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https://www.readbyqxmd.com/read/28821337/intraoperative-cerebral-perfusion-disturbances-during-transcatheter-aortic-valve-replacement
#1
Jonathon P Fanning, Darren L Walters, Allan J Wesley, Chris Anstey, Samuel Huth, Judith Bellapart, Caroline Collard, Ivan L Rapchuk, Sarvesh Natani, Michael Savage, John F Fraser
BACKGROUND: Transcatheter aortic valve replacement entails profound and unavoidable hemodynamic perturbations that may contribute to the neurological injury associated with the procedure. METHODS: Thirty-one patients were monitored with cerebral oximetry as a surrogate marker of perfusion while undergoing transcatheter aortic valve replacement via a transfemoral approach under general anesthesia to detect intraoperative hypoperfusion insult. Serial neurologic, cognitive, and cerebral magnetic resonance imaging assessments were administered to objectively quantify perioperative neurologic injury and ascertain any association with significant cerebral oximetry disturbances...
August 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28820560/severe-valvular-aortic-stenosis-and-fixed-subvalvular-aortic-stenosis-a-rare-and-challenging-combination
#2
Ayman Elbadawi, Marwan Saad, Islam Y Elgendy, Basarat Baig, Farhad Abtahian
A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820554/warfarin-therapy-after-mechanical-valve-replacement-a-tool-for-predicting-bleeding-events
#3
Insil Jang, Sukjung Choo, Kyunghee Kim
BACKGROUND: Mechanical valve replacement is associated with positive outcomes, but patients must undergo life-long anticoagulation therapy with warfarin, which carries a significant risk of bleeding complications. Therefore, a systematic and continuous assessment and supervision of warfarin treatment is essential in such patients, and approaches that can predict the risk of bleeding in advance are required. The study aim was to develop a classification tool to predict bleeding events in South Korean patients with mechanical valve replacement undergoing oral warfarin therapy...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820551/fungal-endocarditis-due-to-aspergillus-oryzae-the-first-case-reported-in-the-literature
#4
Andrea Mazza, Nicola Luciani, Marco Luciani, Federico Cammertoni, Alessia Giaquinto, Natalia Pavone, Piergiorgio Bruno, Massimo Massetti
Infective endocarditis (IE) is a severe disease with high mortality and morbidity. Prosthetic valve endocarditis is a life-threatening complication which can occur in less than 10% of patients with valve prosthesis. A fungal etiology of IE is rare and accounts for only 2-4% of all case of endocarditis, but is associated with a higher mortality and morbidity. Herein is reported the first case of fungal endocarditis of aortic valve prosthesis due to Aspergillus oryzae in a 67-year-old caucasian man who nine years previously underwent mitral and aortic valve replacement with mechanical prostheses, and tricuspid annuloplasty for acute IE due to Enterococcus spp...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820550/is-fasting-for-ramadan-safe-in-patients-with-mechanical-cardiac-valves
#5
Ersin Yildirim, Ozlem Secen, Okkes Uku, Mehmet Nail Bilen, Makbule Kutlu Karadag
BACKGROUND: The study aim was to investigate the safety and effects of fasting during Ramadan on the International Normalized Ratio (INR) in patients with mechanical cardiac valves. METHODS: A total of 105 patients admitted to the authors' hospital between June and October 2015, who had history of prosthetic valve replacement, was investigated. The patients were allocated to two groups: those fasting during Ramadan (n = 42) and those not fasting (n = 63). All patients were examined by a cardiologist, and the clinical findings and complaints for the past three months were evaluated...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#6
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820543/minimally-invasive-versus-transcatheter-and-surgical-aortic-valve-replacement-a-propensity-matched-study
#7
Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Prakash Balan, Catalin Loghin, Daniel Ocazionez, Anthony Estrera, Carson T Hoffmann, Vasilis C Babaliaros, Joseph Lamelas, Tom C Nguyen
