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https://www.readbyqxmd.com/read/27925332/left-atrial-appendage-closure-with-the-new-occlutech%C3%A2-device-first-in-man-experience-and-neurological-outcome
#1
Barbara Bellmann, Steffen Schnupp, Peter Kühnlein, Christian Javernik, Caroline Kleinecke, Andreas Rillig, Ulf Landmesser, Johannes Brachmann, Jai-Wun Park
AIMS: Percutaneous left atrial appendage closure (LAAC) is a valuable treatment option for stroke prevention in patients with atrial fibrillation and a HAS-BLED-Score ≥ 3. Determinants of procedural safety events and neurological outcome of the patients with the Occlutech Device (OD) are not established yet. METHODS AND RESULTS: Between 2012 and 2016, 30 patients underwent LAAC using the OD. This is a prospective, study. Neurological examination and transesophageal echocardiography was performed directly before and after the procedure and after 1, 3 and 12 months...
December 7, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27923487/reimplantation-of-the-aortic-valve-at-20%C3%A2-years
#2
Tirone E David, Carolyn M David, Christopher M Feindel, Cedric Manlhiot
OBJECTIVE: To provide additional information on clinical and echocardiographic outcomes after reimplantation of the aortic valve (RAV) in patients with aortic root aneurysm. METHODS: All 333 patients who underwent RAV at our hospital between 1989 and 2012 were followed prospectively with periodical clinical assessment and echocardiography. The mean duration of clinical follow-up was 10.3 ± 6.8 years, and follow-up was completed within 2 years before this report...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27919928/impact-of-surgical-ablation-of-atrial-fibrillation-on-the-progression-of-tricuspid-regurgitation-and-right-sided-heart-remodeling-after-mitral-valve-surgery-a-propensity-score-matching-analysis
#3
Jiangang Wang, Jie Han, Yan Li, Qing Ye, Fei Meng, Tiange Luo, Baiyu Tian, Haibo Zhang, Yixin Jia, Wen Zeng, Chunlei Xu, Wei Han, Yuqing Jiao, Xu Meng
BACKGROUND: This study assessed the role of surgical ablation for atrial fibrillation (AF) in decreasing tricuspid regurgitation (TR) and right-sided heart remodeling in patients after mitral valve procedure. METHODS AND RESULTS: Between 1994 and 2014, 1568 consecutive patients with AF undergoing mitral valve procedure were identified. In 26.0% (n=408), surgical ablation of AF was used. Propensity-score matching (PSM) was performed on the basis of 41 known perioperative risk variables...
December 5, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27916590/retrospective-cohort-study-examining-reduced-intensity-and-duration-of-anticoagulant-and-antiplatelet-therapy-following-left-atrial-appendage-occlusion-with-the-watchman-device
#4
Matthew K Tung, Satish Ramkumar, James D Cameron, Benjamin Pang, Nitesh Nerlekar, Emily Kotschet, Jeffrey Alison
BACKGROUND: Anticoagulant and antiplatelet therapy are recommended following WATCHMAN implantation (45 days and 6 months) to reduce the risk of embolic events. These patients are often also at high risk of recurrent bleeding complications. We aimed to assess the safety of reduced duration of treatment with anticoagulant and antiplatelet therapy in the early post implant period. METHODS: This was a retrospective cohort study assessing the duration of antiplatelet and anticoagulant therapy in 47 consecutive patients following WATCHMAN implant...
November 15, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27915586/rosuvastatin-prevents-aortic-arch-plaque-progression-and-improves-prognosis-in-ischemic-stroke-patients
#5
Kazuyoshi Kaneko, Hiroki Saito, Toshiki Sasaki, Shigeo Sugawara, Masahiro Akasaka, Tohru Kanaya, Isao Kubota
OBJECTIVES: Complicated aortic arch plaques (CAP) and their progression are important for recurrent ischemic stroke (IS) and its prognosis. We investigated the effects and clinical benefits of rosuvastatin therapy on this pathophysiology. The purpose of this study was to investigate whether rosuvastatin prevention of aortic arch plaque progression improved the prognosis of IS patients. METHODS: Ninety-seven consecutive acute cerebral embolism patients were retrospectively surveyed...
December 5, 2016: Neurological Research
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#6
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27899867/a-very-rare-case-of-co-existence-of-cor-triatriatum-sinister-and-left-pulmonary-vein-atresia
#7
Mustafa Aparci, Murat Yalcin, Zafer Isilak, Mehmet Dogan, Ejder Kardesoglu
Cor triatriatum sinister (CTS) is a rare congenital abnormality. Clinical presentation of patients with CTS mainly depends on the anatomic features of membrane and may vary from mild or moderate symptoms mimicking mitral stenosis to more severe and complicated cardioembolic stroke or a new onset heart failure. We herein have reported on a young male who presented with the signs and symptoms of mitral stenosis and was diagnosed as CTS with gradient on the orifice of the membrane after transthrocacic echocardiography...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899119/clinical-outcome-and-hemodynamic-behavior-of-the-labcor-dokimos-plus-aortic-valve
#8
Torsten Christ, Konstantin Zhigalov, Wolfgang Konertz, Sebastian Holinski
BACKGROUND: The Labcor Dokimos Plus (LDP) is a stented externally mounted pericardial aortic bioprosthesis, which was recently introduced in Europe. Aims of the study are evaluation of operative and postoperative results as well as hemodynamic performance. METHODS: One hundred consecutive patients with a mean age of 65.9 ± 10.7 years (range 35-87) and a mean EuroSCORE II of 3.1 ± 3.9 (range 0.67-24.5) underwent aortic valve replacement with the LDP. Mean valve-size was 25...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27898433/transcatheter-aortic-valve-implantation-in-nonagenarians
#9
Adam Penkalla, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, Volkmar Falk
OBJECTIVE: In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. METHODS: Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90-98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23...
