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https://www.readbyqxmd.com/read/29668501/transcaval-valve-in-valve-in-valve-aortic-valve-replacement-for-bioprosthetic-valve-degeneration
#1
A Claire Watkins, Chandan M Devireddy, Talal Al-Atassi, Amy E Simone, Jessica Forcillo, Vinod H Thourani
A 74-year-old man presented with progressive dyspnea on exertion. History included peripheral arterial disease and coronary artery bypass grafting with aortic valve replacement 12 years ago. Subsequently, the surgical valve developed severe stenosis and moderate insufficiency. He underwent a transapical valve-in-valve transcatheter aortic valve replacement 5 years before presentation. This second valve developed a mean gradient of 66 mm Hg with mild insufficiency. The patient was treated with a third aortic valve using an alternative transcaval approach, significantly alleviating his symptoms...
April 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29602220/degenerative-mitral-regurgitation-predicts-worse-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement
#2
Bryan Kindya, Elisha Ouzan, Stamatios Lerakis, Erhan Gonen, Vasilis Babaliaros, Eren Karayel, Vinod H Thourani, Israel Gotsman, Chandan M Devireddy, Haim D Danenberg, Bradley G Leshnower, Ronen Beeri, Yi-An Ko, Dan Gilon, Hina Ahmed, Chang Liu, Chaim Lotan, Kreton Mavromatis
OBJECTIVES: To evaluate the role mitral regurgitation (MR) etiology and severity play in outcomes for patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Multiple prior studies have investigated the influence of MR severity on outcomes for patients undergoing TAVR. Less has been published regarding the effects of MR etiology on outcomes, including its impact on heart failure hospitalization. METHODS: Two hundred and seventy patients undergoing TAVR at 2 hospitals were enrolled...
March 30, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29577925/the-society-of-thoracic-surgeons-2018-adult-cardiac-surgery-risk-models-part-1-background-design-considerations-and-model-development
#3
David M Shahian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Liqi Feng, Xia He, Sean M O'Brien
BACKGROUND: The last published version of the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database (ACSD) risk models were developed in 2008 based on patient data from 2002 to 2006 and have been periodically recalibrated. In response to evolving changes in patient characteristics, risk profiles, surgical practice, and outcomes, STS has now developed a set of entirely new risk models for adult cardiac surgery. METHODS: New models were estimated for isolated coronary artery bypass grafting surgery (CABG, n = 439,092), isolated aortic or mitral valve surgery (n = 150,150), and combined valve + CABG (n = 81,588) procedures...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29577924/the-society-of-thoracic-surgeons-2018-adult-cardiac-surgery-risk-models-part-2-statistical-methods-and-results
#4
Sean M O'Brien, Liqi Feng, Xia He, Ying Xian, Jeffrey P Jacobs, Vinay Badhwar, Paul A Kurlansky, Anthony P Furnary, Joseph C Cleveland, Kevin W Lobdell, Christina Vassileva, Moritz C Wyler von Ballmoos, Vinod H Thourani, J Scott Rankin, James R Edgerton, Richard S D'Agostino, Nimesh D Desai, Fred H Edwards, David M Shahian
BACKGROUND: The Society of Thoracic Surgeons (STS) uses statistical models to create risk-adjusted performance metrics for Adult Cardiac Surgery Database (ACSD) participants. Because of temporal changes in patient characteristics and outcomes, evolution of surgical practice, and additional risk factors available in recent ACSD versions, completely new risk models have been developed. METHODS: Using July 2011 to June 2014 ACSD data, risk models were developed for operative mortality, stroke, renal failure, prolonged ventilation, mediastinitis /deep sternal wound infection (DSWI), reoperation, major morbidity or mortality composite, and prolonged postoperative length of stay (PLOS) or short PLOS among patients who underwent isolated coronary artery bypass grafting (CABG; n = 439,092), aortic or mitral valve surgery (n = 150,150), or combined valve + CABG (n = 81,588)...
