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Structural heart intervention

Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
Kari A Teramo, Miira M Klemetti, John A Widness
Fetal erythropoietin (EPO), in addition to regulating erythropoiesis, has also tissue-protective properties based on its anti-inflammatory, anti-apoptotic, antioxidant, and neurotrophic effects. Notably, EPO concentrations needed for tissue protection are 100-1000 times higher than concentrations needed for regulating erythropoiesis. This dual effect of EPO is based on EPO-receptor (EPO-R) isoforms, which differ structurally and functionally. We hypothesize in this Integrated Mechanism Review that during severe fetal hypoxia the observed, but poorly understood, marked increases of fetal plasma EPO concentrations occur to protect the brain, heart, and other vital fetal organs...
June 12, 2018: Pediatric Research
Ahmed Fouad Ahmed, Mohammed Nabil Abd Al Jawad
BACKGROUND: Proper visualization has always been the cornerstone for conducting proper cardiac interventions. Although many incisions have been described for mitral valve exposure, the feasibility of some comes at the expense of proper exposure. When it comes to a small left atrium, larger incisions may venture into critically situated structures, creating a heavy toll of increased morbidity and mortality. We aim to evaluate the safety and efficacy of a superior left atrium approach for mitral valve interventions and left atrial mass resection, particularly in a small left atrium...
May 29, 2018: Heart Surgery Forum
Frederik Beckhoff, Brunilda Alushi, Christian Jung, Eliano Navarese, Marcus Franz, Daniel Kretzschmar, Bernhard Wernly, Michael Lichtenauer, Alexander Lauten
Severe tricuspid regurgitation (TR) is a complex condition of the right ventricle (RV) and tricuspid valve apparatus and is frequently associated with symptomatic heart failure and a significant morbidity and mortality. In these patients, left heart pathologies lead to chronic pressure overload of the RV, eventually causing progressive RV dilatation and functional TR. Therefore, TR cannot be considered as isolated heart valve disease pathology but has to be understood and treated as one component of a complex structural RV pathology and is frequently also a marker of an advanced stage of cardiac disease...
2018: Frontiers in Cardiovascular Medicine
Maria J Brosnan, Dhrubo Rakhit
In athletes who undertake a high volume of high intensity exercise, the resultant changes in cardiac structure and function which develop as a result of physiological adaptation to exercise (so called "Athlete's Heart") may overlap with some features of pathological conditions. This chapter will focus on the left side of the heart, where left ventricular cavity enlargement, increase in left ventricular wall thickness and increased left ventricular trabeculation associated with athletic remodelling may sometimes be difficult to differentiate from conditions such as dilated cardiomyopathy, hypertrophic cardiomyopathy or isolated left ventricular non-compaction...
May 16, 2018: Heart, Lung & Circulation
Einat Bigelman, Lena Cohen, Genya Aharon-Hananel, Ran Levy, Zach Rozenbaum, Ann Saada, Gad Keren, Michal Entin-Meer
BACKGROUND: Mitochondria hold crucial importance in organs with high energy demand especially the heart. We investigated whether chronic kidney disease (CKD), which eventually culminates in cardiorenal syndrome, could affect cardiac mitochondria and assessed the potential involvement of angiotensin II (AngII) in the process. METHODS: Male Lewis rats underwent 5/6 nephrectomy allowing CKD development for eight months or for eleven weeks. Short-term CKD rats were administered with AngII receptor blocker (ARB)...
2018: PloS One
Eliza M L Wong, Doris Y P Leung, Janet W H Sit, Aileen W K Chan, Sek Ying Chair
PURPOSE: The aim of this study was to further evaluate the psychometric properties of the Chinese version of the Self-Efficacy for Exercise Scale (SEE-C) among middle-aged outpatients with coronary heart disease (CHD). DESIGN: Psychometric evaluation design. METHODS: A convenience sample of 355 CHD patients was recruited and followed up at 3 and 6 months. Cronbach's alpha, construct validity (exploratory factor analysis), and concurrent and predictive validity were examined...
June 8, 2018: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Yohan Chacko, Rushi V Parikh, Jennifer A Tremmel
Women undergoing cardiac catheterization, percutaneous coronary intervention, transcatheter aortic valve replacement, and other structural heart interventions have a significantly higher risk of vascular complications and bleeding than men, leading to significant morbidity and mortality. This review highlights the importance of recognizing female sex as a specific and independent risk factor, and focuses on mechanisms of increased risk and strategies to minimize that risk. Smaller caliber peripheral vessels, low body weight, variations in platelet reactivity, and inappropriate dosing of anticoagulant and antiplatelet agents are the currently identified mechanisms for elevated bleeding and vascular complication risk in women...
