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https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#1
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#2
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28917497/comparison-of-outcome-of-possible-versus-definite-infective-endocarditis-involving-prosthetic-or-bioprosthetic-heart-valves
#3
Laurent Fauchier, Lauriane Pericart, Thierry Bourguignon, Thibaud Genet, Arnaud Bisson, Anne Bernard, Louis Bernard, Dominique Babuty
The objectives of this study were to describe and compare the clinical characteristics and outcomes of patients with definite and possible infective endocarditis (IE) involving prosthetic heart valve, and to identify prognostic factors for long-term mortality, using data from an unselected cohort of consecutive patients. We studied data from 133 consecutive patients with IE involving prosthetic heart valve seen in an academic institution between 1990 and 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 47, 35%) and patients with definite IE (n = 86, 65%)...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28890066/ascending-aorta-endovascular-repair-of-a-symptomatic-penetrating-atherosclerotic-ulcer-with-a-custom-made-endo-graft
#4
Theodoros Kratimenos, Nikolaos G Baikoussis, Dimitrios Tomais, Michalis Argiriou
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has become lately the procedure of choice in the treatment of most pathologies of descending thoracic aorta. Aortic arch aneurysms also came to be treated by TEVAR with various hybrid techniques or custom made scalloped/fenestrated stent-grafts. Zone 0; ascending TEVAR is more challenging than TEVAR of the descending thoracic aorta or aortic arch because of the more complex pathology, hemodynamics, and anatomy. Ascending TEVAR can be a lifesaving treatment in selected high surgical risk patients...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28878879/if-i-had-a-hammer
#5
M Tarazi, N Mayooran, J Hinchion
We present the case of a 64-year-old man who was referred to our service after sustaining a self-inflicted nail-gun injury to his chest. He received three nails penetrated into his chest. Computer tomography revealed no massive haemorrhage or damage to major vessels. He underwent an emergency sternotomy, two nails caused pericardial perforation and myocardial injury were noted easily and removed easily via sternotomy. Myocardial injury showed a trajectory near the junction of the left anterior descending artery and the diagonal artery with no significant bleeding appreciated...
August 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28877873/the-in-vitro-zebrafish-heart-as-a-model-to-investigate-the-chronotropic-effects-of-vapor-anesthetics
#6
Matthew R Stoyek, Michael K Schmidt, Florentin M Wilfart, Roger P Croll, Frank M Smith
In addition to their intended clinical actions, all general anesthetic agents in common use have detrimental intra- and post-surgical side effects on organs and systems including the heart. The major cardiac side effect of anesthesia is bradycardia, which increases the probability of insufficient systemic perfusion during surgery. These side effects also occur in all vertebrate species so far examined, but the underlying mechanisms are not clear. The zebrafish heart is a powerful model for studying cardiac electrophysiology, employing the same pacemaker system and neural control as do mammalian hearts...
September 6, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28864321/frequency-of-recovery-from-complete-atrioventricular-block-after-cardiac-surgery
#7
Pierre Socie, Florence Nicot, Pierre Baudinaud, Philippe Estagnasie, Alain Brusset, Pierre Squara, Lee S Nguyen
Best timing for permanent pacemaker implantation to treat complete atrioventricular block (AVB) after cardiac surgery is unclear, as late pacemaker dependency was found low in recent observational studies. This study aimed to identify factors associated with spontaneous recovery from AVB. In a prospective and observational cohort, all patients who underwent cardiothoracic surgery during a 14-month-period were included (n = 1,200). Risk factors of postoperative AVB were assessed by logistic regression. Among patients who developed AVB, variables associated with recovery from AVB were assessed by Cox and logistic regression...
