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Procedure: Heart Valve Surgery

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Total 1289 results found since Jan 2013.

Minimally Invasive Placement of the Impella Assist Device is Associated with Low Stroke Risk
Cardiogenic shock is associated with high mortality rate and mechanical circulatory devices are critical in its treatment. The Impella device is a microaxial left ventricular assist device (LVAD) that is inserted through the aortic valve into left ventricular apex. The purpose of the study is to determine the incidence of stroke with the Impella device when it is placed through a minimally invasive approach.
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Anthony Lemaire, Lindsay Volk, Leonard Y. Lee Tags: Cardiac Surgery Source Type: research

Paradoxical Increase of Stroke in Patients with Defect of High Molecular Weight Multimers of the von Willebrand Factors following Transcatheter Aortic Valve Replacement.
CONCLUSION:  MLBCs and CT-ADP > 180 seconds were identified as predictors for ischemic stroke or TIA. The present study suggests that the defects of HMW multimers of the VWFs may contribute not only to bleeding events but also to thrombotic events. PMID: 32726854 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - July 28, 2020 Category: Hematology Authors: Matsushita K, Marchandot B, Trimaille A, Kibler M, Heger J, Peillex M, Hess S, Grunebaum L, Reydel A, Kindo M, Hoang MT, Sato C, De Poli F, Leddet P, Ohana M, Jesel L, Ohlmann P, Susen S, Morel O Tags: Thromb Haemost Source Type: research

Impact of Perioperative Stroke on Mid Term Outcomes after Transcatheter Aortic Valve Replacement.
CONCLUSIONS: Stroke increases short term and mid-term mortality following TAVR. Risk prediction for neurologic events in TAVR could aid framework for patient selection, further improving outcomes. PMID: 32151578 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - March 5, 2020 Category: Cardiovascular & Thoracic Surgery Authors: Habertheuer A, Gleason TG, Kilic A, Schindler J, Kliner D, Bianco V, Toma C, Aranda-Michel E, Kacin A, Sultan I Tags: Ann Thorac Surg Source Type: research

Thrombolysis for Acute Ischemic Stroke Following Transcatheter Aortic Valve Replacement: Case Report and Literature Review
Conclusion: Previously undescribed, we suggest that tPA should be considered for post-TAVR AIS patients who otherwise satisfy inclusion and exclusion criteria.
Source: The Neurologist - March 1, 2020 Category: Neurology Tags: Case Report/Case Series Source Type: research

Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Replacement —Effective in Stroke Prevention?
Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for severe symptomatic aortic stenosis. Despite advances in device technology and procedural techniques, periprocedural stroke remains a severe complication of TAVR, affecting 2% of patients. The embolization of calcific debris from the degenerated aortic valve and atherosclerotic plaque from the aorta, both of which are manipulated during TAVR, is the likely mechanism of periprocedural stroke. Accordingly, cerebral embolic protection devices (EPDs) have been designed to prevent stroke by sequestering embolic debris during TAVR.
Source: JAMA Internal Medicine - February 24, 2020 Category: Internal Medicine Source Type: research

Abbott Wins Approval for CATALYST Trial for At-Risk Stroke Patients
This study is an extremely important step in assessing the Amplatzer Amulet as an effective non-prescription drug alternative for patients with AFib who are at an increased risk for ischemic stroke." In an email sent to MD+DI, Abbott wrote, “We already have an Amulet IDE trial underway that is intended to support our submission for approval in the U.S. for Amplatzer Amulet. The newly announced CATALYST trial will support our submission for an expanded indication for Amulet as a safe and effective alternative to NOAC drugs for patients with atrial fibrillation and at risk of stroke.” Abbo...
Source: MDDI - February 3, 2020 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Regulatory and Compliance Source Type: news

