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https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#1
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28633257/takayasu-arteritis-mimicking-type-a-intramural-hematoma
#2
Salvatore Torre, Paola Caramaschi, Giuseppe Faggian, Giovanni Battista Luciani
Takayasu arteritis is a panarteritis of unknown etiology involving the aorta and its main branches, with higher prevalence in women and peak of incidence in the second and third decades of life. Up to 30% of patients have coronary lesions and aortic valve involvement. Presentation mimicking aortic dissection is quite rare. Here described is the case of a young patient, presenting with an acute coronary syndrome associated with severe aortic regurgitation, who underwent emergent surgery with the suspicion of acute aortic dissection...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631767/-conservative-treatment-of-a-pseudoaneurysm-of-the-mitral-aortic-intervalvular-fibrosa-9-years-of-follow-up
#3
Domenico Riccardo Rosario Chieppa, Antonio Davide Scardigno, Giovanni Deluca, Saverio Capodivento, Nicola Quinto, Mariangela Cicala
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF-P) is one of the rare complications of endocarditis or, more rarely, of surgical trauma. This condition is characterized by a pseudoaneurysm in the intra-annular area between the mitral valve and the aortic valve communicating with the outflow tract of the left ventricle, between the coronary or noncoronary left aortic valve and the front flap of the mitral valve. Nowadays, surgery is recommended to avoid further growth and complications. We hereby describe the case of a patient with MAIVF-P as a consequence of a surgical trauma and early appearance of MAIVF-P...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28628610/outcome-of-cardiac-surgery-in-patients-with-congenital-heart-disease-in-england-between-1997-and-2015
#4
Aleksander Kempny, Konstantinos Dimopoulos, Anselm Uebing, Gerhard-Paul Diller, Ulrich Rosendahl, George Belitsis, Michael A Gatzoulis, Stephen J Wort
BACKGROUND: The number of patients with congenital heart disease (CHD) is increasing worldwide and most of them will require cardiac surgery, once or more, during their lifetime. The total volume of cardiac surgery in CHD patients at a national level and the associated mortality and predictors of death associated with surgery are not known. We aimed to investigate the surgical volume and associated mortality in CHD patients in England. METHODS: Using a national hospital episode statistics database, we identified all CHD patients undergoing cardiac surgery in England between 1997 and 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#5
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#6
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28622047/repositionable-and-retrievable-lotus-valve-system-for-the-treatment-of-bicuspid-aortic-stenosis-is-it-time-to-treat-all-valves
#7
Roberto Nerla, Fausto Castriota, Antonio Micari, Estevao de Campos Martins, Alberto Cremonesi
INTRODUCTION: For a long time, a bicuspid valve has been considered a contraindication to transcatheter aortic valve implantation (TAVI) due to worse procedural results. Currently available technologies are changing the scenario, with initial experiences reporting much better results with second-generation devices. AREAS COVERED: This review will analyze the risk and potential pitfalls of TAVI on bicuspid valves and will try ascertain how the use of a new-generation fully repositionable device, the Lotus Valve System (LVS), could improve procedural and clinical results in bicuspid anatomies...
