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https://www.readbyqxmd.com/read/29033504/procedural-characteristics-and-outcomes-of-transcatheter-aortic-valve-implantation-a-single-center-experience-of-the-first-100-inoperable-or-high-surgical-risk-patients-with-severe-aortic-stenosis
#1
Ying-Hwa Chen, Hsiao-Huang Chang, Po-Lin Chen, Zen-Chung Weng, I-Ming Chen, Hsin-Bang Leu, Chun-Yang Huang, Su-Man Lin, Mei-Han Wu
BACKGROUND: This is the first study of a Taiwanese population reporting transcatheter aortic valve implantation (TAVI) outcomes of the first 100 cases from a single center offering two different transcatheter heart valve technologies via six types of approaches. We herein report the 30-day and one-year outcomes in our first 100 TAVI patients at Taipei Veterans General Hospital. METHODS: From May 2010 to April 2016, 100 consecutive patients with severe aortic stenosis (AS) who were considered unsuitable or at high risk for surgical aortic valve replacement underwent TAVI...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29024382/comparison-of-outcomes-with-surgical-cut-down-versus-percutaneous-transfemoral-transcatheter-aortic-valve-replacement-tavr-transfemoral-access-comparisons-between-surgical-cut-down-and-percutaneous-approach
#2
Brandon C Drafts, Charles H Choi, Kunal Sangal, Michael W Cammarata, Robert J Applegate, Sanjay K Gandhi, Edward H Kincaid, Neal Kon, David X Zhao
OBJECTIVES: The objective is to compare the short-term (30 days) and late (12 months) vascular adverse events in patients undergoing transfemoral (TF)-transcatheter aortic valve replacement (TAVR) by surgical cut-down (SC) vs. percutaneous (PC) approaches. BACKGROUND: Programs continue to utilize both approaches in TF-TAVR. There are limited data comparing outcomes by SC vs. PC approaches and long-term effects of endovascular intervention facilitated hemostasis on late vascular adverse events...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28977565/transcarotid-transcatheter-aortic-valve-implantation-multicentre-experience-in-france
#3
Thierry Folliguet, Nicolas Laurent, Maxime Bertram, Konstantinos Zannis, Mazen Elfarra, Fabrice Vanhuyse, Pablo Maureira, Thomas Modine
OBJECTIVES: Transcatheter aortic valve implantation is a well-recognized treatment option for high-risk patients with aortic stenosis. The femoral approach is possible in 80% of cases and remains the access of choice. When this approach is not feasible, other alternative routes have been proposed such as transapical, transaortic and subclavian. Transcarotid aortic valve implantation has been proposed as another direct vascular access. Its use is relatively new and still under evaluation...
August 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28941480/a-double-crossover-technique-in-an-obese-patient-undergoing-transfemoral-transcatheter-aortic-valve-implantation-how-to-accomplish-hemostasis-percutaneously
#4
Hirokazu Onishi, Toru Naganuma, Sunao Nakamura
Percutaneous transfemoral transcatheter aortic valve implantation (TF-TAVI) is generally an acceptable procedure but may be associated with vascular complications at femoral access sites, particularly in obese patients. This report aimed to describe a case of successful performance of our "double crossover technique" in an obese patient undergoing TF-TAVI with a percutaneous transfemoral intra-aortic balloon pump (TF-IABP). A 75-year-old man presented with heart failure due to a left ventricular ejection fraction of 35% and low-flow, low-gradient severe aortic stenosis...
September 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#5
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/28893450/emergency-medicine-evaluation-and-management-of-the-end-stage-renal-disease-patient
#6
REVIEW
Brit Long, Alex Koyfman, Courtney M Lee
BACKGROUND: End stage renal disease (ESRD) is increasing in the U.S., and these patients demonstrate greater all-cause mortality, cardiovascular events, and hospitalization rates when compared to those with normal renal function. These patients may experience significant complications associated with loss of renal function and dialysis. OBJECTIVE: This review evaluates complications of ESRD including cardiopulmonary, neurologic, infectious disease, vascular, and access site complications, as well as medication use in this population...
September 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874169/transfemoral-versus-transapical-approach-for-transcatheter-aortic-valve-implantation-hospital-outcome-and-risk-factor-analysis
#7
Enrico Ferrari, Eric Eeckhout, Sanjiv Keller, Olivier Muller, Piergiorgio Tozzi, Denis Berdajs, Ludwig Karl von Segesser
BACKGROUND: Transcatheter aortic valve implantation is indicated in high-risk patients with aortic stenosis. We compared the clinical outcome of 180 consecutive patients who underwent transapical (TA) and transfemoral (TF) procedures in a single centre. METHODS: Ninety consecutive TA (TA-group) and 90 consecutive TF (TF-group) were performed from 2009 to 2014. Clinical variables were prospectively collected and retrospectively analysed for hospital outcomes and to identify risk factors for hospital mortality, vascular complications and stroke...
