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https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#1
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#2
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935512/analysis-of-short-and-long-term-outcomes-of-patients-with-surgically-treated-left-sided-infective-endocarditis-a-5-year-longitudinal-follow-up-study
#3
Oksana Marushchak, Holy Cole, Brett Hiebert, Evelyn Lo, Yoav Keynan, James Tam, Nasir Shaikh, Alan H Menkis, Rakesh C Arora, Pallav Shah
This study aims to analyze survival, repeat hospitalization, and risk factors for surgically treated left-sided endocarditis. Retrospective review of all 166 (114 native and 52 prosthetic) patients operated between January 2004 and March 2015 was performed. Long-term survival and repeat hospitalization data for 134 of 166 patients were obtained via linked clinical databases with the Manitoba Centre for Health Policy. Kaplan-Meier estimates of survival and hospital readmission and Cox multivariable regression analysis of factors influencing outcomes were performed...
August 23, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28935245/early-onset-prosthetic-valve-endocarditis-definition-revisited-prospective-study-and-literature-review
#4
Rinaldo Focaccia Siciliano, Bruno Azevedo Randi, Danielle Menosi Gualandro, Roney Orismar Sampaio, Márcio Sommer Bittencourt, Christian Emmanuel da Silva PelaesRN, Alfredo José Mansur, Pablo Maria Alberto Pomerantzeff, Flávio Tarasoutchi, Tânia Mara Varejão Strabelli
OBJECTIVE: to determine prosthetic valve endocarditis (PVE) annual incidence and to evaluate its current classification based on the epidemiological distribution of identified agents, and their sensitivity profile. METHODS: Between 1997 and 2014, consecutive cases of PVE within the first year of valve surgery were included in a prospective cohort study. Incidence, demographic, clinical, microbiological and in-hospital mortality data of PVE patients were recorded...
September 18, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28934975/right-anterolateral-thoracotomy-an-attractive-alternative-to-repeat-sternotomy-for-high-risk-patients-undergoing-reoperative-mitral-and-tricuspid-valve-surgery
#5
Hailong Cao, Qing Zhou, Fudong Fan, Yunxing Xue, Jun Pan, Dongjin Wang
BACKGROUND: Reoperative cardiac valve surgery via sternotomy is associated with a substantial morbidity and mortality. This study evaluated the right anterolateral thoracotomy for high-risk patients undergoing mitral and tricuspid valve redo procedures. METHODS: Out of a series of 173 patients undergoing redo cardiac valve surgery, 24 patients were reoperative via the right anterolateral thoracotomy as the high-risk group on the basis of the proximity of the heart and great vessels to the sternum and the presence and location of patent bypass grafts...
September 21, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28934519/intra-pericardial-use-of-recombinant-factor-viia-in-a-patient-with-acute-hemorrhagic-pericardial-effusion-following-transcutaneous-aortic-valve-replacement-a-case-report
#6
Vanya Jaitly, Kimberly Klein, Hlaing Tint, Alice Chen, Paul Allison, Bindu Akkanti, Pranav Loyalka, Brian Castillo
Perioperative bleeding can be a serious life-threatening complication in adult patients undergoing cardiac surgery, given the older age and additional comorbidities present in this patient population. The standard treatment options include transfusion of blood components and surgical re-exploration. We report the first case of an elderly female patient treated with local administration of recombinant factor VIIa (rFVIIa) for intractable hemorrhagic pericardial effusion, which developed following a transcutaneous aortic valve replacement (TAVR) procedure for severe aortic stenosis...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28933244/ventricular-fibrillation-and-myocardial-depression-following-pulmonary-valve-replacement-in-tetralogy-of-fallot-with-an-intramural-coronary-artery-and-coronary-artery-compression-by-chest-tube
#7
Mubbasheer Ahmed, Nathan E Thompson, Susan R Foerster, Michele A Frommelt, Michael E Mitchell, John P Scott
We describe the case of a 10-year-old male with a history of repaired Tetralogy of Fallot and known intramural right coronary artery (RCA) who presented for bioprosthetic pulmonary valve replacement. The operation was complicated by postoperative ventricular fibrillation arrest. Selective coronary angiography revealed external compression of the mid-RCA by a mediastinal chest tube that improved immediately upon removal of the tube. Ultimately, the patient required additional unroofing of the intramural coronary for full recovery...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28933040/paravalvular-leakages-between-sewing-cuffs-after-the-second-surgery-for-double-valve-replacement-evaluation-by-three-dimensional-color-doppler-transesophageal-echocardiography
#8
Hideta Takushi, Akihiro Hayashida, Nobuyuki Kagiyama, Misako Toki, Atsushi Hirohata, Keizo Yamamoto, Kiyoshi Yoshida
No abstract text is available yet for this article.
