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https://www.readbyqxmd.com/read/28279317/outcomes-after-paravalvular-leak-closure-transcatheter-versus-surgical-approaches
#1
John A Wells, Jose F Condado, Norihiko Kamioka, Andy Dong, Andrew Ritter, Stamatios Lerakis, Stephen Clements, James Stewart, Bradley Leshnower, Robert Guyton, Jessica Forcillo, Ateet Patel, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: The aim of this study was to compare outcomes of transcatheter intervention (TI) versus surgical intervention (SI) for paravalvular leak (PVL). BACKGROUND: Data comparing the treatment of PVL with TI and SI are limited. METHODS: A retrospective cohort study was conducted comparing baseline characteristics, procedural details, and 1-year survival in consecutive patients who underwent TI or SI for moderate or greater PVL from 2007 to 2016...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28211605/end-stage-renal-disease-and-severe-aortic-stenosis-does-valve-replacement-improve-one-year-outcomes
#2
Jose F Condado, Aneel Maini, Bradley Leshnower, Vinod Thourani, Jessica Forcillo, Chandan Devireddy, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Amy Simone, Patricia Keegan, Stamatios Lerakis, Peter C Block, Vasilis Babaliaros
BACKGROUND: Treatment for patients with end-stage renal disease (ESRD) and severe aortic stenosis (AS) includes balloon aortic valvuloplasty (BAV), surgical (SAVR), or transcatheter (TAVR) aortic valve replacement. We compared outcomes among these strategies. METHODS: A retrospective review of patients with ESRD undergoing treatment for severe AS between 07/2007 and 06/2015 was performed at our center. Patients were classified based on treatment: BAV-only, TAVR, or SAVR...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28079579/detailed-2-dimensional-and-3-dimensional-transesophageal-evaluation-of-the-aortic-root-and-aortic-valve-in-complex-type-a-dissections
#3
J Kirk Edwards, Bradley G Leshnower, Michael Duggan, Kathryn E Glas
No abstract text is available yet for this article.
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27993378/aortic-remodeling-after-endovascular-repair-of-complicated-acute-type-b-aortic%C3%A2-dissection
#4
Bradley G Leshnower, Yazan M Duwayri, Edward P Chen, Chun Li, Carl A Zehner, Jose N Binongo, Ravi K Veeraswamy
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is the optimal therapy for complicated acute type B aortic dissection (aTBAD). This study examined clinical outcomes and aortic remodeling parameters after TEVAR for patients with complicated aTBAD. METHODS: From January 2012 to December 2015, 51 patients underwent TEVAR for complicated aTBAD. Preoperative and postoperative imaging studies were analyzed for sizes of the true lumen (TL) and false lumen (FL) and for the FL thrombosis status at five locations in the thoracic and abdominal aorta...
December 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27969802/tct-43-outcomes-after-paravalvular-leak-closure-percutaneous-versus-surgical-approaches
#5
John Wells, Jose Condado C, Norihiko Kamioka, Andy Dong, Andrew Ritter, Stamatios Lerakis, James Stewart, Bradley Leshnower, Kreton Mavromatis, Robert Guyton, Chandan Devireddy, Jessica Forcillo, Ateet Patel, Vinod Thourani, Peter Block, Vasilis Babaliaros
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27964919/clinical-outcomes-of-the-david-v-valve-sparing-root-replacement-compared-with-bioprosthetic-valve-conduits-for-aortic-root-aneurysms
#6
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Michael E Halkos, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. Limited insight exists when the results of VSRR are compared with those of conventional root replacement with use of a bioprosthetic composite conduit (BIO). This study compares the operative and midterm results of VSRR and BIO. METHODS: A retrospective review from 2002 to 2015 at a United States academic center identified 282 patients who underwent VSRR and 425 patients who underwent BIO...
December 10, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#7
Jose F Condado, Moosa N Haider, Stamatios Lerakis, Patricia Keegan, Hope Caughron, Vinod H Thourani, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Jessica Forcillo, Ateet Patel, Amy Simone, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: TF-TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety/efficacy of this technique in patients with severe COPD is unknown. METHODS: We compared demographics, 30-day outcomes and 1-year survival of patients with severe COPD (FEV1% ≤50) who underwent minimalist vs...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27821786/temperature-management-for-aortic-arch-surgery
#8
REVIEW
Edward P Chen, Bradley Graham Leshnower
Surgical treatment of aortic arch disease is a technically challenging procedure that requires complex circulation management strategies involving the use of hypothermic circulatory arrest. The definition of hypothermia has evolved with comfort and surgical adjuncts. This review describes the various circulation and temperature management strategies used during hemiarch and total arch replacement.
