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Long-Term Outcomes of Patients With Mediastinal Radiation-Associated Severe Aortic Stenosis and Subsequent Surgical Aortic Valve Replacement: A Matched Cohort Study Valvular Heart Disease
BackgroundCardiac disease after mediastinal radiotherapy for thoracic malignancy (chest radiotherapy [XRT]) often manifests as progressive aortic stenosis. In patients with XRT‐induced severe aortic stenosis undergoing surgical aortic valve replacement (SAVR), we sought to: (1) study long‐term survival and compare these patients with a matched cohort undergoing SAVR during the same time frame; and (2) identify potential predictors of long‐term mortality.Methods and ResultsWe studied patients with symptomatic severe aortic stenosis undergoing SAVR at our institution, of which there were 172 mediastinal XRT patients (6...
Source: JAHA:Journal of the American Heart Association - May 5, 2017 Category: Cardiology Authors: Donnellan, E., Masri, A., Johnston, D. R., Pettersson, G. B., Rodriguez, L. L., Popovic, Z. B., Roselli, E. E., Smedira, N. G., Svensson, L. G., Griffin, B. P., Desai, M. Y. Tags: Valvular Heart Disease Original Research Source Type: research

Neurological Inȷury in Intermediate-Risk Transcatheter Aortic Valve Implantation Interventional Cardiology
ConclusionsObjectively measured subclinical neurological injuries remain a concern in intermediate‐risk patients undergoing TAVI and are likely to manifest with early neurocognitive changes.Clinical Trial RegistrationURL: http://www.anzctr.org.au. Australian & New Zealand Clinical Trials Registry: ACTRN12613000083796.
Source: JAHA:Journal of the American Heart Association - November 14, 2016 Category: Cardiology Authors: Fanning, J. P., Wesley, A. J., Walters, D. L., Eeles, E. M., Barnett, A. G., Platts, D. G., Clarke, A. J., Wong, A. A., Strugnell, W. E., O'Sullivan, C., Tronstad, O., Fraser, J. F. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Cerebrovascular Disease/Stroke, Cognitive Impairment Original Research Source Type: research

Histological Findings and Predictors of Cerebral Debris From Transcatheter Aortic Valve Replacement: The ALSTER Experience Arrhythmia and Electrophysiology
ConclusionThis study showed a high rate of embolic debris consisting of typical anatomic structures known to be altered in patients with aortic stenosis undergoing transcatheter aortic valve replacement. Female patients with diabetes mellitus have increased risk of embolic debris and should be protected by a cerebral protection system during transcatheter aortic valve replacement. Because valve tissue embolizes more often in patients with predilation, procedural planning should consider this finding. Both cerebral arteries (brachiocephalic trunk, left carotid artery) should be protected in the same way.
Source: JAHA:Journal of the American Heart Association - November 9, 2016 Category: Cardiology Authors: Schmidt, T., Akdag, O., Wohlmuth, P., Thielsen, T., Schewel, D., Schewel, J., Alessandrini, H., Kreidel, F., Bader, R., Romero, M., Ladich, E., Virmani, R., Schafer, U., Kuck, K.–H., Frerker, C. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Catheter-Based Coronary and Valvular Interventions, Treatment Original Research Source Type: research

Relationship Between QT Interval and Outcome in Low-Flow Low-Gradient Aortic Stenosis With Low Left Ventricular Eȷection Fraction Valvular Heart Disease
ConclusionsIn patients with LF‐LG AS and reduced LVEF, longer QTc interval was associated with worse LV function and increased risk of death. Assessment of QTc may provide a simple and inexpensive tool to enhance risk stratification in LF‐LG AS patients.Clinical Trial RegistrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT 01835028.
Source: JAHA:Journal of the American Heart Association - October 19, 2016 Category: Cardiology Authors: Dahou, A., Toubal, O., Clavel, M.–A., Beaudoin, J., Magne, J., Mathieu, P., Philippon, F., Dumesnil, J. G., Puri, R., Ribeiro, H. B., Larose, E., Rodes-Cabau, J., Pibarot, P. Tags: Heart Failure, Valvular Heart Disease, Echocardiography, Electrocardiology (ECG), Prognosis Original Research Source Type: research

Critical Role of Coaptive Strain in Aortic Valve Leaflet Homeostasis: Use of a Novel Flow Culture Bioreactor to Explore Heart Valve Mechanobiology Cardiovascular Surgery
Conclusions Failure of AV to close initiates an extensive response characterized by expression changes common to progression to calcific aortic valve disease. AV coaptation, whether phasic or chronic, preserved phenotypic gene expression. These results demonstrate, for the first time, that coaptation of valve leaflets is a fundamentally important biomechanical cue driving homeostasis.
Source: JAHA:Journal of the American Heart Association - July 26, 2016 Category: Cardiology Authors: Maeda, K., Ma, X., Hanley, F. L., Riemer, R. K. Tags: Animal Models of Human Disease, Basic Science Research, Etiology, Physiology, Translational Studies Cardiovascular Surgery Source Type: research

