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Valve surgery

Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
Tetsuro Uchida, Azumi Hamasaki, Mitsuaki Sadahiro
No abstract text is available yet for this article.
March 14, 2018: Journal of Cardiac Surgery
Hector Cubero-Gallego, Maria Heredia-Rodriguez, Eduardo Tamayo
We aimed to assess the influence of impairment in renal function over the high-sensitivity cardiac troponin T (hs-cTnT) accuracy to diagnose perioperative myocardial infarction (MI) after heart valve surgery. Heart valve surgery was performed in 805 patients from June 2012 to January 2016. Patients with enzymatic curves of hs-cTnT suggestive of myocardial necrosis and electrocardiogram and/or transthoracic echocardiogram criteria were identified as patients with perioperative MI. Impairment in renal function was defined as a postoperative creatinine clearance <50 ml/min at 16 h after surgery and for at least 48 h...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Hsiu-An Lee, Chun-Yu Lin, Yung-Chang Chen, Shao-Wei Chen, Yu-Yun Nan, Kuo-Sheng Liu, Meng-Yu Wu, Yu-Sheng Chang, Jaw-Ji Chu, Pyng-Jing Lin, Feng-Chun Tsai
The feasibility and durability of mitral valve (MV) repair in active infective endocarditis (IE) has been reported, but proper management of perioperative neurological complications and surgical timing remains uncertain and may crucially affect the outcome.In this single-center retrospective observational study, patients who underwent isolated MV surgery for active native IE in our institution between August 2005 and August 2015 were reviewed and analyzed. Patients who were operated on for healed IE or who required combined procedures were excluded from this study...
March 2018: Medicine (Baltimore)
Jason Talmadge, Robin High, William Wesley Heckman
IMPORTANCE: Spreader grafts are commonly used for nasal valve stenosis. There is debate among practitioners regarding the optimal approach for spreader graft placement. OBJECTIVE: This study aimed to determine whether an endonasal spreader graft placement leads to equivalent postoperative outcomes using a standardized nasal obstruction symptom score and whether there is a significant difference in operative time between the 2 approaches. DESIGN: A retrospective review of functional rhinoplasties by a single facial plastic surgeon over a 2-year period was conducted...
March 13, 2018: Annals of Plastic Surgery
Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano
BACKGROUND: Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. METHODS: We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA)...
March 10, 2018: Lancet
Shinya Higuchi, Iwao Matsunaga, Kiyokazu Koga, Eiichi Teshima, Atsuhiro Nakashima, Ryuji Tominaga, Tsuyoshi Ito
In almost every type of artificial valve, structural failure has been described. We are reporting on a case of a sudden leaflet escape of an Edwards TEKNA mitral valve prosthesis 12 years after implantation. The patient had a sudden onset of dyspnea and severe pulmonary edema with subsequent cardiogenic shock. An emergency mitral replacement was successfully performed. A multi-detector computed tomography scanning and three-dimensional imaging showed two fragments that had embolized in the terminal aorta and the left common iliac artery...
March 13, 2018: General Thoracic and Cardiovascular Surgery
Ashwin Rammohan, Sripriya Srinivas, Yahya Al Azri, Mettu Srinivas Reddy, Mohamed Rela
Roux-en-Y (RY) hepaticojejunostomy (HJ) is a critical component of complex hepatobiliary operations, and it is the treatment of choice for post-cholecystectomy biliary strictures (PCBS). Complications related to the Roux limb, particularly those leading to cholangitis, can severely compromise outcomes. We present a case of a 54-year-old lady who had previously undergone two HJ procedures for recurrent PCBS. The same Roux limb had been used in each of the operations. Short Roux/Roux reflux syndrome led to recurrent cholangitis in this patient, as proven by the reflux of oral contrast into the biliary tree on imaging...
February 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Sigita Glaveckaite, Egle Uzdavinyte-Gateliene, Zaneta Petrulioniene, Darius Palionis, Nomeda Valeviciene, Gintaras Kalinauskas, Pranas Serpytis, Aleksandras Laucevicius
OBJECTIVES: We aimed to evaluate (i) the effectiveness of combined surgery (coronary artery bypass grafting with restrictive mitral valve annuloplasty) and (ii) the late gadolinium enhancement cardiovascular magnetic resonance-based predictors of ischaemic mitral regurgitation (IMR) recurrence. METHODS: The prospective analysis included 40 patients with multivessel coronary artery disease, IMR >II° and left ventricular (LV) dysfunction undergoing combined surgery...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Jonathan Rilinger, Claudia Heilmann, Ulrich Beitinger, Christoph B Olivier, Philipp Diehl, Friedhelm Beyersdorf, Matthias Siepe
BACKGROUND: Ischemic mitral regurgitation (IMR) is a frequent complication of coronary artery heart disease and is associated with increased mortality. Controversies exists whether patients with moderate IMR may benefit from a combined procedure with coronary artery bypass grafting (CABG) and treatment of mitral regurgitation. METHODS: 451 patients with moderate IMR (grade 2) receiving either CABG alone (CABG only) or additional mitral valve repair or replacement (CABG+MV) were included in this observational single-centre study...
March 12, 2018: Journal of Cardiovascular Surgery
Tasalak Thonghong, Ole De Backer, Lars Søndergaard
New European guidelines on the management of valvular heart disease-supported by the European Society of Cardiology (ESC) and European Association of CardioThoracic Surgery (EACTS)-were recently published. Although these guidelines are very comprehensive, these typically are not very inviting to read. In this document, we aimed to distil all the information about transcatheter aortic valve replacement (TAVR) in the new 2017 ESC/EACTS guidelines to the essential and give additional comments on the position of TAVR in 2017...