Investigation of Computed-Tomography Based Predictors of Acute Stroke Related to Transcatheter Aortic Valve Replacement: Aortic Wall Plaque Thickness Might be a Predictive Parameter of Stroke.
CONCLUSION: Aortic wall plaque thickness measured by contrast-enhanced CT might be a predictive parameter of strokes that occur within 48 hours after TAVR. PMID: 32005786 [PubMed - in process]
Source: The Journal of Invasive Cardiology - February 3, 2020 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Impact of Stroke Volume Index and Left Ventricular Ejection Fraction on Mortality After Aortic Valve Replacement
To assess the impact of stroke volume index (SVI) and left ventricular ejection fraction (LVEF) on prognosis in patients with severe aortic stenosis, comparing those undergoing transcatheter aortic valve replacement (TAVR) and those with surgical AVR (SAVR).
Source: Mayo Clinic Proceedings - December 31, 2019 Category: Internal Medicine Authors: Saki Ito, Vuyisile T. Nkomo, David A. Orsinelli, Grace Lin, Joao Cavalcante, Jeffrey J. Popma, David H. Adams, Stanley J. Checuti, G. Michael Deeb, Michael Boulware, Jian Huang, Stephen H. Little, Sidney A. Cohen, Michael J. Reardon, Jae K. Oh Tags: Original article Source Type: research

Flow, Reflected by Stroke Volume Index, Is a Risk Marker in High-Gradient Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Replacement
ConclusionsSVi can further characterize patients with HG-AS and may help to identify those who are at increased risk after TAVR.RésuméContexteDes outils sont nécessaires pour dépister les patients exposés à un risque accru à la suite d’un remplacement valvulaire aortique par cathéter (RVAC). Le volume systolique indexé (VSI) est une mesure échocardiographique utilisée dans les cas de sténose aortique à faible gradient. Nous avons vérifié si un faible VSI était un marqueur de risque accru chez les patients présentant une sténose aortique à gradient élevé et avons évalué comment la relation entre le ...
Source: Canadian Journal of Cardiology - December 24, 2019 Category: Cardiology Source Type: research

Predictors and outcomes of stroke after transcatheter aortic valve replacement
ConclusionsAlternative access approach and a history of transient ischemic attack emerged as independent predictors of postoperative stroke. Patients with stroke suffered more complications and had worse survival, underscoring the importance of characterizing the stroke risk in these patients.
Source: Journal of Cardiac Surgery - December 2, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Sarah A. Hatfield, Marcos A. Nores, Taylor M. James, Mark Rothenberg, Arvind Kapila, Roberto J. Cubeddu, Sotiris C. Stamou Tags: ORIGINAL ARTICLE Source Type: research

Early and late risk of ischemic stroke after TAVR as compared to a nationwide background population
In conclusion, TAVR was associated with an increased risk of ischemic CVE in the early phase, but not in the late phase, as compared to their matched con trols—OAC therapy reduced this early risk of ischemic CVE by half.
Source: Clinical Research in Cardiology - October 29, 2019 Category: Cardiology Source Type: research

Research Articles Ventricular stroke work and vascular impedance refine the characterization of patients with aortic stenosis
Aortic stenosis (AS) management is classically guided by symptoms and valvular metrics. However, the natural history of AS is dictated by coupling of the left ventricle, aortic valve, and vascular system. We investigated whether metrics of ventricular and vascular state add to the appreciation of AS state above valve gradient alone. Seventy patients with severe symptomatic AS were prospectively followed from baseline to 30 days after transcatheter aortic valve replacement (TAVR). Quality of life (QOL) was assessed using the Kansas City Cardiomyopathy Questionnaire. Left ventricular stroke work (SWLV) and vascular impedance...
Source: Science Translational Medicine - September 10, 2019 Category: Biomedical Science Authors: Ben-Assa, E., Brown, J., Keshavarz-Motamed, Z., de la Torre Hernandez, J. M., Leiden, B., Olender, M., Kallel, F., Palacios, I. F., Inglessis, I., Passeri, J. J., Shah, P. B., Elmariah, S., Leon, M. B., Edelman, E. R. Tags: Research Articles Source Type: research

Flow, Reflected by Stroke Volume Index, is a Risk Marker in High Gradient Aortic Stenosis Patients Undergoing Transcatheter Aortic Valve Replacement
ConclusionsSVi can further characterise patients with HG-AS and may help to identify those who are at increased risk following TAVR.
Source: Canadian Journal of Cardiology - August 30, 2019 Category: Cardiology Source Type: research

