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https://www.readbyqxmd.com/read/28506647/acute-structural-failure-of-the-trifecta-aortic-valve-bioprosthesis
#1
Michael Z L Zhu, Mark A Newman, Pragnesh Joshi, Jurgen Passage
Advancements in bioprosthetic valve technology have greatly enhanced the haemodynamic performance and long-term durability of tissue valves. These features, along with the key advantage of avoiding lifelong anticoagulation, have made bioprosthetic valves increasingly attractive for clinicians and patients alike. The St Jude Trifecta valve is a novel, bovine pericardial bioprosthesis with promising early data for performance and safety. However, no prosthetic valve is perfect and prosthesis failure can occur with even the most reliable and well-designed devices...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28497767/-evaluation-of-a-thyroid-nodule
#2
Geir Tryggvason, Birgir Briem
Thyroid nodules are common and their incidence has increased due to various factors. Systematic approach to the work-up of thyroid nodules is necessary to decrease overdiagnosis as well as over treatment. Applying the trifecta of history, physicial examination and high-resolution ultrasound (HRUS) as well as fine needle aspiration biopsy (FNAB) with added TSH measurement is important in the work-up. HRUS is a central part in the diagnostic approach, being able to risk classify nodules and selecting nodules for FNAB...
January 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28475560/hydrodynamic-and-geometric-behavior-of-two-pericardial-prostheses-implanted-in-small-aortic-roots
#3
Giordano Tasca, Gianfranco Beniamino Fiore, Paola Redaelli, Claudia Romagnoni, Alberto Redaelli, Amando Gamba, Carlo Antona, Riccardo Vismara
Hydrodynamic performance of stented bioprostheses is far below that of the native valve. One of the reasons is that the internal diameter of the prosthesis is usually smaller than that of the native valve. However, other valve characteristics are also important in generating the pressure drop. We aimed to assess, in an ex vivo pulsatile mock loop, the hydrodynamic behavior of two bioprostheses, Trifecta and Mitroflow, to ascertain which geometric terms are limiting factors in hydrodynamic performance. At stroke volumes between 30 and 60 ml, Trifecta showed lower pressure drop, energy dissipation and valve resistance, and greater effective orifice area...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28471972/outcomes-of-robot-assisted-simple-enucleation-of-renal-masses-a-single-european-center-experience
#4
Deliu Victor Matei, Mihai Dorin Vartolomei, Gennaro Musi, Giuseppe Renne, Valeria Maria Lucia Tringali, Francesco Alessandro Mistretta, Maurizio Delor, Andrea Russo, Antonio Cioffi, Roberto Bianchi, Gabriele Cozzi, Ettore Di Trapani, Danilo Bottero, Giovanni Cordima, Giuseppe Lucarelli, Matteo Ferro, Ottavio de Cobelli
The aim of this study was to assess the ability of pre-and intraoperative parameters, to predict the risk of perioperative complications after robot-assisted laparoscopic simple enucleation (RASE) of renal masses, and to evaluate the rate of trifecta achievement of this approach stratifying the cohort according to the use of ischemia during the enucleation.From April 2009 to June 2016, 129 patients underwent RASE at our Institution. We stratified the procedures in 2 groups: clamping and clamp-less RASE. After RASE, all specimens were retrospectively reviewed to assess the surface-intermediate-base (SIB) scoring system...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28464554/does-the-training-of-fellows-affect-perioperative-outcomes-of-robotic-partial-nephrectomy
#5
Zine-Eddine Khene, Benoit Peyronnet, Elise Bosquet, Benjamin Pradère, Corentin Robert, Tarek Fardoun, Solène-Florence Kammerer-Jacquet, Grégory Verhoest, Nathalie Rioux-Leclercq, Romain Mathieu, Karim Bensalah
OBJECTIVE: To evaluate the impact of fellows' involvement on robot-assisted partial nephrectomy (RAPN) perioperative outcomes. MATERIALS AND METHODS: We analysed 216 patients who underwent RAPN for a small renal tumour. We stratified our cohort into two groups according to the involvement of a fellow surgeon during the procedure: expert surgeon operating alone (expert group) or fellow operating under the supervision of the expert surgeon (fellow group). Perioperative data were compared between the two groups...
