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https://www.readbyqxmd.com/read/28820543/minimally-invasive-versus-transcatheter-and-surgical-aortic-valve-replacement-a-propensity-matched-study
#1
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/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#2
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28734891/ct-defined-prosthesis-patient-mismatch-downgrades-frequency-and-severity-and%C3%A2-demonstrates-no-association-with-adverse-outcomes-after-tavr
#3
John Mooney, Stephanie L Sellers, Phillip Blanke, Philippe Pibarot, Rebecca T Hahn, Danny Dvir, Pamela S Douglas, Neil J Weissman, Susheel K Kodali, Vinod H Thourani, Hasan Jilaihawi, Omar Khalique, Craig R Smith, Shaw Hua Kueh, Mickael Ohana, Romi Grover, Christopher Naoum, Aaron Crowley, Wael A Jaber, Maria C Alu, Rupa Parvataneni, Michael Mack, John G Webb, Martin B Leon, Jonathon A Leipsic
OBJECTIVES: This study sought to determine if indexed effective orifice area (EOAi), using left ventricular outflow tract measured from computed tomography (EOAiCT), reclassified prosthesis-patient mismatch (PPM) compared with conventional echocardiogram-defined measurements (EOAiTTE). BACKGROUND: PPM does not predict mortality following transcatheter aortic valve replacement (TAVR). However, it is unknown if the EOAiCT of the left ventricular outflow tract improves risk stratification...
July 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28728785/operative-strategies-to-reduce-cerebral-embolic-events-during-on-and-off-pump-coronary-artery-bypass-surgery-a-stratified-prospective-randomized-trial
#4
Michael E Halkos, Aaron Anderson, Jose Nilo G Binongo, Anthony Stringer, Yi Lasanajak, Vinod H Thourani, Omar M Lattouf, Robert A Guyton, Kim T Baio, Eric Sarin, William B Keeling, N Renee Cook, Katherine Carssow, Alexis Neill, Kathryn E Glas, John D Puskas
OBJECTIVE: To determine the impact of different aortic clamping strategies on the incidence of cerebral embolic events during coronary artery bypass grafting (CABG). METHODS: Between 2012 and 2015, 142 patients with low-grade aortic disease (epiaortic ultrasound grade I/II) undergoing primary isolated CABG were studied. Those undergoing off-pump CABG were randomized to a partial clamp (n = 36) or clampless facilitating device (CFD; n = 36) strategy. Those undergoing on-pump CABG were randomized to a single-clamp (n = 34) or double-clamp (n = 36) strategy...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28728688/transcatheter-versus-surgical-aortic%C3%A2-valve%C3%A2-replacement-propensity-matched-comparison
#5
J Matthew Brennan, Laine Thomas, David J Cohen, David Shahian, Alice Wang, Michael J Mack, David R Holmes, Fred H Edwards, Naftali Z Frankel, Suzanne J Baron, John Carroll, Vinod Thourani, E Murat Tuzcu, Suzanne V Arnold, Roberta Cohn, Todd Maser, Brenda Schawe, Susan Strong, Allen Stickfort, Elizabeth Patrick-Lake, Felicia L Graham, Dadi Dai, Fan Li, Roland A Matsouaka, Sean O'Brien, Fan Li, Michael J Pencina, Eric D Peterson
BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. OBJECTIVES: The aim of this study was to determine the safety and effectiveness of TAVR versus surgical aortic valve replacement (SAVR), particularly in intermediate- and high-risk patients, in a nationally representative real-world cohort...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28724752/the-fluid-mechanics-of-transcatheter-heart-valve-leaflet-thrombosis-in-the-neo-sinus
#6
Prem A Midha, Vrishank Raghav, Rahul Sharma, Jose F Condado, Ikechukwu U Okafor, Tanya Rami, Gautam Kumar, Vinod H Thourani, Hasan Jilaihawi, Vasilis Babaliaros, Raj R Makkar, Ajit P Yoganathan
Background -Transcatheter heart valve (THV) thrombosis has been increasingly reported. In these studies, thrombus quantification has been based on 2D assessment of a 3D phenomenon. Methods -Post-procedural four-dimensional, volume-rendered CT (4DCT) data of CoreValve, Evolut R, and SAPIEN 3 transcatheter aortic valve replacement (TAVR) patients enrolled in the RESOLVE trial were included in this analysis. Patients on anticoagulation were excluded. SAPIEN 3 and CoreValve/Evolut R patients with and without hypo-attenuated leaflet thickening (HALT) were included in order to study differences between groups...
July 19, 2017: Circulation
https://www.readbyqxmd.com/read/28711323/transapical-and-transaortic-transcatheter-aortic-valve-replacement-still-part-of-the-game-and-at-what-cost
#7
EDITORIAL
Jessica Forcillo, Vinod H Thourani
No abstract text is available yet for this article.