Impact of stroke volume on severe aortic stenosis in patients with normal left ventricular function
ConclusionPatients with LF AS had worse operative and long-term outcomes than those with NF, even though they had preserved LV function.
Source: General Thoracic and Cardiovascular Surgery - July 7, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Perioperative changes of the slope in the preload recruitable stroke work relationship by a single-beat technique after mitral valve surgery in functional mitral regurgitation with non-ischemic dilated cardiomyopathy
ConclusionsThe change of slope was dependent on surgical procedures. In functional mitral regurgitation, the slope may be a more sensitive parameter in reflecting the left ventricular contractile function than the left ventricular ejection fraction.
Source: General Thoracic and Cardiovascular Surgery - June 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Incidence and aetiological mechanism of stroke in cardiac surgery
ConclusionIn our setting, strokes occurring after cardiac surgery are usually small and have a good long-term prognosis. Most of them occur within 2 days, and they are mostly embolic in origin. The incidence of stroke in patients aged 80 and older and undergoing cardiac surgery is twice as high as that of the general population.ResumenObjetivoEstudiar a los pacientes que tuvieron un ictus en el postoperatorio de cirugía cardiaca, para ver la evolución y determinar los factores que influyen en su pronóstico y tratamiento.MétodosEstablecimos un protocolo para la detección precoz de ictus en los pacientes tras cirugía c...
Source: Neurologia - June 20, 2019 Category: Neurology Source Type: research

Early Stroke After TAVR in US Practice
This cohort study uses registry data to describe trends and incidence of 30-day stroke among patients who had undergone transcatheter aortic valve replacement (TAVR) in the first 5 years the procedure ’s use in US clinical practice.
Source: JAMA - June 18, 2019 Category: General Medicine Source Type: research

Stroke After Transcatheter Aortic Valve Replacement
This study reported about a 7% risk of stroke, which was not surprising given the patient population and the likelihood of particulate embolization when expanding a new valve within the annulus of the stenosed and calcified native valve. Nevertheless, even with this stroke risk, there was a clear mortality benefit and quality of life was improved as well. After the PARTNER 1A high-risk cohort demonstrated similar or improved outcomes relative to open surgical aortic valve replacement (SAVR) in patients at high (but not inoperable) surgical risk, the US Food and Drug Administration (FDA) approved TAVR in 2011 and the proced...
Source: JAMA - June 18, 2019 Category: General Medicine Source Type: research

Inter- and intrasite variability of mortality and stroke for sites performing both surgical and transcatheter aortic valve replacement for aortic valve stenosis in intermediate-risk patients
Multisite procedure-based randomized trials may be confounded by performance variability and variability among sites. Therefore, we studied variability in mortality and stroke after patients were randomized to surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in the Placement of Aortic Transcatheter Valves-2A (PARTNER-2A) randomized trial.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kevin L. Greason, Eugene H. Blackstone, Jeevanantham Rajeswaran, Ashley M. Lowry, Lars G. Svensson, John G. Webb, E. Murat Tuzcu, Craig R. Smith, Raj R. Makkar, Michael J. Mack, Vinod H. Thourani, Susheel K. Kodali, Martin B. Leon, D. Craig Miller Tags: Adult Source Type: research

Inter- and Intra-site Variability of Mortality and Stroke for Sites Performing both Surgical and Transcatheter Aortic Valve Replacement for Aortic Valve Stenosis in Intermediate-risk Patients
Multi-site procedure-based randomized trials may be confounded by performance variability and variability among sites. Therefore, we studied variability in mortality and stroke after patients were randomized to surgical (SAVR) or transcatheter aortic valve replacement (TAVR) in PARTNER-2A.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kevin L. Greason, Eugene H. Blackstone, Jeevanantham Rajeswaran, Ashley M. Lowry, Lars G. Svensson, John G. Webb, E.Murat Tuzcu, Craig R. Smith, Raj R. Makkar, Michael J. Mack, Vinod H. Thourani, Susheel K. Kodali, Martin B. Leon, D.Craig Miller Source Type: research