November 28, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27887692/mechanisms-of-effort-intolerance-in-patients-with-heart-failure-and-borderline-ejection-fraction
#10
Yan Topilsky, Zach Rozenbaum, Shafik Khoury, Gregg S Pressman, Yaniv Gura, Jack Sherez, Avi Man, Jason Shimiaie, Sanford Edwards, Joshua Berookhim, Thierry Le Tourneau, Amir Halkin, Simon Biner, Gad Keren, Galit Aviram
Combining echocardiography and cardiopulmonary stress testing allows noninvasive assessment of hemodynamics, and oxygen extraction (A-VO2 difference). We evaluated mechanisms of effort intolerance in patients with heart failure with borderline (40% to 49%) left ventricular ejection fraction (EF) (HF and Borderline Ejection fraction). We included 89 consecutive patients with HF and Borderline Ejection fraction (n = 25; 63.6 ± 14 years, 64% men), control subjects (n = 22), patients with HF with preserved EF (n = 26; EF ≥50%), and patients with HF with reduced EF (n = 16; <40%)...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27885496/descending-aortic-mechanics-and-atrial-fibrillation-a-two-dimensional-speckle-tracking-transesophageal-echocardiography-study
#11
Rogério Teixeira, Ricardo Monteiro, Paulo Dinis, Maria José Santos, Ana Botelho, Nuno Quintal, Nuno Cardim, Lino Gonçalves
Vascular mechanics assessed with two-dimensional speckle tracking echocardiography (2D-STE) could be used as a new imaging surrogate of vascular stiffening. The CHA2DS2-VASc score is considered accurate as an estimate of stroke risk in non-valvular AF, although many potential stroke risk factors have not been included in this scoring method. The purpose of this research is to study the feasibility of evaluating vascular mechanics at the descending aorta in non-valvular AF patients using transesophageal 2D-STE and to analyze the association between descending aortic mechanics and stroke...
November 24, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27882613/improvements-of-procedural-results-with-a-new-generation-self-expanding-transfemoral-aortic-valve-prosthesis-in-comparison-to-the-old-generation-device
#12
Bruna Gomes, Nicolas A Geis, Emmanuel Chorianopoulos, Benjamin Meder, Florian Leuschner, Hugo A Katus, Raffi Bekeredjian
OBJECTIVES: In this study, we compare procedural results of our first Evolut R (Medtronic, Minneapolis, MN, USA) implantations with the last CoreValve implantations. Main endpoints include paravalvular regurgitation, major vascular complications, stroke, and pacemaker implantation. BACKGROUND: The evolution of transcatheter aortic valve replacement (TAVR) was possible due to various technical improvements, leading to better periprocedural and long-term outcome. The newly designed Evolut R valve has the potential to further improve TAVR's performance...
November 24, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27879304/aortic-valve-fibroelastoma-a-rare-cause-of-stroke
#13
Vivek Kumar, Parita Soni, Arsalan Hashmi, Manfred Moskovits
The prevalence of primary cardiac tumours varies from 0.02% to 0.45%. Cardiac papillary fibroelastoma (CPF) is a rare tumour diagnosed incidentally on imaging. The clinical manifestations result from thromboembolisation and include transient ischaemic attack, stroke and sudden cardiac death. We present a patient aged 57 years with CPF arising from the aortic valve. The patient presented with right hemiparesis due to acute stroke. He received tissue plasminogen activator with complete resolution of neurological symptoms...
November 22, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27878925/left-ventricular-deformation-at-rest-predicts-exercise-induced-elevation-in-pulmonary-artery-wedge-pressure-in-patients-with-unexplained-dyspnoea
#14
Tor Biering-Sørensen, Mário Santos, Jose Rivero, Shane D McCullough, Erin West, Alexander R Opotowsky, Aaron B Waxman, David M Systrom, Amil M Shah
AIMS: Impaired left ventricular (LV) deformation despite preserved LV ejection fraction (LVEF) is common and predicts outcomes in heart failure with preserved LVEF. We hypothesized that impaired LV deformation at rest is a marker of impaired cardiac systolic and diastolic reserve, and aimed to determine whether resting longitudinal (LS) and circumferential strain (CS) are associated with invasively measured haemodynamic response to exercise in patients with dyspnoea and a normal LVEF...