March 22, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29566805/inclusion-of-functional-status-measures-in-the-risk-adjustment-of-30-day-mortality-after-transcatheter-aortic-valve-replacement-a-report-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-tvt-registry
#5
Suzanne V Arnold, Sean M O'Brien, Sreekanth Vemulapalli, David J Cohen, Amanda Stebbins, J Matthew Brennan, David M Shahian, Fred L Grover, David R Holmes, Vinod H Thourani, Eric D Peterson, Fred H Edwards
OBJECTIVES: The aim of this study was to develop and validate a risk adjustment model for 30-day mortality after transcatheter aortic valve replacement (TAVR) that accounted for both standard clinical factors and pre-procedural health status and frailty. BACKGROUND: Assessment of risk for TAVR is important both for patient selection and provider comparisons. Prior efforts for risk adjustment have focused on in-hospital mortality, which is easily obtainable but can be biased because of early discharge of ill patients...
March 26, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29556943/imaging-the-myocardial-ischemic-cascade
#6
REVIEW
Arthur E Stillman, Matthijs Oudkerk, David A Bluemke, Menko Jan de Boer, Jens Bremerich, Ernest V Garcia, Matthias Gutbertlet, Pim van der Harst, W Gregory Hundley, Michael Jerosch-Herold, Dirkjan Kuijpers, Raymond Y Kwong, Eike Nagel, Stamatios Lerakis, John Oshinski, Jean-François Paul, Riemer H J A Slart, Vinod Thourani, Rozemarijn Vliegenthart, Bernd J Wintersperger
Non-invasive imaging plays a growing role in the diagnosis and management of ischemic heart disease from its earliest manifestations of endothelial dysfunction to myocardial infarction along the myocardial ischemic cascade. Experts representing the North American Society for Cardiovascular Imaging and the European Society of Cardiac Radiology have worked together to organize the role of non-invasive imaging along the framework of the ischemic cascade. The current status of non-invasive imaging for ischemic heart disease is reviewed along with the role of imaging for guiding surgical planning...
March 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29554232/outcomes-after-coronary-artery-bypass-grafting-in-patients-with-myocardial-infarction-cardiogenic-shock-and-unresponsive-neurological-state-analysis-of-the-society-of-thoracic-surgeons-database
#7
Morgan L Cox, Brian C Gulack, Dylan P Thibault, Xia He, Matthew L Williams, Vinod H Thourani, Jeffery P Jacobs, J Matthew Brennan, Mani A Daneshmand, Deepak Acharya
OBJECTIVES: Previous studies have demonstrated a 20% mortality rate among patients undergoing isolated coronary artery bypass grafting (CABG) for cardiogenic shock. However, outcomes following CABG for cardiogenic shock in patients who are neurologically unresponsive preoperatively are unknown. METHODS: Utilizing the Society of Thoracic Surgeons Adult Cardiac Surgery Database between July 2011 and December 2013, patients undergoing urgent or emergent CABG within 7 days of an acute myocardial infarction complicated by cardiogenic shock were identified...
March 14, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29502934/association-of-tricuspid-regurgitation-with-transcatheter-aortic-valve-replacement-outcomes-a-report-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#8
Fenton H McCarthy, Sreekanth Vemulapalli, Zhuokai Li, Vinod Thourani, Roland A Matsouaka, Nimesh D Desai, Ajay Kirtane, Saif Anwaruddin, Matthew L Williams, Jay Giri, Prashanth Vallabhajosyula, Robert H Li, Howard C Herrmann, Joseph E Bavaria, Wilson Y Szeto
BACKGROUND: The purpose of this study is to evaluate the association of tricuspid regurgitation (TR) severity with outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We analyzed data from 34,576 patients who underwent TAVR at 365 US hospitals from November 2011 through March 2015 submitted to The Society of Thoracic Surgeon/American College of Cardiology Transcatheter Valve Therapy Registry. We examined unadjusted mortality and heart failure readmission stratified by degree of preoperative TR and used multivariable models for 1-year mortality and heart failure readmission...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29475042/pulmonary-heart-valves-redefining-outcomes
#9
EDITORIAL
Saina Attaran, Vinod H Thourani
No abstract text is available yet for this article.