Stroke in patients with prosthetic valve endocarditis : Single-center cohort study in China.
CONCLUSION: Stroke is a common complication in PVE that increases patient mortality. Rheumatic heart disease, double valve replacement, and fungal infection may be risk factors for patients with PVE complicated by stroke. PMID: 31076822 [PubMed - as supplied by publisher]
Source: Herz - May 12, 2019 Category: Cardiology Tags: Herz Source Type: research

Thrombectomy and reconstruction of the left vertebral artery after total arch replacement: never give up on postoperative stroke
AbstractThe patient was a 64-year-old man who had aortic regurgitation, ischemic heart disease, a transverse aortic aneurysm, and an abdominal-common iliac aneurysm. Concomitant operations including aortic valve replacement, coronary artery bypass grafting, and total aortic arch replacement with elephant trunk technique were performed successfully. The patient developed postoperative cardiac tamponade on the 5th postoperative day, resulting in bulbar palsy due to occlusion of the dominant left vertebral artery. Thrombectomy of the vertebral artery with reconstruction by a saphenous vein was performed. The patient ’s neur...
Source: General Thoracic and Cardiovascular Surgery - March 13, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

Systematic preoperative CT scan is associated with reduced risk of stroke in minimally invasive mitral valve surgery: A meta-analysis
Minimally invasive mitral valve surgery (MIMVS) is performed with increasing frequency. However, patients undergoing MIMVS might be at increased risk of perioperative stroke, mainly due to retrograde aortic embolization during femoral cardio-pulmonary bypass. Pre-operative computed tomography (CT) screening allows visualization of the aorta and femoro-iliac vessels and individualization of the surgical approach. In this meta-analysis, we aim to determine if systematic pre-operative CT screening is associated with decreased incidence of post-operative stroke and other complications following MIMVS.
Source: International Journal of Cardiology - December 13, 2018 Category: Cardiology Authors: Jeremy R. Leonard, Matthew Henry, Mohamed Rahouma, Faiza M. Khan, Matthew Wingo, Irbaz Hameed, Antonino Di Franco, T. Sloane Guy, Leonard N. Girardi, Mario Gaudino 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

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.
CONCLUSIONS: A 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. PMID: 30529671 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 7, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Thourani VH, O'Brien SM, Kelly JJ, Cohen DJ, Peterson ED, Mack MJ, Shahian DM, Grover FL, Carroll EJ, Brennan JM, Forcillo J, Arnold SV, Vemulapalli S, Fitzgerald S, Holmes DR, Bavaria JE, Edwards FH Tags: Ann Thorac Surg Source Type: research

Balloons are not for angioplasty alone: A novel occlusion technique for stroke prevention
Stroke remains a significant source of morbidity and mortality after thoracic endovascular aortic repair (TEVAR). This is especially true with “hybrid” aortic arch aneurysm repairs, with stroke rates as high as 8% reported previously.1 Many of these patients have significant medical comorbidities, including previous stroke, peripheral vascular, and coronary artery disease, and resultant aortic atheroma and calcifications. It is well kn own that endovascular procedures in the aortic arch result in significant cerebral embolization; in fact, in the SENTINEL trial evaluating transcatheter cerebral embolic protection devic...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 2, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Christopher R. Burke, Pavan Atluri Tags: Editorial Commentary Source Type: research

Commentary: Balloons are not for angioplasty alone: A novel occlusion technique for stroke prevention
Stroke remains a significant source of morbidity and mortality after thoracic endovascular aortic repair (TEVAR). This is especially true with “hybrid” aortic arch aneurysm repairs, with stroke rates as high as 8% reported previously.1 Many of these patients have significant medical comorbidities, including previous stroke, peripheral vascular, and coronary artery disease, and resultant aortic atheroma and calcifications. It is well kn own that endovascular procedures in the aortic arch result in significant cerebral embolization; in fact, in the SENTINEL trial evaluating transcatheter cerebral embolic protection devic...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 1, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Christopher R. Burke, Pavan Atluri Tags: Commentary Source Type: research