May 2, 2017: BJU International
https://www.readbyqxmd.com/read/28392432/-surgical-approach-and-sexual-outcomes-after-radical-prostatectomy
#6
K Caillet, A Lipsker, E Alezra, P De Sousa, G Pignot
BACKGROUND: Radical prostatectomy is curative surgical treatment of choice for localized prostate cancer. The objectives are cancer control, preservation of continence and preservation of sexuality, the combination of the three constituting the Trifecta. OBJECTIVE: The objective of this study was to assess, through the analysis of the literature, the sexual outcomes according to surgical approach: radical prostatectomy by laparotomy (PRL), laparoscopic radical prostatectomy (PRLa) and laparoscopic robot-assisted radical prostatectomy (PRLaRA), when nerve sparing was practiced...
April 6, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28352149/robot-assisted-partial-nephrectomy-for-t1b-tumors-strict-trifecta-outcomes
#7
Ilter Tufek, Panagiotis Mourmouris, Tunkut Doganca, Can Obek, Omer Burak Argun, Mustafa Bilal Tuna, Mehmet Selcuk Keskin, Ali Rıza Kural
BACKGROUND AND OBJECTIVES: "Trifecta" in partial nephrectomy consists of negative surgical margins, minimal renal function decrease and absence of complications. In the present article, our single-center robot-assisted partial nephrectomy (RAPN) experience in T1b renal masses is reported in terms of strict Trifecta outcomes. METHODS: This is a retrospective analysis of patients with a tumor diameter between 4 and 7 cm (stage T1b), who underwent RAPN by a single surgeon...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28260351/trifecta-of-complications-post-ercp-it-can-happen
#8
Thanh-Truc LE, Mohammad Bilal, Sreeram Parupudi
No abstract text is available yet for this article.
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28157718/in-vitro-comparative-assessment-of-decellularized-bovine-pericardial-patches-and-commercial-bioprosthetic-heart-valves
#9
Paola Aguiari, Laura Iop, Francesca Favaretto, Cátia Marisa Lourenco Fidalgo, Filippo Naso, Gabriella Milan, Vincenzo Vindigni, Michel Spina, Franco Bassetto, Andrea Bagno, Roberto Vettor, Gino Gerosa
Notwithstanding their wide exploitation, biological prosthetic heart valves are characterized by limited durability (10-15 years). The treatment of biological tissues with chemical crosslinking agents such as glutaraldehyde accounts for the enhanced risk of structural deterioration associated with the early failure of bioprosthetic valves. To overcome the shortcomings of the currently available solutions, adoption of decellularized biological tissues of animal origin has emerged as a promising approach. The present study aims to assess in vitro cardiovascular scaffolds composed of bovine pericardium decellularized with the novel TRITDOC (TRIton-X100 and TauroDeOxyCholic acid) procedure...
February 3, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28131425/evaluation-of-hemodynamic-performance-of%C3%A2-aortic-valve-bioprostheses-in-a-model-of%C3%A2-oversizing
#10
John D Cleveland, Michael E Bowdish, Carol E Eberhardt, Wendy J Mack, James A Crabtree, Thomas A Vassiliades, Alan M Speir, Yogesh A Darekar, Amy E Hackmann, Vaughn A Starnes, Robbin G Cohen
BACKGROUND: The risk of patient-prosthesis mismatch drives most surgeons to select the largest bioprosthesis possible during aortic valve replacement, but interactions between the native aortic annulus and valve prosthesis remain poorly defined. We examined the hemodynamic and functional consequences of oversizing contemporary bioprostheses in an in vitro model. METHODS: Three sizes each (21, 23, and 25 mm) of 5 aortic bioprostheses (Magna, Edwards Lifesciences, Irvine, CA; Trifecta and Epic, St...
