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‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Urgent surgery compared with fibrinolytic therapy for the treatment of left-sided prosthetic heart valve thrombosis: a systematic review and meta-analysis of observational studies
Conclusion Urgent surgery was not superior to FT at restoring valve function, but substantially reduced the occurrence of thrombo-embolic events, major bleeding, and recurrent PVT. In experienced centres, urgent surgery should probably be preferred over FT for treating left-sided PVT, pending the results of randomized controlled trials.
Source: European Heart Journal - June 1, 2013 Category: Cardiology Authors: Karthikeyan, G., Senguttuvan, N. B., Joseph, J., Devasenapathy, N., Bahl, V. K., Airan, B. Tags: Valvular heart disease Source Type: research

Aortic valve replacement with mechanical vs. biological prostheses in patients aged 50-69 years
Conclusion Patients aged 50–69 years who received mechanical valves had better long-term survival after AVR than those with bioprostheses. The risk of stroke was similar; however, patients with bioprostheses had a higher risk of aortic valve reoperation and a lower risk of major bleeding. Clinical Trial Registration http://clinicaltrials.gov/show/NCT02276950. ClinicalTrials.gov Identifier NCT02276950.
Source: European Heart Journal - September 20, 2016 Category: Cardiology Authors: Glaser, N., Jackson, V., Holzmann, M. J., Franco-Cereceda, A., Sartipy, U. Tags: Cardiovascular surgery Source Type: research

Perioperative risk of major non-cardiac surgery in patients with severe aortic stenosis: a reappraisal in contemporary practice
Conclusion Severe aortic stenosis is associated with increased risk of MACE. In contemporary practice, perioperative mortality of patients with SAS is lower than previously reported and the difference from controls did not reach statistical significance. Emergency surgery is the strongest predictor of post-operative death. These results have implications for perioperative risk assessment and management strategies in patients with SAS.
Source: European Heart Journal - September 14, 2014 Category: Cardiology Authors: Tashiro, T., Pislaru, S. V., Blustin, J. M., Nkomo, V. T., Abel, M. D., Scott, C. G., Pellikka, P. A. Tags: Valvular heart disease Source Type: research

Paradoxical low-flow, low-gradient aortic stenosis despite preserved left ventricular ejection fraction: new insights from weights of operatively excised aortic valves
Conclusion The aortic valve weight data reported in this study provide evidence that a large proportion of patients with PLF and low-gradient have a severe stenosis and that the gradient may substantially underestimate stenosis severity in these patients. A multi-parametric approach including all Doppler-echocardiographic parameters of valve function as well as other complementary diagnostic tests may help correctly identify these patients.
Source: European Heart Journal - October 7, 2014 Category: Cardiology Authors: Clavel, M.-A., Cote, N., Mathieu, P., Dumesnil, J. G., Audet, A., Pepin, A., Couture, C., Fournier, D., Trahan, S., Page, S., Pibarot, P. Tags: Valvular heart disease Source Type: research

Paravalvular regurgitation after transcatheter aortic valve replacement with the Edwards sapien valve in the PARTNER trial: characterizing patients and impact on outcomes
Conclusion Differences in baseline characteristics in patients with increasing severities of PVR may increase the risk of this complication. Despite these differences, multivariable analysis demonstrated that both mild and moderate/severe PVR predicted higher 1-year mortality.
Source: European Heart Journal - February 14, 2015 Category: Cardiology Authors: Kodali, S., Pibarot, P., Douglas, P. S., Williams, M., Xu, K., Thourani, V., Rihal, C. S., Zajarias, A., Doshi, D., Davidson, M., Tuzcu, E. M., Stewart, W., Weissman, N. J., Svensson, L., Greason, K., Maniar, H., Mack, M., Anwaruddin, S., Leon, M. B., Hah Tags: Valvular heart disease Source Type: research

Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study)
Conclusion Rheumatic heart disease patients were young, predominantly female, and had high prevalence of major cardiovascular complications. There is suboptimal utilization of secondary antibiotic prophylaxis, oral anti-coagulation, and contraception, and variations in the use of percutaneous and surgical interventions by country income level.
Source: European Heart Journal - May 7, 2015 Category: Cardiology Authors: Zuhlke, L., Engel, M. E., Karthikeyan, G., Rangarajan, S., Mackie, P., Cupido, B., Mauff, K., Islam, S., Joachim, A., Daniels, R., Francis, V., Ogendo, S., Gitura, B., Mondo, C., Okello, E., Lwabi, P., Al-Kebsi, M. M., Hugo-Hamman, C., Sheta, S. S., Haile Tags: Valvular heart disease Source Type: research