The Utility of Flow Rate Compared with Left Ventricular Stroke Volume Index in the Hemodynamic Classification of Severe Aortic Stenosis with Preserved Ejection Fraction
Conclusions: The FRlow/MGlow subset of AS is associated with the worst prognosis, and FR is not superior to SVi in the hemodynamic classification of severe AS.Cardiology 2018;141:37 –45
Source: Cardiology - October 10, 2018 Category: Cardiology Source Type: research

Acute stroke intervention after transcatheter aortic valve replacement.
Abstract Stroke is a devastating complication in patients undergoing transcatheter aortic valve replacement (TAVR). We sought to determine whether early stroke intervention after TAVR would improve the neurological outcomes. Two patients experienced stroke immediately after TAVR, one treated with mechanical thrombectomy and localized lytic therapy and one treated with systemic lytic therapy. Our limited experience showed that early stroke intervention with either treatment option may reduce the risk of complications and improve neurological outcomes. PMID: 30948989 [PubMed]
Source: Baylor University Medical Center Proceedings - September 30, 2018 Category: Universities & Medical Training Authors: Hamandi M, Farber AJ, Tatum JK, Brinkman WT, Brown DL, Lawrence ME, Mack MJ Tags: Proc (Bayl Univ Med Cent) Source Type: research

FDA warns of high stroke, mortality risk with SynCardia TAH-t C2 controller
The FDA on Friday released a letter warning of a higher mortality risk and stroke rate than expected for patients receiving treatment from SynCardia Systems’ Temporary Total Artificial Heart Companion 2 Driver System. Data indicating the higher mortality and stroke rate came from a post-approval study conducted by the company itself, the FDA said. The study indicated that patients treated with the previous generation driver of the device, the Circulatory Support System Console, experienced a lower rate of stroke and mortality compared with the C2. The TAH-t system is designed to function as a bridge to a heart transplant...
Source: Mass Device - August 20, 2018 Category: Medical Devices Authors: Fink Densford Tags: Cardiovascular Clinical Trials Food & Drug Administration (FDA) SynCardia Source Type: news

Performance of CHA2DS2-VASc Score for Stroke Prediction after Surgical Aortic Valve Replacement
Stroke is a frequent complication occurring early and late after surgical aortic valve replacement (SAVR). There is an unmet clinical need for simple tools to assess postoperative stroke risk. We sought to assess the predictive performance of CHA2DS2-VASc score in patients undergoing SAVR with a bioprosthesis.
Source: The Journal of Thoracic and Cardiovascular Surgery - July 28, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Tuomas Kiviniemi, Joonas Lehto, Maunu Nissinen, Tuomo Nieminen, Juha Hartikainen, Markus Malmberg, Fredrik Yannopoulos, Jyri Savolainen, Pasi Karjalainen, K E Juhani Airaksinen, Stefano Rosato, Fausto Biancari Source Type: research

Meta-Analysis Comparing the Frequency of Stroke After Transcatheter Versus Surgical Aortic Valve Replacement
Stroke is one of the most feared complications of aortic valve replacement. Although the outcomes of transcatheter aortic valve implantation (TAVI) improved substantially over time, concerns remained about a potentially higher incidence of stroke with TAVI compared with surgical replacement (SAVR). However, comparative data are sparse. We performed a meta-analysis comparing the incidence of stroke among patients undergoing TAVI versus SAVR. Of the 5067 studies screened, 28 eligible studies (22 propensity-score matched studies and 6 randomized trials) were analyzed.
Source: The American Journal of Cardiology - July 5, 2018 Category: Cardiology Authors: Kuldeep Shah, Zakeih Chaker, Tatiana Busu, Vinay Badhwar, Fahad Alqahtani, Muhammad Alvi, Amelia Adcock, Mohamad Alkhouli Source Type: research

