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By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
Birgid Gonska, Julia Seeger, Justus Baarts, Christoph Rodewald, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual paravalvular moderate or severe aortic regurgitation (AR) has been an independent risk factor for mortality after transcatheter aortic valve implantation (TAVI). The design of the third generation Edwards Sapien 3 (ES3; Edwards Lifesciences, Irvine, CA, USA) valve was optimized with an outer skirt to address the issue of paravalvular AR. METHODS AND RESULTS: We compared 100 consecutive patients treated with the ES3 for severe aortic stenosis with 100 patients treated with the Medtronic CoreValve (CV; Medtronic, Minneapolis, MN, USA) (Clinical Trial Registration: NCT02162069)...
September 7, 2016: Journal of Cardiology
Luciana Thiago, Selma Rumiko Tsuji, Jonathan Nyong, Maria Es Puga, Aecio Ft Gois, Cristiane R Macedo, Orsine Valente, Álvaro N Atallah
BACKGROUND: Aortic valve stenosis is the most common type of valvular heart disease in the USA and Europe. Aortic valve stenosis is considered similar to atherosclerotic disease. Some studies have evaluated statins for aortic valve stenosis. OBJECTIVES: To evaluate the effectiveness and safety of statins in aortic valve stenosis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS - IBECS, Web of Science and CINAHL Plus...
September 5, 2016: Cochrane Database of Systematic Reviews
Nuray Kahraman Ay, Yasin Ay, Osman Sönmez, Mehmet Akif Vatankulu, Ömer Göktekin
BACKGROUND: Very elderly patients represent a distinct patient group in clinical setting in terms of a decision for trans-catheter aortic valve replacement (TAVR) when one considers the potential improvement in the quality of life (QoL) on one hand and the benefit to risk ratio on the other. This study aimed to compare functional and QoL outcomes of TAVR between octogenarians and septuagenarians. METHODS: This prospective cohort study included 136 elderly patients (70 to 89 years of age), who underwent transfemoral TAVR due to degenerative aortic stenosis...
July 2016: Journal of Geriatric Cardiology: JGC
Daniel Grinberg, Matteo Pozzi, Fadi Farhat, Jean-François Obadia
The initial aorta (aortic valve, ring, sinuses and ascending aorta) constitutes an inseparable anatomical-functional entity. The "normal" diameter grows with age and body surface area. Two potential risks: aortic regurgitation (chronic complication) and aortic dissection (acute complication) The aortic diameter is the main factor of aortic dissection. Issues of the recommendations: set thresholds to indicate prophylactic surgery (avoid complication) Betablockers are indicated, especially in cases of hypertension or proven familial dystrophy...
September 2, 2016: La Presse Médicale
Jeffrey J Popma, Thomas G Gleason, Steven J Yakubov, J Kevin Harrison, John K Forrest, Brijeshwar Maini, Carlos E Ruiz, Duane S Pinto, Marco Costa, Jon Resar, John Conte, Juan Crestanello, Yanping Chang, Jae K Oh, Michael J Reardon, David H Adams
BACKGROUND: Multidetector computed tomography is useful for determining the appropriate transcatheter heart valve (THV) size in patients with severe aortic stenosis who are suboptimal surgical candidates. The relationship between adherence to the recommended CoreValve sizing algorithm and clinical outcomes is not known. METHODS AND RESULTS: We evaluated 1023 patients with severe aortic stenosis deemed high or extreme risk for surgery treated with the CoreValve THV...
July 2016: Circulation. Cardiovascular Interventions
Tai Fuchigami, Masahiko Nishioka, Toru Akashige, Shotaro Higa, Kazuhiro Takahashi, Mami Nakayashiro, Taisuke Nabeshima, Arata Sashinami, Kenzo Sakurai, Kiyotaka Takefuta, Nobuhiro Nagata
OBJECTIVES: Bilateral pulmonary artery banding (bPAB) is utilized for some patients with a ventricular septal defect (VSD) and aortic coarctation (CoA) or interrupted aortic arch (IAA). We evaluated aortic valve (AoV) diameter and patient outcomes following bPAB. METHODS: Between August 2010 and September 2015, 10 consecutive patients with VSD and patent ductus arteriosus-dependent CoA or IAA underwent bPAB because of an AoV diameter of approximately <50% of the normal value (n = 6), severe subaortic stenosis and poor patient condition (n = 1, respectively), or low birthweight (n = 2)...
July 1, 2016: Interactive Cardiovascular and Thoracic Surgery
Yuhao Shi, Harindra C Wijeysundera, Stephen E Fremes, Andrew E Simor
We identified risk factors for infection following transcatheter aortic valve implantation (TAVI); infection occurred in 35 (13.8%) of 253 patients. Variables associated with infection included chronic obstructive pulmonary disease (OR, 1.2; 95% CI, 1.1-1.4), postprocedural hemorrhage (OR, 1.2; 95% CI, 1.0-1.3), and procedure-related stroke (OR, 1.6; 95% CI, 1.3-2.1). Infect Control Hosp Epidemiol 2016;37:1094-1097.
