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Aortic valve replacement

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https://www.readbyqxmd.com/read/29775605/outcomes-of-planned-2-stage-hybrid-aortic-repair-with-dacron-replaced-proximal-landing-zone
#1
David N Ranney, Babatunde A Yerokun, Ehsan Benrashid, Muath Bishawi, Adam Williams, Richard L McCann, G Chad Hughes
BACKGROUND: Results of hybrid arch repair (HAR) utilizing native zone 0 proximal landing zone (PLZ) have been unsatisfactory in many series, especially in the setting of ascending aortic dilation (>4.0 cm). This study reports early and late outcomes of planned 2-stage HAR with open 1st stage proximal aortic replacement (PAR) followed by 2nd stage thoracic endovascular aortic repair (TEVAR) with PLZ within the Dacron replaced zone 0. METHODS: N=34 patients underwent planned 2-stage HAR between 1/2006-8/2017...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774601/the-impact-of-mitral-stenosis-on-outcomes-of-aortic-valve-stenosis-patient-undergoing-surgical-aortic-valve-replacement-or-transcatheter-aortic-valve-replacement
#2
Yasser Al-Khadra, Fahed Darmoch, Motaz Baibars, Amir Kaki, Zaher Fanari, M Chadi Alraies
BACKGROUND: The concomitant presence of mitral stenosis (MS) in the setting of symptomatic aortic stenosis represent a clinical challenge. Little is known regarding the outcome of mitral stenosis (MS) patients undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Therefore, we sought to study the outcome of MS patients undergoing aortic valve replacement (AVR). METHOD: Using weighted data from the National Inpatient Sample (NIS) database between 2011 and 2014, we identified patients who were diagnosed with MS...
May 17, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29773445/transcatheter-aortic-valve-insertion-in-patients-with-hostile-ascending-aorta-calcification
#3
Akio Nakasu, Kevin L Greason, Vuyisile T Nkomo, Mackram F Eleid, Alberto Pochettino, Katherine S King, Gurpreet S Sandhu, Eric E Williamson, David R Holmes
OBJECTIVE: Calcification of the ascending aorta complicates aortic valve replacement. Transcatheter aortic valve replacement is an alternative procedure in this situation, but it requires manipulation through the hostile area in the ascending aorta. We reviewed our transcatheter aortic valve insertion experience to better understand the surgical mortality risk of valve insertion in patients with extensive calcification of the ascending aorta. METHODS: We retrospectively reviewed the records of 665 consecutive patients who received transcatheter aortic valve insertion from November 2008 through December 2015...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29772584/survival-after-aortic-valve-replacement-with-bovine-or-porcine-valve-prostheses-a-systematic-review-and-meta-analysis
#4
Natalie Glaser, Veronica Jackson, Anders Franco-Cereceda, Ulrik Sartipy
BACKGROUND:  Bovine and porcine bioprostheses are commonly used for surgical aortic valve replacement. It is unknown if the long-term survival differs between the two valve types.We performed a systematic review and meta-analysis to compare survival in patients who underwent aortic valve replacement and received a bovine or a porcine prosthesis. METHODS:  We performed a systematic search of Medline, Embase, Web of Science, and the Cochrane Library. Cohort studies that compared survival between patients who underwent aortic valve replacement and received either a bovine or a porcine bioprosthesis and that reported overall long-term survival with hazard ratio (HR) and 95% confidence interval (CI) were included...
May 17, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29770290/current-surgical-strategies-and-techniques-of-aortic-valve-diseases-in-children
#5
REVIEW
Kun Wang, Huifeng Zhang, Bing Jia
While the long-term outcome of surgical aortic valvotomy (SAV) appears to be better than that of balloon aortic valvuloplasty (BAV) as the primary procedure of aortic valve stenosis, the surgical strategies and techniques of treating aortic valve disease in children in other situations remain controversial. Valve repair should be first considered while replacement is still unavoidable in some cases, and new repair techniques developed by innovative surgeons are gradually becoming adopted. Some complex repair procedures such as cusp extension, leaflet replacement/reconstruction have provided satisfactory outcomes...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29766266/-syncope-and-fitness-to-drive
#6
REVIEW
Hermann H Klein
Although medical students are rarely instructed in traffic medicine in Germany, they are obliged to inform their patients about their fitness to drive after having become a medical doctor. This article gives an overview on the fitness to drive for patients with syncope by referring to the driving license regulation and the current guidelines released by the department of traffic. The driving license regulation distinguishes between group 1 and group 2 drivers. Group 1 drivers drive vehicles with a total weight less than 3...
May 15, 2018: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/29765465/the-development-or-worsening-of-hypertension-after-transcatheter-aortic-valve-replacement-tavr-improves-short-term-and-long-term-patient-outcomes
#7
Brent J Klinkhammer, Cornelius M Dyke, Thomas A Haldis
Objectives: In patients with symptomatic aortic valve disease who are at intermediate to high risk for open surgical aortic valve replacement, transcatheter aortic valve replacement (TAVR) decreases overall mortality and improves quality of life. Hypertension (HTN) after TAVR has been associated with improved cardiac function and short-term survival but its effect on survival over 1 year is unclear. Our study aims to evaluate the effect of HTN following TAVR on short-term and long-term clinical and echocardiographic outcomes...
