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https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#1
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29230286/asthma-mimic-case-report-and-literature-review-of-vocal-cord-nodule-associated-with-wheezing
#2
Muhammad Kashif, Tushi Singh, Ahsan Aslam, Misbahuddin Khaja
Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29229783/heartbeat-what-is-the-best-emergency-treatment-for-decompensated-severe-aortic-stenosis
#3
Catherine M Otto
No abstract text is available yet for this article.
January 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29229143/myocardial-functional-changes-in-transfemoral-versus-transapical-aortic-valve-replacement
#4
Niraj Asthana, Aditya Mantha, Eric H Yang, William Suh, Olcay Aksoy, Richard J Shemin, Gabriel Vorobiof, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has greatly expanded the treatment options available for patients with severe aortic stenosis at high surgical risk. MATERIALS AND METHODS: We compared changes in myocardial function in TAVR with a transfemoral (TF) versus a transapical (TA) approach at a major tertiary hospital from 2012-2016. Traditional echocardiographic measures of cardiac structure and function were tracked, alongside the use of two-dimensional speckle tracking echocardiography to measure myocardial strain and strain rates...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29226900/diffuse-hypoplasia-of-the-aortic-arch-and-isthmus-in-a-patient-with-williams-syndrome
#5
İsmihan Selen Onan, Erkut Öztürk, Aylin Demirel Başgöze, Ayse Çicek, Burak Onan
Williams syndrome is a rare neurodevelopmental disorder characterized by mental retardation, growth deficiency, hypercalcemia, cardiac defects, and a distinctive facial appearance. Cardiovascular abnormalities are present in approximately 80% of Williams syndrome patients. Surgical treatment is generally performed for supravalvular aortic stenosis, aortic coarctation, pulmonary artery stenosis, or ventricular septal defect. In rare cases, diffuse hypoplasia of the aortic arch with a normal left ventricular outflow tract and ascending aorta may be diagnosed in early childhood...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29226889/assessment-of-bicuspid-aortic-valve-phenotypes-and-associated-pathologies-a-transesophageal-echocardiographic-study
#6
Selcen Yakar Tülüce, Kamil Tülüce, Ersin Çağrı Şimşek, Özgen Şafak, Mehmet Şefa Ökten, Zeynep Yapan Emren, Sadık Volkan Emren, Uğur Kocabaş, Serdar Bayata, Cem Nazlı
OBJECTIVE: We investigated the frequency of different bicuspid aortic valve disease (BAV) phenotypes,the associated valvular pathologies, and the aortopathy phenotypes, using 2-dimensional (2D) transthoracic, 2D transesophageal echocardiography (TEE) and 3-dimensional (3D) TEE. METHODS: A total of 154 patients with BAV were included. Five BAV phenotypes were detected. To better define valvular pathologies, binary classifications of BAV were used: BAV with antero-posterior commisural line (BAV-AP) and right-left commissural line (BAV-RL)...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29226573/power-of-gradients
#7
EDITORIAL
Pradeep Yadav, Marvin H Eng
Patients with high baseline gradients benefit most after TAVR. In severe symptomatic aortic stenosis, every 10 mm Hg increase in mean gradient has 20% reduction in mortality after TAVR. Low gradient severe aortic stenosis continues to be a clinical cohort with variable benefit from TAVR.
December 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29226506/optimizing-hemodynamics-of-transcatheter-aortic-valve-in-valve-implantation-in-19-mm-surgical-aortic-prostheses
#8
Jayendrakumar S Patel, Amar Krishnaswamy, Jonathon White, Stephanie Mick, Jose Navia, Anand Mehta, Faisal Bakaeen, Zoran Popovic, Lars Svensson, Samir R Kapadia
OBJECTIVE: To demonstrate the feasibility of achieving good hemodynamic results with valve-in-valve transcatheter aortic valve replacement (ViV TAVR) for degenerated 19 mm surgical bioprosthetic valves. BACKGROUND: Considerable controversy exists regarding ViV TAVR within 19mm surgical prostheses due to concerns of elevated valve gradients and mortality. METHODS: Among all patient undergoing ViV TAVR between 7/2016 and 4/2017 for symptomatic severe bioprosthetic aortic stenosis (AS), five had a 19 mm surgical valve in place and were included in this publication...