February 20, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29427617/single-versus-multi-center-surgeons-risk-adjusted-coronary-artery-bypass-graft-procedural-outcomes
#10
A Laurie W Shroyer, William E Gioia, Muath Bishawi, Amelia S Wallace, Brian C Gulack, Ying Xian, Sean M O'Brien, Vinod H Thourani, Thomas V Bilfinger
BACKGROUND: Since 2010, 460+ hospital mergers have occurred in the United States rerouting historical coronary artery bypass graft [CABG] referral patterns. The goals of this study were: 1) to compare risk-adjusted CABG outcomes between single-center versus multi-center surgeons; and 2) for multi-center surgeons, to evaluate the risk-adjusted outcomes between their home (primary) versus satellite (secondary) hospitals. METHODS: Using the Society of Thoracic Surgeons Adult Cardiac Surgery Database, non-emergent, first-time CABG procedures (n = 543,403) performed in the United States between 2011 and 2014 were extracted across 1,120 centers and for 2,676 surgeons...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29413254/mitral-bioprosthetic-valve-fracture-bailout-procedure-for-undersized-bioprosthesis-during-mitral%C3%A2-valve-in-valve-procedure-with-paravalvular-leak-closure
#11
Norihiko Kamioka, Frank Corrigan, Jose Miguel Iturbe, Hope Caughron, Stamatios Lerakis, Vinod Thourani, Peter Block, Robert Guyton, Vasilis Babaliaros
No abstract text is available yet for this article.
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29391145/associations-between-surgical-ablation-and-operative-mortality-following-mitral-valve-procedures
#12
J Scott Rankin, Maria V Grau-Sepulveda, Niv Ad, Ralph J Damiano, A Marc Gillinov, J Matthew Brennan, Patrick M McCarthy, Vinod H Thourani, Jeffrey P Jacobs, David M Shahian, Vinay Badhwar
BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) concomitant to mitral valve repair/replacement (MVRR) improves longitudinal sinus rhythm. However, the risk of adding SA remains a clinical question. This study examined whether the addition of contemporary SA for AF has an impact on operative outcomes. METHODS: The study cohort included 88,765 MVRR patients ± SA, CABG, septal defect, and tricuspid repair in the STS Database between 2011 and 2014. Group 1 did not have AF (No-AF) and did not receive SA (No-SA); Group 2 had No-AF immediately preoperatively but received SA; Group 3 had AF but No-SA; and Group 4 had AF with SA...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29374578/mean-aortic-pressure-gradient-and-global-longitudinal-strain-recovery-after-transcatheter-aortic-valve-replacement-a-retrospective-analysis
#13
Frank E Corrigan, Xiao Zhou, John C Lisko, Salim S Hayek, Ioannis Parastatidis, Patricia Keegan, Sharon Howell, Vinod Thourani, Vasilis C Babaliaros, Stamatios Lerakis
BACKGROUND: Global longitudinal strain (GLS) has incremental value in assessing left ventricular (LV) function in severe aortic stenosis and is related to clinical outcome after transcatheter aortic valve replacement (TAVR). We sought to identify relevant echocardiographic predictors of GLS improvement and myocardial function recovery after TAVR. METHODS: We analyzed baseline and 12-month follow-up echocardiograms for LV strain analysis from 123 patients who underwent at Emory University Hospital with the Edwards SAPIEN valve between 7/2007 and 7/2013...
