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Anne-Sophie Zenses, Morgane A Evin, Viktória Stanová, Marie-Annick Clavel, Paul Barragan, Josep Rodés-Cabau, Jean-François Obadia, Philippe Pibarot, Régis Rieu
AIMS: Valve-in-Valve (ViV) procedure has become a valuable alternative for the treatment of failed surgical bioprostheses (BP) in high risk patients. However, in small BPs, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed at examining the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the hemodynamics of ViV within small BPs. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of 3 BP models: Trifecta, Mitroflow and Epic Supra...
March 13, 2018: EuroIntervention
Benoit Peyronnet, Lauranne Tondut, Jean-Christophe Bernhard, Christophe Vaessen, Nicolas Doumerc, Philippe Sebe, Benjamin Pradere, Bertrand Guillonneau, Zine-Eddine Khene, Francois-Xavier Nouhaud, Nicolas Brichart, Thomas Seisen, Quentin Alimi, Jean-Baptiste Beauval, Romain Mathieu, Adham Rammal, Alexandre De La Taille, Herve Baumert, Stéphane Droupy, Franck Bruyere, Morgan Roupret, Arnaud Mejean, Karim Bensalah
OBJECTIVE: To assess the impact of hospital volume (HV) and surgeon volume (SV) on perioperative outcomes of robot assisted partial nephrectomy (RAPN). PATIENTS AND METHODS: All consecutive patients who underwent a RAPN from 2009 to 2015 at eleven institutions were included in a retrospective study. To evaluate the impact of hospital volume we divided RAPN into four quartiles according to the caseload per year: low HV (<20/year); moderate HV (20-44/year); High HV (45-70/year); very high HV (>70/year)...
March 5, 2018: BJU International
Roberto Castellucci, Giulia Primiceri, Pietro Castellan, Michele Marchioni, Carlo D'Orta, Francesco Berardinelli, Fabio Neri, Luca Cindolo, Luigi Schips
OBJECTIVES: Robotic-assisted partial nephrectomy (RAPN) is preferred to radical nephrectomy because it guarantees superior functional outcomes in patients with small renal masses (RMs). Only a few studies so far have evaluated the feasibility of RAPN for the treatment of RM ≥4 cm. The aim of this study is to evaluate the safety and feasibility of RAPN based on a comparison of trifecta and pentafecta rates for RMs ≥4 cm. MATERIAL AND METHODS: We retrospectively analyzed prospectively collected data from an institutional database of patients undergoing RAPN from September 2013 to November 2016...
March 1, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Olamide O Omidele, Natan Davoudzadeh, Michael Palese
Background and Objectives: The learning curve for achieving desirable perioperative outcomes in robot-assisted partial nephrectomy (RAPN) has not been well studied. Information is available regarding "trifecta" outcomes of no complications, no positive margins, warm ischemia time (WIT) of ≤25 minutes, and a ≤15% decrease in postoperative glomerular filtration rate (GFR). This study was conducted to assess the impact of the learning curve on surgical outcomes in patients undergoing RAPN...
January 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Jean-Baptiste Beauval, Benoit Peyronnet, Thibaut Benoit, Bastien Cabarrou, Thomas Seisen, Mathieu Roumiguié, Benjamin Pradere, Zine-Eddine Khene, Quentin Manach, Gregory Verhoest, Mathieu Thoulouzan, Jerome Parra, Nicolas Doumerc, Romain Mathieu, Christophe Vaessen, Michel Soulié, Morgan Roupret, Karim Bensalah
PURPOSE: This study aimed at reporting the long-term oncological outcomes of robotic partial nephrectomy (RPN) for renal cell carcinoma (RCC). METHODS: Data from all consecutive patients who underwent RAPN for RCC from July 2009 to January 2012 in three departments of urology were prospectively collected. Overall survival (OS), cancer-specific survival (CSS) and disease free-survival (DFS) were estimated using the Kaplan-Meier method. Prognostic factors associated with CSS were sought in univariate analysis...
