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Preoperative Venoarterial Extracorporeal Membrane Oxygenation Slashes Risk Score in Advanced Structural Heart Disease.
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 - September 17, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Watkins AC, Maassel NL, Ghoreishi M, Dawood MY, Pham SM, Kon ZN, Taylor BS, Griffith BP, Gammie JS Tags: Ann Thorac Surg Source Type: research

TAVI and the brain: update on definitions, evidence of neuroprotection and adjunctive pharmacotherapy.
Authors: Lansky A, Ghare MI, Tchétché D, Baumbach A Abstract Transcatheter aortic valve implantation (TAVI) has become the preferred method of treatment for high-risk patients with severe symptomatic aortic stenosis (AS) and is a preferred alternative to surgical valve replacement for intermediate-risk patients. Stroke remains one of the most clinically devastating complications following TAVI. We review the incidence of neurologic injury related to TAVI, proposed definitions for neurologic events and current evidence for neuroprotection and adjunctive pharmacotherapy. PMID: 30158096 [PubMed - in process]
Source: EuroIntervention - August 31, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Hemiarch Reconstruction Versus Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
ConclusionsHemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared with a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multiprocedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Early commercial experience from transcatheter aortic valve implantation using the Portico ™ bioprosthetic valve: 30-day outcomes in the multicentre PORTICO-1 study.
CONCLUSIONS: The Portico TAVI system allows safe and effective treatment of aortic stenosis in patients at increased surgical risk. At 30 days, mortality was low, and good haemodynamic performance was indicated by low transvalvular gradient and a low rate of moderate or higher PVL. PMID: 30111522 [PubMed - as supplied by publisher]
Source: EuroIntervention - August 17, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

One-year outcomes of patients with severe aortic stenosis and an STS-PROM of less than three percent in the SURTAVI trial.
CONCLUSIONS: Among patients at intermediate surgical risk but with STS PROM<3%, TAVI may achieve superior clinical outcomes compared to SAVR. These findings support the need for an adequately powered randomized trial to compare TAVI with SAVR in patients at low operative risk. PMID: 29992904 [PubMed - as supplied by publisher]
Source: EuroIntervention - July 12, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Transcatheter aortic valve implantation with the self-expanding Portico ™ valve system in an all-comers population: procedural and clinical outcomes.
CONCLUSIONS: The PorticoTM TAVI system was safe to implant and achieved a high device success rate. With learning curve effects, the device achieves lower rates of PVL and pacemaker implantation and provides adequate clinical and hemodynamic outcomes through 1 year. PMID: 29969432 [PubMed - as supplied by publisher]
Source: EuroIntervention - July 5, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm
Conclusions Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery.
Source: The Annals of Thoracic Surgery - May 4, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Hemiarch Reconstruction Vs Clamped Aortic Anastomosis for Concomitant Ascending Aortic Aneurysm.
CONCLUSIONS: Hemiarch replacement using DHCA with RCP does not increase the risk of operative complications compared to a normothermic, clamped-distal aortic anastomosis, and therefore its use should not be limited when planning complex multi-procedural reconstructions during elective ascending thoracic aortic replacement with concomitant cardiac surgery. PMID: 29730345 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - May 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Sultan I, Bianco V, Yajzi I, Kilic A, Dufendach K, Cardounel A, Althouse AD, Masri A, Navid F, Gleason TG Tags: Ann Thorac Surg Source Type: research

Outcomes in 937 Intermediate-Risk Patients Undergoing Surgical Aortic Valve Replacement in PARTNER-2A
Conclusions In this adjudicated prospective study, SAVR in intermediate-risk patients had excellent results at 2 years. However, there were more in-hospital strokes than expected, most likely attributable to mandatory neurologic assessment after the procedure. No pronounced structural valve deterioration was found during 2-year follow-up. Continued long-term surveillance remains important.
Source: The Annals of Thoracic Surgery - April 22, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Minimally Invasive SAPIEN in Mitral Annular Calcification Following Transcatheter Aortic Valve Replacement: Feasibility and Lessons Learned
In this report, we present a case of concomitant left main disease, severe aortic stenosis, and severe mitral stenosis secondary to MAC using a hybrid approach culminating in transcatheter mitral valve replacement (TMVR) via a minimally invasive right thoracotomy.
Source: Seminars in Thoracic and Cardiovascular Surgery - April 4, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Tom C. Nguyen, Juan B. Umana-Pizano, Gina P. Landinez, Prakash Balan Tags: Adult – Case Report Source Type: research

Hemodynamic Consequence of Different Pacing Modes after Aortic Valve Replacement.
CONCLUSION: An increase in the heart rate does not lead to a notable drop in SV postoperatively in left-ventricular hypertrophy; hence a rise in cardiac output can be anticipated up to a rate of 100 beats/min. A standardized response in terms of an ideal pacemaker stimulation mode could not be identified. PMID: 29658865 [PubMed - in process]
Source: The Heart Surgery Forum - March 6, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Kiessling AH Tags: Heart Surg Forum Source Type: research

Novel Predictors of Mild Paravalvular Aortic Regurgitation in SAPIEN 3 Transcatheter Aortic Valve Implantation.
CONCLUSIONS: LVOT eccentricity and discordant sizing predict PVL after S3 TAVI. Further studies are needed to understand their mechanism and significance. PMID: 29488887 [PubMed - as supplied by publisher]
Source: EuroIntervention - March 2, 2018 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Supra ‐annular structure assessment for self‐expanding transcatheter heart valve size selection in patients with bicuspid aortic valve
ConclusionsA supra‐annular structure based sizing strategy is feasible for TAVR in patients with bicuspid AS.
Source: Catheterization and Cardiovascular Interventions - February 5, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Xianbao Liu, Yuxin He, Qifeng Zhu, Feng Gao, Wei He, Lei Yu, Qijing Zhou, Minjian Kong, Jian'an Wang Tags: ORIGINAL STUDIES Source Type: research

Transcatheter versus surgical aortic valve replacement in patients at low surgical risk: A meta ‐analysis of randomized trials and propensity score matched observational studies
ConclusionsIn patients who are at low surgical risk, TAVR seems to be associated with increased mortality risk. Until more data in this population is available, SAVR should remain the treatment of choice for these patients.
Source: Catheterization and Cardiovascular Interventions - February 1, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Guy Witberg, Adi Lador, Dafna Yahav, Ran Kornowski Tags: VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research

Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral
ConclusionsOur study suggests that TSc approach may be, not only an alternative route to TF approach for TAVI, but even a competitive one in certain patients with increased risk of femoral injury.
Source: Catheterization and Cardiovascular Interventions - January 3, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Ignacio J. Amat ‐Santos, Paol Rojas, Hipólito Gutiérrez, Silvio Vera, Javier Castrodeza, Javier Tobar, L. Renier Goncalves‐Ramirez, Manuel Carrasco, Pablo Catala, José A. San Román Tags: VSD ‐ VALVULAR AND STRUCTURAL HEART DISEASES Source Type: research

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