June 8, 2018: Current Atherosclerosis Reports
David Attias, Mohammed Nejjari, Francesco Nappi, Julien Dreyfus, Mackram F Eleid, Charanjit S Rihal
The optimal management of aortic surgical bioprosthesis presenting with severe symptomatic structural valve deterioration is currently a matter of debate. Over the past 20 years, the number of implanted bioprostheses worldwide has been rapidly increasing at the expense of mechanical prostheses. A large proportion of patients, however, will require intervention for bioprosthesis structural valve deterioration. Current options for older patients who often have severe comorbidities include either transcatheter valve-in-valve (TVIV) implantation or redo valve surgery...
June 2, 2018: European Journal of Cardio-thoracic Surgery
Karen M Goldstein, Leah L Zullig, Eugene Z Oddone, Sara M Andrews, Mary E Grewe, Susanne Danus, Michele Heisler, Lori A Bastian, Corrine I Voils
Peer support may be an effective strategy to improve heart healthy behaviors among populations who have a strong communal identity, such as women veterans. Women veterans are a particularly important group to target as they are the fastest growing sub-population within the Veterans Affairs healthcare system. Our goal was to identify aspects of peer support and modalities for providing peer support that are preferred by women veterans at risk for cardiovascular disease (CVD). In 2016, we conducted 25 semi-structured individual interviews with women veterans from the Durham VA Healthcare System aged 35-64 who were at risk of CVD, defined as presence of at least one of the following: hypertension, hyperlipidemia, obesity (BMI ≥ 30), non-insulin dependent diabetes or prediabetes, or current smoking...
June 2018: Preventive Medicine Reports
Godsent C Isiguzo, Moleen Zunza, Maxwell Chirehwa, Bongani M Mayosi, Lehana Thabane
Background: Pilot trials are miniature researches carried out with the sole aim of acting as the precursor for larger more definitive studies. Abstracts are used to summarize and introduce the findings to the reading audience. There is substantive empirical evidence showing that abstracts, despite their important roles, are not informative enough, lacking the necessary details. This systematic survey was designed to assess the quality of reporting of heart failure pilot trial abstracts...
2018: Pilot and Feasibility Studies
Allyson K Getty, Tia R Wisdo, Lauren N Chavis, Cassandra C Derella, Kelly C McLaughlin, Avery N Perez, William T DiCiurcio, Meaghan Corbin, Deborah L Feairheller
As the global burden of cardiovascular disease (CVD) rises, public health-related interventions aimed at prevention of heart disease have gained medical attention. Clinical research reports that exercise is a protective risk factor associated with CVD and that clinicians need to provide exercise recommendations to patients. Nevertheless, physical inactivity remains a public health problem. In certain populations, like firefighters (FF), increased risk of CVD is especially concerning. The workload FF face is extreme, 50% of line-of-duty deaths (LODD) in FF are cardiac-related, and research on the volunteer FF population is scarce...
June 2018: Preventive Medicine Reports
Alex Koo, Anna Stein, Ryan Walsh
We present a case of pacing-induced cardiomyopathy. The patient presented with clinical symptoms of dyspnea, leg swelling, and orthopnea several months after a dual-chambered pacemaker was placed for third-degree heart block. The echocardiogram demonstrated a depressed ejection fraction. Coronary angiography was performed, which showed widely patent vessels. Single- and dual-chambered pacemakers create ventricular dyssynchrony, which in turn can cause structural, molecular changes leading to cardiomyopathy...
November 2017: Clinical practice and cases in emergency medicine
Yun-Xiao Lyu, Yun-Xiao Cheng, Ting Li
BACKGROUND: Spontaneous rupture of omental vessels is an infrequent medical condition possibly causing severe intra-abdominal hemorrhage. Omental bleeding results from trauma associated injury and irritation, neoplasia, arterial aneurysm rupture, and anticoagulant treatment. Idiopathic omental bleeding rarely causes acute abdominal bleeding which has been reported to occur in previous studies. Here we reported a case with idiopathic omental hemorrhage due to vascular malformation. A systematic review of literature is provided...
