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Total 1212 results found since Jan 2013.

Safety and feasibility of PCI in patients undergoing TAVR: A systematic review and meta-analysis
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure.
Source: Heart and Lung - January 12, 2017 Category: Intensive Care Authors: Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor Source Type: research

Aortic valve repair in the paediatric population: insights from a 38-year single-centre experience CONGENITAL
CONCLUSIONS In our experience, AV repair in the paediatric population provides excellent results in terms of both overall survival and valve-related reoperation. It obviates the need for chronic anticoagulation and in most cases delays the time at which more complex surgery such as the Ross procedure should be undertaken.
Source: European Journal of Cardio-Thoracic Surgery - January 11, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Poncelet, A. J., El Khoury, G., De Kerchove, L., Sluysmans, T., Moniotte, S., Momeni, M., Detaille, T., Rubay, J. E. Tags: Basic research vascular CONGENITAL Source Type: research

Transcatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses
CONCLUSIONS Despite a higher risk profile in the ViV group, early mortality rates were not different compared with those of surgery. Although ViV resulted in elevated transvalvular gradients and therefore a lower rate of device success, mortality rates were similar to those with redo-SAVR. At present, both techniques serve as complementary approaches, and allow individualized patient care with excellent outcomes.
Source: Interactive CardioVascular and Thoracic Surgery - January 4, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Silaschi, M., Wendler, O., Seiffert, M., Castro, L., Lubos, E., Schirmer, J., Blankenberg, S., Reichenspurner, H., Schäfer, U., Treede, H., MacCarthy, P., Conradi, L. Tags: History, Basic research vascular ADULT CARDIAC Source Type: research

Incidence, Predictors, and Mid-Term Outcomes of Possible Leaflet Thrombosis After TAVR
Conclusions HALT with reduced leaflet motion was not rare but usually subclinical. Valve hemodynamics and mid-term outcomes were uneventful even without additional anticoagulant therapy in our limited number of cases. Male sex, larger sinus and bioprosthesis size, and elevated D-dimer levels during follow-up were associated with this phenomenon.
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - January 2, 2017 Category: Radiology Authors: Yanagisawa, R., Hayashida, K., Yamada, Y., Tanaka, M., Yashima, F., Inohara, T., Arai, T., Kawakami, T., Maekawa, Y., Tsuruta, H., Itabashi, Y., Murata, M., Sano, M., Okamoto, K., Yoshitake, A., Shimizu, H., Jinzaki, M., Fukuda, K. Tags: Original Research Source Type: research

Long-Term Valve Performance of TAVR and SAVR: A Report From the PARTNER I Trial
Conclusions Longitudinal assessment of the PARTNER (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial) I trial demonstrates that valve performance and cardiac hemodynamics are stable after implantation in both SAPIEN TAVR and SAVR in patients alive at 5 years. (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial [PARTNER]; NCT00530894)
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - January 2, 2017 Category: Radiology Authors: Daubert, M. A., Weissman, N. J., Hahn, R. T., Pibarot, P., Parvataneni, R., Mack, M. J., Svensson, L. G., Gopal, D., Kapadia, S., Siegel, R. J., Kodali, S. K., Szeto, W. Y., Makkar, R., Leon, M. B., Douglas, P. S. Tags: Original Research Source Type: research

Apixaban in Patients With Atrial Fibrillation After Transfemoral Aortic Valve Replacement
Conclusions In patients undergoing TAVR, AF was associated with a significantly higher rate of all-cause mortality throughout 12 months follow-up. The early safety endpoint in patients with AF on apixaban was significantly less frequent compared with patients receiving a VKA.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - January 2, 2017 Category: Cardiology Authors: Seeger, J., Gonska, B., Rodewald, C., Rottbauer, W., Wöhrle, J. Tags: Structural Source Type: research