2018: Heart Asia
https://www.readbyqxmd.com/read/29764687/intraoperative-aortic-root-pressure-study-for-quantitative-assessment-of-aortic-regurgitation-during-valve-sparing-root-replacement-a-preliminary-report
#8
Yuki Ikeno, Hiroshi Tanaka, Yutaka Okita
No abstract text is available yet for this article.
April 17, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29764686/comparison-of-transcatheter-versus-surgical-aortic-valve-implantation-in-high-risk-patients-a-nationwide-study-in-france
#9
Xavier Armoiry, Jean-François Obadia, Léa Pascal, Stéphanie Polazzi, Antoine Duclos
OBJECTIVE: To compare the clinical outcomes and direct costs at 5 years between transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) using real-world evidence. METHODS: We performed a nationwide longitudinal study using data from the French Hospital Information System from 2009 to 2015. We matched, inside hospitals, 2 cohorts of adults who underwent TAVI or SAVR during 2010 on propensity score based on patient characteristics...
April 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29764497/activated-prothrombin-complex-concentrate-to-reverse-the-factor-xa-inhibitor-apixaban-effect-before-emergency-surgery-a-case-series
#10
Nina Haagenrud Schultz, Runar Lundblad, Pål Andre Holme
BACKGROUND: The lack of an antidote against factor Xa inhibitors in case of major bleeding or need for urgent surgery is a concern to clinicians. Guidelines on managing major bleeding in patients under anticoagulation with a factor Xa inhibitor suggest several hemostatic agents to reverse the effect, but there is no consensus regarding the choice of drug or appropriate dose. The ability of prothrombin complex concentrate, activated prothrombin complex concentrate, and recombinant factor VIIa to reverse the effect of factor Xa inhibitors has been evaluated in animal studies, in vitro studies, and healthy volunteers, but not yet in randomized clinical studies...
May 16, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29762936/bentall%C3%A2-s-procedure-in-pediatric-mixed-connective-tissue-disease-syndrome-management-of-pediatric-aortic-aneurysm-a-brief-review
#11
Krithika Ramaprabhu, Om Prakash, Noveen Davidson, Sanjay Bhalero, Satish Radhakrishnan, Robert Coelho
Mixed connective tissue disease (MCTD) syndrome in children may lead to large aortic aneurysms, which in turn pose a difficult surgical problem. Valve-sparing root replacement is not always a viable option as the disease process invariably affects the aortic valve leaflets. Among pediatric patients, the Ross procedure is contraindicated on account of weakness of the pulmonary root, while Bentall surgery is the 'gold standard' treatment of aortic aneurysm, with reproducible and excellent long-term results. The case is presented of a three-year-old girl with a large thoracic aortic aneurysm in whom Bentall's surgery was performed, with a good result...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762935/septic-shock-meningoencephalitis-and-multiple-pulmonary-emboli-case-report-of-an-uncommon-clinical-presentation-of-ventricular-septal-defect-acute-infective-endocarditis
#12
Laura Varela Barca, Jose López-Menéndez, Ana Redondo Palacios, Jorge Rodríguez-Roda Stuart
The case is reported of a 55 year-old woman, with a previously known congenital septal defect, who was admitted to the emergency department with a diagnosis of meningoencephalitis, septic shock, and rapid clinical deterioration. Echocardiography revealed a vegetation occupying the right-side heart. Endocarditis affectation of the septal defect, aortic and tricuspid valves was noted and blood cultures were positive for Staphylococcus aureus. Urgent surgical treatment was performed whereby the ventricular septal defect was closed, a meticulous debridement of the affected area was conducted, and the aortic and tricuspid valves were replaced...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762933/ross-procedure-following-a-dislodged-transcatheter-aortic-valve-replacement
#13
Samuel R Schnittman, Aaron J Weiss, Robin Varghese, Paul Stelzer
A 36-year-old pregnant woman with a history of rheumatic heart disease and prior aortic valve replacement and mitral valve repair presented to an outside hospital with severe aortic stenosis. The patient had a cardiac arrest upon labor induction and underwent a transcatheter aortic valve replacement (TAVR), which dislodged two days later. Five months later, the patient underwent removal of the dislodged TAVR and a Ross procedure at the authors' institution. The patient was stable upon discharge, with minimal aortic and pulmonary regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762930/cusp-tear-of-trifecta%C3%A2-aortic-bioprosthesis-resulting-in-acute-heart-failure
#14
Anne-Kristin Schaefer, Alfred Kocher, Günther Laufer, Dominik Wiedemann
Herein is presented the case of an 83-year-old male patient in cardiogenic shock with acute aortic regurgitation that occurred six years after aortic valve replacement (AVR) with a 23 mm Trifecta™ valve. Prosthesis endocarditis was initially suspected because of a floating structure attached to the aortic valve that was visible on echocardiography. Emergency redo-AVR surgery was performed, but no signs of endocarditis were found intraoperatively. Hence, cusp tearing of the implanted bioprosthesis was considered to be the reason for the severe aortic regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762921/long-term-up-to-21-years-follow-up-after-biological-and-mechanical-aortic-valve-replacement-in-younger-patients