January 26, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28104190/in%C3%A2-vitro-coronary-flow-after-transcatheter-aortic-valve-in-valve-implantation-a-comparison-of-2-valves
#11
Sina Stock, Michael Scharfschwerdt, Roza Meyer-Saraei, Doreen Richardt, Efstratios I Charitos, Hans-Hinrich Sievers, Thorsten Hanke
BACKGROUND: Transcatheter aortic valve-in-valve implantation (TAVI-ViV) is an evolving treatment strategy for degenerated surgical aortic valve bioprostheses (SAVBs). However, there is some concern regarding coronary obstruction, especially after TAVI-ViV in calcified SAVBs with externally mounted leaflets. We investigated in vitro coronary flow and hydrodynamics after TAVI-ViV using 2 modern SAVBs with externally and internally mounted leaflets. METHODS: Aortic root models including known risk factors for coronary obstruction served for the implantation of SAVBs with either externally mounted leaflets (St Jude Trifecta, size 25) or internally mounted leaflets (Edwards Perimount Magna Ease, size 25)...
February 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27988978/early-surgical-outcomes-and-oncological-results-of-robot-assisted-partial-nephrectomy-a-multicentre-study
#12
Rajan Veeratterapillay, Sanjai K Addla, Clare Jelley, John Bailie, David Rix, Steve Bromage, Neil Oakley, Robin Weston, Naeem A Soomro
OBJECTIVE: To describe a multicentre experience of robot-assisted partial nephrectomy (RAPN) in northern England, with focus on early surgical outcomes and oncological results. PATIENTS AND METHODS: All consecutive patients undergoing RAPN at four tertiary referral centres in northern England in the period 2012-2015 were included for analysis. RAPN was performed via a transperitoneal approach using a standardized technique. Prospective data collection was performed to capture preoperative characteristics (including R...
December 18, 2016: BJU International
https://www.readbyqxmd.com/read/27980283/pure-cusp-tear-of-trifecta-bioprosthesis-2-years-after-aortic-valve-replacement
#13
Masaki Hamamoto, Taira Kobayashi, Masamichi Ozawa, Kosuke Yoshimura
Trifecta is a stented bioprosthetic heart valve with a bovine pericardial sheet externally mounted on a titanium stent. This valve is applied only for aortic valve replacement (AVR), providing excellent hemodynamics and extremely low incidence of structural valve deterioration (SVD). A 76-year-old woman presented with dyspnea on effort 24 months after AVR with a 21-mm Trifecta valve. Echocardiography revealed severe aortic regurgitation with prolapse of a cusp of Trifecta valve, which suggested that she developed acute heart failure due to early SVD...
December 14, 2016: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27964975/midterm-multicenter-clinical-and-hemodynamic-results-for-the-trifecta-aortic-pericardial-valve
#14
Scott Goldman, Anson Cheung, Joseph E Bavaria, Michael R Petracek, Mark A Groh, Hartzell V Schaff
OBJECTIVE: To evaluate the midterm hemodynamic performance and clinical outcomes of the Trifecta aortic pericardial valve. METHODS: In a multicenter, prospective, nonrandomized, follow-up study, 710 patients underwent surgical implantation of a pericardial stented aortic prosthesis (Trifecta valve; St Jude Medical, St. Paul, Minn). The valve is constructed from bovine pericardium mounted externally onto a titanium stent. Subjects were followed on an annual basis over 6 years...
March 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27955900/midterm-durability-and-hemodynamic-performance-of-a-third-generation-bovine-pericardial-prosthetic-aortic-valve-the-leipzig-experience
#15
Sven Lehmann, Anna Meyer, Thomas Schroeter, Madlen Uhlemann, Julia Fischer, Sergey Leontyev, Jens Garbade, David Holzhey, Martin Misfeld, Friedrich-Wilhelm Mohr
BACKGROUND: The Trifecta valve (St. Jude Medical, St. Paul, MN) is a stented bovine pericardial bioprosthesis for aortic valve replacement (AVR). Implantation experience and midterm follow-up of this valve have not yet been reported from a large single-center cohort. METHODS: We retrospectively analyzed data from 918 patients (73.2 ± 6.5 years; logistic European System for Cardiac Operative Risk Evaluation [EuroSCORE], 13.2 ± 14.3) who underwent AVR. Analyses addressed implantation safety, short- and long-term survival, and hemodynamic valve performance...