Prospective comparison between three TAVR devices: ACURATE neo vs. CoreValve vs. SAPIEN XT. A single heart team experience in patients with severe aortic stenosis
ConclusionsIn a “real world” registry, ACT compared favorably against the well‐studied SXT and MCV devices in both safety and efficacy. MCV implantation was associated with lower device success rates and higher rates of new permanent pacemaker implantation. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - December 28, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Tannas Jatene, Antonio Castro ‐Filho, Rafael A. Meneguz‐Moreno, Dimytri A. Siqueira, Alexandre A.C. Abizaid, Auristela I.O. Ramos, Magaly Arrais, David C.S. Le Bihan, Rodrigo B.M. Barretto, Adriana C. Moreira, Amanda G.M.R. Sousa, J. Eduardo Sousa Tags: Valvular and Structural Heart Diseases Source Type: research

A Left-to-Right Shunt After Transfemoral TAVR Using Edwards SAPIEN 3.
Authors: Steffen J, Köhler A, Schwarz F, Sadoni S, Hagl C, Massberg S, Greif M Abstract Transcatheter aortic valve replacement (TAVR) is used for the treatment of aortic stenosis (AS). Besides major bleeding, conduction blocks, stroke or atrial fibrillation, complications include cardiac perforation with possible left-to-right-shunts. Herein is reported the sixth case of a left-to-right shunt in an 87-year-old man who underwent TAVR using a 29 mm Edwards SAPIEN S3 prosthesis to treat AS. Soon after the procedure, a small channel evolving from the right coronary cusp could be detected on echocardiography. The patie...
Source: Journal of Heart Valve Disease - December 25, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Aortic Valve Replacement in Redo-Scenarios: A Comparison Between Traditional Aortic Valve Replacement (TAVR) and Transapical-TAVR from Two Real-World Multicenter Registries.
CONCLUSIONS: Outcome differences between RAVR and TaTAVR in redo-scenarios reflect methodological differences and different baseline risk profiles. Propensity-matched patients showed a better renal outcome after TaTAVR. *Drs. Onorati and D'Onofrio contributed equally to this article and should both be considered as first authors. PMID: 27997769 [PubMed]
Source: Journal of Heart Valve Disease - December 22, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Direct oral anticoagulant use in nonvalvular atrial fibrillation with valvular heart disease: a systematic review
In conclusion, subanalyses of DOAC landmark AF trials revealed that dabigatran, rivaroxaban, and apixaban may be safely used in AF patients with certain types of VHD: aortic stenosis, aortic regurgitation, and mitral regurgitation. More evidence is needed before routinely recommending these agents for patients with bioprosthetic valves or mild mitral stenosis. Patients with moderate to severe mitral stenosis or mechanical valves should continue to receive warfarin, as these patients were excluded from all landmark AF trials.
Source: Clinical Cardiology - December 22, 2016 Category: Cardiology Authors: Ryan E. Owens, Rajesh Kabra, Carrie S. Oliphant Tags: Reviews Source Type: research

Acute Invasive Hemodynamic Effects of Transcatheter Aortic Valve Replacement.
CONCLUSIONS: Successful TAVR results in immediate and sizeable improvements in SV and CI, reductions in left and right ventricular filling pressures, and marked reductions in systemic and pulmonary vascular resistances. PMID: 27989060 [PubMed - in process]
Source: Journal of Heart Valve Disease - December 21, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Anticoagulation After Biological Aortic Valve Replacement: Is There An Optimal Regimen?
CONCLUSIONS: Plasma anticoagulation with warfarin during the early postoperative phase was shown statistically to be inferior to platelet aggregation inhibition by aspirin with regards to postoperative bleeding risk, cerebral ischemic events, and survival. PMID: 27989055 [PubMed - in process]
Source: Journal of Heart Valve Disease - December 21, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Transcatheter Aortic Valve Implantation for Treatment of Aortic Valve Stenosis: A Health Technology Assessment.
CONCLUSIONS: Moderate quality evidence showed that TAVI and SAVR had similar mortality rates in patients who were eligible for surgery. Information about quality of life showed similar results for TAVI and SAVR in the first year, but was based on low quality evidence. Moderate quality evidence also showed that TAVI was associated with higher rates of adverse events than SAVR. In patients who were not suitable candidates for surgery, moderate quality evidence showed that TAVI improved survival compared with balloon aortic valvuloplasty. When TAVI was compared with SAVR, the incremental cost-effectiveness ratio was $51,988 p...
Source: Ontario Health Technology Assessment Series - December 21, 2016 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker
ConclusionsPOAF frequently occurred in patients undergoing AVR, and was significantly related to prolonged ICU stay and postoperative stroke. Our findings show that advanced age and absence of preoperative β-blocker usage are risk factors for POAF. Furthermore, in patients undergoing AVR, perioperative intravenous β-blocker administration may be useful for prevention.
Source: General Thoracic and Cardiovascular Surgery - December 20, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Long-term follow-up after aortic root replacement with the Shelhigh(R) biological valved conduit: a word of caution! ADULT CARDIAC
CONCLUSIONS The first long-term follow-up after aortic root replacement with the Shelhigh® BioConduit revealed a relatively high rate of death and very high rate of reoperations due to endocarditis, aorto-ventricular disconnection and structural valve failure. This may be potentially connected to the nature of the implanted valved conduit.
Source: European Journal of Cardio-Thoracic Surgery - December 20, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Sahin, A., Müggler, O., Sromicki, J., Caliskan, E., Reser, D., Emmert, M. Y., Alkadhi, H., Maisano, F., Falk, V., Holubec, T. Tags: Pericardium, Basic research vascular ADULT CARDIAC Source Type: research