Atrial Fibrillation Patients Treated With Long-Term Warfarin Anticoagulation Have Higher Rates of All Dementia Types Compared With Patients Receiving Long-Term Warfarin for Other Indications Cardiovascular Surgery
Conclusions The presence of AF significantly increases risk of dementia, including Alzheimer's disease, compared with matched patients receiving warfarin anticoagulation for other reasons. Quality of anticoagulation management remains an important risk factor for dementia in all patients.
Source: JAHA:Journal of the American Heart Association - July 10, 2016 Category: Cardiology Authors: Bunch, T. J., May, H. T., Bair, T. L., Crandall, B. G., Cutler, M. J., Day, J. D., Jacobs, V., Mallender, C., Osborn, J. S., Stevens, S. M., Weiss, J. P., Woller, S. C. Tags: Arrhythmias, Electrophysiology, Atrial Fibrillation Cardiovascular Surgery Source Type: research

Transcatheter Aortic Valve Implantation With or Without Preimplantation Balloon Aortic Valvuloplasty: A Systematic Review and Meta-Analysis Interventional Cardiology
Conclusions Our analysis suggests that TAVI procedures with or without preimplantation BAV were associated with similar outcomes for a number of clinically relevant end points. Further studies including a large number of patients are needed to ascertain the impact of TAVI without preimplantation BAV as a standard practice.
Source: JAHA:Journal of the American Heart Association - June 12, 2016 Category: Cardiology Authors: Bagur, R., Kwok, C. S., Nombela-Franco, L., Ludman, P. F., de Belder, M. A., Sponga, S., Gunning, M., Nolan, J., Diamantouros, P., Teefy, P. J., Kiaii, B., Chu, M. W. A., Mamas, M. A. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Catheter-Based Coronary and Valvular Interventions Interventional Cardiology Source Type: research

Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis Valvular Heart Disease
Conclusions Six-month mortality after IE is 25% and is predicted by host factors, IE characteristics, and IE complications. Surgery during the index hospitalization is associated with lower mortality but is performed less frequently in the highest risk patients. A simplified risk model may be used to identify specific risk subgroups in IE.
Source: JAHA:Journal of the American Heart Association - April 17, 2016 Category: Cardiology Authors: Park, L. P., Chu, V. H., Peterson, G., Skoutelis, A., Lejko-Zupa, T., Bouza, E., Tattevin, P., Habib, G., Tan, R., Gonzalez, J., Altclas, J., Edathodu, J., Fortes, C. Q., Siciliano, R. F., Pachirat, O., Kanj, S., Wang, A., for the International Collaborat Tags: Clinical Studies, Infectious Endocarditis, Valvular Heart Disease, Mortality/Survival Source Type: research

Synergistic Utility of Brain Natriuretic Peptide and Left Ventricular Strain in Patients With Significant Aortic Stenosis Valvular Heart Disease
Conclusions In normal LVEF patients with significant aortic stenosis, BNP and LV-GLS provide incremental (additive not duplicative) prognostic information over established predictors, suggesting that both play a synergistic role in defining outcomes.
Source: JAHA:Journal of the American Heart Association - January 5, 2016 Category: Cardiology Authors: Goodman, A., Kusunose, K., Popovic, Z. B., Parikh, R., Barr, T., Sabik, J. F., Rodriguez, L. L., Svensson, L. G., Griffin, B. P., Desai, M. Y. Tags: Metabolism, Valvular Heart Disease, Echocardiography, Cardiovascular Surgery Source Type: research

Outcome Reporting in Cardiac Surgery Trials: Systematic Review and Critical Appraisal Cardiovascular Surgery
Conclusions Outcome reporting in the cardiac surgery literature is heterogeneous, and efforts should be made to standardize the outcomes reported and the definitions used to ascertain them. The development of standardizing outcome reporting is an essential step toward strengthening the process of evidence-based care in cardiac surgery.
Source: JAHA:Journal of the American Heart Association - August 17, 2015 Category: Cardiology Authors: Goldfarb, M., Drudi, L., Almohammadi, M., Langlois, Y., Noiseux, N., Perrault, L., Piazza, N., Afilalo, J. Tags: Cardiovascular Surgery Source Type: research

Importance of Exercise Capacity in Predicting Outcomes and Determining Optimal Timing of Surgery in Significant Primary Mitral Regurgitation Valvular Heart Disease
Conclusion In patients with primary MR that underwent exercise echocardiography followed by MV surgery, lower achieved metabolic equivalents were associated with worse long-term outcomes. In those with preserved exercise capacity, delaying MV surgery by ≥1 year did not adversely affect outcomes.
Source: JAHA:Journal of the American Heart Association - September 11, 2014 Category: Cardiology Authors: Naji, P., Griffin, B. P., Barr, T., Asfahan, F., Gillinov, A. M., Grimm, R. A., Rodriguez, L. L., Mihaljevic, T., Stewart, W. J., Desai, M. Y. Tags: Valvular Heart Disease Source Type: research