December 9, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27867812/comparisons-of-oncological-and-functional-outcomes-among-radical-retropubic-prostatectomy-high-dose-rate-brachytherapy-cryoablation-and-high-intensity-focused-ultrasound-for-localized-prostate-cancer
#16
Po Hui Chiang, Yi Yang Liu
PURPOSE: To conduct a retrospective, single institutional and comparative study for radical retropubic prostatectomy (RRP), high dose rate brachytherapy (HDRBT), cryoablation and high-intensity focused ultrasound (HIFU) in localized prostate cancer with respect to oncological and functional outcomes. METHODS: We reviewed 97, 161, 114 and 120 patients of RRP, HDRBT, cryoablation and HIFU respectively for localized prostate cancer from May 2008 to December 2013. PSA biochemical recurrence, salvage treatment-free rate, metastasis-free rate, and biochemical recurrence-free survival were analyzed for oncological outcomes...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27862788/robot-assisted-partial-nephrectomy-continued-refinement-of-outcomes-beyond-the-initial-learning-curve
#17
David J Paulucci, Ronney Abaza, Daniel D Eun, Ashok K Hemal, Ketan K Badani
OBJECTIVES: To evaluate trends in peri-operative outcomes of 250 consecutive cases beyond the initial learning curve (LC) of robot-assisted partial nephrectomy (RAPN) among multiple surgeons. PATIENTS AND METHODS: A multi-institutional database was used to evaluate trends in patient demographics (e.g. age, gender, comorbidities), tumour characteristics (e.g. size, complexity) and peri-operative outcomes (e.g. warm ischaemia time [WIT], operating time, complications, estimated blood loss [EBL], trifecta achievement) in consecutive cases 50-300 (n = 960) from 2008 to 2016 among four experienced surgeons...
November 8, 2016: BJU International
https://www.readbyqxmd.com/read/27773869/valve-in-valve-outcome-design-impact-of-a-pre-existing-bioprosthesis-on-the-hydrodynamics-of-an-edwards-sapien-xt-valve
#18
Christian Doose, Maximilian Kütting, Sandrine Egron, Pejman Farhadi Ghalati, Christoph Schmitz, Marc Utzenrath, Alexander Sedaghat, Buntaro Fujita, Thomas Schmitz-Rode, Stephan Ensminger, Ulrich Steinseifer
OBJECTIVES: Bioprosthetic aortic heart valves are increasingly implanted in younger patients. Therefore, a strategy for potential valve failure should be developed before implanting the 'first valve'. The goal of this in vitro study was to provide insight into the effects of the design of a bioprosthesis on a valve-in-valve implanted Sapien XT valve. METHODS: The hydrodynamic performance of a 23-mm Sapien XT valve implanted in Vascutek Aspire, Edwards Perimount, Medtronic Mosaic and St...
March 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27697360/mid-term-durability-of-the-trifecta-bioprosthesis-for-aortic-valve-replacement
#19
Amedeo Anselmi, Vito Giovanni Ruggieri, Bernard Lelong, Erwan Flecher, Hervé Corbineau, Thierry Langanay, Jean-Philippe Verhoye, Alain Leguerrier
OBJECTIVE: To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR). METHODS: We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively. RESULTS: Operative mortality was 3...
January 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27668693/retroperitoneoscopic-partial-nephrectomy-for-moderately-complex-ventral-hilar-tumors-surgical-technique-and-trifecta-outcomes-from-a-single-institution-in-china
#20
Longfei Liu, Lin Qi, Yangle Li, Minfeng Chen, Chao Li, Xu Cheng, Peihua Liu, Xiongbing Zu
OBJECTIVES: T1 ventral renal hilar tumors (VRHTs) represent a very special type of tumor, for which laparoscopic partial nephrectomy (LPN) by the retroperitoneal approach is challenging. In this study, we report our surgical technique and Trifecta results. METHODS: Renal rotation technique has been established for retroperitoneal laparoscopic partial nephrectomy (RLPN) for VRHTs in our institution. Trifecta was used as a composite outcome measure for assessing quality of PLPN using this technique...
September 26, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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