September 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28868755/matrix-metalloproteinase-2-predicts-arteriovenous-fistula-failure-in-hemodialysis-patients
#8
Dacian Călin Tirinescu, Ciprian Tomuleasa, Laura Pop, Cosmina Ioana Bondor, Dan Ştefan Vlăduţiu, Ioan Mihai Paţiu, Crina Claudia Rusu, Diana Tania Moldovan, Alina Potra, Ina Maria Kacsó
In hemodialysis patients the principal cause of arteriovenous fistula dysfunction is stenosis. Matrix-metalloproteinase-2 is implicated in the pathophysiological mechanism of stenosis development. Our study tried to assess the clinical impact of this protease on arteriovenous fistula survival. Seventy-nine prevalent dialysis patients with functional arteriovenous fistulas were included in the study. The presence of stenosis and the serum levels of matrix-metalloproteinase-2 were determined at the beginning of the study...
September 3, 2017: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/28854521/substitution-rate-based-screening-model-to-assess-stenosis-progression-in-experimental-stenotic-arteriovenous-grafts
#9
Chung-Dann Kan, Wei-Ling Chen, Chia-Hung Lin, Ming-Jui Wu, Yi-Chen Mai
An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model...
August 15, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/28852577/sequential-venous-percutaneous-transluminal-angioplasty-and-balloon-dilatation-of-the-interatrial-septum-during-percutaneous-edge-to-edge-mitral-valve-repair
#10
Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28836953/efficacy-and-safety-of-transcatheter-aortic-valve-replacement-in-aortic-stenosis-patients-at-low-to-moderate-surgical-risk-a-comprehensive-meta-analysis
#11
Ahmed Elmaraezy, Ammar Ismail, Abdelrahman Ibrahim Abushouk, Moutaz Eltoomy, Soha Saad, Ahmed Negida, Osama Mahmoud Abdelaty, Ahmed Ramadan Abdallah, Ahmed Magdy Aboelfotoh, Hossam Mahmoud Hassan, Aya Gamal Elmaraezy, Mahmoud Morsi, Farah Althaher, Moath Althaher, Ammar M AlSafadi
BACKGROUND: Recently, transcatheter aortic valve replacement (TAVR) has become the procedure of choice in high surgical risk patients with aortic stenosis (AS). However, its value is still debated in operable AS cases. We performed this meta-analysis to compare the safety and efficacy of TAVR to surgical aortic valve replacement (SAVR) in low-to-moderate surgical risk patients with AS. METHODS: A systematic search of five authentic databases retrieved 11 eligible studies (20,056 patients)...
August 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28822538/smooth-muscle-nitric-oxide-responsiveness-and-clinical-maturation-of-hemodialysis-arteriovenous-fistulae
#12
Xiaoyong Tong, Xiuyun Hou, Christopher Wason, Tal Kopel, Richard A Cohen, Laura M Dember
The arteriovenous fistula is the preferred type of hemodialysis vascular access for patients with end-stage renal disease, but a high proportion of newly created fistulas fail to mature for use. Stenosis caused by neointimal hyperplasia often is present in fistulas with maturation failure, suggesting that local mechanisms controlling vascular smooth muscle cell (SMC) migration and proliferation are important contributors to maturation failure. SMCs cultured from explants of vein tissue obtained at the time of fistula creation from 19 patients with end-stage renal disease were studied to determine whether smooth muscle responsiveness to nitric oxide is associated with fistula maturation outcomes...
September 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28804237/aneurysmal-degeneration-of-the-brachial-artery-after-vascular-access-creation-surgical-treatment-results
#13
Sérgio Teixeira, Pedro Sá Pinto, Carlos Veiga, Ivone Silva, Rui Almeida
True peripheral artery aneurysms proximal to a longstanding arteriovenous fistula is a well-recognized complication. Late aneurysmal degeneration is rare. This study analyzed the characteristics, therapeutic options, and outcomes of true donor brachial artery aneurysms (DBAA) after arteriovenous fistula (AVF) for hemodialysis. We retrospectively collected the data of patients with DBAA after AVF creation, surgically repaired between January 2001 and September 2015. We excluded patients with pseudoaneurysms, anastomotic aneurysms, and infected aneurysms...
September 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28779784/drug-coated-balloon-angioplasty-for-dialysis-access-fistula-stenosis
#14
REVIEW
Auréline Boitet, Ziad A Massy, Olivier Goeau-Brissonniere, Isabelle Javerliat, Marc Coggia, Raphaël Coscas
Maintaining vascular access patency represents a tremendous challenge in hemodialysis patients. Although "native" arteriovenous fistula (AVF) is currently recommended as primary vascular access, neointimal hyperplasia stenoses frequently develop, with a risk for AVF thrombosis and vascular access loss. For years, first-line treatment of AVFs stenoses has been percutaneous transluminal angioplasty, generally with high-pressure or cutting uncoated balloons. However, restenosis and reintervention rates remain incredibly high and occur, according to recent studies, in up to 60% and 70% of patients at 6 and 12 months, respectively...