September 2016: Infection Control and Hospital Epidemiology
Phillip M Freeman, Majd B Protty, Omar Aldalati, Arron Lacey, William King, Richard A Anderson, Dave Smith
OBJECTIVES: Determine the real-world difference between 2 groups of patients with severe aortic stenosis and similar baseline comorbidities: surgical turn down (STD) patients, who were managed medically prior to the availability of transcatheter aortic valve implantation (TAVI) following formal surgical outpatient assessment, and patients managed with a TAVI implant. DESIGN: Retrospective cohort study from real-world data. SETTING: Electronic patient letters were searched for patients with a diagnosis of severe aortic stenosis and a formal outpatient STD prior to the availability of TAVI (1999-2009)...
2016: Open Heart
Stefan Toggweiler, Stefan Stortecky, Erik Holy, Katarzyna Zuk, Florim Cuculi, Fabian Nietlispach, Zaid Sabti, Raluca Suciu, Willibald Maier, Peiman Jamshidi, Francesco Maisano, Stephan Windecker, Richard Kobza, Peter Wenaweser, Thomas F Lüscher, Ronald K Binder
OBJECTIVES: The study sought to identify predictors for delayed high-degree atrioventricular block (AVB) in patients undergoing transcatheter aortic valve replacement (TAVR) and determine the need and required duration of telemetry monitoring. BACKGROUND: Little is known about predictors and timing of high-degree AVB. METHODS: A total of 1,064 patients (52% women) without a permanent pacemaker undergoing TAVR at 3 centers in Switzerland were investigated...
June 27, 2016: JACC. Cardiovascular Interventions
Sameer Arora, Jacob A Misenheimer, Wesley Jones, Amol Bahekar, Melissa Caughey, Cassandra J Ramm, Thomas G Caranasos, Michael Yeung, John P Vavalle
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been approved in patients with high or prohibited surgical risk for surgery for treatment of severe symptomatic aortic stenosis. Prospective studies examining the benefits of TAVR in intermediate risk patients are ongoing. Other smaller studies including lower risk patients have been conducted, but further meta-analysis of these studies is required to draw more broad comparisons. METHODS: A Medline search was conducted using standard methodology to search for clinical trials and observational studies including intermediate risk patients...
June 2016: Cardiovascular Diagnosis and Therapy
Jonathan W Weinsaft, Richard B Devereux, Liliana R Preiss, Attila Feher, Mary J Roman, Craig T Basson, Alexi Geevarghese, William Ravekes, Harry C Dietz, Kathryn Holmes, Jennifer Habashi, Reed E Pyeritz, Joseph Bavaria, Karianna Milewski, Scott A LeMaire, Shaine Morris, Dianna M Milewicz, Siddharth Prakash, Cheryl Maslen, Howard K Song, G Michael Silberbach, Ralph V Shohet, Nazli McDonnell, Tabitha Hendershot, Kim A Eagle, Federico M Asch
BACKGROUND: Aortic dissection (AoD) is a serious complication of thoracic aortic aneurysm (TAA). Relative risk for AoD in relation to TAA etiology, incidence, and pattern after prophylactic TAA surgery are poorly understood. OBJECTIVES: This study sought to determine the incidence, pattern, and relative risk for AoD among patients with genetically associated TAA. METHODS: The population included adult GenTAC participants without AoD at baseline...
June 14, 2016: Journal of the American College of Cardiology
Giuseppe Gargiulo, Anna Sannino, Davide Capodanno, Marco Barbanti, Sergio Buccheri, Cinzia Perrino, Piera Capranzano, Ciro Indolfi, Bruno Trimarco, Corrado Tamburino, Giovanni Esposito
BACKGROUND: The comparative benefits and harms of transcatheter aortic valve implantation (TAVI) and surgical aortic valve replacement (SAVR) for patients with aortic stenosis are unclear. PURPOSE: To compare clinical outcomes, including early (≤30-day) and midterm (≤1-year) mortality, in adults with severe aortic stenosis undergoing either TAVI or SAVR. DATA SOURCES: MEDLINE, Cochrane, and Scopus databases (without language restrictions) from April 2002 to 5 April 2016; multiple registries and Web sites; scientific meeting presentations...
September 6, 2016: Annals of Internal Medicine
Ofer Havakuk, Maayan Konigstein, Eyal Ben Assa, Yaron Arbel, Yigal Abramowitz, Amir Halkin, Samuel Bazan, Haim Shmilovich, Gad Keren, Ariel Finkelstein, Shmuel Banai
BACKGROUND: Direct mechanical compression of the frame struts on the adjacent bundle branch with local inflammatory reaction might cause conduction system disturbances and need for pacemaker implantation following transcatheter aortic valve implantation (TAVI). We assessed the impact of preprocedural anti-inflammatory steroid therapy on the occurrence of conduction disturbances following TAVI. METHODS AND RESULTS: From a cohort of 324 patients who underwent transfemoral TAVI, 39 (12%) were pretreated with steroids because of iodine allergy (n=29) or active obstructive pulmonary disease (n=10)...