February 9, 2018: World Journal of Urology
Murray Esler
No abstract text is available yet for this article.
March 2018: Heart, Lung & Circulation
Burkhard Ubrig, Alexander Roosen, Christian Wagner, Guenter Trabs, Frank Schiefelbein, Jorn H Witt, Georg Schoen, Nina Natascha Harke
PURPOSE: To demonstrate the surgical feasibility of robot-assisted partial nephrectomy for complex renal masses with comparison of low/intermediate risk versus high-risk tumors according to the PADUA score. METHODS: Since 2008, 538 robot-assisted partial nephrectomies were performed at three German robotic centers. Both the MIC (margin, ischemia, complications) criteria and trifecta were applied. RESULTS: 60.1% of the tumors were of low and intermediate complexity (PADUA score 6-9, n = 326, group A), while 39...
January 29, 2018: World Journal of Urology
Rui J Cerqueira, Renata Raimundo, Soraia Moreira, Francisca A Saraiva, Marta Andrade, Elson Salgueiro, Jorge Almeida, Mário Jorge Amorim, Paulo Pinho, André P Lourenço, Adelino Leite-Moreira
OBJECTIVES: The goal of this study was to compare the stentless Freedom Solo® (FS) and the stented Trifecta® (TF) aortic bioprostheses with regard to haemodynamic profile, left ventricular mass regression and early and late postoperative outcomes and survival. METHODS: A longitudinal cohort study of consecutive patients undergoing aortic valve replacement (2009-16) with either the FS or TF at 1 centre was performed. Local databases and national records were queried...
January 16, 2018: European Journal of Cardio-thoracic Surgery
Brendan Hermenigildo Dias, Mohammed Shahid Ali, Shiv Dubey, Srinivas Arkalgud Krishnaswamy, Amrith Raj Rao, Deepak Dubey
Introduction: Robot-assisted partial nephrectomy (RAPN) is an established, minimally invasive technique to treat patients with renal masses. The aim of this study was to assess the learning curve (LC) of RAPN, evaluate its impact on perioperative outcomes following RAPN and to study the role of surgeon experience in achieving "trifecta" outcomes following RAPN. Methods: We prospectively analyzed the clinical and pathological outcomes of 108 consecutive patients who underwent RAPN for renal tumors from January 2012 to December 2016 by a laparoscopy trained surgeon with no prior robotic experience...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Aditya P Sharma, Ravimohan Suryanarayana Mavuduru, Girdhar Singh Bora, Sudheer K Devana, Kiruthika Palani, Anupam Lal, Nandita Kakkar, Shrawan K Singh, Arup K Mandal
Introduction and Objective: The RENAL, PADUA and centrality index (C-index) nephrometry scoring systems (SS) have been individually evaluated for their role in predicting trifecta outcomes after nephron-sparing surgery (NSS). However, there is little data on their comparative superiority. The present study was designed to evaluate the predictive value of three SS and to assess interobserver reliability. Materials and Methods: Fifty patients undergoing NSS at our center between January 2014 and April 2016 were included in the study...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Derrick Y Tam, Stephen E Fremes
No abstract text is available yet for this article.
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
Alexander Sedaghat, Jan-Malte Sinning, Nikos Werner, Georg Nickenig, Lenard Conradi, Stefan Toggweiler, Ulrich Schäfer
AIMS: The aim of this study was to assess the in-vitro hydrodynamic performance of a novel self-expanding transcatheter heart valve prosthesis (THV), the NVT AllegraTM, in 5 different surgical bioprostheses. In addition, we present a series of valve-in-valve implantations in the clinical setting using the 23mm AllegraTM prosthesis. METHODS AND RESULTS: The 23mm NVT AllegraTM was implanted in 5 different surgical bioprostheses of 23mm nominal size, namely the Edwards Perimount, the Sorin MitroFlow, the St...