December 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/28777398/impaired-maturation-of-arteriovenous-fistula-for-haemodialysis-due-to-forearm-artery-stenosis-percutaneous-endovascular-treatment
#15
Nicola Pirozzi, Jacopo Scrivano, Roberto Pirozzi, Emanuela Cordova, Giorgio Punzo, Paolo Menè
INTRODUCTION: Distal autogenous arteriovenous fistula (dAVF), considered the "gold standard" vascular access for haemodialysis, suffers from a high rate of impaired maturation. One of the usual causes is low-flow associated forearm arterial stenosis. In such cases, endovascular treatment by percutaneous transluminal angioplasty represents a helpful option to enable maturation of the vascular access.Currently, there are few reports concerning the treatment of this complication. Therefore, we describe our single-centre experience based on a retrospective review of prospectively collected data...
August 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28774836/transcatheter-aortic-valve-replacement-through-transcaval-aortic-access-in-a-patient-with-duplicated-inferior-vena-cava-and-poor-iliofemoral-anatomy
#16
Zaher Fanari, Mohammad Al-Akchar, Hadi Mahmaljy, Sachin Goel, Nilesh J Goswami
Transthoracic (transapical and transaortic) access is inferior compared with femoral artery access. Percutaneous transcaval aortic access is a reasonable alternative approach that is being used in transcatheter aortic valve replacement (TAVR) in patients with poor iliofemoral anatomy. Duplicated Inferior vena cava (DIVC) is an uncommon abnormality. We report the case of 76-year-old lady with history of severe peripheral vascular disease, morbid obesity, diabetes, hypertension, hyperlipidemia and duplicated IVC that had severe symptomatic aortic stenosis...
July 1, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28766859/transulnar-cardiac-catheterization-and-percutaneous-coronary-intervention-techniques-transradial-comparisons-anatomical-considerations-and-comprehensive-literature-review
#17
Subrata Kar
Ulnar arterial access for cardiac catheterization and intervention is an alternative approach compared with radial or femoral access. Ulnar access is infrequently performed since the radial artery is readily palpable and is commonly used worldwide to minimize vascular complications from femoral access. Nevertheless, ulnar access provides a suitable access site in patients who are poor candidates for femoral access, have pre-existing radial occlusion, radial artery hypoplasia or hyperplasia from prior radial artery procedures, radial stenosis, radial loops, radial tortuosity, small radial arteries, and/or have future need for radial graft for dialysis or coronary artery bypass graft...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28762638/principles-of-treating-enlarging-pseudoaneurysm-in-a-dialysis-arteriovenous-graft
#18
Daniel V Patel, Tushar J Vachharajani
The arteriovenous graft (AVG) is one of the major types of permanent vascular access used to provide hemodialysis. Complications encountered with AVG use include stenosis, infection, thrombosis, and pseudoaneurysm formation. Venous outflow stenosis along with frequent needle cannulation at the same site can lead to breakdown of the graft material, resulting in pseudoaneurysm formation. In the following case, we illustrate common management principles used to treat pseudoaneurysms. While stent-grafts have been utilized for pseudoaneurysm repair, stent-graft usage is not always optimal...
August 1, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28735994/kidney-transplantation-using-gonadal-vein-for-venous-anastomosis-in-patients-with-iliac-vein-thrombosis-or-stenosis-a-series-of-cases
#19
J B G de Cerqueira, C M C de Oliveira, B G B Silva, L C O Santos, A G Fernandes, P F C B C Fernandes, E L Maia
BACKGROUND: Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The standard surgery uses the recipient's iliac vessels for vascular anastomosis. Thrombosis and/or stenosis of the iliac vein, which are possible complications of multiple vascular access points for dialysis, can be detected intraoperatively, constituting a surgical challenge. An infrequently reported option is the use of the gonadal vein. OBJECTIVES: This study aims to evaluate the outcomes of venous anastomosis in the gonadal vein in patients with iliac vein thrombosis and/or stenosis submitted to kidney transplantation...
July 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28734705/a-proficiency-based-stepwise-endovascular-curricular-training-prospect-program-enhances-operative-performance-in-real-life-a-randomised-controlled-trial
#20
H Maertens, R Aggarwal, N Moreels, F Vermassen, I Van Herzeele
OBJECTIVES: Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. DESIGN: A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions...
September 2017: European Journal of Vascular and Endovascular Surgery
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