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Aortic valve surgery

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https://www.readbyqxmd.com/read/29792393/outcomes-of-transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-geriatric-patients-with-chronic-kidney-disease
#1
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a less invasive treatment modality for patients with severe aortic valve stenosis (AS) who are at a higher risk if they have surgery. Preoperative chronic kidney disease (CKD) influences outcomes of cardiac surgery and is associated with a higher mortality and more complicated hospital course. The aims of our study were to evaluate the comparative outcomes of TAVI versus surgical aortic valve replacement (SAVR) in geriatric patients with preoperative CKD...
May 24, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29786406/mitroflow-lxa-structural-deterioration-following-aortic-valve-replacement-a-single-centre-experience
#2
Kostantinos Zannis, Konstantinos Diplaris, Jean-Luc Monin, Nizar Khelil, Mathieu Debauchez, Patrice Dervanian, Emmanuel Lansac, Daniel Czirom, Milena Noghin, Leila Mankoubi, Nicolas Amabile
BACKGROUND: Concerns have been previously raised regarding the potential early degenera- tion of the Mitroflow (Sorin, Italy) bioprostheses. We aimed to evaluate our clinical experience with the Mitroflow LXA prosthesis for aortic valve replacement. METHODS: We prospectively analyzed data from 227 consecutive patients (133 males, mean age 73.9± 9.2 y ) implanted with the Mitroflow LXA between February 2007 and October 2011. Follow up data were obtained by contacting the referring cardiologists...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29784004/positive-impact-of-retrograde-autologous-priming-in-adult-patients-undergoing-cardiac-surgery-a-randomized-clinical-trial
#3
Britt Hofmann, Claudia Kaufmann, Markus Stiller, Thomas Neitzel, Andreas Wienke, Rolf-Edgar Silber, Hendrik Treede
BACKGROUND: Adult cardiac surgery with extracorporeal circulation is known to be associated with increased risk of blood transfusion leading to adverse outcomes. Procedures like retrograde autologous priming (RAP) may reduce these negative side effects. This randomized prospective study was initiated to assess whether RAP using specifically designed RAP bag (Terumo) has immediate effects on patient outcome. METHODS: One hundred eighteen adults undergoing elective CABG or elective aortic valve replacement were randomly assigned by a computer program into two groups: the RAP group (n = 54) in which the retrograde autologous priming was applied and the non-RAP (n = 64) group in which the same setting was used without the possibility to save priming volume...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29783996/hegar-based-method-for-aortic-valve-replacement-in-multiple-valve-surgery
#4
Marco Gennari, Marco Agrifoglio, Gabriella Ricciardi, Gianluca Polvani
BACKGROUND: Small aortic annuli are a challenge and a proper valve size is needed to avoid important prosthesis-patient mismatch, especially in case of multiple valves surgery. CASE PRESENTATION: We proposed a technique involving the use of Hegar dilators in the aortic position while replacing the mitral valve, in order to maintain the proper aortic diameter. We used this method on two patients and we found it easy and reproducible. CONCLUSIONS: We report neither operative nor postoperative complications...
May 21, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29783950/effects-of-the-cardiac-myosin-activator-omecamtiv-mecarbil-on-severe-chronic-aortic-regurgitation-in-wistar-rats
#5
Bachar El-Oumeiri, Kathleen Mc Entee, Filippo Annoni, Antoine Herpain, Frédéric Vanden Eynden, Pascal Jespers, Guido Van Nooten, Philippe van de Borne
BACKGROUND: Aortic regurgitation (AR) is a valvular disease that can lead to systolic heart failure. Treatment options besides cardiac surgery are limited and consequently severe AR is associated with higher mortality and morbidity when not operated. In this investigation, we examined the effects of a novel cardiac myosin activator, Omecamtiv-mecarbil (OM), in rats with chronic severe AR. METHODS: AR was created by retrograde puncture of the aortic valve leaflets in 20 adults Wistar rats...
May 21, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29781182/valve-in-valve-transcatheter-aortic-valve-implantation-viv-tavi-versus-redo-surgical-aortic-valve-replacement-redo-savr-a-systematic-review-and-meta-analysis
#6
REVIEW
Nikhil Nalluri, Varunsiri Atti, Abdullah B Munir, Boutros Karam, Nileshkumar J Patel, Varun Kumar, Praveen Vemula, Susruth Edla, Deepak Asti, Amrutha Paturu, Sriramya Gayam, Jonathan Spagnola, Emad Barsoum, Gregory A Maniatis, Frank Tamburrino, Ruben Kandov, James Lafferty, Chad Kliger
BACKGROUND: Bioprosthetic (BP) valves have been increasingly used for aortic valve replacement over the last decade. Due to their limited durability, patients presenting with failed BP valves are rising. Valve in Valve - Transcatheter Aortic Valve Implantation (ViV-TAVI) emerged as an alternative to the gold standard redo-Surgical Aortic Valve Replacement (redo-SAVR). However, the utility of ViV-TAVI is poorly understood. METHODS: A systematic electronic search of the scientific literature was done in PubMed, EMBASE, SCOPUS, Google Scholar, and ClinicalTrials...