2018: Open Heart
Qiang Wang, Jia-Xin Ye, Min Ge, Dong-Jin Wang
This study reviews our results and experience with cardiothoracic surgery via RVIAT over the past 15 years. This retrospective overview summarises our results, describing the early and late clinical outcomes of 1,126 patients, including 370 ASD closures, 488 VSD closures and 268 valve surgeries, at a single center between October 2001 and December 2015. The mean follow-up time was 52 ± 35 months (range 8-120 months). The mean incision length was 6 ± 2.22 cm (range 3.9-8.9 cm). No patient required conversion to median sternotomy...
March 12, 2018: Scientific Reports
Robert B Hawkins, J Hunter Mehaffey, Eric J Charles, John A Kern, D Scott Lim, Nicholas R Teman, Gorav Ailawadi
BACKGROUND: Frailty is an important predictor of outcomes after cardiac surgery, but utility is limited by difficult assessment and quantification. We hypothesize that sarcopenia defined as psoas muscle cross-sectional area is a useful predictor of surgical aortic valve replacement (SAVR) outcomes in moderate to high-risk patients. METHODS: Moderate to high-risk (predicted risk of mortality [PROM] >3%) patients who underwent SAVR with or without coronary bypass were extracted from an institutional database (2009-2016)...
March 9, 2018: Annals of Thoracic Surgery
Sophie Malekzadeh-Milani, Ali Houeijeh, Zakaria Jalal, Sébastien Hascoet, Mohamed Bakloul, Philippe Aldebert, Jean-François Piéchaud, François Heitz, Helene Bouvaist, Claire Dauphin, Patrice Guérin, Olivier Villemain, Jérome Petit, François Godart, Jean-Benoit Thambo, Younes Boudjemline
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is a routine treatment for dysfunctional right ventricular outflow tract. Infective endocarditis (IE) is a major concern. AIM: To report French experience with the Melody™ valve (Medtronic Inc., Minneapolis, MN, USA). METHODS: All patients who underwent PPVI were recorded in a multicentre French national survey. Demographic and procedural data were collected from patients with IE...
March 9, 2018: Archives of Cardiovascular Diseases
Luke M Wiggins, S Ram Kumar
No abstract text is available yet for this article.
February 8, 2018: Journal of Thoracic and Cardiovascular Surgery
Juan Manuel Monteagudo Ruiz, Maurizio Galderisi, Agostino Buonauro, Luigi Badano, Patrizia Aruta, Martin J Swaans, Laura Sanchis, Antti Saraste, Mark Monaghan, Konstantinos C Theodoropoulos, Michael Papitsas, Noah Liel-Cohen, Sergio Kobal, Mojca Bervar, Boštjan Berlot, Gerasimos Filippatos, Ignatios Ikonomidis, Spyridon Katsanos, Felix C Tanner, Daniela Cassani, Francesco F Faletra, Laura A Leo, Amparo Martinez, Javier Matabuena, Antonio Grande-Trillo, David Alonso-Rodriguez, Dolores Mesa, Teresa Gonzalez-Alujas, Marta Sitges, Fernando Carrasco-Chinchilla, Chi Hion Li, Covadonga Fernandez-Golfin, José Luis Zamorano
Aims: To determine the prevalence of mitral regurgitation (MR) in a large cohort of consecutive patients undergoing clinically indicated echocardiography and to examine the distribution of primary and secondary MR. Methods and results: All patients undergoing an echocardiographic study in 19 European centres within a 3-month period were prospectively included. MR assessment was performed as recommended by the European Association of Cardiovascular Imaging (EACVI)...
February 23, 2018: European Heart Journal Cardiovascular Imaging
Phillip S Naimo, Tyson A Fricke, Yves d'Udekem, Johann Brink, Robert G Weintraub, Christian P Brizard, Igor E Konstantinov
OBJECTIVES: Preoperative moderate or greater truncal valve (TV) insufficiency is one of the most important factors influencing mortality in children with truncus arteriosus. We therefore sought to determine the impact of TV insufficiency and concomitant TV surgery on children who underwent truncus arteriosus repair at a single institution. METHODS: We reviewed 180 patients who underwent truncus arteriosus repair between 1979 and 2016. Preoperative echocardiography demonstrated TV insufficiency in 80 patients (mild: 33...
March 8, 2018: European Journal of Cardio-thoracic Surgery
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 Clin Rep
Brianna J Shinn, Laura J Tafe, Pantila Vanichakarn
BACKGROUND Carcinoid tumor, benign, low-grade malignant, and high-grade malignant, can be associated with the release of vasoactive substances that cause symptoms including cutaneous flushing, diarrhea, and bronchospasm. In 50-60% of patients with carcinoid syndrome, the vasoactive substances cause fibrosis of the pulmonary and tricuspid heart valves which lead to regurgitation and right-sided heart failure. The right side of the heart is usually affected because monoamine oxidases in the lungs usually inactivate the vasoactive substances...
March 12, 2018: American Journal of Case Reports
Shannon N Nees, Jonathan N Flyer, Anjali Chelliah, Jeffrey D Dayton, Lorraine Touchette, David Kalfa, Paul J Chai, Emile A Bacha, Brett R Anderson
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare cardiac anomaly associated with sudden cardiac death (SCD). Single-center studies describe surgical repair as safe, although medium- and long-term effects on symptoms and risk of SCD remain unknown. We sought to describe outcomes of surgical repair of AAOCA. METHODS: We reviewed institutional records for patients who underwent AAOCA repair, from 2001 to 2016, at 2 affiliated institutions...
February 8, 2018: Journal of Thoracic and Cardiovascular Surgery
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