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Trends, Predictors, and Outcomes of Stroke After Surgical Aortic Valve Replacement in the United States
Conclusions The incidence of stroke after AVR has decreased but remains a significant cause of morbidity in medium- and high-risk patients. Superior outcomes can be achieved in medium- to high-risk patients at high-volume centers.
Source: The Annals of Thoracic Surgery - November 27, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Development and Application of a Risk Prediction Model for In-Hospital Stroke After Transcatheter Aortic Valve Replacement – A Report from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry
ConclusionsA risk model for in-hospital stroke following TAVR was developed from the STS/ACC TVT Registry and used to estimate site-specific stroke performance. This model can serve as a valuable resource for quality improvement, clinical decision-making, and patient counseling.
Source: The Annals of Thoracic Surgery - December 8, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

In DeBakey Type I Aortic Dissection, Bovine Aortic Arch Is Associated With Arch Tears and Stroke
Conclusions BAA is an independent predictor for the distinctive location of the entry site in the aortic arch and risk factor for stroke.
Source: The Annals of Thoracic Surgery - August 17, 2017 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

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

Should We Perform Carotid Doppler Screening Before Surgical or Transcatheter Aortic Valve Replacement?
Conclusions We found no statistically significant association between ICAS severity procedure-related stroke after aortic valve replacement. This suggests that universal carotid Doppler screening before isolated TAVR or SAVR is unnecessary.
Source: The Annals of Thoracic Surgery - October 4, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis
ConclusionsAortic valve sparing appears to be safe, and associated with reduced late mortality, thromboembolism/stroke and bleeding compared with composite valve grafting. Late durability is equivalent. Aortic valve sparing should be considered in patients with favorable aortic valve morphology.Graphical abstract
Source: The Annals of Thoracic Surgery - January 23, 2020 Category: Cardiovascular & Thoracic Surgery Source Type: research

One-Year Outcomes of Transcatheter Aortic  Valve Replacement in Patients With End-Stage Renal Disease
Conclusions Early mortality in patients with ESRD is comparable to previously published data on extreme-risk patients without ESRD, but our data suggest a higher mortality rate at 1 year for ESRD patients, likely due to comorbid conditions. Stroke and major vascular injury are infrequent, and improved valve hemodynamics are maintained at 1 year.
Source: The Annals of Thoracic Surgery - April 18, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Late Neurologic Events After Surgery for Atrial Fibrillation: Rare but Relevant ORIGINAL ARTICLES: ADULT CARDIAC
Conclusions After surgery for AF ablation, there is ongoing low risk of LNE even when the LAA is surgically excised. Further investigation should be pursued to clarify whether a difference exists with alternative elimination techniques and in patients in whom AF is successfully eliminated.
Source: The Annals of Thoracic Surgery - December 31, 2012 Category: Cardiovascular & Thoracic Surgery Authors: Lee, R., Jivan, A., Kruse, J., McGee, E. C., Malaisrie, S. C., Bernstein, R., Lapin, B., Passman, R., Knight, B. P., McCarthy, P. M. Tags: Electrophysiology - arrhythmias ORIGINAL ARTICLES: ADULT CARDIAC 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

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

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

The Midterm Impact of Transcatheter Aortic Valve Replacement on Surgical Aortic Valve Replacement in Michigan
Conclusions TAVR implementation in Michigan has dramatically increased overall SAVR volume. This phenomenon has occurred with a concomitant decrease in preoperative risk profile and has improved early SAVR outcomes, particularly at TAVR hospitals, but surprisingly not in patients considered at high preoperative risk. As TAVR use increases, these issues may be further clarified and elucidated.
Source: The Annals of Thoracic Surgery - May 3, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Comparison of the Performance of a Sutureless Bioprosthesis With Two Pericardial Stented Valves on Small Annuli: An In  Vitro Study
Conclusions All of the valves tested provided good fluid dynamic performances. The sutureless bioprosthesis provided the best performance with the least hindrance to flow behavior. From the hydrodynamic perspective, the sutureless prosthesis may present an advance in the evolution of bioprostheses, ensuring low gradients and potential for low incidence of patient-prosthesis mismatch even in small annuli.
Source: The Annals of Thoracic Surgery - August 17, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

A Systemic Review and Meta-Analysis of Sutureless Aortic Valve Replacement Versus Transcatheter Aortic Valve Implantation
ConclusionsOur meta-analysis of observational studies demonstrates that early mortality is lower after SU-AVR than after TAVI in selected patients. The rates of stroke and pacemaker implant are comparable between procedures; however, the incidence of paravalvular leak is higher after TAVI.
Source: The Annals of Thoracic Surgery - August 21, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

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