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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
BackgroundThe mechanisms behind the association of atrial fibrillation (AF) and dementia are unknown. We previously found a significantly increased risk of dementia in AF patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which AF itself increases dementia risk, in addition to long‐term anticoagulation exposure.Methods and ResultsA total of 10 537 patients anticoagulated with warfarin (target INR 2–3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included. Warfarin indication was for AF (n=...
Source: JAHA:Journal of the American Heart Association - July 11, 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 Original Research Source Type: research

Iatrogenic dissection of the descending aorta: Conservative or endovascular treatment?
In this report, we refer the bibliographic data and we discuss the treatment options in these cases. PMID: 27397470 [PubMed - in process]
Source: Annals of Cardiac Anaesthesia - July 1, 2016 Category: Anesthesiology Authors: Baikoussis NG, Argiriou M, Kratimenos T, Karameri V, Dedeilias P Tags: Ann Card Anaesth Source Type: research

Sex ‐Based Differences In Outcomes With Bivalirudin Or Unfractionated Heparin For Transcatheter Aortic Valve Replacement: Results From The BRAVO 3 Randomized Trial
Conclusions: There was no difference in early outcomes with bivalirudin versus UFH in men or women undergoing contemporary TAVR. This article is protected by copyright. All rights reserved.
Source: Catheterization and Cardiovascular Interventions - July 1, 2016 Category: Cardiovascular & Thoracic Surgery Authors: A Asgar, J Chandrasekhar, G Mikhail, J Webb, T Lefevre, C Tamburino, D Hildick ‐Smith, R Hambrecht, E Van Belle, J Widder, N Dumonteil, U Hink, R Jeger, A Linke, E Dellargyris, P Gao, R Mehran, C Hengstenberg, P Anthopoulos, G Dangas, Tags: Original Studies Source Type: research

Taking Risk: Early Results From Teaching Hospitals’ Participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative
The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk. The first round of participants entered risk agreements on October 1, 2013 and January 1, 2014. In April 2014, CMMI selected additional participants who started takin...
Source: Academic Medicine - June 30, 2016 Category: Universities & Medical Training Tags: Articles Source Type: research

New Ventricular Septal Defects Following Balloon-Expandable Transcatheter Aortic Valve Replacement.
Authors: Rene AG, Jagasia D, Wickramasinghe SR, Desai N, Szeto W, Vallabhajosyula P, Li RH, Silvestry FE, Giri J, Jha S, Herrmann HC, Anwaruddin S Abstract Transcatheter aortic valve replacement (TAVR) has been commercially approved in the United States for the treatment of high-risk and inoperable patients with severe symptomatic aortic stenosis. While TAVR has proven benefits with regard to survival and quality of life in studied populations, the procedure is also associated with several well-described complications including stroke, vascular injury, and paravalvular regurgitation. More infrequent complications a...
Source: The Journal of Invasive Cardiology - June 29, 2016 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Residual aortic regurgitation after transcatheter aortic valve replacement under the echocardiographic microscope
Transcatheter aortic valve replacement (TAVR) for patients with severe aortic stenosis has expanded dramatically in patients deemed suboptimal for surgical aortic valve replacement (SAVR). The explosive growth of TAVR has been supported by unparalleled clinical trial data in specifically defined patient subsets, with equal or superior survival and stroke rates,1-3 improved early quality of life,4 lower major adverse clinical events,1 and improved systolic flow parameters,1 including lower rates of patient prosthetic mismatch5 when compared with SAVR.
Source: The Journal of Thoracic and Cardiovascular Surgery - June 28, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Michael J. Reardon, Jeffrey J. Popma Tags: Editorial commentary Source Type: research

Treatment of Chronic Functional Mitral Valve Regurgitation With a Percutaneous Annuloplasty System
ConclusionsPercutaneous direct annuloplasty is feasible and safe in high-risk FMR patients. This treatment initiates LV reverse remodeling, and provides clinical improvement during 6 months after treatment. (Mitralign Percutaneous Annuloplasty First in Man Study; NCT01852149).
Source: Journal of the American College of Cardiology - June 21, 2016 Category: Cardiology Source Type: research