November 22, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27873227/the-relationship-between-aortic-root-size-and-hypertension-an-unsolved-conundrum
#15
Giuseppe Mulè, Emilio Nardi, Massimiliano Morreale, Antonella Castiglia, Giulio Geraci, Dario Altieri, Valentina Cacciatore, Margherita Schillaci, Francesco Vaccaro, Santina Cottone
Thoracic aortic aneurysms rupture and dissection are among the most devastating vascular diseases, being characterized by elevated mortality, despite improvements in diagnostic imaging and surgical techniques.An increased aortic root diameter (ARD) represents the main risk factor for thoracic aortic dissection and rupture and for aortic valve regurgitation.Even though arterial hypertension is commonly regarded as a predisposing condition for the development of thoracic aorta aneurysms, the role of blood pressure (BP) as determinant of aortic root enlargement is still controversial...
November 22, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27870971/modes-of-death-in-patients-with-heart-failure-and-preserved-ejection-fraction
#16
Stefan Aschauer, Caroline Zotter-Tufaro, Franz Duca, Andreas Kammerlander, Daniel Dalos, Julia Mascherbauer, Diana Bonderman
BACKGROUND: Recent studies suggest that reduced right ventricular function is an important predictor of outcome in patients with heart failure and preserved ejection fraction (HFpEF). Because affected patients suffer from a broad spectrum of non-cardiac co-morbidities, it remains unclear, whether they actually die from right heart failure (RHF) or as a consequence of other conditions. METHODS: Consecutive patients with a confirmed diagnosis of HFpEF were enrolled in this prospective registry...
November 18, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867289/amplatzer-cardiac-plug-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-bigger-left-atrial-appendix-size
#17
Yoga Yuniadi, Dicky A Hanafy, Sunu B Raharjo, Ario Soeryo, IIf Yasmina, Amiliana M Soesanto
Left atrial appendage (LAA) dimensions have been shown as an independent predictor of higher risk for stroke in AF patients. Little data exist on the outcomes after LAA closure in patients with nonvalvular atrial fibrillation (NVAF) who have relatively bigger LAA size. This study aims to evaluate the results associated with LAA closure with the Amplatzer cardiac plug (ACP, AGA, St. Jude Medical, Minneapolis, MN) in bigger LAA size. A total of 25 patients with NVAF underwent LAA closure with the ACP device. All patients received short-term (up to 3 months) dual-antiplatelet therapy (clopidogrel and aspirin) after the procedure and aspirin only thereafter...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27866432/maternal-cardiac-haemodynamics-in-severe-pre-eclampsia-complicated-by-acute-pulmonary-oedema-a-review
#18
I Bhorat, D P Naidoo, J Moodley
AIM: To establish alterations in maternal cardiac haemodynamics and function using electrocardiography and echocardiography in severe pre-eclampsia complicated by acute pulmonary oedema. METHODS: An extensive literature search including any research articles, randomised control trials, observational study, case report or expert or consensus statement pertaining to severe pre-eclampsia, eclampsia, hypertensive crises of pregnancy, pulmonary oedema, maternal cardiac haemodynamics, Holter monitoring and maternal echocardiography was done...
November 21, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27865723/mechanisms-of-effort-intolerance-in-patients-with-rheumatic-mitral-stenosis-combined-echocardiography-and-cardiopulmonary-stress%C3%A2-protocol
#19
Michal Laufer-Perl, Yaniv Gura, Jason Shimiaie, Jack Sherez, Gregg S Pressman, Galit Aviram, Simon Maltais, Ricki Megidish, Amir Halkin, Meirav Ingbir, Simon Biner, Gad Keren, Yan Topilsky
OBJECTIVES: This study sought to evaluate mechanisms of effort intolerance in patients with rheumatic mitral stenosis (MS). BACKGROUND: Combined stress echocardiography and cardiopulmonary testing allows assessment of cardiac function, hemodynamics, and oxygen extraction (A-Vo2 difference). METHODS: Using semirecumbent bicycle exercise, 20 patients with rheumatic MS (valve area 1.36 ± 0.4 cm(2)) were compared to 20 control subjects at 4 pre-defined activity stages (rest, unloaded, anaerobic threshold, and peak)...
November 10, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27865719/pre-load-induced-changes-in-forward-lv-stroke-and%C3%A2-functional-mitral%C3%A2-regurgitation-echocardiographic-detection-of-the-descending-limb%C3%A2-of%C3%A2-starling-s-curve
#20
Yukio Abe, Kanako Akamatsu, Atsuko Furukawa, Kazato Ito, Yoshiki Matsumura, Kazuo Haze, Takahiko Naruko, Minoru Yoshiyama, Junichi Yoshikawa
OBJECTIVES: To clarify the prognostic significance of diagnosing whether the failing heart is functioning on the descending limb of the Starling curve by using echocardiography with passive leg lifting (PLL). BACKGROUND: Patients with advanced heart failure can shift to the descending limb of the Starling curve, in which pre-load does not lead to an expected increase in forward left ventricular stroke volume (LVSV). METHODS: Thirty-five consecutive patients with left ventricular (LV) ejection fraction of <40% underwent echocardiography at rest during baseline and during PLL to increase pre-load...
November 10, 2016: JACC. Cardiovascular Imaging
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