May 20, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#7
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#8
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29778817/extent-of-aortic-replacement-in-type-a-dissection-current-answers-for-an-endless-debate
#9
REVIEW
Stephen D Waterford, Rita L Gardner, Marc R Moon
BACKGROUND: The proximal and distal extent of surgery for type A dissection is the subject of this review article. METHODS: In this report, we summarize select series that illumine the issue at hand and provide insight into the surgical approach at our institution to DeBakey type I aortic dissections. RESULTS: For proximal extent, we discuss preservation of the aortic valve in the presence of aortic insufficiency, as well as management of the aortic root in the setting of root dilation...
May 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#10
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29776957/sudden-death-in-patients-with-severe-aortic-stenosis-observations-from-the-current-as-registry
#11
Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Takao Kato, Katsuhisa Ishii, Kazuya Nagao, Yoshihisa Nakagawa, Mamoru Toyofuku, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura
BACKGROUND: The annual incidence of sudden death has been reported to be low (<1%/year) in asymptomatic patients with severe aortic stenosis (AS), and there is a paucity of data on the risk factors of sudden death in patients with severe AS. METHODS AND RESULTS: We evaluated the incidence and risk factors of sudden death during the median follow-up period of 1334 days in the Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis (CURRENT AS) registry enrolling 3815 consecutive patients with severe AS between 2003 and 2011...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776652/meta-analysis-of-transcatheter-valve-in-valve-implantation-versus-redo-aortic-valve-surgery-for-bioprosthetic-aortic-valve-dysfunction
#12
Saroj Neupane, Hemindermeet Singh, Johannes Lämmer, Hussein Othman, Hiroshi Yamasaki, Howard S Rosman, Eduardo Bossone, Rajendra H Mehta, Holger Eggebrecht
Transcatheter valve-in-valve implantation (ViV-TAVI) has evolved as an alternative to redo surgical valve replacement (redo-SAVR) for high-risk patients with aortic bioprosthetic valve (BPV) dysfunction. The differences in procedural success and outcomes in a large number of patients who underwent ViV-TAVI compared with redo-SAVR for aortic BPV dysfunction are not known. We conducted a meta-analysis of the previously reported studies to determine outcomes after ViV-TAVI and redo-SAVR. PubMed, MEDLINE, and Google Scholar databases were searched for studies that reported comparative outcomes of patients who underwent either ViV-TAVI or redo-SAVR...
April 19, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#13
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770299/regenerative-medicine-therapy-for-single-ventricle-congenital-heart-disease
#14
REVIEW
Chetan Ambastha, Gregory J Bittle, David Morales, Nathaniel Parchment, Progyaparamita Saha, Rachana Mishra, Sudhish Sharma, Alexander Vasilenko, Muthukumar Gunasekaran, Manal T Al-Suqi, Deqiang Li, Peixin Yang, Sunjay Kaushal
One of the most complex forms of congenital heart disease (CHD) involving single ventricle physiology is hypoplastic left heart syndrome (HLHS), characterized by underdevelopment of the left ventricle (LV), mitral and aortic valves, and narrowing of the ascending aorta. The underdeveloped LV is incapable of providing long-term systemic flow, and if left untreated, the condition is fatal. Current treatment for this condition consists of three consecutive staged palliative operations: the first is conducted within the first few weeks of birth, the second between 4 to 6 months, and the third and final surgery within the first 4 years...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29768939/higher-preoperative-plasma-thrombin-potential-in-patients-undergoing-surgery-for-aortic-stenosis-compared-to-surgery-for-stable-coronary-artery-disease
#15
Axel Dimberg, Ulrica Alström, Elisabeth Ståhle, Christina Christersson
Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29764497/activated-prothrombin-complex-concentrate-to-reverse-the-factor-xa-inhibitor-apixaban-effect-before-emergency-surgery-a-case-series
#16
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
#17
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/29762930/cusp-tear-of-trifecta%C3%A2-aortic-bioprosthesis-resulting-in-acute-heart-failure
#18
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/29762918/impact-of-heart-rate-on-flow-measurements-in-aortic-regurgitation
#19
Mats Lidén, Maciej Wodecki, Per Thunberg, Peter Rask
BACKGROUND: Flow measurements using cardiac magnetic resonance imaging (CMRI) enable quantification of the stroke volume, regurgitant volume (RV) and regurgitant fraction (RF) in patients with aortic regurgitation (AR). These variables are used to assess the severity of the valve disease and for the timing of surgery. The aim of the study was to investigate the impact of an increased heart rate on measurement of the RV and RF in patients with AR. METHODS: Among 13 patients with known moderate or severe AR, regurgitant flow measurements, using phase-contrast cine magnetic resonance imaging, were obtained in the ascending aorta...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29759739/aortic-valve-bypass-surgery-in-severe-aortic-valve-stenosis-insights-from-cardiac-and-brain-magnetic-resonance-imaging
#20
Cesare Mantini, Massimo Caulo, Daniele Marinelli, Piero Chiacchiaretta, Armando Tartaro, Antonio Raffaele Cotroneo, Gabriele Di Giammarco
OBJECTIVE: To investigate and describe the distribution of aortic and cerebral blood flow (CBF) in patients with severe valvular aortic stenosis (AS) before and after aortic valve bypass (AVB) surgery. METHODS: We enrolled 10 consecutive patients who underwent AVB surgery for severe AS. Cardiovascular magnetic resonance imaging (CMR) and brain magnetic resonance imaging were performed as baseline before surgery and twice after surgery. Quantitative flow measurements were obtained using 1...
April 13, 2018: Journal of Thoracic and Cardiovascular Surgery
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