BACKGROUND: An increasing number of options exist for the treatment of severe symptomatic aortic stenosis. The study aim was to compare short-term outcomes in patients undergoing surgical aortic valve replacement (SAVR), minimally invasive aortic valve replacement (MIAVR), and transcatheter aortic valve replacement (TAVR). METHODS: A multi-institutional retrospective review of 2,571 patients undergoing SAVR (n = 842), MIAVR via right anterior thoracotomy (n = 699) and TAVR (n = 1,030) between 2011 and 2014 was conducted...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820540/endoscopic-port-access-surgery-for-late-orthotopic-cardiac-transplantation-atrioventricular-valve-disease
#8
Johan van der Merwe, Filip Casselman, Bernard Stockman, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
BACKGROUND: The study aim was to present details of the perioperative and long-term outcomes of redo-endoscopic port access surgery (REPAS) for late atrioventricular valve disease (AVVD) in orthotopic cardiac transplant (OCT) patients. METHODS: Between February 2004 and October 2015, REPAS was performed for late AVVD in seven consecutive OCT patients (mean age 57.9 ± 17.2 years; EuroSCORE II 21.2 ± 14.7%) at the authors' institution. The mean OCT-REPAS time interval was 7...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820030/epidemiology-of-cardiovascular-disease-in-the-united-states-implications-for-the-perfusion-profession-a-2017-update
#9
Joseph J Sistino, David C Fitzgerald
INTRODUCTION: By analyzing epidemiological trends in cardiovascular disease (CVD), key stakeholders can make informed decisions on the future of disease burden and treatment. Accordingly, the cardiovascular perfusion community would benefit from data that would help predict future professional resource utilization. METHODS: In 2003, the changes in the number of hospital discharges for CVD from 1990 to 2000 were published, based on data from the National Center for Health Statistics (NCHS)...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28819363/combined-analysis-of-endothelial-hematopoietic-and-mesenchymal-stem-cell-compartments-shows-simultaneous-but-independent-effects-of-age-and-heart-disease
#10
Carine Ghem, Lucinara Dadda Dias, Roberto Tofani Sant'Anna, Renato A K Kalil, Melissa Markoski, Nance Beyer Nardi
Clinical trials using stem cell therapy for heart diseases have not reproduced the initial positive results obtained with animal models. This might be explained by a decreased regenerative capacity of stem cells collected from the patients. This work aimed at the simultaneous investigation of endothelial stem/progenitor cells (EPCs), mesenchymal stem/progenitor cells (MSCs), and hematopoietic stem/progenitor cells (HSCs) in sternal bone marrow samples of patients with ischemic or valvular heart disease, using flow cytometry and colony assays...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28818015/bioglue-associated-loss-of-aortic-valve-leaflet-motility-sonographically-masked-by-both-newly-replaced-mechanical-aortic-and-mitral-valves
#11
Alan Matthew Smeltz, Thomas G Caranasos, Emily G Teeter
BioGlue is a surgical adhesive widely used to help reinforce complex cardiac and vascular repairs. Since its introduction, several case reports have emerged revealing complications that all providers should be mindful of whenever the product is used. This report considers a unique situation where BioGlue was used after double cardiac valve repair that resulted in adhesion of the new mechanical aortic valve leaflets and was difficult to visualize with transesophageal echocardiography.
August 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28817669/the-association-between-renal-recovery-after-acute-kidney-injury-and-long-term-mortality-after-transcatheter-aortic-valve-replacement
#12
Charat Thongprayoon, Wisit Cheungpasitporn, Narat Srivali, Wonngarm Kittanamongkolchai, Ankit Sakhuja, Kevin L Greason, Kianoush B Kashani
BACKGROUND: This study aimed to examine the association between renal recovery status at hospital discharge after acute kidney injury (AKI) and long-term mortality following transcatheter aortic valve replacement (TAVR). METHODS: We screened all adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary referral medical center from January 1, 2008, through June 30, 2014. An AKI was defined as an increase in serum creatinine level of 0...