January 25, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29348004/predictors-and-clinical-outcomes-of-next-day-discharge-after-minimalist-transfemoral-transcatheter-aortic-valve-replacement
#14
Norihiko Kamioka, John Wells, Patricia Keegan, Stamatios Lerakis, Jose Binongo, Frank Corrigan, Jose Condado, Ateet Patel, Jessica Forcillo, Leslie Ogburn, Andy Dong, Hope Caughron, Amy Simone, Bradley Leshnower, Chandan Devireddy, Kreton Mavromatis, Robert Guyton, James Stewart, Vinod Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: This study sought to investigate predictors and safety of next-day discharge (NDD) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Information about predictors and safety of NDD after TAVR is limited. METHODS: The study reviewed 663 consecutive patients who underwent elective balloon-expandable TAVR (from July 2014 to July 2016) at our institution. We first determined predictors of NDD in patients who underwent minimalist transfemoral TAVR...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29337126/rigid-plate-fixation-versus-wire-cerclage-patient-reported-and-economic-outcomes-from-a-randomized-trial
#15
Keith B Allen, Vinod H Thourani, Yoshifumi Naka, Kendra J Grubb, John Grehan, Nirav Patel, T Sloane Guy, Kevin Landolfo, Marc Gerdisch, Mark Bonnell, David J Cohen
BACKGROUND: In a multicenter randomized trial, sternal closure after cardiac operations using rigid plate fixation (RPF) compared with wire cerclage (WC) resulted in improved sternal healing, reduced sternal complications, and was cost neutral at 6 months. Additional secondary end points are presented from this trial. METHODS: Twelve United States centers randomized 236 patients to RPF (n = 116) or WC (n = 120). Patient-reported outcomes measures, including pain, function, and quality of life scores, were assessed through 6 months and correlated to computed tomography-derived sternal healing scores using logistic regression...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29326112/epidemiology-of-new-onset-atrial-fibrillation-following-coronary-artery-bypass-graft-surgery
#16
Giovanni Filardo, Ralph J Damiano, Gorav Ailawadi, Vinod H Thourani, Benjamin D Pollock, Danielle M Sass, Teresa K Phan, Hoa Nguyen, Briget da Graca
OBJECTIVES: Postoperative atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is significantly associated with reduced survival, but poor characterisation and inconsistent definitions present barriers to developing effective prophylaxis and management. We sought to address this knowledge gap. METHODS: From 2002 to 2010, 11 239 consecutive patients without AF underwent isolated CABG at five sites. Clinical data collected for the Society of Thoracic Surgeons (STS) Database were augmented with details on AF detected via continuous in-hospital ECG/telemetry monitoring to assess new-onset post-CABG AF (adjusted for STS risk of mortality); time to first AF; durations of first and longest AF episodes; total in-hospital time in AF; number of in-hospital AF episodes; operative mortality; stroke; discharge in AF; and length of stay (LOS)...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#17
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29301644/sex-specific-outcomes-of-transcatheter-aortic-valve-replacement-with-the-sapien-3-valve-insights-from-the-partner-ii-s3-high-risk-and-intermediate-risk-cohorts
#18
Molly Szerlip, Sarah Gualano, Elizabeth Holper, John J Squiers, Jonathon M White, Darshan Doshi, Mathew R Williams, Rebecca T Hahn, John G Webb, Lars G Svensson, Ajay J Kirtane, David J Cohen, Pamela S Douglas, Maria C Alu, Aaron Crowley, E Murat Tuzcu, Raj R Makkar, Howard C Herrmann, Vasilis Babaliaros, Vinod H Thourani, Martin B Leon, Susheel K Kodali, Michael J Mack
OBJECTIVES: The purpose of this study was to identify sex-specific outcomes of intermediate risk patients undergoing transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: A survival difference has been observed in women as compared with men in inoperable and high-risk patients receiving early-generation balloon-expandable valves for transcatheter aortic valve replacement (TAVR). Whether a sex-specific outcome difference persists with newer-generation valves and in lower-risk patients is unknown...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29224637/valve-hemodynamic-deterioration-and-cardiovascular-outcomes-in-tavr-a-report-from-the-sts-acc-tvt-registry
#20
MULTICENTER STUDY
Sreekanth Vemulapalli, David R Holmes, David Dai, Roland Matsouaka, Michael J Mack, Fred L Grover, Raj R Makkar, Vinod H Thourani, Pamela S Douglas
BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) and its association with cardiovascular outcomes. METHODS AND RESULTS: Consecutive cases with paired postimplant and follow-up echocardiograms from November 2011 to March 2015 in the STS/ACC TVT Registry were allocated into 2 overlapping cohorts: early (paired echocardiograms at 0 and 30 days) and late (paired echocardiograms at 30 days and 1 year)...
January 2018: American Heart Journal
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