June 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28697894/underestimation-of-the-incidence-of-new-onset-post-coronary-artery-bypass-grafting-atrial-fibrillation-and-its-impact-on-30-day-mortality
#8
Giovanni Filardo, Benjamin D Pollock, Briget da Graca, Teresa K Phan, Danielle M Sass, Gorav Ailawadi, Vinod Thourani, Ralph Damiano
OBJECTIVE: Inconsistent definitions of atrial fibrillation after coronary artery bypass grafting have caused uncertainty about its incidence and risk. We examined the extent to which limiting the definition to post-coronary artery bypass grafting atrial fibrillation events requiring treatment underestimates its incidence and impact on 30-day mortality. METHODS: We assessed in-hospital atrial fibrillation and 30-day mortality in 9268 consecutive patients without preoperative atrial fibrillation who underwent isolated coronary artery bypass grafting at 5 US hospitals (2004-2010)...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673705/reoperative-aortic-root-replacement-outcome-in-a-contemporary-series
#9
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Vinod H Thourani, Edward P Chen
OBJECTIVES: Reoperative aortic root replacement is a challenging procedure associated with significant mortality and morbidity. The purpose of this study was to investigate the outcomes of reoperative aortic root replacement when performed in a number of complex clinical settings and to identify risk factors for operative mortality and long-term survival. METHODS: From 2006 to 2015, 280 consecutive patients at an academic center underwent reoperative aortic root replacement after a variety of previous aortic or cardiac operations...
June 3, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28669501/surgical-ablation-of-atrial-fibrillation-in-the-united-states-trends-and-propensity-matched-outcomes
#10
Vinay Badhwar, J Scott Rankin, Niv Ad, Maria Grau-Sepulveda, Ralph J Damiano, A Marc Gillinov, Patrick M McCarthy, Vinod H Thourani, Rakesh M Suri, Jeffrey P Jacobs, James L Cox
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) effectively restores sinus rhythm. Incompletely defined risk has previously limited concomitant performance of SA during cardiac operations. The study goals were to define performance trends and risk-adjusted outcomes for contemporary SA. METHODS: From July 2011 to June 2014, 86,941 patients with AF, but without endocarditis, underwent primary nonemergent cardiac operations in The Society of Thoracic Surgeons (STS) database...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28658491/health-status-benefits-of-transcatheter-vs-surgical-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis-at-intermediate-surgical-risk-results-from-the-partner-2-randomized-clinical-trial
#11
Suzanne J Baron, Suzanne V Arnold, Kaijun Wang, Elizabeth A Magnuson, Khaja Chinnakondepali, Raj Makkar, Howard C Herrmann, Susheel Kodali, Vinod H Thourani, Samir Kapadia, Lars Svensson, David L Brown, Michael J Mack, Craig R Smith, Martin B Leon, David J Cohen
Importance: In patients with severe aortic stenosis (AS) at intermediate surgical risk, treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in similar 2-year survival. The effect of TAVR vs SAVR on health status in patients at intermediate surgical risk is unknown. Objective: To compare health-related quality of life among intermediate-risk patients with severe AS treated with either TAVR or SAVR. Design, Setting, and Participants: Between December 2011 and November 2013, 2032 intermediate-risk patients with severe AS were randomized to TAVR with the Sapien XT valve or SAVR in the Placement of Aortic Transcatheter Valve 2 Trial and were followed up for 2 years...
August 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28645829/from-sutures-to-wires-the-evolving-necessities-of-cardiac-surgery-training
#12
EDITORIAL
Marc P Pelletier, Tsuyoshi Kaneko, Mark D Peterson, Vinod H Thourani
No abstract text is available yet for this article.
May 25, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28633216/transatlantic-editorial-on-transcatheter-aortic-valve-replacement
#13
EDITORIAL
Vinod H Thourani, Michael A Borger, David Holmes, Hersh Maniar, Fausto Pinto, Craig Miller, Josep Rodés-Cabau, Friedrich-Wilhelm Mohr, Holger Schröfel, Neil E Moat, Friedhelm Beyersdorf, G Alexander Patterson, Richard Weisel
No abstract text is available yet for this article.
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28633212/transatlantic-editorial-on-transcatheter-aortic-valve-replacement
#14
EDITORIAL
Vinod H Thourani, Michael A Borger, David Holmes, Hersh Maniar, Fausto Pinto, Craig Miller, Josep Rodés-Cabau, Friedrich-Wilhelm Mohr, Holger Schröfel, Neil E Moat, Friedhelm Beyersdorf, G Alexander Patterson, Richard Weisel
No abstract text is available yet for this article.