September 20, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28931366/prolonged-intensive-care-unit-stay-following-transcatheter-aortic-valve-replacement
#9
Ryosuke Higuchi, Morimasa Takayama, Kenichi Hagiya, Mike Saji, Keitaro Mahara, Itaru Takamisawa, Jun Shimizu, Tetsuya Tobaru, Nobuo Iguchi, Shuichiro Takanashi
PURPOSE: Postoperative intensive care unit (ICU) stay after cardiac surgeries has been extensively studied, but little attention has been given to ICU stay following transcatheter aortic valve replacement (TAVR). This study examined ICU stay after TAVR. METHODS: Two hundred and forty-five patients who underwent TAVR between April 2010 and October 2016 were studied retrospectively. We investigated the status of ICU stay, the predictors of prolonged ICU stay (PICUS), and its impact on short- and long-term outcomes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28929616/noninvasive-assessment-of-left-ventricular-end-diastolic-pressure-by-deceleration-time-of-early-diastolic-mitral-annular-velocity-in-patients-with-heart-failure
#10
Kazushi Takemoto, Kumiko Hirata, Takeshi Hozumi, Takashi Tanimoto, Makoto Orii, Yasutsugu Shiono, Yoshiki Matsuo, Yasushi Ino, Hironori Kitabata, Takashi Kubo, Atsushi Tanaka, Takashi Akasaka
OBJECTIVE: To examine the diagnostic ability of the deceleration time of early mitral annular velocity (e'DT) as determined by tissue Doppler velocity image, a method for assessing LV filling pressure. BACKGROUNDS: Estimation of LV filling pressure by Doppler echocardiography requires a combination of various parameters. Therefore, there remains a need for a simple index in LV filling pressure estimation. The e' is known to be reduced and delayed with increased LV filling pressure during development of heart failure...
September 2017: Echocardiography
https://www.readbyqxmd.com/read/28929526/the-influence-of-marfans-and-bicuspid-valves-on-outcomes-following-aortic-valve-reimplantation
#11
Carlos E Martín, Carlos García Montero, Santiago-Fiz Serrano, Ana González, Susana Mingo, Vanessa Moñivas, Jorge Centeno, Alberto Forteza
BACKGROUND: We analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. METHODS: Between March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 50 ± 3 mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome...
September 20, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28929446/new-imaging-tools-in-cardiovascular-medicine-computational-fluid-dynamics-and-4d-flow-mri
#12
Keiichi Itatani, Shohei Miyazaki, Tokoki Furusawa, Satoshi Numata, Sachiko Yamazaki, Kazuki Morimoto, Rina Makino, Hiroko Morichi, Teruyasu Nishino, Hitoshi Yaku
Blood flow imaging is a novel technology in cardiovascular medicine and surgery. Today, two types of blood flow imaging tools are available: measurement-based flow visualization including 4D flow MRI (or 3D cine phase-contrast magnetic resonance imaging), or echocardiography flow visualization software, and computer flow simulation modeling based on computational fluid dynamics (CFD). MRI and echocardiography flow visualization provide measured blood flow but have limitations in temporal and spatial resolution, whereas CFD flow calculates the flow according to assumptions instead of flow measurement, and it has sufficiently fine resolution up to the computer memory limit, and it enables even virtual surgery when combined with computer graphics...
September 19, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28929044/transcatheter-tricuspid-valve-in-ring-and-aortic-valve-in-valve-implantation
#13
Daniel Reichart, Niklas Schofer, Florian Deuschl, Andreas Schaefer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
Background  Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce. Case Description  Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc...