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27717427/should-we-perform-carotid-doppler-screening-before-surgical-or-transcatheter-aortic-valve-replacement
#9
Jose F Condado, Hanna A Jensen, Aneel Maini, Yi-An Ko, Mohammad H Rajaei, Lillian L Tsai, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert A Guyton, Vasilis Babaliaros, Edward P Chen, Michael Halkos, Amy Simone, Patricia Keegan, Peter C Block, Vinod H Thourani
BACKGROUND: Screening for internal carotid artery stenosis (ICAS) with Doppler ultrasound is commonly used before cardiovascular surgery. Nevertheless, the relationship between ICAS and procedure-related stroke in isolated aortic valve replacement is unclear. METHODS: We retrospectively reviewed patients with artery stenosis who underwent ICAS screening before surgical (SAVR) or transcatheter aortic valve replacement (TAVR) between January 2007 and August 2014. Logistic regression models were used to determine the relation between post-procedure stroke and total (sum of left and right ICAS) and maximal unilateral ICAS...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27717426/the-racial-paradox-in-multiarterial-conduit-utilization-for-coronary-artery-bypass-grafting
#10
W Brent Keeling, Jose Binongo, Michael E Halkos, Bradley G Leshnower, Duc Q Nguyen, Edward P Chen, Eric L Sarin, Jeffrey S Miller, Steven Macheers, Omar M Lattouf, Robert A Guyton, Vinod H Thourani
BACKGROUND: It has been established that outcomes for black patients undergoing coronary artery bypass graft surgery (CABG) are inferior to those of their white counterparts. The purpose of this study was to determine (1) whether rates of multiarterial grafting are different among black patients and white patients, and (2) whether racial differences exist in postoperative outcomes after accounting for grafting strategy. METHODS: A retrospective review of black patients (n = 2,810) and white patients (n = 13,569) who underwent isolated, primary CABG from January 2002 to June 2014 at a US academic institution was performed...
October 4, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27666783/severity-of-preoperative-aortic-regurgitation-does-not-impact-valve-durability-of-aortic-valve-repair-following-the-david-v-valve-sparing-aortic-root-replacement
#11
W Brent Keeling, Bradley G Leshnower, Jose Binongo, Yi Lasanajak, LaRonica McPherson, Edward P Chen
BACKGROUND: The David V valve-sparing aortic root replacement (VSRR) is an established and durable method of root reconstruction for varying pathologies. However, the impact of the severity of preoperative aortic regurgitation (AR) on long-term durability remains unclear. The purpose of this research was to investigate the impact of the degree of preoperative AR on midterm durability following VSRR. METHODS: A retrospective review of the adult cardiac surgical database at a single academic center was undertaken from 2005 to 2015 for 223 adult patients who underwent VSRR...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27662477/transcatheter-aortic-valve-replacement-current-technology-and-future-directions
#12
Richard C Gilmore, Vinod H Thourani, Hanna A Jensen, Jose F Condado, Michael O Kayatta, Mohammad H Rajaei, Amjad O Syed, Vasilis C Babaliaros, Eric L Sarin, Bradley G Leshnower
Transcatheter aortic valve replacement as an alternative to open surgical repair is rapidly becoming more used in high-risk patients with aortic stenosis. Transcatheter aortic valve replacement offers the benefit of being much less invasive than traditional surgical repair and has evolved as a therapeutic option for patients with prohibitive surgical risk or those deemed surgically inoperable. Nevertheless, despite its potential to mitigate risk in this frail population, it comes with its own unique set of complications...
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27563551/when-and-how-to-replace-the-aortic-root-in-type-a-aortic-dissection
#13
Bradley G Leshnower, Edward P Chen
Management of aortic root pathology during repair of acute type A aortic dissection (TAAD) requires a comprehensive evaluation of the patient's anatomy, demographics, comorbidities and physiologic status at the time of emergent operative intervention. Surgical options include conservative repair of the root (CRR) (with or without replacement of the aortic valve), replacement of the native valve and aortic root using a composite valve-conduit and valve sparing root replacement (VSRR). The primary objective of this review is to provide data for surgeons to aid in their decision-making process regarding management of the aortic root during repair of TAAD...
July 2016: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27544602/neutrophil-lymphocyte-ratio-nlr-and-platelet-lymphocyte-ratio-plr-can-risk-stratify-patients-in-transcatheter-aortic-valve-replacement-tavr
#14
Jose F Condado, Parichart Junpaparp, Jose N Binongo, Yi Lasanajak, Christian F Witzke-Sanz, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, James Stewart, Robert Guyton, David Wheeler, Jessica Forcillo, Ateet Patel, Peter C Block, Vinod Thourani, Janani Rangaswami, Vasilis Babaliaros
BACKGROUND: Neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) mark systemic inflammation. Patients with high NLR and PLR have worse cardiovascular disease and outcomes. We assessed the role of these ratios in predicting outcomes after transcatheter aortic valve replacement (TAVR). METHODS: The association between NLR and PLR with baseline characteristics, 30-day outcomes, and 1-year readmission/survival was determined in patients that underwent TAVR between 2007 and 2014 and had baseline complete blood count with differential...