August 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28858547/junctional-rhythm-preoperatively-and-during-general-anesthesia-for-oral-and-maxillofacial-surgery
#8
Naotaka Kishimoto, Ikue Kinoshita, Yoshihiro Momota
We report a case of junctional rhythm that occurred both preoperatively and later during a portion of general anesthesia. A 19-year-old woman was scheduled to undergo bilateral sagittal split ramus osteotomy after being diagnosed with a jaw deformity. Preoperative electrocardiography (ECG) revealed a junctional rhythm with a slow heart rate (HR). At 90 minutes after anesthesia induction, local anesthesia with 10 mL of 1% lidocaine and 1:100,000 adrenaline was administered. A junctional rhythm appeared 15 minutes after the local anesthesia...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28807663/incidence-and-predictors-of-late-atrioventricular-conduction-recovery-among-patients-requiring-permanent-pacemaker-for-complete-heart-block-after-cardiac-surgery
#9
Erich L Kiehl, Tarek Makki, Ralph M Matar, Douglas R Johnston, John W Rickard, Khaldoun G Tarakji, Mohamed Kanj, Oussama M Wazni, Walid I Saliba, Niraj Varma, Bruce L Wilkoff, Daniel J Cantillon
BACKGROUND: New-onset complete heart block (CHB) commonly complicates cardiac surgery, for which some patients require a permanent pacemaker (PPM). Little is known regarding late atrioventricular (AV) conduction recovery. OBJECTIVE: The purpose of this study was to characterize the incidence and predictors of late AV conduction recovery among patients requiring PPM after cardiac surgery. METHODS: Consecutive patients receiving PPM for CHB after cardiac surgery at a high-volume U...
August 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28782492/impact-of-pre-existing-kidney-dysfuntion-on-outcomes-following-transcatheter-aortic-valve-replacement
#10
Ikechukwu A Ifedili, Oluwaseyi Bolorunduro, Tamunoinemi Bob-Manuel, Mark R Heckle, Ellis Christian, Saibal Kar, Uzoma N Ibebuogu
BACKGROUND: Pre-existing chronic kidney disease (CKD) portends adverse outcomes following heart valve surgery. However, only limited and conflicting evidence is available on the impact of CKD on outcomes following transcatheter aortic valve replacement (TAVR). The objective of this review was to evaluate the effect of pre-existing CKD on TAVR outcomes. METHODS: We performed a systematic electronic search using the PRISMA statement to identify all randomized controlled trials and observational studies investigating the effect of pre-existing CKD on outcomes following TAVR...
August 4, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28760721/transcatheter-aortic-valve-implantation-versus-re-do-surgery-for-failing-surgical-aortic-bioprosthesis-a-multi-centre-propensity-score-analysis
#11
Marco Spaziano, Darren Mylotte, Pascal Thériault-Lauzier, Ole De Backer, Lars Søndergaard, Johan Bosmans, Nicolas Debry, Thomas Modine, Marco Barbanti, Corrado Tamburino, Jan-Malte Sinning, Eberhard Grube, Georg Nickenig, Fritz Mellert, Sabine Bleiziffer, Rüdiger Lange, Benoit de Varennes, Kevin Lachapelle, Giuseppe Martucci, Nicolo Piazza
AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV- in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aims to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching. METHODS AND RESULTS: Patients from 7 centres in Europe and Canada who had undergone either TAV- in-SAV (n=79) or redo-SAVR (n=126) were identified...
August 1, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28756420/safety-and-feasibility-of-rotational-atherectomy-in-elderly-patients-with-severe-aortic-stenosis
#12
Matthew Lippmann, Jigar Patel, Jared Kvapil, David Westover, Michael Pierpoline, Peter Tadros, Mark Wiley, George Zorn, Greg Muehlebach, Ashwani Mehta, Eric Hockstad, Matthew Earnest, Kamal Gupta
BACKGROUND: Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28756079/-exercise-testing-new-guidelines
#13
Dany Michel Marcadet
The GERS (Exercise Rehabilitation and Sports Group of the French Society of Cardiology) has decided to update current guidelines regarding the practice of EKG stress tests. Since the last update dates from 1997, the GERS judged it necessary to integrate data from new works and advancements made in the last 20 years. Good clinical practices and safety conditions are better defined regarding the structure, location, material, staff competency, as well as convention with hospital structures. The diagnosis of coronary artery disease remains the principal indication for a stress test...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28738900/impact-of-ablation-duration-on-rhythm-outcome-after-concomitant-maze-procedure-using-cryoablation-in-patients-with-persistent-atrial-fibrillation
#14
Dong Seop Jeong, Ji Hoon You, Chang-Seok Jeon, Pyo Won Park, Kiick Sung, Wook Sung Kim, Young Tak Lee
BACKGROUND: The aim of this study was to evaluate the impact of ablation duration during a maze procedure using a nitrous oxide-based cryosurgical system. METHODS: From May 2001 to December 2006, 256 consecutive patients who underwent a concomitant maze procedure using nitrous oxide-based cryoablation for chronic atrial fibrillation (AF) during cardiac surgery were enrolled. The ablation duration for each lesion was between 120 s at -60 °C in 140 patients (control group) and 160 s in 116 patients (long duration group)...
