heart valves (THVs) in all anatomic positions. METHODS: Seventy-five consecutive patients (74.1 ± 12.9 years, 50.7% male (38/75), logEuroSCORE I 26.2% ± 17.8%, STS-PROM 8.8% ± 7.4%) receiving ViV procedures from 2008 to 2014 were included for analysis...
December 2015: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26298131/the-spectroscopy-and-photochemistry-of-quinioline-structural-isomers-e-and-z-phenylvinylnitrile
#12
Deepali N Mehta-Hurt, Joseph A Korn, Polina Navotnaya, Alexander P Parobek, Rachel M Clayton, Timothy S Zwier
In Titan's atmosphere, photochemical pathways that lead to nitrogen heteroaromatics may incorporate photoisomerization of their structural isomers as a final step. (E)- and (Z)-phenylvinylnitrile ((E)- and (Z)-PVN, C6H5-CH=CHCN) are structural isomers of quinoline that themselves possess extensive absorptions in the ultraviolet, and thus may engage in such photoisomerization pathways. The present study explores the vibronic spectroscopy and photo-induced isomerization of gas-phase (E)- and (Z)-PVN in the 33,600-35,850 cm(-1) region under jet-cooled conditions...
August 21, 2015: Journal of Chemical Physics
https://www.readbyqxmd.com/read/26275070/patient-defined-goals-for-the-treatment-of-severe-aortic-stenosis-a-qualitative-analysis
#13
Megan Coylewright, Roseanne Palmer, Elizabeth S O'Neill, John F Robb, Terri R Fried
BACKGROUND: Patients with severe aortic stenosis (AS) at high risk for aortic valve replacement are a unique population with multiple treatment options, including medical therapy, surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR). Traditionally, in elderly populations, goals of treatment may favour quality of life over survival. Professional guidelines recommend that clinicians engage patients in shared decision making, a process that may lead to decisions more aligned with patient-defined goals of care...
October 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/26182615/prosthesis-specific-predictors-of-paravalvular-regurgitation-after-transcatheter-aortic-valve-replacement-impact-of-calcification-and-sizing-on-balloon-expandable-versus-self-expandable-transcatheter-heart-valves
#14
COMPARATIVE STUDY
Barbara E Stähli, Thi Dan Linh Nguyen-Kim, Cathérine Gebhard, Ladina Erhart, Thomas Frauenfelder, Felix C Tanner, Volkmar Falk, Ulf Landmesser, Fabian Nietlispach, Thomas F Lüscher, Willibald Maier, Ronald K Binder
BACKGROUND AND AIM OF THE STUDY: The study aim was to investigate prosthesis-specific predictors for paravalvular aortic regurgitation (PAR) in self-expandable versus balloon-expandable transcatheter heart valves (THVs). PAR is frequently observed after transcatheter aortic valve replacement (TAVR). As self-expandable and balloon-expandable THVs engage differently with the native aortic valve structures, factors that impact PAR may differ between the prosthesis types. METHODS: A total of 137 TAVR patients who underwent pre-procedural multidetector computed tomography and post-procedural transthoracic echocardiography were studied...
January 2015: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/26160399/device-landing-zone-calcification-and-its-impact-on-residual-regurgitation-after-transcatheter-aortic-valve-implantation-with-different-devices
#15
Moritz Seiffert, Buntaro Fujita, Maxim Avanesov, Clemens Lunau, Gerhard Schön, Lenard Conradi, Emir Prashovikj, Smita Scholtz, Jochen Börgermann, Werner Scholtz, Ulrich Schäfer, Gunnar Lund, Stephan Ensminger, Hendrik Treede
AIMS: Calcification of the device landing zone is linked to paravalvular regurgitation after transcatheter aortic valve implantation (TAVI). The mechanisms remain incompletely understood and the performance of next-generation transcatheter heart valves (THV) has not been investigated. We evaluated the impact of calcification patterns on residual aortic regurgitation (AR) after TAVI with different THV in patients with severe aortic stenosis. METHODS AND RESULTS: TAVI was performed in 537 patients at two centres...