October 2016: Cardiovascular Therapeutics
Hugo González-Saldivar, Carlos Rodriguez-Pascual, Gonzalo de la Morena, Covadonga Fernández-Golfín, Carmen Amorós, Mario Baquero Alonso, Luis Martínez Dolz, Albert Ariza Solé, Gabriela Guzmán-Martínez, Juan José Gómez-Doblas, Antonio Arribas Jiménez, María Eugenia Fuentes, Laura Galian Gay, Martin Ruiz Ortiz, Pablo Avanzas, Emad Abu-Assi, Tomás Ripoll-Vera, Oscar Díaz-Castro, Eduardo P Osinalde, Manuel Martínez-Sellés
The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77...
July 15, 2016: American Journal of Cardiology
George L Hines, Vita Jaspan, Brian J Kelly, Rose Calixte
Background Transfemoral aortic valve replacement (TAVR) is a novel technique for treating aortic stenosis, yet vascular complications are yet to be delineated. Objectives This study aims to study the vascular complications of TAVR with Edwards Sapien valves (Edwards Lifesciences Corp., Irvine, CA). Methods We performed a retrospective evaluation of TAVR patients. Standard demographics, femoral vessel and sheath size, access type (femoral cut-down [FC], percutaneous access [PFA], and iliac conduit [IC]), and treatment method were recorded...
June 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Scott Somerville, Elizabeth Rosolowsky, Somjate Suntratonpipat, Rose Girgis, Benjamin H Goot, Edythe B Tham
OBJECTIVE: To compare the detection of cardiac lesions with the use of cardiac magnetic resonance imaging (CMR) and conventional echocardiography in children with Turner syndrome. STUDY DESIGN: Twenty-four girls with Turner syndrome, 8-18 years of age, were recruited through the Pediatric Endocrinology Program. Participants underwent CMR and echocardiography within a 2-year period, and discrepancies between the results of each modality were identified. RESULTS: Fifteen of 24 (63%) girls had a cardiac lesion identified on CMR or echocardiography...
August 2016: Journal of Pediatrics
Jehangir J Appoo, John Bozinovski, Michael W A Chu, Ismail El-Hamamsy, Thomas L Forbes, Michael Moon, Maral Ouzounian, Mark D Peterson, Jacques Tittley, Munir Boodhwani
In 2014, the Canadian Cardiovascular Society (CCS) published a position statement on the management of thoracic aortic disease addressing size thresholds for surgery, imaging modalities, medical therapy, and genetics. It did not address issues related to surgical intervention. This joint Position Statement on behalf of the CCS, Canadian Society of Cardiac Surgeons, and the Canadian Society for Vascular Surgery provides recommendations about thoracic aortic disease interventions, including: aortic valve repair, perfusion strategies for arch repair, extended arch hybrid reconstruction for acute type A dissection, endovascular management of arch and descending aortic aneurysms, and type B dissection...
June 2016: Canadian Journal of Cardiology
Victor Dayan, Gustavo Vignolo, Gerardo Soca, Juan Jose Paganini, Daniel Brusich, Philippe Pibarot
OBJECTIVES: This study sought to evaluate predictors of prosthesis-patient mismatch (PPM) and its association with the risk of perioperative and overall mortality. BACKGROUND: PPM is associated with increased mid- and long-term mortality after surgical aortic valve replacement. Conflicting results have been reported with regard to its association with perioperative mortality. METHODS: Databases were searched for studies published between 1965 and 2014...
August 2016: JACC. Cardiovascular Imaging
Romain Didier, Edward Koifman, Sarkis Kiramijyan, Smita I Negi, Rebecca Torguson, Petros Okubagzi, Augusto D Pichard, Ron Waksman
AIMS: The present study aimed to evaluate the impact of prior cardiovascular events (CVE) on outcome in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: Patients with severe AS undergoing TAVR between May 2007 and March 2015 were included and categorized to patients with and without prior stroke, defined as embolic, hemorrhagic stroke and transit ischemic attack. Baseline, procedural characteristics, in-hospital outcomes, and 1-month and 1-year mortality were compared in accordance with the Valve Academic Research Consortium-2 consensus...
July 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Seyed Hossein Aalaei-Andabili, Negiin Pourafshar, Anthony A Bavry, Charles T Klodell, R David Anderson, Ashkan Karimi, John W Petersen, Thomas M Beaver
BACKGROUND: Acute kidney injury (AKI) during transcatheter aortic valve replacement (TAVR) increases morbidity and mortality. In this study, we investigated the incidence and risk factors for AKI in patients undergoing TAVR. METHODS: Two hundred ninety consecutive patients underwent TAVR. Valve Academic Research Consortium (VARC)-I criteria for AKI diagnosis at 72 hours, and VARC-II criteria at seven days were employed. RESULTS: Overall AKI incidence was 24...
July 2016: Journal of Cardiac Surgery
2016-05-26 12:58:19
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