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infarction/heart failure/valve

Mitsunobu Kitamura, Tobias Schmidt, Karl-Heinz Kuck, Christian Frerker
PURPOSE OF REVIEW: Interventional techniques have been developed for a wide spectrum of mechanisms of heart failure (HF), especially in valvular heart disease and cardiomyopathies (ischaemic cardiomyopathy and hypertrophic cardiomyopathy). In this article, we review recent reports on catheter interventions to treat patients with HF. RECENT FINDINGS: Direct modification using the Parachute device and the REVIVENT-TC device for patients with impaired left ventricle with large infarct scars improves geometry and haemodynamic efficiency, resulting in a reduction of HF symptoms...
February 12, 2018: Current Cardiology Reports
Bo Yang, Aroosa Malik, Victoria Waidley, Xiaoting Wu, Elizabeth L Norton, David M Williams, Minhaj S Khaja, Whitney E Hornsby
OBJECTIVE: To evaluate short-term outcomes following direct aortic root and arch repair in patients with acute type A aortic dissection (ATAAD) without technical adjuncts. METHODS: Between 2012 and 2016, 94 consecutive patients with ATAAD underwent surgical repair, including aortic root repair (n = 45), root replacement (n = 39), or no root procedure (n = 10). Aortic root repair was achieved by running approximation of the dissected aortic wall circumferentially at the sinotubular junction and reinforcing the coronary ostia with 5-0 Prolene...
December 16, 2017: Journal of Thoracic and Cardiovascular Surgery
Adham Elmously, Berhane Worku, Katherine D Gray, Arash Salemi
BACKGROUND: Transapical transcatheter mitral valve-in-valve implantation (TA-MVIVI) for bioprosthetic valve failure is an emerging alternative to re-operation in high risk patients. We report our outcomes in a patient population with a high proportion of cardiogenic shock. METHODS: Retrospective review was performed of all patients undergoing TA-MVIVI with an Edwards SAPIEN (Edwards Life sciences, Irvine, CA) prosthesis at our center between the years of 2013-2017...
January 27, 2018: Annals of Thoracic Surgery
Edward Sze, Zainab Samad, Allison Dunning, Kristen Bova Campbell, Zak Loring, Brett D Atwater, Karen Chiswell, Joseph A Kisslo, Eric J Velazquez, James P Daubert
BACKGROUND: Patients with left bundle branch block (LBBB) often respond to cardiac resynchronization therapy (CRT) with left ventricular ejection fraction (LVEF) improvement. Guideline-directed medical therapy (GDMT), not CRT, is first-line therapy for patients with reduced LVEF with LBBB. However, there are little data on how patients with reduced LVEF and LBBB respond to GDMT. OBJECTIVES: This study examined patients with cardiomyopathy and sought to assess rates of LVEF improvement for patients with LBBB compared to other QRS morphologies...
January 23, 2018: Journal of the American College of Cardiology
Alaide Chieffo, Anna Sonia Petronio, Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuele Meliga, Nicholas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Samin Sharma, Maria Cruz Ferrer, Christoph Naber, Peter Kievit, Usman Baber, Clayton Snyder, Madhav Sharma, Marie Claude Morice, Roxana Mehran
OBJECTIVES: This study sought to examine the safety and performance of contemporary transcatheter aortic valve replacement (TAVR) in an exclusive all-women TAVR population, and to further investigate the potential impact of female sex-specific characteristics on composite 1-year clinical outcomes. BACKGROUND: Women comprise ≥50% patients undergoing TAVR. Several data have shown the noninferiority of TAVR compared with surgical aortic valve replacement for symptomatic significant aortic stenosis, but no study so far has been specifically powered to detect differences by sex...
January 8, 2018: JACC. Cardiovascular Interventions
Sabreen Mkalaluh, Marcin Szczechowicz, Bashar Dib, Gabor Szabo, Matthias Karck, Alexander Weymann
BACKGROUND Overall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution. MATERIAL AND METHODS We performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Preoperative comorbidities, early mortality, postoperative clinical course, and predictors of mortality were examined...
December 31, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Y B Lishmanov, M O Gulya, K V Zavadovsky, S L Andreev, E A Alexandrova
PURPOSE: To study capabilities of perfusion-metabolic myocardial scintigraphy for prediction of the left ventricular (LV) reverse remodeling after comprehensive surgical treatment of ischemic cardiomyopathy (ICMP). METHODS: The study included ICMP patients aged 56±7 years (n=32) who underwent surgical correction of LV dysfunction (myocardial revascularization, LV reconstruction, and mitral valve restoration). Inclusion criteria were significant coronary artery disease; myocardial infarction; New York Heart Association (NYHA) class III-IV heart failure; LV ejection fraction (EF) ≤45%; LV end-systolic index (ESI) >60 mL/m2; and LV akinesia or dyskinesia according to echocardiography...