Meta-Analysis Comparing The Frequency of Stroke After Transcatheter vs. Surgical Aortic Valve Replacement
Stroke is one of the most feared complication of aortic valve replacement. Although the outcomes of transcatheter aortic valve implantation (TAVI) improved substantially overtime, concerns remained about a potentially higher incidence of stroke with TAVI compared with surgical replacement (SAVR). However, comparative data are sparse. We performed a meta-analysis comparing the incidence of stroke amongst patients undergoing TAVI versus SAVR. Of the 5067 studies screened, 28 eligible studies (22 propensity-score matched studies and 6 randomized trials) were analyzed.
Source: The American Journal of Cardiology - July 5, 2018 Category: Cardiology Authors: Kuldeep Shah, Zakeih Chaker, Tatiana Busu, Vinay Badhwar, Fahad Alqahtani, Muhammad Alvi, Amelia Adcock, Mohamad Alkhouli Source Type: research

Stroke and Cardiovascular Outcomes in Patients With Carotid Disease Undergoing Transcatheter Aortic Valve Replacement Structural Heart Disease
Conclusions— CD is common among TAVR patients, present in 1 of 5. CD was not associated with an increased risk of stroke or mortality at 30 day or 1 year. Post-TAVR stroke seems to be because of mechanisms other than CD.
Source: Circulation: Cardiovascular Interventions - June 12, 2018 Category: Cardiology Authors: Kochar, A., Li, Z., Harrison, J. K., Hughes, G. C., Thourani, V. H., Mack, M. J., Matsouaka, R. A., Cohen, D. J., Peterson, E. D., Jones, W. S., Vemulapalli, S. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Mortality/Survival, Cerebrovascular Disease/Stroke, Vascular Disease Structural Heart Disease Source Type: research

Propensity Score Matched Analysis of Mechanical vs. Bioprosthetic Valve Replacement in Patients With Previous Stroke.
CONCLUSIONS: In patients with previous stroke, bioprosthetic valves had a lower incidence of complications connected to major bleeding than did the mechanical valves. Survival and stroke recurrence rates, however, did not differ between the 2 groups. We recommend bioprosthetic valves for patients >60 years or who have a history of GI bleeding. PMID: 29794401 [PubMed - as supplied by publisher]
Source: Circulation Journal - May 24, 2018 Category: Cardiology Authors: Chen SW, Wu VC, Lin YS, Chen CC, Chen DY, Chang CH, Chu PH, Ting PC, Chou AH, Chen TH Tags: Circ J Source Type: research

After Stroke, Delaying SAVR Cuts Risk for New Stroke After Stroke, Delaying SAVR Cuts Risk for New Stroke
The recurrent-stroke risk truly spikes at surgical aortic valve replacement within 3 months of a prior stroke, say researchers of a cohort study, cautioning that such SAVR be delayed ' at least 3 or 4 months. 'Medscape Medical News
Source: Medscape Cardiology Headlines - April 27, 2018 Category: Cardiology Tags: Cardiology News Source Type: news

Previous Stroke Tied to Higher Risks in Aortic Valve Replacement
FRIDAY, April 27, 2018 -- For patients undergoing surgical aortic valve replacement (SAVR), previous stroke is a risk factor for recurrent ischemic stroke and major adverse cardiovascular events (MACE), according to a study published online April 25...
Source: Drugs.com - Pharma News - April 27, 2018 Category: Pharmaceuticals Source Type: news

Recurrent Acute Ischemic Stroke after Infective Endocarditis Caused by Streptococcus Constellatus: First Case Report and Analysis of the Case Series
Acute ischemic stroke (AIS) is highly prevalent in patients with infective endocarditis (IE) and associated with high rates of death and disability. IE presenting as an acute ischemic stroke, especially recurrent concurrence of acute anterior and posterior circulation infarct, has rarely been reported. Herein, we report a case study of a 60-year-old man with a history of aortic valve replacement and was under warfarin, presented with recurrent acute ischemic stroke which was found to have no vegetation secondary to infective endocarditis caused by Streptococcus constellatus as the embolic source.
Source: Journal of Stroke and Cerebrovascular Diseases - April 26, 2018 Category: Neurology Authors: Yumin Wang, Weili Zhao, Jun Lu, Guoli Li, Bin Peng, Hongquan Wang Tags: Case Studies Source Type: research