July 24, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28733067/hospital-quality-variation-matters-a-time-trend-and-cross-section-analysis-of-outcomes-in-german-hospitals-from-2006-to-2014
#15
Christoph Pross, Reinhard Busse, Alexander Geissler
Awareness of care variation and associated differences in outcome quality is important for patients to recognize and leverage the benefits of hospital choice and for policy makers, providers, and suppliers to adapt initiatives to improve hospital quality of care. We examine panel data on outcome quality in German hospitals between 2006 and 2014 for cholecystectomy, pacemaker implantation, hip replacement, percutaneous coronary intervention (PCI), stroke, and acute myocardial infarction (AMI). We use risk-adjusted and unadjusted outcomes based on 16 indicators...
July 8, 2017: Health Policy
https://www.readbyqxmd.com/read/28728260/-clinical-analysis-of-pacing-therapy-and-treatment-of-complications-during-follow-up-in-children
#16
P J Zhao, Y W Chen, F Li, Y Li, J P Yang, J J Wu
Objective: To analyze characteristics of permanent pacemaker implantation in children as well as treatment and prognosis of complications. Method: Clinical data of children who underwent endocardial or epicardial permanent pacemaker implantation between April 2000 and June 2016 in Shanghai Xinhua Hospital and Shanghai Children's Medical Center were analyzed retrospectively. These patients were discharged 5 days after implantation. Electrocardiogram, chest X ray, echocardiography and pacemaker programming were performed during follow-up...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#17
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28713024/to-retrieve-or-not-to-retrieve-system-revisions-with-the-micra-transcatheter-pacemaker
#18
Eric Grubman, Philippe Ritter, Christopher R Ellis, Michael Giocondo, Ralph Augostini, Petr Neuzil, Bipin Ravindran, Anshul M Patel, Pamela Omdahl, Karen Pieper, Kurt Stromberg, J Harrison Hudnall, Dwight Reynolds
BACKGROUND: Early experience with leadless pacemakers has shown a low rate of complications. However, little is known about system revision in patients with these devices. OBJECTIVE: The purpose of this study was to describe the system revision experience with the Micra Transcatheter Pacing System (TPS). METHODS: Implanted patients from the Pre-market Micra Transcatheter Pacing Study and the Micra Transcatheter Pacing System Continued Access Study (N = 989) were analyzed and compared with 2667 patients with transvenous pacemakers (TVP)...
July 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28709664/current-results-of-single-ventricle-palliation-of-patients-with-double-inlet-left-ventricle
#19
Bahaaldin Alsoufi, Courtney McCracken, Kirk Kanter, Subhadra Shashidharan, Brian Kogon
BACKGROUND: Double inlet left ventricle (DILV) is a heterogeneous single ventricle anomaly in which initial presentation, and consequently, timing and palliation mode vary based on morphology and degree of pulmonary or systemic outflow obstruction. Very few reports, mostly old, focused on palliation outcomes of DILV. We report current-era results and examine whether morphologic and subsequently surgical factors influence survival. METHODS: Fifty-eight infants with DILV underwent single ventricle palliation...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707515/successful-repositioning-of-leadless-cardiac-pacemaker-during-open-heart-surgery
#20
Christophe Garweg, Joris Ector, Wouter Oosterlinck, Rik Willems, Paul Herijgers
No abstract text is available yet for this article.
July 14, 2017: Acta Cardiologica
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