2017: PloS One
https://www.readbyqxmd.com/read/28816101/measurement-of-total-hemoglobin-reduces-red-cell-transfusion-in-hospitalized-patients-undergoing-cardiac-surgery-a-retrospective-database-analysis
#13
Christopher Craver, Kathy W Belk, Gerard J Myers
INTRODUCTION: Historically, perioperative hemoglobin monitoring has relied on calculated saturation, using blood gas devices that measure plasma hematocrit (Hct). Co-oximetry, which measures total hemoglobin (tHb), yields a more comprehensive assessment of hemodilution. The purpose of this study was to examine the association of tHb measurement by co-oximetry and Hct, using conductivity with red blood cell (RBC) transfusion, length of stay (LOS) and inpatient costs in patients having major cardiac surgery...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28814589/ureaplasma-parvum-causing-life-threatening-disease-in-a-susceptible-patient
#14
Alexander Korytny, Roni Nasser, Yuval Geffen, Tom Friedman, Mical Paul, Nesrin Ghanem-Zoubi
A 56-year-old man with lymphoma developed orchitis followed by septic arthritis of his right glenohumeral joint. Synovial fluid cultures were negative but PCR amplification test was positive forUreaplasmaparvum. The patient was treated with doxycycline. Two and a half years later, the patient presented with shortness of breath and grade III/IV diastolic murmur on auscultation. Echocardiography revealed severely dilated left heart chambers, severe aortic regurgitation and several mobile masses on the aortic valve cusps suspected to be vegetations...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814490/clinical-features-and-prognosis-of-patients-with-isolated-severe-aortic-stenosis-and-valve-area-less-than-1-0-cm-2
#15
Praveen Mehrotra, Katrijn Jansen, Timothy C Tan, Aidan Flynn, Judy W Hung
OBJECTIVE: Current guidelines define severe aortic stenosis (AS) as an aortic valve area (AVA)≤1.0 cm(2), but some authors have suggested that the AVA cut-off be decreased to 0.8 cm(2). The aim of this study was, therefore, to better describe the clinical features and prognosis of patients with an AVA of 0.8-0.99 cm(2). METHODS: Patients with isolated, severe AS and ejection fraction ≥55% with an AVA of 0.8-0.99 cm(2) (n=105) were compared with those with an AVA<0...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28814237/statins-in-aortic-stenosis
#16
Karl Norrington, Emmanuel Androulakis, Evangelos Oikonomou, Georgia Vogiatzi, Dimitris Tousoulis
Calcific aortic stenosis (AS) is the most common form of valvular heart disease in Europe and North America. It is a progressive disease with a prolonged period of asymptomatic latency which eventually leads to critical left ventricular outflow tract obstruction necessitating surgical replacement of the valve. Statins are lipid-lowering drugs with a robust evidence base demonstrating clinical benefit in atherosclerotic coronary artery disease. There has therefore been significant interest in the potential benefit of statins in AS...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28813234/cardiac-mr-strain-a-noninvasive-biomarker-of-fibrofatty-remodeling-of-the-left-atrial-myocardium
#17
Adrian T Huber, Jérôme Lamy, Amer Rahhal, Morgane Evin, Fabrice Atassi, Carine Defrance, Guillaume Lebreton, Karine Clément, Myriam Berthet, Richard Isnard, Pascal Leprince, Philippe Cluzel, Stéphane N Hatem, Nadjia Kachenoura, Alban Redheuil
Purpose To determine whether left atrial (LA) strain quantification with cardiac magnetic resonance (MR) imaging feature tracking is associated with the severity of LA fibrofatty myocardial remodeling at histologic analysis. Materials and Methods This prospective case-control study was approved by the institutional review board. LA strain was evaluated with cardiac MR feature tracking between January 2014 and March 2015 in 13 consecutive patients (mean age, 61 years ± 19; nine male) with mitral regurgitation in the 24 hours before mitral valve surgery and 13 age- and sex-matched healthy control subjects...
August 16, 2017: Radiology
https://www.readbyqxmd.com/read/28812435/transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-patients-with-anaemia
#18
Paola D'Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco, Fulvia Seccareccia
OBJECTIVES: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. METHODS: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. RESULTS: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1...
August 16, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28808772/longitudinal-strain-assessed-by-cardiac-magnetic-resonance-correlates-to-hemodynamic-findings-in-patients-with-severe-aortic-stenosis-and-predicts-positive-remodeling-after-transcatheter-aortic-valve-replacement
#19
Dominik Buckert, Maciej Cieslik, Raid Tibi, Michael Radermacher, Volker Rasche, Peter Bernhardt, Vinzenz Hombach, Wolfgang Rottbauer, Jochen Wöhrle
AIMS: To assess left-ventricular strain parameters before and after transcatheter aortic valve replacement (TAVR) by feature tracking cardiac magnetic resonance imaging (FT CMR) and to correlate the findings to hemodynamic state and left-ventricular remodeling. METHODS AND RESULTS: Patients with symptomatic AS underwent FT CMR before and after TAVR. Patients were carefully evaluated by a comprehensive work-up including CMR, echocardiography and left and right heart catheterization...
August 14, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28806252/quality-and-safety-in-health-care-part-xxx-transcatheter-aortic-valve-therapy
#20
Jay A Harolds
Initially, the transcatheter aortic valve replacement procedure was approved only for patients with aortic stenosis that was both severe and symptomatic who either also had too high a risk of aortic valve replacement surgery to have the surgery or who had a high risk for the surgery. Between the years 2012 and 2015, the death rate at 30 days declined from an initial rate of 7.5% to 4.6%. There has also been more use of the transfemoral approach over the years. In 2016, the transcatheter aortic valve replacement was approved for patients with aortic stenosis at intermediate risk of surgery...
August 12, 2017: Clinical Nuclear Medicine
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