Clinical Outcomes of the David V Valve-Sparing Root Replacement Compared With Bioprosthetic Valve-Conduits for Aortic Root Aneurysms
Conclusions VSRR and BIO result in equivalent operative mortality and morbidity with similar midterm survival and valve durability. VSRR is an effective alternative to BIO for aortic root pathologic conditions; however, careful patient selection is paramount.
Source: The Annals of Thoracic Surgery - December 11, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Clinical Outcomes of the David V Valve-Sparing Root Replacement Compared With Bioprosthetic Valve-Conduits for Aortic Root Aneurysms.
CONCLUSIONS: VSRR and BIO result in equivalent operative mortality and morbidity with similar midterm survival and valve durability. VSRR is an effective alternative to BIO for aortic root pathologic conditions; however, careful patient selection is paramount. PMID: 27964919 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 10, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Esaki J, Leshnower BG, Binongo JN, Lasanajak Y, McPherson L, Halkos ME, Guyton RA, Chen EP Tags: Ann Thorac Surg Source Type: research

Outcomes of Dialysis-Dependent Patients After Cardiac Operations in a Single-Center Experience of 483 Patients
Conclusions Patients with DD CRF undergoing cardiac operations have high perioperative and medium-term mortality, particularly in the presence of combined aortic and mitral valve pathologic conditions, active endocarditis, and poor left ventricular function.
Source: The Annals of Thoracic Surgery - December 7, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

MassDevice.com +5 | The top 5 medtech stories for December 6, 2016
Say hello to MassDevice +5, a bite-sized view of the top five medtech stories of the day. This feature of MassDevice.com’s coverage highlights our 5 biggest and most influential stories from the day’s news to make sure you’re up to date on the headlines that continue to shape the medical device industry. Get this in your inbox everyday by subscribing to our newsletters.   5. MedyMatch looks to future of stroke detection with AI platform launch Artificial intelligence healthcare startup MedyMatch Technology said late last month its AI platform designed to detect intracranial hemorrhage or brain blee...
Source: Mass Device - December 6, 2016 Category: Medical Equipment Authors: MassDevice Tags: News Well Plus 5 Source Type: news

Outcomes of Dialysis-Dependent Patients After Cardiac Operations in a Single-Center Experience of 483 Patients.
CONCLUSIONS: Patients with DD CRF undergoing cardiac operations have high perioperative and medium-term mortality, particularly in the presence of combined aortic and mitral valve pathologic conditions, active endocarditis, and poor left ventricular function. PMID: 27938884 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 6, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Leontyev S, Davierwala PM, Gaube LM, Röhrig KA, Lehmann S, Holzhey DM, Seeburger J, Noack T, Misfeld M, Mohr FW Tags: Ann Thorac Surg Source Type: research