October 2017: Kardiologiia
Niv Ad, Sari D Holmes, Paul S Massimiano, Anthony J Rongione, Lisa M Fornaresio, David Fitzgerald
OBJECTIVES: The del Nido cardioplegia solution has been used extensively in congenital heart surgery for more than 20 years and more recently for adults. This randomized controlled trial examined whether expanding this technique to adult cardiac surgery confers benefits in surgical workflow and clinical outcome compared with blood-based cardioplegia. METHODS: Adult first-time coronary artery bypass grafting (CABG), valve, or CABG/valve surgery patients requiring cardiopulmonary bypass (CPB) were randomized to del Nido cardioplegia (n = 48) or whole blood cardioplegia (n = 41)...
November 13, 2017: Journal of Thoracic and Cardiovascular Surgery
Sreekanth Vemulapalli, David R Holmes, David Dai, Roland Matsouaka, Michael J Mack, Fred L Grover, Raj R Makkar, Vinod H Thourani, Pamela S Douglas
BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) and its association with cardiovascular outcomes. METHODS AND RESULTS: Consecutive cases with paired postimplant and follow-up echocardiograms from November 2011 to March 2015 in the STS/ACC TVT Registry were allocated into 2 overlapping cohorts: early (paired echocardiograms at 0 and 30 days) and late (paired echocardiograms at 30 days and 1 year)...
January 2018: American Heart Journal
Puja B Parikh, Samantha Novotny, Allen Jeremias, Javed Butler, Jie Yang, Donglei Yin, Luis Gruberg
BACKGROUND: Balloon aortic valvuloplasty (BAV) is often utilized as a bridge prior to surgical or transcatheter aortic valve replacement. Chronic kidney disease (CKD) is commonly present in patients with aortic stenosis, however, its association with outcomes following BAV has not been well studied. Accordingly, we sought to assess the impact of CKD on mortality in adults undergoing BAV. METHODS: The Nationwide Inpatient Sample was screened for hospitalizations involving adults undergoing BAV from 2006 to 2012...
October 26, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Bernhard Schwaab
Physical training, psychosocial intervention, nutrition counselling and optimisation of secondary preventive medication to reduce morbidity and mortality of the disease as well as the reintegration into social life and return to work are equivalent goals of cardiac rehabilitation. This requires multifactorial intervention by a multidisciplinary team. In Germany, cardiac rehabilitation starting early after an index event could demonstrate a significant reduction of total mortality, myocardial infarction and hospitalisation during a follow-up of 1-2 years in 5 controlled cohort studies including 12 556 patients after myocardial infarction and CABG surgery...
December 7, 2017: Die Rehabilitation
Angela Kornberger, Tillmann Emrich, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Metastatic cardiac tumors may cause different symptoms including angina, symptoms of heart failure and/or arrhythmia. In patients with concomitant coronary artery disease, it may be difficult to distinguish between angina caused by metastases to the heart, for example, by stealing perfusion from the coronary arteries, and angina caused by coronary stenosis. Identifying the origin of the symptoms is, however, essential for designing appropriate surgical strategies. CASE PRESENTATION: A 69-year-old male with multifocal recurrence of a hepatocellular carcinoma (HCC) presented with increasing ventricular arrhythmia and angina several weeks after posterior myocardial infarction and PCI of the RCA culprit lesion during which two further lesions present in the distal RCX and a posterolateral branch, and a chronically occluded LAD had not been addressed...
December 7, 2017: World Journal of Surgical Oncology
Frans A van Nieuwenhoven, Chantal Munts, Roel C Op't Veld, Arantxa González, Javier Díez, Stephane Heymans, Blanche Schroen, Marc van Bilsen
Heart failure is accompanied by extracellular matrix (ECM) remodelling, often leading to cardiac fibrosis. In the present study we explored the significance of cartilage intermediate layer protein 1 (CILP1) as a novel mediator of cardiac ECM remodelling. Whole genome transcriptional analysis of human cardiac tissue samples revealed a strong association of CILP1 with many structural (e.g. COL1A2 r2  = 0.83) and non-structural (e.g. TGFB3 r2  = 0.75) ECM proteins. Gene enrichment analysis further underscored the involvement of CILP1 in human cardiac ECM remodelling and TGFβ signalling...
