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Aortic valve surgery

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https://www.readbyqxmd.com/read/28535202/clinical-implications-of-hypothermic-ventricular-fibrillation-versus-beating-heart-technique-during-cardiopulmonary-bypass-for-pulmonary-valve-replacement-in-patients-with-repaired-tetralogy-of-fallot
#1
Ji-Hyun Lee, Ji-Eun Lee, Jungho Shin, In-Kyung Song, Hee-Soo Kim, Chong-Sung Kim, Woong-Han Kim, Jin-Tae Kim
OBJECTIVES: This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). METHODS: We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28535198/transcatheter-aortic-valve-implantation-for-recurrent-valsalva-sinus-re-dissection-and-severe-aortic-regurgitation-shortly-after-surgery-for-type-a-aortic-dissection
#2
Elena Caporali, Giovanni Pedrazzini, Stefanos Demertzis, Enrico Ferrari
Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28531333/the-flaws-in-the-detail-of-an-observational-study-on-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risks-patients
#3
Fabio Barili, Nick Freemantle, Thierry Folliguet, Claudio Muneretto, Michele De Bonis, Martin Czerny, Jean Francois Obadia, Nawwar Al-Attar, Nikolaos Bonaros, Jolanda Kluin, Roberto Lorusso, Prakash Punjabi, Rafael Sadaba, Piotr Suwalski, Umberto Benedetto, Andreas Böning, Volkmar Falk, Miguel Sousa-Uva, Pieter A Kappetein, Lorenzo Menicanti
The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results...
June 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28530152/new-onset-fixation-off-sensitivity-or-scotosensitivity-in-an-adult-male-after-bilateral-embolic-strokes-of-the-parietal-and-occipital-regions
#4
Francis G Tirol
A 50-year old male suffered new-onset clinical and subclinical seizures provoked by acute bilateral embolic strokes in the parietal and occipital regions as a complication of aortic valve replacement surgery. After successful treatment of these refractory symptomatic seizures with intravenous propofol and antiseizure medications, video-EEG recordings revealed acute and transient fixation-off sensitivity or scotosensitivity that resolved within 10 weeks.
May 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#5
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28520542/hybrid-palliation-for-interrupted-aortic-arch-with-small-aortic-valve
#6
Yoshimasa Uno, Ayumu Masuoka, Kentarou Hotoda, Toshiyuki Katogi, Takaaki Suzuki
OBJECTIVES: Open heart surgery for interrupted aortic arch in the neonatal period is still a high-risk procedure related in part to patient factors such as low birth weight, other morphologic anomalies, and, especially, small aortic valve size. Recently, we performed hybrid palliation with bilateral pulmonary artery banding and ductal stenting as the first-stage palliation for such cases. In this study, the outcomes of this procedure were examined. METHODS: Six cases of interrupted aortic arch with a small aortic valve underwent the hybrid procedure in the neonatal period in our institute from 2010 to 2015 (mean age: 6...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28517030/gerbode-defect-and-multivalvular-dysfunction-complex-complications-in-adult-congenital-heart-disease
#7
Catarina Ruivo, Joana Guardado, Fernando Montenegro Sá, Fátima Saraiva, Alexandre Antunes, Joana Correia, João Morais
We report a clinical case of a 40-year-old male with surgically corrected congenital heart disease (CHD) 10 years earlier: closure of ostium primum, mitral annuloplasty, and aortic valve and root surgery. The patient was admitted with acute heart failure. Transesophageal echocardiography (TEE) revealed a dysmorphic and severely incompetent aortic valve, a partial tear of the mitral valve cleft repair and annuloplasty ring dehiscence. A true left ventricular-to-right atrial shunt confirmed a direct Gerbode defect...