Twenty ‐five year outcomes following composite graft aortic root replacement
ConclusionsComposite graft aortic root replacement is associated with low operative risk, excellent long‐term survival, and low incidence of reoperation and late events.
Source: Journal of Cardiac Surgery - December 1, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Salvior C.M. Mok, Wei ‐Guo Ma, Ahmed Mansour, Paris Charilaou, Alan S. Chou, Sven Peterss, Maryann Tranquilli, Bulat A. Ziganshin, John A. Elefteriades Tags: Original Article Source Type: research

Trial design: Rivaroxaban for the prevention of major cardiovascular events after transcatheter aortic valve replacement: Rationale and design of the GALILEO study
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy–based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - November 26, 2016 Category: Cardiology Source Type: research

Safety and efficacy of valve repositioning during transcatheter aortic valve replacement with the Lotus Valve System.
CONCLUSION: Repositioning facilitated correct anatomical positioning of all devices leading to optimal prosthesis hemodynamics and a trend to lower pacemaker rate without increased risk of MACCE. PMID: 27890512 [PubMed - as supplied by publisher]
Source: Journal of Cardiology - November 24, 2016 Category: Cardiology Authors: Rashid HN, Gooley R, McCormick L, Zaman S, Ramkumar S, Jackson D, Amiruddin A, Nasis A, Cameron J, Meredith IT Tags: J Cardiol Source Type: research

Avoiding coronary obstruction after transcatheter aortic valve replacement: Is it the skirt or what's inside that counts?
In this issue of the Journal, Chu and colleagues1 posit that coronary obstruction in patients at high risk undergoing transcatheter aortic valve replacement (TAVR) may be mitigated by the unique engagement mechanism and protective skirt of the ACURATE TA device (Symetis Inc, Ecublens, Switzerland). Initial obstacles with TAVR, including stroke, vascular complications, and paravalvular leak (PVL) have seen marked improvements through case selection and device design; however, the rare and lethal complication of coronary artery obstruction remains vexing, particularly in patients at high risk with small aortic diameters, low...
Source: The Journal of Thoracic and Cardiovascular Surgery - November 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Mohamad Alkhouli, Vinay Badhwar Tags: Editorial commentary Source Type: research

The Association Between Preoperative Hemoglobin A1C and Postoperative Glycemic Variability on 30-Day Major Adverse Outcomes Following Isolated Cardiac Valvular Surgery.
CONCLUSIONS: This study did not show an association between preoperative HbA1c and postoperative glycemic variability with MAEs after isolated cardiac valvular surgery. Specifically, lack of association between postoperative glycemic variability and MAEs is noteworthy and is in contrast to our previous finding in CABG patients. Future studies should focus a targeted glycemic variability reduction in CABG patients and evaluate the reduction in MAEs, without risk of employing a one-size fits all approach when approaching other cardiac procedures. PMID: 27861432 [PubMed - as supplied by publisher]
Source: Anesthesia and Analgesia - November 17, 2016 Category: Anesthesiology Authors: Bardia A, Khabbaz K, Mueller A, Mathur P, Novack V, Talmor D, Subramaniam B Tags: Anesth Analg Source Type: research

Initial Single-Center Experience With the Fully Repositionable Transfemoral Lotus Aortic Valve System.
CONCLUSION: Our first real-time experience with the fully repositionable Lotus TAVR system mimics the results of early clinical studies like REPRISE II. Further next-generation modifications in combination with gaining experience with this new device will likely reduce the need for new permanent pacemaker implantation and vascular complications in the future. PMID: 27845874 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - November 16, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Pre-treatment clinical assessment in head and neck cancer: United Kingdom National Multidisciplinary Guidelines.
Authors: Robson A, Sturman J, Williamson P, Conboy P, Penney S, Wood H Abstract This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hypertens...
Source: Journal of Laryngology and Otology - November 16, 2016 Category: ENT & OMF Tags: J Laryngol Otol 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 10, 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