December 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29226341/inflammation-and-its-consequences-after-surgical-versus-transcatheter-aortic-valve-replacement
#9
Florian Uhle, Christian Castrup, Anna-Maria Necaev, Philippe Grieshaber, Christoph Lichtenstern, Markus Alexander Weigand, Andreas Böning
Symptomatic aortic stenosis can be treated by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR), the latter of which is regarded as a minimally invasive procedure. Differences between these procedures regarding immune responses or changes in coagulation and neurocognitive function have thus far been evaluated only sparsely. We carried out a prospective, single-center, nonrandomized explorative study with 38 patients. Thirteen patients were subjected to either SAVR or transfemoral (TF-) TAVR, and 12 patients underwent transapical (TA-) TAVR...
December 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29223842/interstage-evaluation-of-homograft-valved-right-ventricle-to-pulmonary-artery-conduits-for-palliation-of-hypoplastic-left-heart-syndrome
#10
Nefthi Sandeep, Rajesh Punn, Sowmya Balasubramanian, Shea N Smith, Olaf Reinhartz, Yulin Zhang, Gail E Wright, Lynn F Peng, Lisa Wise-Faberowski, Frank L Hanley, Doff B McElhinney
OBJECTIVE: Palliation of hypoplastic left heart syndrome with a standard nonvalved right ventricle to pulmonary artery conduit results in an inefficient circulation in part due to diastolic regurgitation. A composite right ventricle pulmonary artery conduit with a homograft valve has a hypothetical advantage of reducing regurgitation, but may differ in the propensity for stenosis because of valve remodeling. METHODS: This retrospective cohort study included 130 patients with hypoplastic left heart syndrome who underwent a modified stage 1 procedure with a right ventricle to pulmonary artery conduit from 2002 to 2015...
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29223748/is-tricuspid-annuloplasty-increasing-surgical-mortality-and-morbidity-during-mitral-valve-replacement-a-single-centre-experience
#11
Constance Verdonk, Arthur Darmon, Claire Cimadevilla, Laurent Lepage, Richard Raffoul, Patrick Nataf, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: Performance of tricuspid annuloplasty (TA) in patients undergoing mitral valve surgery is recommended based on the degree of tricuspid regurgitation and tricuspid annulus size, but is often underused. AIM: To evaluate the impact of combined TA on in-hospital outcome in patients undergoing mitral valve replacement (MVR). METHODS: We selected all consecutive patients who underwent MVR for native valve disease. Clinical, echocardiographic and in-hospital complications were obtained from chart review...
December 6, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29223500/impact-of-chronic-kidney-disease-on-mortality-in-adults-undergoing-balloon-aortic-valvuloplasty
#12
Puja B Parikh, Samantha Novotny, Allen Jeremias, Javed Butler, Jie Yang, Donglei Yin, Luis Gruberg
BACKGROUND: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV. METHODS: The Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29223434/durability-of-quality-of-life-benefits-of-transcatheter-aortic-valve-replacement-long-term-results-from-the-corevalve-us-extreme-risk-trial
#13
Suzanne J Baron, Suzanne V Arnold, Matthew R Reynolds, Kaijun Wang, Michael Deeb, Michael J Reardon, James Hermiller, Steven J Yakubov, David H Adams, Jeffrey J Popma, David J Cohen
BACKGROUND: For patients with severe aortic stenosis (AS) at extreme surgical risk, transcatheter aortic valve replacement (TAVR) leads to improved survival and health status when compared with medical therapy. Whether the early health status benefits of TAVR in these patients are sustained beyond 1 year of follow-up is unknown. METHODS AND RESULTS: Six hundred thirty-nine patients with severe AS at extreme surgical risk underwent TAVR in the CoreValve US Extreme Risk Pivotal trial...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222124/assessment-of-normal-flow-aortic-stenosis-delving-too-deep
#14
EDITORIAL
Caroline Bleakley, Mark J Monaghan
No abstract text is available yet for this article.
