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Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Aged 40 to 70 Years: A Systematic Review and Meta-Analysis
Publication date: Available online 12 January 2016 Source:The Annals of Thoracic Surgery Author(s): James J. Wu, Michael Seco, James B. Edelman, Guy D. Eslick, Michael K. Wilson, Michael P. Vallely, Michael J. Byrom, Paul G. Bannon Prosthetic valve choice for middle-aged adults undergoing aortic valve replacement is a complex decision. Database searches identified 13 studies comparing mechanical and bioprosthetic valves in aortic valve replacement patients aged 40 to 70 years. No significant difference was found at 15 years for survival, freedom from stroke, and freedom from endocarditis. Mechanical valves were a...
Source: The Annals of Thoracic Surgery - January 13, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting
Conclusions For patients with prior coronary artery bypass graft surgery and aortic stenosis, TAVR offers a significant morbidity advantage and a strong trend toward improved survival over SAVR at 1 year.
Source: The Annals of Thoracic Surgery - December 15, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Intermediate Clinical and Hemodynamic Outcomes After Transcatheter Aortic Valve Implantation
Conclusions Our data show that TAVI has good early and intermediate-term clinical and hemodynamic outcomes in high-risk or inoperable patients with severe symptomatic aortic valve stenosis. PVL of any grade has a significant impact on survival.
Source: The Annals of Thoracic Surgery - October 24, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes in Nonagenarians Undergoing Transcatheter Aortic Valve Replacement in the PARTNER-I Trial
Conclusions A TAVR can be performed in nonagenarians with acceptable short- and mid-term outcomes. Although TF- and TA-TAVR outcomes are not directly comparable, TA-TAVR appears to carry a higher risk of early death without a difference in intermediate-term mortality. Age alone should not preclude referral for TAVR in nonagenarians.
Source: The Annals of Thoracic Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Expanding Role of Endoscopic Robotics in Mitral Valve Surgery: 1,257 Consecutive Procedures
Conclusions Mitral valve repair or replacement, including concomitant procedures, can be performed safely and effectively using the LEAR technique. With a dedicated robotic team, the vast majority of patients with MV disorders, either isolated or with concomitant problems, can be treated using the LEAR technique.
Source: The Annals of Thoracic Surgery - August 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States
Conclusions Patients undergoing TAo TAVR are older, more likely female, and have significantly higher STS predicted risk of mortality scores than patients operated on by TA access. There were no risk-adjusted differences between TA and TAo access in mortality, stroke, or readmission rates as long as 1 year after TAVR.
Source: The Annals of Thoracic Surgery - July 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contemporary Outcomes of Repeat Aortic Valve Replacement: A Benchmark for Transcatheter Valve-in-Valve Procedures
Conclusions Re-AVR is now performed with an acceptable operative mortality, which is higher than primary AVR. The overall incidence of stroke, vascular complication, and postoperative aortic insufficiency was low although higher than primary AVR. These results may serve as a benchmark for future analysis of valve-in-valve transcatheter aortic valve replacement and may have an effect on future choice of transcatheter aortic valve replacement vs re-AVR.
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Institutional Variation in Mortality After Stroke After Cardiac Surgery: An Opportunity for Improvement
Conclusions Institutional variation, more so than individual patient risk factors, is highly associated with postoperative stroke and FTR rates after stroke after cardiac surgery. Postoperative stroke remains significantly associated with mortality and morbidity. Institutional practice patterns may confer a disproportionate influence on postoperative stroke independent of case mix. Understanding differences between high and low performing centers is essential to improving outcomes, costs, and hospital quality.
Source: The Annals of Thoracic Surgery - July 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcomes for Transcatheter Aortic Valve Replacement in Nonagenarians
Conclusions Extreme-aged nonagenarian patients may have excellent outcomes from TAVR at 30-day and midterm follow-up. Alternative access TAVR is associated with higher morbidity and mortality than transfemoral TAVR. Referral for TAVR of nonagenarians should not be precluded based on age alone.
Source: The Annals of Thoracic Surgery - July 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Endoaortic Clamping Does Not Increase the Risk of Stroke in Minimal Access Mitral Valve Surgery: A Multicenter Experience
Conclusions Once procedural proficiency is acquired, endoaortic balloon clamping in MIMVS is a safe and effective technique. Despite the fact that this patient cohort also includes combined and redo procedures, the observed mortality and stroke rate compared favorably with the existing literature on primary isolated mitral valve surgery irrespective of the approach.
Source: The Annals of Thoracic Surgery - July 7, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Low Incidence of Paravalvular Leakage With the Balloon-Expandable Sapien 3 Transcatheter Heart Valve
Conclusions The present study shows excellent clinical and hemodynamic outcomes of high-risk transapical valve replacement patients treated with the new S3 THV. The S3 THV shows a low incidence of postoperative aortic regurgitation, with 98% presenting with less than mild aortic regurgitation.
Source: The Annals of Thoracic Surgery - June 24, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Simultaneous Carotid Artery Stenting and Heart Surgery: Expanded Experience of Hybrid Surgical Procedures
Conclusions Same-day hybrid approach appeared safe in terms of early and long-term results not only for CAS and isolated CABG but also for CAS and noncoronary isolated procedures. In complex cases, the rate of stroke and myocardial infarction seemed low; in-hospital mortality, as expected, was higher. Long-term survival appeared similarly satisfactory, thus confirming the hybrid approach as a valid therapeutic option for all patients with significant internal carotid artery stenosis associated with coronary and other cardiac lesions, at least for noncomplex cases.
Source: The Annals of Thoracic Surgery - February 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Postoperative Atrial Fibrillation After Thoracic Aortic Surgery
Conclusions Several risk factors contribute to the incidence of POAF after thoracic aortic surgery. We found that POAF significantly increased 30-day operative mortality (p < 0.0001). Our findings can be used to develop a risk stratification system for the prediction of POAF.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

Operative Mortality and Complication Risk Model for All Major Cardiovascular Operations in Japan
Conclusions These risk models increased the discriminatory power of former models. Thus, our models can be said to reflect the current state of Japan. With respect to major complications, useful feedback can now be provided through the Japan Cardiovascular Surgery Database Web-based system.
Source: The Annals of Thoracic Surgery - December 30, 2014 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Impact of Specific Preoperative Organ Dysfunction in Patients Undergoing Aortic Valve Replacement ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions The presence of chronic renal failure most profoundly decreases survival, followed by severe chronic obstructive pulmonary disease and prior stroke. Furthermore, multiple OD systems significantly decrease short- and long-term survival.
Source: The Annals of Thoracic Surgery - February 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Thourani, V. H., Chowdhury, R., Gunter, R. L., Kilgo, P. D., Chen, E. P., Puskas, J. D., Halkos, M. E., Lattouf, O. M., Cooper, W. A., Guyton, R. A. Tags: Valve disease ORIGINAL ARTICLES: ADULT CARDIAC Source Type: research

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