#15
Stanislav Tsvelodub, Barbara Pieper, Sina Stock, Hans-Hinrich Sievers, Doreen Richardt
BACKGROUND: Despite the limited durability of biological aortic valves, increasing numbers of younger patients are choosing to receive them, due mainly to the lack of a need for permanent anticoagulation. Few data exist, however, regarding the outcomes of valve replacement in patients aged <55 years, and additional data are required in this patient population. METHODS: Between 1993 and 2014, at the authors' institution, a total of 448 patients (237 males, 101 females; mean age 45...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762920/outcomes-of-a-new-generation-stentless-aortic-valve-a-single-center-experience-with-251-consecutive-implants
#16
Guglielmo Stefanelli, Fabrizio Pirro, Giuseppe Danniballe, Alina Olaru, Marco Meli, Luca Weltert
BACKGROUND: The study aim was to investigate the hemodynamic behavior over time and ease of implant and durability of the Sorin Pericarbon Freedom (SPF)® stentless pericardial aortic xenograft. METHODS: Between March 2003 and April 2010, a total of 251 consecutive, non-selected patients (mean age 70.1 years; range: 17-89 years; 17.1% aged >80 years) received a SPF bioprosthesis as an aortic valve substitute at the authors' institution. All implantations were performed by a single surgeon using a classical, double-line, subcoronary implant technique...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762917/association-of-change-in-patient-reported-health-status-after-transcatheter-aortic-valve-replacement-and-postoperative-outcomes
#17
Alexis Kofi Okoh, Nathan Kang, Dhaval Chauhan, Nicky Haik, Dustin Hanos, Marc Cohen, Chungeng Chen, Bruce Haik, Mark J Russo
BACKGROUND: The study aim was to investigate the relationship between postoperative morbidity after transcatheter aortic valve replacement (TAVR) and short-term patient-reported health status, using the Kansas City Cardiomyopathy Questionnaire (KCCQ). METHODS: The association between 30-day post-procedure changes in patient-reported heath status and post-TAVR outcomes was examined. Patients were stratified into three groups based on observed changes in KCCQ-Overall scores (OS): Group A, increase in KCCQ-OS ≥10 points; Group B, KCCQ-OS scores <10 points; and Group C, decline in KCCQ-OS ≥10 points...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29759854/a-meta-analysis-of-reduced-leaflet-motion-for-surgical-and-transcatheter-aortic-valves-relationship-to-cerebrovascular-events-and-valve-degeneration
#18
Nader Makki, Satya Shreenivas, Dean Kereiakes, Scott Lilly
BACKGROUND: Reduced leaflet motion (RLM) of transcatheter aortic valves (TAV) is observed in up to 4% of cases with similar frequency in surgical valves, with an overall incidence that differs based on prosthesis type and size. This phenomenon likely represents subclinical leaflet thrombosis. Herein we sought to analyze the existing reported literature to assess whether or not RLM is associated with subsequent valve degeneration or cerebrovascular events. METHODS AND RESULTS: We searched PubMed, and EMBASE (2008-2017) to identify relevant studies...
April 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29759737/long-term-outcome-of-cryopreserved-allograft-for-aortic-valve-replacement
#19
Francesco Nappi, Antonio Nenna, Tommasangelo Petitti, Cristiano Spadaccio, Ivancarmine Gambardella, Mario Lusini, Massimo Chello, Christophe Acar
OBJECTIVE: The most efficient surgical approach to severe aortic valve disease in the young adult is still debated: cryopreserved aortic allograft offers excellent hemodynamic and avoid anticoagulation, but long-term durability is influenced by structural valve deterioration (SVD). This study aimed to describe long-term results of aortic allografts and to identify factors influencing long-term durability. METHODS: From January 1993 to August 2010, 210 patients underwent aortic allograft replacement via the free-hand subcoronary implantation technique (N = 55) or root replacement with coronary reimplantation (N = 155)...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29758214/transcatheter-aortic-valve-replacement-comparing-transfemoral-transcarotid-and-transcaval-access
#20
Gaetano Paone, Marvin Eng, Loay S Kabbani, Jamil Borgi, Ed Peterson, Brianna Novitsky, Benjamin Burroughs, Dee Dee Wang, William W O'Neill, Adam S Greenbaum
BACKGROUND: Despite newer generation valves using smaller sized sheaths, 10-20 percent of patients undergoing transcatheter aortic valve replacement (TAVR) require non-femoral artery access for valve delivery. To avoid a trans-thoracic procedure, we have utilized transcarotid (TC) and transcaval (TCav) approaches in these patients. This study compared the results of a contemporary experience with TF, TC and TCav approaches. METHODS: Between January 2015 and March 2017, 491 patients underwent TAVR at our institution of which 463 were included in this analysis...
May 11, 2018: Annals of Thoracic Surgery
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