Impact of Hospital Procedural Volume on Outcomes Following Balloon Aortic Valvuloplasty

Balloon aortic valvuloplasty (BAV) is indicated in patients with acute decompensated heart failure or cardiogenic shock secondary to severe aortic stenosis,1 either as palliative therapy for patients who are not candidates for valve replacement,2 or as a bridge to transcatheter (TAVR) or surgical aortic valve replacement (SAVR).1,3 Given the high morbidity and mortality associated with BAV, especially because it is performed not infrequently in critically ill patients, it is important to understand the effect of hospital procedural volume on outcomes following BAV.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research

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All eyes will be on ISCHEMIA in Philadelphia, but a study on asymptomatic aortic stenosis as well as trials in heart failure and cardiogenic shock also piqued Dr John Mandrola's interest.theheart.org on Medscape
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Cardiology Commentary Source Type: news
Abstract Cardiogenic shock is a critical clinical situation, requiring rapid diagnosis, aetiological assessment and immediate initiation of therapy. In industrialized countries, aortic stenosis is the most frequent left-sided valvulopathy, followed by mitral regurgitation, aortic regurgitation and mitral stenosis. Severe valvulopathies leading to cardiogenic shock are not rare conditions, but few data are available on their optimal management. Therapeutic options for such critical conditions include inotropic agents, mechanical support (when feasible) and rapid valvular intervention. Although surgery remains the g...
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
ConclusionsECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
CONCLUSIONS: ECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients. Through recovery of end-organ function, ECMO may allow surgical correction of structural heart disease in patients considered inoperable or convert a salvage situation to an elective operation. PMID: 30236527 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
AbstractTranscatheter aortic valve implantation (TAVI) has been established as a low-invasive therapy for aortic stenosis, but circulatory collapse necessitating mechanical circulatory support could occur during TAVI due to procedure itself or procedural complications. The purpose of this study is to describe the outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in TAVI. Among 384 consecutive patients undergoing TAVI from April 2010 to July 2017 in Sakakibara Heart Institute, we evaluated seven patients (1.8%) who required ECMO during procedure. The definitions of outcome were derived from Valve Aca...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Abstract A 50-year-old man presented with acute onset dyspnea following cocaine use. He had severe aortic stenosis (AS), mild mitral regurgitation (MR) due to mitral valve prolapse, and no coronary artery disease on recent coronary angiography. He was in acute heart failure with signs of impending cardiogenic shock. Urgent bedside echocardiography revealed hyperdynamic left ventricular systolic function with acute severe MR from a ruptured chordae tendineae. The acute cocaine-induced spike of his already elevated left ventricular systolic pressure from severe AS likely precipitated chordal rupture of his vulnerabl...
Source: Methodist DeBakey Cardiovascular Journal - Category: Cardiology Authors: Tags: Methodist Debakey Cardiovasc J Source Type: research
The prognosis of patients with cardiogenic shock (CS) or refractory pulmonary edema due to severe aortic stenosis remains poor. The purpose of this study was to assess the outcomes of rescue percutaneous balloon aortic valvuloplasty (PBAV) in the transcatheter aortic valve implantation (TAVI) era. Patients were consecutively included between 2008 and 2016. CS was defined as ≥ 1 sign of systemic hypoperfusion and need of catecholamines. Refractory pulmonary edema was defined as not controlled by optimal medical treatment.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
CONCLUSION: Our case series demonstrate that even with elevated comorbidity index, clinical endpoints and valve-associated results are relatively favorable in nonagenarians treated with TAVR. PMID: 29054182 [PubMed - in process]
Source: Indian Heart J - Category: Cardiology Authors: Tags: Indian Heart J Source Type: research
Publication date: Available online 17 July 2017 Source:Cor et Vasa Author(s): Tadeas Butta, Petr Hajek, Josef Veselka Transcatheter aortic valve implantation (TAVI) is an established treatment option in patients with symptomatic severe aortic stenosis, who are at high or intermediate risk for surgical aortic valve replacement. The vast majority of TAVI are performed on patients without acute decompensated heart failure. In this case report we present the successful TAVI in a patient with a cardiogenic shock.
Source: Cor et Vasa - Category: Cardiology Source Type: research
We present a case of a 19-year-old woman who died suddenly from cardiogenic shock complicating an unknown Takayasu arteritis. At the autopsy, the aorta showed a significant thickening of the wall. The coronary arteries were slightly thickened and did not show any occlusion. Microscopic examination of the aorta showed an abundant granulomatous and a lymphoplasmacytic infiltrate. Microscopic sections of other internal organs showed signs of cardiac hypertrophy and an extensive edema of the lung. Death was attributed to acute heart failure complicating a supravalvular aortic stenosis secondary to unknown Takayasu arteritis. ...
Source: The American Journal of Forensic Medicine and Pathology - Category: Forensic Medicine Tags: Case Reports Source Type: research
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