Beyond Stroke Prevention in Atrial Fibrillation: Exploring Further Unmet Needs with Rivaroxaban.
This article provides an update on three randomized controlled trials of rivaroxaban, a direct, oral factor Xa inhibitor, that are complete or are ongoing, in these unmet areas of stroke prevention: oPen-label, randomized, controlled, multicentre study explorIng twO treatmeNt stratEgiEs of Rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in patients with Atrial Fibrillation who undergo Percutaneous Coronary Intervention (PIONEER AF-PCI) trial; the New Approach riVaroxaban Inhibition of factor Xa in a Global trial vs Aspirin to prevenT Embolism in Embolic Stroke of Undetermined Source (NAVIGATE E...
Source: Thrombosis and Haemostasis - March 22, 2018 Category: Hematology Authors: Gibson CM, Hankey GJ, Nafee T, Welsh RC Tags: Thromb Haemost Source Type: research

Impact of low stroke volume on mortality in patients with severe aortic stenosis and preserved left ventricular ejection fraction
ConclusionLow flow defined as SVi  <  30 mL/m2 or SV  <  55 mL is an important outcome predictor in severe AS with preserved LVEF under medical and surgical management. Further studies are needed to prospectively test these values for risk stratification and decision making.
Source: European Heart Journal - March 13, 2018 Category: Cardiology Source Type: research

Perioperative stroke: pathophysiology and management.
Authors: Ko SB Abstract Although perioperative stroke is uncommon during low-risk non-vascular surgery, if it occurs, it can negatively impact recovery from the surgery and functional outcome. Based on the Society for Neuroscience in Anesthesiology and Critical Care Consensus Statement, perioperative stroke includes intraoperative stroke, as well as postoperative stroke developing within 30 days after surgery. Factors related to perioperative stroke include age, sex, a history of stroke or transient ischemic attack, cardiac surgery (aortic surgery, mitral valve surgery, or coronary artery bypass graft surgery), and...
Source: Korean Journal of Anesthesiology - February 16, 2018 Category: Anesthesiology Tags: Korean J Anesthesiol Source Type: research

Stroke After Transcatheter Aortic Valve Replacement: Incidence, Definitions, Etiologies and Management Options
Neurologic complications after transcatheter aortic valve replacement are devastating. The etiologies of stroke in this setting are best addressed in an integrated fashion during each phase of the perioperative pathway. The conduct of this triphasic approach will continue to be refined to reduce the stroke risks even further, given the major focus on aspects such as embolic protection devices and valve thrombosis. This neurologic focus in transcatheter aortic valve replacement has transformed the investigational approach to neurologic events in cardiovascular clinical trials, resulting in novel guidelines for the diagnosis...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 22, 2017 Category: Anesthesiology Authors: Prakash A. Patel, Saumil Patel, Jared W. Feinman, Jacob T. Gutsche, Prashanth Vallabhajosyula, Ronak Shah, Jay Giri, Nimesh D. Desai, Elizabeth Zhou, Stuart J. Weiss, John G. Augoustides Tags: Review Article Source Type: research

Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement Significantly Reduces Death and Stroke Compared With Unprotected Procedures
Conclusions In patients undergoing TAVR use of a cerebral embolic protection device demonstrated a significant higher rate of stroke-free survival compared with unprotected TAVR.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - November 20, 2017 Category: Cardiology Authors: Seeger, J., Gonska, B., Otto, M., Rottbauer, W., Wöhrle, J. Tags: Structural Source Type: research

Perioperative Stroke and Mortality After Surgical Aortic Valve Replacement: A Meta-Analysis
Objective: Perioperative stroke rate after surgical aortic valve replacement (SAVR) varies between 1.3% and 6.2%, whereas the operative mortality ranges between 1% and 16.4%. The aim of this study was to determine whether perioperative stroke is a risk factor for operative mortality after SAVR by performing a meta-analysis of relevant studies. Materials and Methods: PubMed, EMBASE, and Web of Science databases were searched to retrieve relevant literature. Screening of the articles was done independently on the basis of predetermined criteria. Data from the relevant studies were extracted and a random effects model was us...
Source: The Neurologist - November 1, 2017 Category: Neurology Tags: Review Article Source Type: research