Extracranial carotid artery stenosis and outcomes of patients undergoing transcatheter aortic valve replacement
Transcatheter aortic valve replacement (TAVR) is an alternative to open cardiac surgery in selected patients with severe aortic stenosis (AS). Carotid artery stenosis (CAS) has been associated with an increased risk of stroke following cardiac surgery, although the association between CAS and outcomes following TAVR is unclear. We therefore sought to study the prognostic impact of CAS on outcomes of patients undergoing TAVR.
Source: International Journal of Cardiology - November 8, 2016 Category: Cardiology Authors: Jeremy Ben-Shoshan, David Zahler, Arie Steinvil, Shmuel Banai, Gad Keren, Natan M. Bornstein, Ariel Finkelstein, Amir Halkin Source Type: research

Freestyle stentless bioprosthesis for aortic valve therapy: 17-year clinical results
Conclusion Long-term results after aortic valve replacement with stentless biological prostheses compare favorably with those obtained with stented bioprostheses.
Source: Asian Cardiovascular and Thoracic Annals - November 7, 2016 Category: Cardiology Authors: Ennker, J., Meilwes, M., Pons-Kuehnemann, J., Niemann, B., Grieshaber, P., Ennker, I. C., Boening, A. Tags: Cardiac Source Type: research

The JUPITER registry: 1-year results of transapical aortic valve implantation using a second-generation transcatheter heart valve in patients with aortic stenosis ADULT CARDIAC
CONCLUSIONS In a high-risk cohort of patients undergoing TA-TAVR for AS, the use of the JenaValve THV is safe and effective. In patients at higher risk for coronary ostia obstruction, annular rupture or with limited aortic valve calcification, the JenaValve might be preferable for implantation due to its clipping-mechanism engaging native aortic valve cusps for fixation with reduced radial forces of the self-expanding stent.
Source: European Journal of Cardio-Thoracic Surgery - November 4, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Silaschi, M., Treede, H., Rastan, A. J., Baumbach, H., Beyersdorf, F., Kappert, U., Eichinger, W., Rüter, F., de Kroon, T. L., Lange, R., Ensminger, S., Wendler, O. Tags: History, Basic research vascular ADULT CARDIAC Source Type: research

Frailty Ups Early Death, Stroke Risk After Either TAVR or SAVR Frailty Ups Early Death, Stroke Risk After Either TAVR or SAVR
And, as suggested by a PARTNER 2A analysis, that applies even to intermediate-risk patients who had either transcatheter or surgical aortic-valve replacement.Heartwire from Medscape
Source: Medscape Medical News Headlines - November 2, 2016 Category: Consumer Health News Tags: Cardiology News Source Type: news

Transfemoral TAVI procedure in women: Minimally-invasive technique.
We report here the case of a patient treated by means of a "minimalist" approach to TAVI allowing a reduction of the risks inherent in the procedure. This simplified strategy relies on an optimal use of CT scan findings prior to TAVI. The procedure is carried out under local anesthesia and the main access site is sutured percutaneously (Proglides). The radial artery is used as a secondary access site. Contrast medium is diluted and stimulation is administered via the intraventricular guidewire. Direct stenting is performed when deemed feasible on the basis of CT scan results. Simplified procedures such as these contribute ...
Source: Annales de Cardiologie et d'Angeiologie - November 2, 2016 Category: Cardiology Authors: Benamer H, Chevalier B, Roy A, Bouzid MA, Perdrix C, Garot P, Hovasse T, Unterseeh T, Champagne S, Lefèvre T Tags: Ann Cardiol Angeiol (Paris) Source Type: research

Transcatheter Aortic Valve Implantation in Nonagenarians
Conclusions: Transcatheter aortic valve implantation can be performed in nonagenarians despite very high preoperative risk scores and substantial multimorbidity, with acceptable outcomes.
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Myocardial Protection and Financial Considerations of Custodiol Cardioplegia in Minimally Invasive and Open Valve Surgery
Objective: Single-dose antegrade crystalloid cardioplegia with Custodiol-HTK (histidine-tryptophan-ketoglutarate) has been used for many years. Its safety and efficacy were established in experimental and clinical studies. It is beneficial in complex valve surgery because it provides a long period of myocardial protection with a single dose. Thus, valve procedures (minimally invasive or open) can be performed with limited interruption. The aim of this study is to compare the use of Custodiol-HTK cardioplegia with traditional blood cardioplegia in patients undergoing minimally invasive and open valve surgery. Methods: A si...
Source: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery - November 1, 2016 Category: Cardiovascular & Thoracic Surgery Tags: Original Articles Source Type: research