November 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27424468/the-impact-of-intimal-tear-location-and-partial-false-lumen-thrombosis-in-acute-type-b-aortic%C3%A2-dissection
#15
COMPARATIVE STUDY
Apoorva Girish, Muralidhar Padala, Kanika Kalra, Bryant V McIver, Ravi K Veeraswamy, Edward P Chen, Bradley G Leshnower
BACKGROUND: Partial false lumen (FL) thrombosis is a risk factor for long-term mortality in acute type B aortic dissection (ATBAD). This study investigates FL pressures in models of ATBAD with patent and partially thrombosed FL. METHODS: Twenty-five porcine aortas were used to create five models of ATBAD that were connected to a pulsatile flow loop. Models A through C had a patent FL with the following morphologies: model A, single proximal tear; model B, single distal tear; and model C, single proximal and single distal tear...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27353485/the-david-v-valve-sparing-root-replacement-provides-improved-survival-compared-with-mechanical-valve-conduits-in-the-treatment-of-young-patients-with-aortic-root-pathology
#16
COMPARATIVE STUDY
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Michael E Halkos, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an attractive therapy for aortic root aneurysms; however, there is a paucity of data comparing VSRR with conventional root replacement using a mechanical valve-conduit (MECH). This study evaluates and compares outcomes of VSRR and MECH. METHODS: A retrospective review from 2002 to 2015 at a US academic center identified 444 patients who underwent VSRR (282 patients) or MECH (162 patients). Propensity score matching was performed, based on 22 preoperative and intraoperative characteristics, and 87 matched pairs were identified...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27209615/does-a-higher-society-of-thoracic-surgeons-score-predict-outcomes-in-transfemoral-and-alternative-access-transcatheter-aortic-valve-replacement
#17
Hanna A Jensen, Vinod H Thourani, Jessica Forcillo, Jose F Condado, Jose N Binongo, Vasilis Babaliaros, Yi Lasanajak, Bradley Leshnower, Chandan Devireddy, Robert Guyton, Kreton Mavromatis, Peter Block, Amy Simone, Patricia Keegan, James Stewart, Lillian L Tsai, Mohammad H Rajaei, Stamatios Lerakis, Eric L Sarin
BACKGROUND: Nontransfemoral (non-TF) transcatheter aortic valve replacement (TAVR) is often associated with worse outcomes than TF TAVR. We investigated the relationship between increasing Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM) score and observed mortality and morbidity in TF and non-TF TAVR groups. METHODS: We reviewed 595 patients undergoing TAVR at Emory Healthcare between 2007 and 2014. Clinical outcomes were reported for 337 TF patients (57%) and 258 non-TF patients (43%)...
August 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27101969/balloon-versus-computed-tomography-sizing-of-the-aortic-annulus-for-transcatheter-aortic-valve-replacement-and-the-impact-of-left-ventricular-outflow-tract-calcification-and-morphology-on-sizing
#18
Jose F Condado, Stamatios Lerakis, James Stewart, Hanna Jensen, Travis S Henry, Sung Min Ko, Arthur Stillman, Mohammad H Rajaei, Kreton Mavromatis, Chandan Devireddy, Eric Sarin, Brad Leshnower, Robert Guyton, Brian Kaebnick, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To evaluate the role of balloon annular sizing in transcatheter aortic valve replacement (TAVR). BACKGROUND: Multidetector cardiac computed tomography (MDCT) is the gold standard for aortic annular sizing in TAVR. Balloon sizing is increasingly used in patients with borderline annular size and severe calcification. A comparison between these two techniques is needed. METHODS: We retrospectively compared baseline characteristics and 30-day outcomes of patients undergoing balloon-expandable TAVR using annular MDCT or balloon sizing...
July 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/26992603/midterm-benefits-of-surgical-pulmonary-embolectomy-for-acute-pulmonary-embolus-on-right-ventricular-function
#19
William Brent Keeling, Bradley G Leshnower, Yi Lasajanak, Jose Binongo, Robert A Guyton, Michael E Halkos, Vinod H Thourani, Omar M Lattouf
OBJECTIVE: Surgical pulmonary embolectomy has been used for the successful treatment of massive and submassive pulmonary emboli. The purpose of this study is to document the short- and midterm echocardiographic follow-up of right ventricular function after surgical pulmonary embolectomy for acute pulmonary embolus. METHODS: A retrospective review of the local Society of Thoracic Surgeons database of patients who underwent surgical pulmonary embolectomy for acute pulmonary embolectomy was conducted from 1998 to 2014 at a US academic center...
September 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26522532/transapical-thoracic-endovascular-aortic-repair-as-a-bridge-to-open-repair-of-an-infected-ascending-aortic-pseudoaneurysm
#20
Christian C Shults, Edward P Chen, Vinod H Thourani, Bradley G Leshnower
Pseudoaneurysms of the ascending aorta pose a significant risk for free rupture during open aortic repair. This report describes the use of a modified thoracic aortic stent graft, delivered through transapical access, as a successful bridge to homograft replacement of the ascending aorta for the treatment of a mycotic ascending aortic pseudoaneurysm.
November 2015: Annals of Thoracic Surgery
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