May 30, 2018: BMC Surgery
T Vandecasteele, P Cornillie, G van Steenkiste, K Vandevelde, I Gielen, K Vanderperren, G van Loon
BACKGROUND: Echocardiography is the imaging technique of choice for the equine heart. Nevertheless, knowledge about ulrasonographic identification of dorsally located structures and vessels, related to the atria, in horses is scarce. OBJECTIVES: To describe the echocardiographic approach and the identification of structures and vessels in relation to the atria in healthy horses. METHODS: CT images from two equine hearts, casted with self-expanding foam, were segmented and used to identify atrial-related structures and vessels...
May 28, 2018: Equine Veterinary Journal
Thomas Schlöglhofer, Johann Horvat, Francesco Moscato, Zeno Hartner, Georg Necid, Harald Schwingenschlögl, Julia Riebandt, Kamen Dimitrov, Philipp Angleitner, Dominik Wiedemann, Günther Laufer, Daniel Zimpfer, Heinrich Schima
Ventricular assist devices (VADs) are an established therapeutic option for patients with chronic heart failure. Continuous monitoring of VAD parameters and their adherence to guidelines are crucial to detect problems in an early stage to optimize outcomes. A telephone intervention algorithm for VAD outpatients was developed, clinically implemented and evaluated. During the phone calls, a structured inquiry of pump parameters, alarms, blood pressure, INR, body weight and temperature, exit-site status and heart failure symptoms was performed and electronically categorized by an algorithm into 5 levels of severity...
May 25, 2018: Artificial Organs
R M R Tulloh, V Garratt, J Tagney, J Turner-Cobb, E Marques, R Greenwood, L Howard, W Gin-Sing, A Barton, P Ewings, P Craggs, W Hollingworth
Background: Pulmonary arterial hypertension (PAH) is an uncommon condition with progressive heart failure and premature death. Treatment costs up to £120,000 per patient per year, and the psychological burden of PAH is substantial. Mindfulness-based stress reduction (MBSR) is an intervention with the potential to reduce this burden, but to date, it has not been applied to people with pulmonary hypertension. We wished to determine whether a trial of MBSR for people with PAH would be feasible...
2018: Pilot and Feasibility Studies
Shin Ono, Hideo Ohuchi, Aya Miyazaki, Osamu Yamada
Protein-losing enteropathy (PLE) is a life-threatening complication in patients following the Fontan operation. However, PLE also develops in some patients with congenital heart disease (CHD) after biventricular repair (BVR). This study compared clinical profiles of PLE patients following the Fontan operation with those after BVR. We retrospectively reviewed clinical charts of postoperative CHD patients with PLE. The study population comprised 42 PLE patients (14BVR, 28Fontan). Postoperative follow-up period until onset was significantly shorter in the Fontan group than in the BVR group (14 ± 2 vs...
May 22, 2018: Pediatric Cardiology
Alaide Chieffo, Gill Louise Buchanan, Julinda Mehilli, Davide Capodanno, Vijay Kunadian, Anna Sonia Petronio, Ghada W Mikhail, Piera Capranzano, Nieves Gonzal, Nicole Karam, Stéphane Manzo-Silberman, Stefanie Schüpke, Robert A Byrne, Giuliana Capretti, Yolande Appelman, Marie-Claude Morice, Patrizia Presbitero, Maria Radu, Josepa Mauri
Several expert documents on sex-based differences in interventional outcomes are now available, however this is the first position paper from the EAPCI Women Committee discussing the potential influence of sex in the percutaneous treatment of coronary and structural heart disease. Despite the misconception that coronary artery disease is a 'man's disease', contemporary data shows a growing incidence in women. However, women are under-represented in randomised coronary clinical trials (~25%). The generalisation of such studies is therefore problematic in decision-making for females undergoing coronary intervention...
May 22, 2018: EuroIntervention
Andres Enriquez, Luis C Saenz, Raphael Rosso, Frank E Silvestry, David Callans, Francis E Marchlinski, Fermin Garcia
The indications for catheter-based structural and electrophysiological procedures have recently expanded to more complex scenarios, in which an accurate definition of the variable individual cardiac anatomy is key to obtain optimal results. Intracardiac echocardiography (ICE) is a unique imaging modality able to provide high-resolution real-time visualization of cardiac structures, continuous monitoring of catheter location within the heart, and early recognition of procedural complications, such as pericardial effusion or thrombus formation...
May 22, 2018: Circulation
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