Transcatheter vs surgical aortic valve replacement in patients with interstitial lung disease
AbstractBackgroundPatients with underlying interstitial lung disease (ILD) who undergo cardiac surgery are at high risk of postoperative pulmonary complications. It remains unclear if transcatheter aortic valve replacement (TAVR) offers any benefit over surgical aortic valve replacement (SAVR) in ILD patients with severe aortic stenosis.MethodsAll adult patients with a diagnosis of ILD who underwent either a TAVR or isolated SAVR between January 2002 and December 2017 were retrospectively reviewed. Operative mortality, 30 ‐day readmissions, and adjusted 1‐year survival were compared between the two cohorts.ResultsThe overall cohort included 52 TAVR and 74 SAVR patients. While TAVR patients were significantly older (77.2 vs 72.9 years) with higher Society of Thoracic Surgeons predicted risk of mortality (STS ‐PROM) scores compared with SAVR patients (6.29 vs 4.49; allP .46). However, TAVR was associated with significantly shorter hospital and intensive care unit (ICU) length of stay, shorter ventilation times, and less requirement for ICU admission (allP
Contributors : Ashley McDonough ; Richard V Lee ; Shahani Noor ; Chungeun Lee ; Thu Le ; Michael Iorga ; Jessica L Phillips ; Sean Murphy ; Thomas M öller ; Jonathan R WeinsteinSeries Type : Expression profiling by arrayOrganism : Mus musculusStroke is the fifth leading cause of death in the United States and is a leading cause of serious long-term disability worldwide. Innate immune responses are critical in stroke pathophysiology, and microglia are key cellular effectors in the CNS response to ischemia/reperfusion. Using a transcriptional analysis approach, we identified a robust interferon (IFN)-stimulated gene res...
Contributors : Bing Han ; Honghong YaoSeries Type : Expression profiling by array ; Non-coding RNA profiling by arrayOrganism : Mus musculusAstrocyte activation is involved in the context of stroke. Our study provides a potential new therapeutic strategy to astrocyte activation in the context of stroke.
Background. Frailty is a clinically recognized syndrome of decreased physiological reserve and a key contributor to suboptimal clinical outcomes in various lung disease groups. Interstitial lung disease (ILD) is fast approaching chronic obstructive pulmonary disease as the number one indication for lung transplantation worldwide. Our aim was to assess whether frailty is a predictor of mortality in patients with ILD referred for lung transplantation in an Australian cohort. Methods. Consecutive patients with ILD referred or on the waiting list for lung transplantation from May 2013 to December 2017 underwent frailty as...
Hypertension (HTN) has been implicated as a risk factor for stroke in continuous-flow Left Ventricular Assist Device (LVAD) populations. Active treatment of HTN has been shown to decrease cerebrovascular accident rates in the recent trial. Current guidelines recommend a mean arterial pressure (MAP) of 80mmHg in LVAD patients; however, it is difficult to reliably measure Blood Pressure (BP) in this cohort. Increased BP will further affect pump output since LVAD flows are altered by both preload and afterload.
Bleeding is the most common complication of left ventricular assist device (LVAD) placement. However, excessive transfusion has been linked to heart failure, stroke, and alloimmunization. We compared 90-day outcomes in patients receiving a blood conservation (BCS) versus liberal transfusion strategy during surgery and the subsequent 24 hours.
Advanced heart failure predisposes patients to intracardiac thrombus (ICT) formation. There is a paucity of evidence examining the impact of pre-existing left atrial (LA) or left ventricular (LV) thrombi on post-operative outcomes in patients undergoing durable LVAD implantation.
In the field of lung transplantation, there is a high wait list mortality. Broader use of extended criteria donors would provide additional organs for transplantation. An increasing number of organ donors are dying from drug overdose. These donors are often considered “high risk” because of their exposure to infectious diseases such as HIV and Hepatitis B and C. However, these organ donors are often younger and healthier than those that die from stroke or cardiac arrest. Successful use of lung donors who have a history of drug abuse may serve to provide addit ional organs for those patients on the wait list.
The initial project of ACTION (Advanced Cardiac Therapies Improving Outcomes Network) is focused on improving stroke rates in patients implanted with a ventricular assist devices (VAD) in participating centers. The initial interventions targeted improving communication, anticoagulation, and blood pressure management. We sought to describe the characteristics and outcomes of patients implanted with intracorporeal, continuous flow VADs (cfVAD).
To characterize the occurrence of stroke in pediatric patients supported with ventricular assist devices.
Patients with significant aortic regurgitation at time of left ventricular assist device (LVAD) implantation, frequently need concomitant aortic valve (AV) replacement (AVR) or AV repair. The aim of this study was to investigate the risk for thromboembolic events (TE) in patients with concomitant continuous-flow LVAD and AV surgery.