November 22, 2017: Scientific Reports
Davide Lazzeroni, Matteo Bini, Umberto Camaiora, Paolo Castiglioni, Luca Moderato, Davide Bosi, Simone Geroldi, Pietro T Ugolotti, Lorenzo Brambilla, Valerio Brambilla, Paolo Coruzzi
Background High levels of serum uric acid have been associated with adverse outcomes in cardiovascular diseases such as myocardial infarction and heart failure. The aim of the current study was to evaluate the prognostic role of serum uric acid levels in patients undergoing cardiac rehabilitation after myocardial revascularization and/or cardiac valve surgery. Design We performed an observational prospective cohort study. Methods The study included 1440 patients with available serum uric acid levels, prospectively followed for 50 ± 17 months...
January 1, 2017: European Journal of Preventive Cardiology
David Montaigne, Xavier Marechal, Thomas Modine, Augustin Coisne, Stéphanie Mouton, Georges Fayad, Sandro Ninni, Cédric Klein, Staniel Ortmans, Claire Seunes, Charlotte Potelle, Alexandre Berthier, Celine Gheeraert, Catherine Piveteau, Rebecca Deprez, Jérome Eeckhoute, Hélène Duez, Dominique Lacroix, Benoit Deprez, Bruno Jegou, Mohamed Koussa, Jean-Louis Edme, Philippe Lefebvre, Bart Staels
BACKGROUND: On-pump cardiac surgery provokes a predictable perioperative myocardial ischaemia-reperfusion injury which is associated with poor clinical outcomes. We determined the occurrence of time-of-the-day variation in perioperative myocardial injury in patients undergoing aortic valve replacement and its molecular mechanisms. METHODS: We studied the incidence of major adverse cardiac events in a prospective observational single-centre cohort study of patients with severe aortic stenosis and preserved left ventricular ejection fraction (>50%) who were referred to our cardiovascular surgery department at Lille University Hospital (Lille, France) for aortic valve replacement and underwent surgery in the morning or afternoon...
October 26, 2017: Lancet
Sungkyu Cho, Woong-Han Kim, Jae Gun Kwak, Jeong Ryul Lee, Yong Jin Kim
OBJECTIVES: Mitral valve (MV) repairs have been performed in paediatric patients with congenital MV stenosis. However, congenital MV stenosis lesions are a heterogeneous group of lesions, and their repair remains challenging. METHODS: From March 1999 to September 2014, MV repair was performed in 22 patients with congenital MV stenosis. The median age was 10.3 months (ranging from 22 days to 9.1 years), and the mean body weight was 7.9 ± 4.0 kg at the time of the operation...
July 4, 2017: Interactive Cardiovascular and Thoracic Surgery
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
October 27, 2017: Heart, Lung & Circulation
Christiane Bretschneider, Hannah-Klara Heinrich, Achim Seeger, Christof Burgstahler, Stephan Miller, Ulrich Kramer, Meinrad Gawaz, Konstantin Nikolaou, Bernhard Klumpp
Objective Ischemic mitral regurgitation is a predictor of heart failure resulting in increased mortality in patients with chronic myocardial infarction. It is uncertain whether the presence of papillary muscle (PM) infarction contributes to the development of mitral regurgitation in patients with chronic myocardial infarction (MI). The aim of the present study was to assess the correlation of PM infarction depicted by MRI with mitral regurgitation and left ventricular function. Methods and Materials 48 patients with chronic MI and recent MRI and echocardiography were retrospectively included...
November 3, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
Giuseppe Tarantini, Paola A M Purita, Augusto D'Onofrio, Chiara Fraccaro, Anna Chiara Frigo, Gianpiero D'Amico, Luca Nai Fovino, Marta Martin, Francesco Cardaioli, Mostafa R A Badawy, Massimo Napodano, Gino Gerosa, Sabino Iliceto
BACKGROUND: Data on transcatheter aortic valve replacement (TAVR) long-term clinical outcomes and hemodynamic performance of the self-expandable CoreValve (CV) and the balloon-expandable Edwards SAPIEN XT (ES) (Edwards Lifesciences, Irvine, California, USA) transcatheter heart valves (THV) are limited. Therefore, this study aimed to compare long-term clinical outcome data and hemodynamic performance of TAVR with either CV or ES. METHODS: We reviewed prospectively collected data of 171 patients treated with TAVR for severe aortic stenosis (AS) at our center between June 2007 and December 2010, with last follow-up contact in 2016...
September 2017: Annals of Cardiothoracic Surgery
Oscar Mendiz, Carlos Fava, Fernando Cura, Carla Agatiello, Matias Sztejfman, Anibal Damonte, Hugo Londero, Alfonsina Candiello, Daniel Berrocal
BACKGROUND: Nonagenarians are mostly denied from different therapeutic strategies due to high preoperative risk. We present the results of nonagenarians with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS: Our retrospective analysis include baseline and procedural data along with clinical outcome. Clinical follow-up was performed in all patients after TAVR. RESULTS: Out of 689 patients, 33 nonagenarians with a mean age of 90...
September 2017: Indian Heart Journal
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