January 2017: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28929043/supraventricular-tachycardia-and-tricuspid-regurgitation-in-the-setting-of-misplaced-implantable-port-catheter-tip
#14
Ahmad Awan, Bisma Ahsan, Hasan Iftikhar, Akbar Khan, Fasil Tiruneh, Yididia Bekele, Ankit Mahajan, Ahmed A Awan
We present the case of a 31-year-old female with a past medical history of B-cell leukemia, on maintenance chemotherapy administered via centrally placed implantable catheter port, who presented to the emergency room with fever, chills, and generalized body pain of one day's duration. After initial workup, the patient was admitted to the intensive care unit and managed for severe sepsis. The patient was found to have a new-onset 3/6 holosystolic murmur at the left lower sternal border. Furthermore, she developed an episode of supraventricular tachycardia that responded to adenosine...
July 11, 2017: Curēus
https://www.readbyqxmd.com/read/28927173/the-relationship-between-preoperative-frailty-and-outcomes-following-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#15
Atul Anand, Catherine Harley, Akila Visvanathan, Anoop S V Shah, Joanna Cowell, Alasdair MacLullich, Susan Shenkin, Nicholas L Mills
Aims: Transcatheter aortic valve implantation (TAVI) is an increasingly common intervention for patients with aortic stenosis deemed high risk for major cardiac surgery, but identifying those who will benefit can be challenging. Frailty reflects physiological reserve and may be a useful prognostic marker in this population. We performed a systematic review and meta-analysis of the association between frailty and outcomes after TAVI. Methods and Results: Five databases were searched between January 2000 and May 2015...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#16
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28921420/causes-of-an-increased-pressure-gradient-through-the-left-ventricular-outflow-tract-a-west-coast-experience
#17
Sayuki Kobayashi, Yoshihiko Sakai, Isao Taguchi, Hiroto Utsunomiya, Takahiro Shiota
BACKGROUND: Left ventricular outflow tract obstruction (LVOTO) occurs from not only obstructive hypertrophic cardiomyopathy but also other conditions such as sigmoid septum or post mitral valve repair. However, the changes of the LVOT pressure gradient (LVOT PG) in LVOTO with various conditions remain unclear. METHODS: The clinical characteristics and echocardiographic parameters of 73 patients with LVOT PG ≥50 mmHg at rest on Doppler ultrasound were retrospectively investigated...
September 18, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28919069/impact-of-discontinuation-of-antiplatelet-therapy-prior-to-isolated-valve-and-combined-coronary-artery-bypass-graft-and-valve-procedures-on-short-and-intermediate-term-outcomes
#18
James Meneguzzi, Matthew Kilpin, Ying Yan Zhu, Atsuo Doi, Christopher Reid, Lavinia Tran, Philip Hayward, Julian Smith
BACKGROUND: A change in cardiac surgery practice over the past decade has seen an increase in urgent or inpatient referrals for surgery, with antiplatelet therapy often continued up until surgery. This study aims to identify the optimal timing for administration of aspirin to minimise risk of perioperative morbidity and mortality. METHODS: From a prospectively compiled database collected by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons, we identified 8,294 patients undertaking combined CABG and valve or isolated valve procedures while discontinuing aspirin...
September 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28918896/role-of-circulating-endothelial-progenitor-cells-in-the-reparative-mechanisms-of-stable-ischemic-myocardium
#19
D Morrone, F Felice, C Scatena, A De Martino, M L E Picoi, N Mancini, S Blasi, M Menicagli, R Di Stefano, U Bortolotti, A G Naccarato, A Balbarini
BACKGROUND: Mobilization of endothelial progenitor cells (EPCs) into circulation from bone marrow in patients with acute myocardial infarction has strong scientific evidence; less is known about EPC mobilization in patients with stable coronary artery disease (CAD). The aim of this study was to investigate the association of stable ischemic heart disease with EPC levels in tissue and blood. METHODS: Fifty-five consecutive patients admitted to a single treatment center for valve or coronary artery bypass grafting (CABG) surgeries were included in the study...
September 14, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28918516/valve-sparing-aortic-root-surgery-con-remodeling
#20
Takashi Kunihara
The two major valve-sparing root replacement procedures, aortic valve reimplantation (reimplantation) and aortic root remodeling (remodeling), have advantages and disadvantages, which are reviewed herein. The main advantage of reimplantation is the resulting annular support, and the disadvantages are the unfavorable hemodynamics and relatively long procedure time. The main advantages of remodeling are the physiological hemodynamics and decreased procedure time, and the disadvantage is the lack of annular support...
September 16, 2017: General Thoracic and Cardiovascular Surgery
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