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29222121/postoperative-reverse-remodeling-and-symptomatic-improvement-in-normal-flow-low-gradient-aortic-stenosis-after-aortic-valve-replacement
#15
Rasmus Carter-Storch, Jacob E Møller, Nicolaj L Christensen, Akhmadjon Irmukhadenov, Lars M Rasmussen, Redi Pecini, Kristian A Øvrehus, Eva V Søndergård, Niels Marcussen, Jordi S Dahl
BACKGROUND: Severe aortic stenosis (AS) most often presents with reduced aortic valve area (<1 cm2), normal stroke volume index (≥35 mL/m2), and either high mean gradient (≥40 mm Hg; normal-flow high-gradient AS) or low mean gradient (normal-flow low-gradient [NFLG] AS). The benefit of aortic valve replacement (AVR) among NFLG patients is controversial. We compared the impact of NFLG condition on preoperative left ventricular (LV) remodeling and myocardial fibrosis and postoperative remodeling and symptomatic benefit...
December 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29221957/endovascular-repair-of-complex-juxtarenal-aortic-aneurysm-using-a-combined-fenestrated-endograft-and-chimney-technique
#16
REVIEW
Zaher Fanari, Nilesh J Goswami
Chimney EVAR (CHEVAR) and Fenestrated EVAR (FEVAR) are two options for management of very complex abdominal aortic aneurysm (AAA). While some anatomical factors may favor one strategy over the other, there are some cases where the anatomical challenges may require using a hybrid approach. We are reporting the case of an 84-year-old male with a 6.8×5.7cm infrarenal abdominal aortic aneurysm that arises immediately below the level of the renal arteries and extends down to just above the iliac bifurcation with occluded celiac and inferior mesenteric arteries and severe bilateral renal artery stenosis with caudally oriented right renal and cranially oriented left renal artery...
November 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29217633/stress-echocardiography-in-patients-with-native-valvular-heart-disease
#17
REVIEW
Patrizio Lancellotti, Raluca Dulgheru, Yun Yun Go, Tadafumi Sugimoto, Stella Marchetta, Cécile Oury, Madalina Garbi
Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient's clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning...
December 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29217006/incidence-prognostic-impact-and%C3%A2-predictive-factors-of-readmission-for-heart-failure-after-transcatheter-aortic-valve-replacement
#18
Eric Durand, Maxime Doutriaux, Nicolas Bettinger, Christophe Tron, Charles Fauvel, Fabrice Bauer, Jean-Nicolas Dacher, Najime Bouhzam, Pierre-Yves Litzler, Alain Cribier, Hélène Eltchaninoff
OBJECTIVES: The aim of this study was to assess the incidence, prognostic impact, and predictive factors of readmission for congestive heart failure (CHF) in patients with severe aortic stenosis treated by transcatheter aortic valve replacement (TAVR). BACKGROUND: TAVR is indicated in patients with severe symptomatic aortic stenosis in whom surgery is considered high risk or is contraindicated. Readmission for CHF after TAVR remains a challenge, and data on prognostic and predictive factors are lacking...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29215470/invasive-assessment-of-microvascular-function-in-patients-with-valvular-heart-disease
#19
Takeshi Nishi, Hideki Kitahara, Saito Yuichi, Tomoko Nishi, Takashi Nakayama, Yoshihide Fujimoto, Goro Matsumiya, Yoshio Kobayashi
BACKGROUND: The aim of this study was to investigate microvascular function in patients with valvular heart disease (VHD), which causes chronic left ventricular volume and/or pressure overload, therefore change in coronary microvascular hemodynamics. PATIENTS AND METHODS: We prospectively enrolled 30 patients with VHD considered for surgery (10 aortic stenosis, 12 aortic regurgitation, and eight mitral regurgitation) and 30 controls. Intracoronary physiological assessments were performed in the unobstructed left anterior descending artery using a pressure-temperature sensor guidewire at rest and hyperemia...
December 5, 2017: Coronary Artery Disease
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
#20
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
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