June 16, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28616570/a-study-of-spectrum-of-rheumatic-heart-disease-in-a-tertiary-care-hospital-in-central-nepal
#8
S Laudari, G Subramanyam
BACKGROUND AND AIMS: Rheumatic heart disease is one of the most common cause for heart failure and associated mortalities/morbidities in the young population in developing countries like Nepal imparting huge familial, social and manpower burden. MATERIALS AND METHODS: This is a hospital based descriptive cross-sectional study during June 2014 to April 2016 over a period of 22 months at College of Medical Sciences-Bharatpur including 235 patients with clinical and/or echocardiographic evidence of definite rheumatic heart disease...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616354/comparing-american-european-and-asian-practice-guidelines-for-aortic-diseases
#9
Jose Rozado, Maria Martin, Isaac Pascual, Daniel Hernandez-Vaquero, Cesar Moris
The aortic disease comprises a group of different pathologies of high prevalence, seriousness and ever changing by the medical and surgical investigations. Therefore cardiovascular scientific societies in USA, Europe and Asia have created Task Force on practice guidelines (PG) to develop, update and revise PG for aortic diseases. These documents issue recommendations on the diagnosis and management of different aortic diseases. The three societies agree on the recommendations about diagnostic tests and on the value of computed tomography and magnetic resonance as the main tools for the diagnosis and follow-up of aortic disease...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616353/double-pseudoaneurysm-recurrent-subvalvular-aortic-membrane-and-small-left-ventricular-outflow-tract-in-the-same-patient-who-dares
#10
Rocío Díaz, Daniel Hernandez-Vaquero, Rubén Álvarez-Cabo, Isaac Pascual, Cecilia Corros, Alberto Alperi, Jose Rozado, Jacobo Silva, César Morís
Patients with pseudoaneurysm in the left ventricular outflow tract (LVOT) commonly present vague and nonspecific symptoms making the diagnosis difficult. We present the case of a 37-year-old patient with two subvalvular pseudoaneurysms in whom a combined resection surgery, enlargement of the LVOT, aortic valve replacement (AVR) and aortic root replacement were performed using the technique of Cabrol.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616349/sparing-aortic-valve-techniques
#11
Rubén Álvarez-Cabo
Prosthetic valve implantation is the most widely used therapeutic option for aortic regurgitation (AR), but complications associated with prosthetic valves, with an incidence of 3-5% patient/year, and the need for anticoagulation in mechanical valves, force us to consider aortic valve repair as an alternative to the prosthetic implant, especially in young people with many potential years of life for these complications. Aortic valve repair techniques are not excessively complicated, but there is no standardization, so they are not reproducible in all medical centers...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616344/vascular-approaches-for-transcatheter-aortic-valve-implantation
#12
REVIEW
Isaac Pascual, Amelia Carro, Pablo Avanzas, Daniel Hernández-Vaquero, Rocío Díaz, Jose Rozado, Rebeca Lorca, María Martín, Jacobo Silva, César Morís
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving therapeutic modality currently available for patients with severe aortic stenosis (AS) that are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk. Transfemoral approach is the preferred TAVI delivery route when possible. Alternative non-transfemoral access options include transaortic, trans-subclavian and transapical access. Other approaches are also feasible (transcarotid, transcaval, and antegrade aortic) but are restricted to operators and hospitals with experience...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616299/rupture-of-right-sinus-of-valsalva-aneurysm-protruding-into-the-pulmonary-artery-with-aortic-and-pulmonary-valve-endocarditis
#13
Tae-Eun Jung, Jong-Hyun Baek, Dong-Hyup Lee
Rupture of right sinus of Valsalva aneurysm (SVA) protruding into the pulmonary artery with aortic and pulmonary valve endocarditis is rare. A 42-year-old man was admitted with fever and dyspnea. He was diagnosed with right sinus of Valsalva rupture with ventricular septal defect (VSD) and vegetation on both aortic and pulmonary valves. Dual exposure technique was performed. The base of the aneurysm sac was closed off, and, together with the VSD, was covered by a Gore-Tex patch. Aortic and pulmonary valves were replaced with mechanical valves...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616279/benefits-of-a-right-anterolateral-minithoracotomy-rather-than-a-median-sternotomy-in-isolated-tricuspid-redo-procedures
#14
Aikebaier Maimaiti, Lai Wei, Ye Yang, Huan Liu, Chunsheng Wang