May 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/25984249/a-technical-review-of-minimally-invasive-mitral-valve-replacements
#16
REVIEW
Georgia L Preston-Maher, Ryo Torii, Gaetano Burriesci
Mitral regurgitation is one of the most common forms of heart valve disorder, which may result in heart failure. Due to the rapid ageing of the population, surgical repair and replacement treatments, which have represented an effective treatment in the past, are now unsuitable for about half of symptomatic patients, who are judged high-risk. Encouraged by the positive experience with transcatheter aortic valves and percutaneous reconstructive mitral treatments, a number of research groups are currently engaged in the development of minimally invasive approaches for the functional replacement of the mitral valve...
June 2015: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/25841857/symetis-valve-implantation-in-failing-freestyle-with-close-proximity-between-coronary-ostia-and-annulus
#17
Jeevan Nagendran, Jorge Catrip, Pantelis Diamantouros, Patrick Teefy, Bob Kiaii, Ian Chan, Aashish Goela, David M Holzhey, Michael W A Chu
Transcatheter treatment of patients with degenerated aortic valve stentless prosthesis and low proximal coronary ostia to the aortic annulus remain a challenge because of the elevated risk for coronary obstruction. Newer generation transcatheter aortic valve devices that engage and pull the aortic valve calcium towards the aortic annulus may be beneficial in these patients. We present a case of successful treatment of a degenerated tubular stentless prosthesis with low coronary ostia with a Symetis Acurate TA prosthesis...
April 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25727083/risk-stratification-and-stroke-prevention-therapy-care-gaps-in-canadian-atrial-fibrillation-patients-from-the-co-ordinated-national-network-to-engage-physicians-in-the-care-and-treatment-of-patients-with-atrial-fibrillation-chart-audit
#18
Ashish D Patel, Mary K Tan, Paul Angaran, Alan D Bell, Murray Berall, Claudia Bucci, Andrew M Demchuk, Vidal Essebag, Lianne Goldin, Martin S Green, Jean C Gregoire, Peter L Gross, Brett Heilbron, Peter J Lin, Krishnan Ramanathan, Allan Skanes, Bruce H Wheeler, Shaun G Goodman
The objectives of this national chart audit (January to June 2013) of 6,346 patients with atrial fibrillation (AF; ≥18 years without a significant heart valve disorder) from 647 primary care physicians were to (1) describe the frequency of stroke and bleed risk assessments in patients with nonvalvular AF by primary care physicians, including the accuracy of these assessments relative to established predictive indexes; (2) outline contemporary methods of anticoagulation used; and (3) report the time in the therapeutic range among patients prescribed warfarin...
March 1, 2015: American Journal of Cardiology
https://www.readbyqxmd.com/read/25720330/challenges-of-coronary-angiography-and-intervention-in-patients-previously-treated-by-tavi
#19
COMPARATIVE STUDY
Johannes Blumenstein, Won-Keun Kim, Christoph Liebetrau, Luise Gaede, Joerg Kempfert, Thomas Walther, Christian Hamm, Helge Möllmann
OBJECTIVE: Since the beginning of the transcatheter aortic valve implantation (TAVI) era, many prosthetic valves have entered clinical practice. TAVI prostheses differ regarding stent design and some may potentially interfere with diagnostic or interventional catheters. The aim of our analysis was to evaluate the feasibility of coronary angiography (CA) or percutaneous coronary intervention (PCI) in patients with prior TAVI. METHODS: From 2011 to 2014, 1,000 patients were treated by TAVI at our center using eight different valve prostheses (Symetis ACURATE TA and ACURATE TF; Medtronic CoreValve and Engager; JenaValve, SJM Portico; Edwards Lifesciences SAPIEN and SAPIEN XT)...
August 2015: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/25661576/single-institution-experience-with-transcatheter-valve-in-valve-implantation-emphasizing-strategies-for-coronary-protection
#20
Daniele Camboni, Andreas Holzamer, Bernhard Flörchinger, Kurt Debl, Dierk Endeman, York Zausig, Lars S Maier, Christof Schmid, Michael Hilker
BACKGROUND: Transcatheter valve-in-valve (VIV) implantation evolved as a therapeutic alternative, despite an increased risk of coronary obstruction in comparison with a regular transcatheter aortic valve implantation (TAVI). We report a comprehensive single-institution experience emphasizing strategies to reduce the risk of myocardial ischemia. METHODS: Since 2009, 639 patients underwent a TAVI procedure in our institution. All patients are prospectively collected into an institutional registry...
May 2015: Annals of Thoracic Surgery
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