Trial design: Rivaroxaban for the prevention of major cardiovascular events post transcatheter aortic valve replacement: rationale and design of the GALILEO study
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy-based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - November 1, 2016 Category: Cardiology Source Type: research

Report: Boston Scientific pauses Lotus Edge heart valve in Europe
Boston Scientific (NYSE:BSX) is reportedly pausing implantations of its next-generation Lotus Edge replacement heart valve in Europe to investigate a locking mechanism issue. Marlborough, Mass.-based Boston Scientific has implanted about 200 of the Lotus Edge transcatheter aortic valve replacements in Europe, according to Barclays analyst Matthew Taylor, encountering about a 4% rate of “some issues with [the] locking mechanism of the valve.” “In these cases (incidence rate of ~4%), the device was recaptured and a new valve was implanted with no major adverse events,” Taylor wrote today in a note to...
Source: Mass Device - October 31, 2016 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiovascular Clinical Trials Replacement Heart Valves Boston Scientific TCT 2016 Transcatheter Cardiovascular Therapeutics symposium (TCT) Source Type: news

Transcarotid Transcatheter Aortic Valve Replacement: General or Local Anesthesia
Conclusions The transcarotid approach for TAVR is feasible using general or local anesthesia. A higher rate of perioperative strokes was observed with GA.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - October 24, 2016 Category: Cardiology Authors: Debry, N., Delhaye, C., Azmoun, A., Ramadan, R., Fradi, S., Brenot, P., Sudre, A., Moussa, M. D., Tchetche, D., Ghostine, S., Mylotte, D., Modine, T. Tags: Structural Source Type: research

Neurological Outcomes With Embolic Protection Devices in Patients Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Conclusions Use of EP seems to be associated with reductions in imaging markers of cerebral infarction and early clinical neurological effectiveness in patients undergoing TAVR.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - October 24, 2016 Category: Cardiology Authors: Giustino, G., Mehran, R., Veltkamp, R., Faggioni, M., Baber, U., Dangas, G. D. Tags: Structural Source Type: research

Transcatheter Aortic Valve Replacement: The New Standard in Patients With Previous Coronary Bypass Grafting?
Conclusions Since its introduction in 2007, TAVR has been increasingly used in Germany in patients with previous CABG, and in-hospital outcome data support the trend away from redo surgery.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - October 24, 2016 Category: Cardiology Authors: Reinöhl, J., Kaier, K., Reinecke, H., Frankenstein, L., Zirlik, A., Zehender, M., von zur Mühlen, C., Bode, C., Stachon, P. Tags: Structural 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 20, 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

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 5, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Outcome of left ventricular surgical remodelling after the STICH trial ADULT CARDIAC
CONCLUSIONS Our findings show that patients, who are candidates for LVSR, have mostly akinetic areas and CIMR requiring surgical correction and are severely symptomatic. Severe LVDD is common and, along with emergency status, is the most important risk factor for early and late outcome.
Source: European Journal of Cardio-Thoracic Surgery - October 5, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Calafiore, A. M., Iaco, A. L., Kheirallah, H., Sheikh, A. A., Al Sayed, H., El Rasheed, M., Allam, A., Awadi, M. O., Alfonso, J. J., Osman, A. A., Di Mauro, M. Tags: Electrophysiology - arrhythmias, Minimally invasive surgery ADULT CARDIAC Source Type: research

Haemodynamic benefits of rapid deployment aortic valve replacement via a minimally invasive approach: 1-year results of a prospective multicentre randomized controlled trial ADULT CARDIAC
CONCLUSIONS MIS-RDAVR is associated with a significantly reduced cross-clamp time and better valvular haemodynamic function than FS-AVR. However, paravalvular leak rates are higher with MIS-RDAVR.
Source: European Journal of Cardio-Thoracic Surgery - October 5, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Borger, M. A., Dohmen, P. M., Knosalla, C., Hammerschmidt, R., Merk, D. R., Richter, M., Doenst, T., Conradi, L., Treede, H., Moustafine, V., Holzhey, D. M., Duhay, F., Strauch, J. Tags: Transplantation - heart, Basic research vascular ADULT CARDIAC Source Type: research

