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Recurrent infarctions due to a dome-shaped pannus above the mitral valve prosthesis.
This report describes a unique case of a 56-year-old female who suffered from recurrent stroke after double mechanical valve replacement. During the four years after the surgery, she remained in normal sinus rhythm, received adequate anticoagulation therapy, and no apparent left atrial thrombus was detected. She underwent redo surgery to prevent further stroke after fourth instance of cerebral infarction. Intraoperative findings revealed a 'dome-shaped' pannus formation covering the sewing ring of the mitral prosthesis circumferentially, probably leading to clot formation and repeated infarctions. She has been stroke free ...
Source: Journal of Thoracic Disease - February 25, 2016 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: The Loire Valley Atrial Fibrillation Project.
CONCLUSION Incidence rates of IS/TE, mortality and bleeding increased with reducing eGFR, across the whole range of renal function. OAC use was associated with a lower incidence of IS/TE and mortality at 1 year, compared with non-anticoagulated individuals in all categories of renal function as measured by eGFR. The NCB balancing IS against serious bleeding was positive, in favour of OAC use amongst patients with renal impairment. PMID: 24356875 [PubMed - as supplied by publisher]
Source: Chest - December 19, 2013 Category: Respiratory Medicine Authors: Banerjee A, Fauchier L, Vourc'h P, Andres CR, Taillandier S, Halimi JM, Lip GY Tags: Chest Source Type: research

Blood pressure control in older patients with carotid artery stenosis.
Authors: Faggiano P, Scodro M, Sbolli M, Branca L, Cani D, Valentini F, Perego C, Provini M Abstract Stroke is the second largest cause of European cardiovascular and total mortality, largely due to atherosclerotic carotid artery narrowing or thromboembolism consequent to internal carotid artery stenosis. Current therapeutic indications suggest lifestyle interventions (smoking cessation, healthy diet and physical activity), adequate control of LDL-cholesterol and glycemic balance. It is nonetheless established that the most important factors in preventing stroke are antiplatelet therapy and blood pressure regulati...
Source: Monaldi Archives for Chest Disease - June 9, 2018 Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research

Left ventricular assist device exchange for the treatment of HeartMate II pump thrombosis.
Conclusions: It is generally feasible to treat pump thrombosis via LVAD exchange. Yet, the exchange procedure is not without risk and the risk of re-thrombosis (34%), stroke (29%), postoperative dialysis (29%) and perioperative complications remains high. PMID: 30034845 [PubMed]
Source: Journal of Thoracic Disease - July 25, 2018 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research

Effectiveness and Safety of Four Direct Oral Anticoagulants in Asians with Non-valvular Atrial Fibrillation.
CONCLUSIONS: In the largest real-world practice study among Asians with NVAF, four DOACs were associated with lower risks of thromboembolism and bleeding than warfarin. There was consistency even amongst high risk subgroups and whether standard dose or low dose regimes were compared. PMID: 31103697 [PubMed - as supplied by publisher]
Source: Chest - May 15, 2019 Category: Respiratory Medicine Authors: Chan YH, Lee HF, See LC, Tu HT, Chao TF, Yeh YH, Wu LS, Kuo CT, Chang SH, Lip GYH Tags: Chest Source Type: research

Outcomes related to anticoagulation management for mechanical valve replacements
CONCLUSIONS: Taking into account relevant comorbidities and valve type, patients with a larger proportion of non-therapeutic INRs during the first post-operative year demonstrated no difference in longitudinal clinical outcomes. Further research into more standardized INR monitoring and potentially expanded INR target ranges for patients undergoing mechanical valve replacement is warranted.PMID:34164179 | PMC:PMC8182532 | DOI:10.21037/jtd-20-2562
Source: Journal of Thoracic Disease - June 24, 2021 Category: Respiratory Medicine Authors: Lauren V Huckaby Laura M Seese Thomas G Gleason Ibrahim Sultan Yisi Wang Floyd Thoma Arman Kilic Source Type: research

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