May 18, 2017: Echocardiography
https://www.readbyqxmd.com/read/28515859/conservative-management-of-aortic-root-rupture-complicated-with-cardiac-tamponade-following-transcatheter-aortic-valve-implantation
#8
Luca Vannini, Rut Andrea, Manel Sabaté
Aortic root rupture and cardiac tamponade during transcatheter aortic valve implantation is a frightening complication with high mortality rate. A conservative management of this complication could represent an initial strategy, especially in high-risk patients, to avoid emergent cardiac surgery. This conservative management includes: Immediate detection of pericardial effusion by echocardiography, a fast instauration of pericardial drainage, auto-transfusion and anticoagulation reversal. We describe two cases of patients who suffered this complication and were treated successfully with this initial approach...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#9
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28512734/mitral-valve-aneurysms-clinical-characteristics-echocardiographic-abnormalities-and-possible-mechanisms-of-formation
#10
José Luiz B Pena, Tarciso O Bomfim, Paulo R L Fortes, Charles Simão-Filho, José de Souza Andrade-Filho
AIMS: Mitral valve aneurysms (MVA) are most frequently associated with endocarditis. Echocardiography is the method of choice for diagnosis, and color flow imaging is an important, easy method to detect MVA ruptures. We aimed to study the clinical and echocardiographic findings and their relation to the mechanism of aneurysm formation. METHODS AND RESULTS: We reviewed clinical and echocardiographic records of 18 patients during a 17-year period, corresponding to 0...
May 16, 2017: Echocardiography
https://www.readbyqxmd.com/read/28511922/simultaneous-transseptal-para-ring-leak-closure-and-transcatheter-mitral-valve-implantation-for-the-treatment-of-surgical-mitral-repair-failure
#11
James Roy, Mehdi Eskandari, Mark Monaghan, Olaf Wendler, Jonathan Byrne, Philip MacCarthy
Repeat cardiac surgery in patients with a previous sternotomy is associated with significant morbidity and mortality. While transcatheter aortic valve implantation in high risk surgical patients is now well established, experience with transcatheter mitral valve replacement is still at an early stage. Although many successful reports of transcatheter mitral valve replacements now exist, the predominant approach has been via a transapical approach. It is likely that, as with the evolution of favoured access routes for transcatheter aortic therapies, future directions for transcatheter mitral valves will focus on smaller delivery systems favouring the transvenous transseptal approach where possible...
April 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28510739/comparison-of-preoperative-and-intraoperative-assessment-of-aortic-stenosis-severity-by-echocardiography
#12
Y Uda, B Cowie, R Kluger
Background: General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Methods: Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28508532/aortic-valve-replacement-for-papillary-fibroelastoma
#13
REVIEW
Ali Ahmet Arikan, Oğuz Omay, Fatih Aydın, Muhip Kanko, Sibel Gür, Emir Derviş, Cansu Eda Yılmaz, Bahar Müezzinoğlu
Surgery is indicated for symptomatic patients with papillary fibroelastomas (PFE) on the aortic valve. The valve is commonly spared during tumor excision. Rarely, aortic valve replacement (AVR) is needed. We present a case requiring AVR for an aortic valve PFE and review the literature to determine the risk factors for failure of aortic valve-sparing techniques in patients with PFE.
May 15, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28505628/markers-of-intestinal-damage-and-their-relation-to-cytokine-levels-in-cardiac-surgery-patients
#14
Quirine L M Habes, Vera Linssen, Suzan Nooijen, Dorien Kiers, Jelle Gerretsen, Peter Pickkers, Gert Jan Scheffer, Matthijs Kox
OBJECTIVES: In patients undergoing cardiac surgery, both extracorporeal circulation (ECC) and intraoperative mesenterial hypoperfusion may account for increased cytokine levels and lead to postoperative gastrointestinal (GI) symptoms. METHODS: We investigated levels of the intestinal damage markers intestinal fatty acid binding protein (I-FABP in plasma [n = 72] and urine [n = 37]), citrulline (in plasma [n = 35]), and claudin-3 (in urine [n = 37]) in patients undergoing aortic or mitral valve surgery with or without coronary artery bypass grafting...