July 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28610886/conversion-from-off-pump-coronary-artery-bypass-grafting-to-on-pump-coronary-artery-bypass-grafting
#15
Brent Keeling, Vinod Thourani, Gorav Aliawadi, Sunghee Kim, Derek Cyr, Vinay Badhwar, Jeff Jacobs, J Matthew Brennan, James Meza, Roland Matsouaka, Michael E Halkos
BACKGROUND: Off-pump coronary artery bypass grafting (OPCAB) has been shown to be an effective strategy for surgical revascularization. The purpose of this study was to define the incidence of intraoperative conversion from OPCAB to on-pump coronary artery bypass grafting (ONCAB) and report outcomes based on the reason for conversion. METHODS: Starting in July 2007, the Society of Thoracic Surgeons database captured patients that were planned OPCAB but then were converted to ONCAB...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577849/the-society-of-thoracic-surgeons-adult-cardiac-surgery-database-2017-update-on%C3%A2-research
#16
Vinod H Thourani, Vinay Badhwar, David M Shahian, Fred H Edwards, Sean O'Brien, Robert H Habib, John J Kelly, J Scott Rankin, Richard Prager, Jeffrey P Jacobs
Containing more than 6 million cumulative operative records and accounting for 90% to 95% of adult cardiac surgery performed in the United States, The Society of Thoracic Surgeons Adult Cardiac Surgery Database is an invaluable resource for performance assessment, quality improvement, and clinical research. This article reviews the seven major research efforts published in 2016 that utilized the Adult Cardiac Surgery Database. Two studies evaluated national trends in clinical practice, three assessed the effect of several risk factors on postoperative morbidity and mortality, and two developed new models to evaluate quality of care...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28577038/a-swine-model-of-percutaneous-intracoronary-ethanol-induced-acute-myocardial-infarction-and-ischemic-mitral-regurgitation
#17
Weiwei Shi, Bryant V McIver, Kanika Kalra, Eric L Sarin, Susan Schmarkey, Michael Duggan, Vinod H Thourani, Robert A Guyton, Muralidhar Padala
Ischemic mitral regurgitation (IMR) is a frequent complication after a myocardial infarction (MI), which doubles mortality. Transcatheter mitral repairs are emerging as alternative treatment options to open heart surgery for IMR, but animal models to test them are lacking. We report a percutaneous swine model of IMR. Seventeen swine were randomized to (group 1, n = 12) MI causing IMR, and (group 2, n = 5) controls. In group 1, MI was induced via percutaneous ethanol injection into the obtuse marginal branches of the left circumflex artery, resulting in ST elevating myocardial infarction...
June 2, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28532575/readmission-rates-after-transcatheter-aortic-valve-replacement-in-high-and-extreme-risk-patients-with-severe-aortic-stenosis
#18
Jessica Forcillo, Jose F Condado, Jose N Binongo, Yi Lasanajak, Hope Caughron, Vasilis Babaliaros, Chandan Devireddy, Bradley Leshnower, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, Paul Khairy, Vinod H Thourani
OBJECTIVE: In high- or extreme-risk patients undergoing transcatheter aortic valve replacement, readmissions have not been adequately studied and are the subject of increased scrutiny by healthcare systems. The objectives of this study were to determine the incidence of 30-day and 1-year cardiac and noncardiac readmissions, identify predictors of readmission, and assess the association between readmission and 1-year mortality. METHODS: A retrospective review was performed on 714 patients who underwent transcatheter aortic valve replacement from September 2007 to January 2015 at Emory University...
August 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28531333/the-flaws-in-the-detail-of-an-observational-study-on-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risks-patients
#19
Fabio Barili, Nick Freemantle, Thierry Folliguet, Claudio Muneretto, Michele De Bonis, Martin Czerny, Jean Francois Obadia, Nawwar Al-Attar, Nikolaos Bonaros, Jolanda Kluin, Roberto Lorusso, Prakash Punjabi, Rafael Sadaba, Piotr Suwalski, Umberto Benedetto, Andreas Böning, Volkmar Falk, Miguel Sousa-Uva, Pieter A Kappetein, Lorenzo Menicanti
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471092/anatomical-risk-models-for-paravalvular-leak-and-landing-zone-complications-for-balloon-expandable-transcatheter-aortic-valve-replacement
#20
Jose F Condado, Frank E Corrigan, Stamatios Lerakis, Ioannis Parastatidis, Arthur E Stillman, Jose N Binongo, James Stewart, Kreton Mavromatis, Chandan Devireddy, Bradley Leshnower, Robert Guyton, Jessica Forcillo, Ateet Patel, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
BACKGROUND: Though several anatomical characteristics have been reported separately as risk factors for paravalvular leak (PVL) and landing zone (LZ) complications after transcatheter aortic valve replacement (TAVR), multivariate risk models are needed. METHODS: Patients that underwent balloon-expandable TAVR with multidetector cardiac computed tomography (MDCT) sizing were studied. MDCT images were analyzed and the association between anatomical factors and ≥mild PVL, ≥moderate PVL, and LZ complications (annular rupture, requirement of new permanent pacemaker, and coronary obstruction) was determined, and subsequently competing predictive models were developed and validated...
May 4, 2017: Catheterization and Cardiovascular Interventions
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