Radiographic and Clinical Brain Infarcts in Cardiac and Diagnostic Procedures Clinical Sciences
Conclusions—One of 10 people with periprocedural RBIs during cardiac surgeries and invasive vascular diagnostic procedures resulted in strokes or transient ischemic attacks, which may serve as a potential surrogate marker of procedural proficiency and perhaps as a predictor of risk for periprocedural strokes.
Source: Stroke - September 25, 2017 Category: Neurology Authors: Sung-Min Cho, Abhishek Deshpande, Vinay Pasupuleti, Adrian V. Hernandez, Ken Uchino Tags: Magnetic Resonance Imaging (MRI), Cerebrovascular Disease/Stroke Original Contributions Source Type: research

Atheromatous disease of the aorta and perioperative stroke
Despite continued improvements in patient outcomes after cardiac surgery, stroke remains one of the most feared and devastating complications of cardiac surgery and is estimated to occur in 1.2% to 1.6% of patients undergoing coronary artery bypass grafting (CABG).1-3 The incidence of stroke increases for other common cardiac surgical procedures, and contemporary studies from the Society of Thoracic Surgeons database have reported perioperative stroke rates of 1.4% for mitral valve repair,4 1.5% for aortic valve replacement,5 2.1% for mitral valve replacement,4 and 6.6% for proximal aorta replacement.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 13, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Nicholas D. Andersen, Stephen A. Hart, Ganesh P. Devendra, Esther S.H. Kim, Douglas R. Johnston, Jacob N. Schroder, Richard A. Krasuski Tags: Expert review Source Type: research

Pathogenesis and Risk Factors for Cerebral Infarct After Surgical Aortic Valve Replacement Brief Reports
Conclusions— The principal mechanism of acute cerebral infarction after aortic valve replacement is embolism. There are distinct factors associated with watershed and embolic infarct, some of which may be modifiable.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Massaro, A., Messe, S. R., Acker, M. A., Kasner, S. E., Torres, J., Fanning, M., Giovannetti, T., Ratcliffe, S. J., Bilello, M., Szeto, W. Y., Bavaria, J. E., Mohler, E. R., Floyd, T. F., for the Determining Neurologic Outcomes From Valve Operations (DeNO Tags: Valvular Heart Disease, Magnetic Resonance Imaging (MRI), Cardiovascular Surgery, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Knowledge Regarding Oral Anticoagulation Therapy among Patients with Stroke and Those at High Risk of Thromboembolic Events
Apart from atrial fibrillation, indications for oral anticoagulation common in our clinical practice include rheumatic heart disease and mechanical heart valve replacement. Evaluation of current patient knowledge regarding oral anticoagulation therapy (OAT) is the first step in improving the quality of anticoagulation therapy and patient care. The aim of the present study was to assess the knowledge regarding OAT among patients with stroke and those at high risk of thromboembolic events in a tertiary care hospital in India.
Source: Journal of Stroke and Cerebrovascular Diseases - January 7, 2015 Category: Neurology Authors: Annu Alphonsa, Kamlesh K. Sharma, Gautam Sharma, Rohit Bhatia Source Type: research

Stroke in Patients With Aortic Stenosis: The Simvastatin and Ezetimibe in Aortic Stenosis Study Clinical Sciences
Conclusions— In patients with aortic stenosis not prescribed oral anticoagulation, atrial fibrillation, AVR with concomitant coronary artery bypass grafting, and CHA2DS2-VASc score were the major predictors of stroke. Incident stroke was strongly associated with mortality. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00092677.
Source: Stroke - June 23, 2014 Category: Neurology Authors: Greve, A. M., Dalsgaard, M., Bang, C. N., Egstrup, K., Ray, S., Boman, K., Rossebo, A. B., Gohlke-Baerwolf, C., Devereux, R. B., Kober, L., Wachtell, K. Tags: Thrombosis risk factors, CV surgery: valvular disease, Acute Cerebral Infarction Clinical Sciences Source Type: research