June 2017: Shock
https://www.readbyqxmd.com/read/28503837/efficacy-of-protocol-based-pharmacotherapy-management-on-anticoagulation-with-warfarin-for-patients-with-cardiovascular-surgery
#15
Y Katada, S Nakagawa, K Minakata, M Odaka, H Taue, Y Sato, A Yonezawa, Y Kayano, I Yano, T Nakatsu, K Sakamoto, K Uehara, H Sakaguchi, K Yamazaki, K Minatoya, R Sakata, K Matsubara
WHAT IS KNOWN AND OBJECTIVE: Anticoagulation therapy with warfarin requires periodic monitoring of prothrombin time-international normalized ratio (PT-INR) and adequate dose adjustments based on the data to minimize the risk of bleeding and thromboembolic events. In our hospital, we have developed protocol-based pharmaceutical care, which we called protocol-based pharmacotherapy management (PBPM), for warfarin therapy. The protocol requires pharmacists to manage timing of blood sampling for measuring PT-INR and warfarin dosage determination based on an algorithm...
May 15, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#16
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28502734/transcatheter-aortic-valve-implantation-in-patients-at-intermediate-surgical-risk
#17
REVIEW
Carmen Spaccarotella, Annalisa Mongiardo, Salvatore De Rosa, Ciro Indolfi
Transcatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic stenosis (AS). Initially tested in unoperable or high surgical risk patients, the safety and efficacy of TAVI has progressively improved, with increasing operators' experience and continuous technical refinements of the devices and of the delivery systems. Hence, the extension of clinical indications for TAVI to the intermediate-risk population has been attracting cardiologists in recent years...
May 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28500139/high-versus-low-gradient-severe-aortic-stenosis-demographics-clinical-outcomes-and-effects-of-the-initial-aortic-valve-replacement-strategy-on-long-term-prognosis
#18
Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Tsukasa Inada, Kazuya Nagao, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura
BACKGROUND: There is considerable debate on the management of patients with low-gradient severe aortic stenosis (LG-AS), defined as aortic valve area <1 cm(2) with peak aortic jet velocity ≤4.0 m/s, and mean aortic pressure gradient ≤40 mm Hg. METHODS AND RESULTS: In the CURRENT AS registry (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis), there were 2097 patients (initial aortic valve replacement [AVR] strategy: n=977, and conservative strategy: n=1120) with high-gradient severe aortic stenosis (HG-AS) and 1712 patients (initial AVR strategy: n=219, and conservative strategy: n=1493) with LG-AS...
May 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499671/tricuspid-annuloplasty-versus-a-conservative-approach-in-patients-with-functional-tricuspid-regurgitation-undergoing-left-sided-heart-valve-surgery-a-study-level-meta-analysis
#19
Matteo Pagnesi, Claudio Montalto, Antonio Mangieri, Eustachio Agricola, Rishi Puri, Mauro Chiarito, Marco B Ancona, Damiano Regazzoli, Luca Testa, Michele De Bonis, Neil E Moat, Josep Rodés-Cabau, Antonio Colombo, Azeem Latib
BACKGROUND: Tricuspid valve (TV) repair at the time of left-sided valve surgery is indicated in patients with either severe functional tricuspid regurgitation (TR) or mild-to-moderate TR with coexistent tricuspid annular dilation or right heart failure. We assessed the benefits of a concomitant TV repair strategy during left-sided surgical valve interventions, focusing on mortality and echocardiographic TR-related outcomes. METHODS: A meta-analysis was performed of studies reporting outcomes of patients who underwent left-sided (mitral and/or aortic) valve surgery with or without concomitant TV repair...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28496076/-early-results-of-complex-fractionated-atrial-electrogram-mapping-guided-atrial-fibrillation-surgery
#20
Kazuaki Fukahara, Mari Sakai, Shigeki Yokoyama, Toshio Doi, Naoki Yoshimura
OBJECTIVE: Although the Cox-maze operation is the standard surgical procedure for permanent atrial fibrillation(AF), conversion to sinus rhythm is limited by patient characteristics, including the duration of AF, atrial size, and voltage of fibrillation waves. A surgical strategy based on structural alteration of the electrical substrates of AF is required to achieve better outcomes of AF surgery. Complex fractionated atrial electrogram (CFAE) plays an important role in the electrical substrate of AF...
May 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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