No clinical effect of prosthesis-patient mismatch after transcatheter versus surgical aortic valve replacement in intermediate- and low-risk patients with severe aortic valve stenosis at mid-term follow-up: an analysis from the NOTION trial ADULT CARDIAC
CONCLUSIONS The incidence of PPM was lower and less severe after TAVR compared with SAVR in intermediate- and low-risk patients with severe AVS. There were no significant differences in MACCE, cardiac-related hospitalizations or NYHA class after 2 years for patients with versus those without severe PPM.
Source: European Journal of Cardio-Thoracic Surgery - October 5, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Thyregod, H. G. H., Steinbrüchel, D. A., Ihlemann, N., Ngo, T. A., Nissen, H., Kjeldsen, B. J., Chang, Y., Hansen, P. B., Olsen, P. S., Sondergaard, L. Tags: History, Basic research vascular ADULT CARDIAC Source Type: research

Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study).
CONCLUSIONS: -Patients with clinical RHD have high mortality and morbidity despite being young; those from low and lower-middle income countries had a poorer prognosis associated with advanced disease and low education. Programs focused on early detection and treatment of clinical RHD are required to improve outcomes. PMID: 27702773 [PubMed - as supplied by publisher]
Source: Circulation - October 4, 2016 Category: Cardiology Authors: Zühlke L, Karthikeyan G, Engel ME, Rangarajan S, Mackie P, Cupido B, Mauff K, Islam S, Daniels R, Francis V, Ogendo S, Gitura B, Mondo C, Okello E, Lwabi P, Al-Kebsi MM, Hugo-Hamman C, Sheta SS, Haileamlak A, Daniel W, Goshu DY, Abdissa SG, Desta AG, Sha Tags: Circulation Source Type: research

Improvements of Procedural Results With a New ‐Generation Self‐Expanding Transfemoral Aortic Valve Prosthesis in Comparison to the Old‐Generation Device
ConclusionsTAVR with the new Evolut R resulted in significantly lower paravalvular regurgitation. This may be due to redesigned cell geometry and higher precision during implantations, as well as the ability to resheath a malpositioned valve.
Source: Journal of Interventional Cardiology - October 1, 2016 Category: Cardiology Authors: Bruna Gomes, Nicolas A. Geis, Emmanuel Chorianopoulos, Benjamin Meder, Florian Leuschner, Hugo A. Katus, Raffi Bekeredjian Tags: Original Investigation Source Type: research

Direct Oral Anticoagulants in Emergency Trauma Admissions.
CONCLUSION: DOACs in the setting of hemorrhage are a clinical challenge in the traumatological emergency room because of the inadequate validity of the relevant laboratory tests. An emergency antidote is now available only for dabigatran. PMID: 27658470 [PubMed - in process]
Source: Deutsches Arzteblatt International - September 24, 2016 Category: Journals (General) Tags: Dtsch Arztebl Int Source Type: research

Transfemoral transcatheter aortic-valve replacement should be preferred over surgery in most intermediate-risk patients
Commentary on: Leon MB, Smith CR, Mack MJ, et al.., PARTNER 2 Investigators. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016;374:1609–20 . Context Evidence derived from randomised clinical trials support transcatheter aortic valve replacement (TAVR) as a choice for patients with aortic stenosis with a prohibitive surgical risk and as a valid alternative therapy for those at high-risk of surgical mortality. Owing to increases in operator experience as well as improvements with transcatheter techniques and devices associated with reduction in procedural complications,...
Source: Evidence-Based Medicine - September 23, 2016 Category: Internal Medicine Authors: Tamburino, C., Capranzano, P. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention 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 21, 2016 Category: Cardiology Authors: Glaser, N., Jackson, V., Holzmann, M. J., Franco-Cereceda, A., Sartipy, U. Tags: Cardiovascular surgery Source Type: research