December 19, 2017: EuroIntervention
Joy Lee, Caroline Kronborg, Robyn E O'Hehir, Mark Hew
The Melbourne thunderstorm asthma epidemic in November 2016 was unprecedented in scale and impact. We systematically reviewed our hospital's patients with thunderstorm asthma to identify key risk factors. Of 85 adult patients assessed, the majority (60%) had no prior diagnosis of asthma. However, allergic rhinitis during the grass pollen season was almost universal (99%), as were ryegrass pollen sensitization (100%) and exposure to the outdoor environment during the thunderstorm (94%). Airborne pollen levels on the thunderstorm day were extreme...
November 2017: Respiratory Medicine
Jeremy Bray, Thomas F Babor
No abstract text is available yet for this article.
January 2018: Journal of Studies on Alcohol and Drugs
Manoras Mathew Chengalath, Bhaskar Ranganathan, Jose Chacko Periappuram
No abstract text is available yet for this article.
January 2018: Asian Cardiovascular & Thoracic Annals
Abhilash Koratala, A Ahsan Ejaz, Wesley M Hiser, William L Clapp
No abstract text is available yet for this article.
December 2017: Kidney International
Giordano Tasca, Riccardo Vismara, Francesco Trinca, Beatrice Riva, Amando Gamba, Elisabetta Lobiati
BACKGROUND: Stentless valves have long been considered the ideal valves in terms of hemodynamics. Recently, the Trifecta valve, a stented bioprosthesis with excellent fluid dynamic characteristics, has become available. The aim of the study was to compare the opening/closing pattern of the Freestyle stentless valve and the Trifecta valve with that of the native aortic valve. METHODS: A total of 12 patients with a Freestyle and 10 with a Trifecta valve were compared to normal native aortic valves in 12 control patients...
November 2017: Journal of Cardiac Surgery
Sina Stock, Inga Lohmann, Thorsten Hanke, Ulrich Stierle, Doreen Richardt, Stanislav Tsvelodub, Hans-Hinrich Sievers
OBJECTIVES: Because bioprosthetic aortic valve replacement remains one of the most frequent cardiac surgical procedures, it is necessary to study patient haemodynamics in more detail. Until now, a few studies assessed haemodynamics during exercise, but none with special regard to small aortic annuli. We compared patients who had the differently designed bioprostheses, Trifecta and Perimount Magna Ease (PME), size ≤ 23 mm, and a healthy control group during rest and exercise. METHODS: We determined the mean transvalvular gradient, the effective orifice area (EOA) and the EOA index during rest and exercise using transthoracic echocardiography in 35 patients with the Trifecta (mean age 71...
October 31, 2017: Interactive Cardiovascular and Thoracic Surgery
Matt T Bianchi
The field of sleep is in many ways ideally positioned to take full advantage of advancements in technology and analytics that is fueling the mobile health movement. Combining hardware and software advances with increasingly available big datasets that contain scored data obtained under gold standard sleep laboratory conditions completes the trifecta of this perfect storm. This review highlights recent developments in consumer and clinical devices for sleep, emphasizing the need for validation at multiple levels, with the ultimate goal of using personalized data and advanced algorithms to provide actionable information that will improve sleep health...
October 25, 2017: Metabolism: Clinical and Experimental
Marco Borghesi, Riccardo Schiavina, Francesco Chessa, Lorenzo Bianchi, Gaetano La Manna, Angelo Porreca, Eugenio Brunocilla
BACKGROUND: The objective of this study was to compare perioperative and early oncological outcomes of a matched cohort of patients who underwent retroperitoneal robot-assisted partial nephrectomy (RP-RAPN) and open partial nephrectomy (OPN) for clinically localized renal tumors. PATIENTS AND METHODS: We performed a retrospective analysis of patients who underwent RP-RAPN and OPN treated at 2 referral centers from January 2011 to December 2015. We focused on the following postoperative outcomes: warm ischemia time (WIT), operative time, blood loss, intra- and postoperative complications, estimated glomerular filtration rate (eGFR), hospital stay, and positive surgical margins...
October 3, 2017: Clinical Genitourinary Cancer
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