BACKGROUND: To compare results of tricuspid valve (TV) reoperation between incision via a right anterolateral minithoracotomy (RAMT) and median sternotomy (MS). METHODS: We performed a retrospective analysis of 49 patients who underwent isolated TV surgery as a reoperation at our institution between 2006 and 2015. Previous cardiac operations included mitral, aortic, and TV surgeries, atrial septal defect repair, and pericardiectomy. The mean age of the patients was 51...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28614262/minimally-invasive-mitral-valve-replacement-is-a-safe-and-effective-surgery-for-patients-with-rheumatic-valve-disease-a-retrospective-study
#15
Junyu Zhai, Lai Wei, Ben Huang, Chunsheng Wang, Hongqiang Zhang, Kanhua Yin
The aim of the study was to evaluate the treatment of minimally invasive mitral valve replacement (MIMVR) through a right minithoracotomy for patients with rheumatic mitral valve disease.From February 2009 to December 2016, 360 patients with rheumatic mitral valve disease underwent mitral valve replacement by the same surgeon. Among them, 150 patients accepted MIMVR through a right minithoracotomy, whereas the other 210 accepted a traditional median sternotomy. After matching by patients by age, sex, EuroSCORE, New York Heart Association (NYHA) classification, renal and liver function, and degree of mitral valve disease, we selected 224 patients for analysis in our retrospective study...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28611348/early-detection-of-subclinical-aortic-valve-endocarditis-with-the-cardiomems-heart-failure-system
#16
Sinan Sarsam, Georgy Kaspar, Shukri David, Marcel Zughaib
BACKGROUND The CardioMEMS Heart Failure System is a well validated tool to optimize management of systolic and diastolic heart failure and has been shown to reduce the risk of hospitalization by 37%. We are reporting a unique case of acute aortic valve insufficiency as a first sign of endocarditis, detected early in a patient with the CardioMEMS device. CASE REPORT A 79-year-old man with dual bioprosthetic mitral and aortic valve replacement and non-ischemic cardiomyopathy had a CardioMEMS Heart Failure System implanted 2 months following valve replacement surgery...
June 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#17
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28607777/type-a-quadricuspid-aortic-valve-infective-endocarditis-complicated-by-multiple-aortocardiac-fistulae-case-report-and-brief-literature-review
#18
Amine Ghalem, Mohammed Bachrif, Anass Hbali, Mostapha Beghi, Nabila Ismaili, Noha El Ouafi
Aortocardiac fistulae (ACF) are exceptionally due to infective endocarditis; they are usually congenital, posttraumatic, or complicate aortic dissection. In infective endocarditis setting, their presence should prompt urgent surgery as patients can deteriorate rapidly. We report the case of a 78-year-old female patient with the first ever reported quadricuspid aortic valve infective endocarditis complicated by multiple aortocardiac fistulae. Additionally, we provide a brief review of ACF, in infective endocarditis and quadricuspid aortic valve...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28605548/early-and-mid-term-aortic-remodelling-after-the-frozen-elephant-trunk-technique-for-retrograde-type-a-acute-aortic-dissection-using-the-new-japanese-j-graft-open-stent-graft
#19
Yoshitaka Yamane, Naomichi Uchida, Shingo Mochizuki, Tomokuni Furukawa, Kazunori Yamada
OBJECTIVES: We previously performed the frozen elephant trunk (FET) technique for acute type A aortic dissection to try to improve the long-term prognosis. In this study, we report the mid-term results of the FET technique for treating retrograde type A acute aortic dissection using a new device, the J Graft open stent graft (JOSG). METHODS: Between January 2008 and December 2015, 24 patients (mean age: 59.3 ± 13.9 years) underwent total arch replacement with the FET technique using the JOSG for retrograde type A acute aortic dissection...
June 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28605423/source-3-1-year-outcomes-post-transcatheter-aortic-valve-implantation-using-the-latest-generation-of-the-balloon-expandable-transcatheter-heart-valve
#20
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Franz-Josef Neumann, Giuseppe Tarantini, José Luis Zamorano, Alec Vahanian
Aims: Transcatheter aortic valve implantation (TAVI) has developed from a procedure for patients with aortic stenosis inoperable or high risk for surgery, into a treatment option even for intermediate risk elderly patients. This development has been facilitated by the clinical learning curve and constant improvements of transcatheter heart valves used. We present total 1-year results of SOURCE 3, the European post-approval multicentre registry of the latest generation balloon expandable SAPIEN 3TM (Edwards Lifesciences, Irvine, CA, USA)...
June 12, 2017: European Heart Journal
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