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https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#1
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
#2
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
#3
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...
October 4, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27717426/the-racial-paradox-in-multiarterial-conduit-utilization-for-coronary-artery-bypass-grafting
#4
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
#5
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...
September 22, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27662477/transcatheter-aortic-valve-replacement-current-technology-and-future-directions
#6
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
#7
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
#8
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
#9
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
#10
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...
June 25, 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
#11
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
#12
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
#13
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
#14
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
https://www.readbyqxmd.com/read/26318351/minimalist-transcatheter-aortic-valve-replacement-the-new-standard-for-surgeons-and-cardiologists-using-transfemoral-access
#15
Hanna A Jensen, Jose F Condado, Chandan Devireddy, Jose Binongo, Bradley G Leshnower, Vasilis Babaliaros, Eric L Sarin, Stamatios Lerakis, Robert A Guyton, James P Stewart, Amjadullah Q Syed, Kreton Mavromatis, Brian Kaebnick, Mohammad Hossein Rajaei, Lillian L Tsai, Ayaz Rahman, Amy Simone, Patricia Keegan, Peter C Block, Vinod H Thourani
BACKGROUND: A minimalist approach for transcatheter aortic valve replacement (MA-TAVR) utilizing transfemoral access under conscious sedation and transthoracic echocardiography is increasing in popularity. This relatively novel technique may necessitate a learning period to achieve proficiency in performing a successful and safe procedure. This report evaluates our MA-TAVR cohort with specific characterization between our early, midterm, and recent experience. METHODS: We retrospectively reviewed 151 consecutive patients who underwent MA-TAVR with surgeons and interventionists equally as primary operator at Emory University between May 2012 and July 2014...
October 2015: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/26309827/ventricular-apical-access-and-closure-and-re-access-devices-to-facilitate-mitral-valve-interventions
#16
Bradley G Leshnower, Vinod H Thourani
No abstract text is available yet for this article.
May 2015: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26277560/transcatheter-aortic-valve-replacement-results-in-improvement-of-pulmonary-function-in-patients-with-severe-aortic-stenosis
#17
Richard C Gilmore, Vinod H Thourani, Hanna A Jensen, Jose Condado, José Nilo G Binongo, Eric L Sarin, Chandan M Devireddy, Bradley Leshnower, Kreton Mavromatis, Amjad Syed, Robert A Guyton, Peter C Block, Amy Simone, Patricia Keegan, James Stewart, Mohammad Rajaei, Brian Kaebnick, Stamatios Lerakis, Vasilis C Babaliaros
BACKGROUND: Chronic obstructive pulmonary disease (COPD) has been identified as a risk factor for morbidity and mortality after transcatheter aortic valve replacement (TAVR). We hypothesized that a portion of pulmonary dysfunction in patients with severe aortic stenosis may be of cardiac origin, and has potential to improve after TAVR. METHODS: A retrospective analysis was made of consecutive TAVR patients from April 2008 to October 2014. Of patients who had pulmonary function testing and serum B-type natriuretic peptide data available before and after TAVR, 58 were found to have COPD (26 mild, 14 moderate, and 18 severe)...
December 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26242213/outcomes-in-nonagenarians-undergoing-transcatheter-aortic-valve-replacement-in-the-partner-i-trial
#18
RANDOMIZED CONTROLLED TRIAL
Vinod H Thourani, Hanna A Jensen, Vasilis Babaliaros, Susheel K Kodali, Jeevanantham Rajeswaran, John Ehrlinger, Eugene H Blackstone, Rakesh M Suri, Creighton W Don, Gabriel Aldea, Mathew R Williams, Raj Makkar, Lars G Svensson, James M McCabe, Larry S Dean, Samir Kapadia, David J Cohen, Augusto D Pichard, Wilson Y Szeto, Howard C Herrmann, Chandan Devireddy, Bradley G Leshnower, Gorav Ailawadi, Hersh S Maniar, Rebecca T Hahn, Martin B Leon, Michael Mack
BACKGROUND: This study describes short-term and mid-term outcomes of nonagenarian patients undergoing transfemoral or transapical transcatheter aortic valve replacement (TAVR) in the Placement of Aortic Transcatheter Valve (PARTNER)-I trial. METHODS: From April 2007 to February 2012, 531 nonagenarians, mean age 93 ± 2.1 years, underwent TAVR with a balloon-expandable prosthesis in the PARTNER-I trial: 329 through transfemoral (TF-TAVR) and 202 transapical (TA-TAVR) access...
September 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26233273/moderate-versus-deep-hypothermia-with-unilateral-selective-antegrade-cerebral-perfusion-for-acute-type-a-dissection
#19
Bradley G Leshnower, Vinod H Thourani, Michael E Halkos, Eric L Sarin, William B Keeling, Mark J Lamias, Robert A Guyton, Edward P Chen
BACKGROUND: Despite improved results with surgical therapy for acute type A aortic dissection (ATAAD), there remains a lack of consensus regarding the optimal method of cerebral protection and circulation management during ATAAD. The purpose of this study is to determine whether in the setting of antegrade cerebral perfusion, moderate hypothermic circulatory arrest (MHCA) provides equivalent cerebral and visceral protection as deep hypothermic circulatory arrest (DHCA) for patients undergoing emergent ATAAD repair...
November 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/26188971/outcomes-for-transcatheter-aortic-valve-replacement-in-nonagenarians
#20
Michael O Kayatta, Vinod H Thourani, Hanna A Jensen, Jose C Condado, Eric L Sarin, Patrick D Kilgo, Chandan M Devireddy, Bradley G Leshnower, Kreton Mavromatis, Chun Li, Robert A Guyton, James P Stewart, Amy Simone, Patricia Keegan, Peter Block, Stamatios Lerakis, Vasilis C Babaliaros
BACKGROUND: Transcatheter aortic valve replacement (TAVR) may offer extreme-aged patients a treatment alternative to surgical aortic valve replacement (SAVR). The objective of this study was to describe outcomes of TAVR in nonagenarians using transfemoral and alternative access techniques. METHODS: In a retrospective review, we found 95 nonagenarians who underwent TAVR from September 2007 through February 2014 at Emory University using a balloon expandable valve: transfemoral (n = 66), transapical (n = 14), transaortic (n = 14), and transcarotid (n = 1)...
October 2015: Annals of Thoracic Surgery
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