Trends over the past 4 years in population characteristics, 30-day outcomes and 1-year survival in patients treated with transcatheter aortic valve implantation.
CONCLUSIONS: Over the past 4 years, TAVI has been increasingly performed using a transfemoral approach. Treated patients are at lower-risk with less co-morbidity. Thirty-day mortality and complications remained unchanged, but length of stay after TAVI and 1-year mortality decreased dramatically. PMID: 27342810 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - June 21, 2016 Category: Cardiology Authors: Avinée G, Durand E, Elhatimi S, Bauer F, Glinel B, Dacher JN, Cellier G, Viart G, Tron C, Godin M, Litzler PY, Cribier A, Eltchaninoff H Tags: Arch Cardiovasc Dis Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes.
CONCLUSIONS: This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients. PMID: 27324524 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - June 18, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Patel HJ, Likosky DS, Pruitt AL, Murphy ET, Theurer PF, Prager RL Tags: Ann Thorac Surg Source Type: research

Aortic Valve Replacement in the Moderately Elevated Risk Patient: A Population-Based Analysis of Outcomes
Conclusions This population-based contemporary assessment suggests moderate-risk patients undergoing AVR experience favorable outcomes. Although increasing PROM is important in preoperative evaluation of risk, preexisting pulmonary hypertension and indication for operation are among other factors that should be considered as TAVR expands into this group of patients.
Source: The Annals of Thoracic Surgery - June 18, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

An approach to a patient with infective endocarditis.
Authors: Hitzeroth J, Beckett N, Ntuli P Abstract Although infective endocarditis (IE) is relatively uncommon, it remains an important clinical entity with a high in-hospital and 1-year mortality. It is most commonly caused by viridans streptococci. Staphylococcus aureus is responsible for a malignant course of IE and often requires early surgery to eradicate. Other rarer causes are various bacilli, including the HACEK (Haemophilus, Actinobacillus,Cardiobacterium, Eikenella and Kingella spp.) group of organisms and fungi. The clinical presentation varies. Patients may present with a nonspecific illness, valve dysfu...
Source: South African Medical Journal - June 17, 2016 Category: African Health Tags: S Afr Med J Source Type: research

Transcatheter aortic valve ‐in‐valve treatment of degenerative stentless supra‐annular Freedom Solo valves: A single centre experience
ConclusionsViV‐TAVI in stentless Freedom Solo valves is high risk. The risk of coronary occlusion is high. The smallest possible prosthesis (1:1 sizing) should be used, and strategies to protect the coronary vessels must be considered. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Authors: James Cockburn, Maureen Dooley, Jessica Parker, Andrew Hill, Nevil Hutchinson, Adam de Belder, Uday Trivedi, David Hildick ‐Smith Tags: Valvular and Structural Heart Diseases Source Type: research

Transcatheter aortic valve‐in‐valve treatment of degenerative stentless supra‐annular Freedom Solo valves: A single centre experience
ConclusionsViV‐TAVI in stentless Freedom Solo valves is high risk. The risk of coronary occlusion is high. The smallest possible prosthesis (1:1 sizing) should be used, and strategies to protect the coronary vessels must be considered. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 17, 2016 Category: Cardiovascular & Thoracic Surgery Authors: James Cockburn, Maureen Dooley, Jessica Parker, Andrew Hill, Nevil Hutchinson, Adam de Belder, Uday Trivedi, David Hildick‐Smith Tags: Valvular and Structural Heart Diseases Source Type: research

Progressive Intermediate-Term Improvement in Ventricular and Atrioventricular Interaction after Transcatheter Pulmonary Valve Replacement in Patients with Right Ventricular Outflow Tract Obstruction
Conclusions Patients with RVOT obstruction had biventricular systolic and diastolic dysfunction at BL. Relieving RVOT obstruction with TPVR reduced adverse ventricular and compensatory atrioventricular interaction, resulting in progressive biventricular functional improvement and remodeling at early and mid-term FU.
Source: American Heart Journal - June 16, 2016 Category: Cardiology Source Type: research

MassDevice.com +5 | The top 5 medtech stories for June 15, 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. Biotronik wins CE Mark for Magmaris bioresorbable scaffold Biotronik said today it won CE Mark for its Magmaris magnesium bioresorbable scaffold designed to treat coronary artery disease. Data from the Biosolve-II trial of the ...
Source: Mass Device - June 15, 2016 Category: Medical Equipment Authors: MassDevice Tags: News Well Plus 5 Source Type: news

Thirty-day outcomes in patients at intermediate risk for surgery from the SAPIEN 3 European approval trial.
CONCLUSIONS: TF-TAVI using the SAPIEN 3 THV in patients at intermediate risk for surgery is associated with a very low risk of death and complications, including new pacemakers and paravalvular leaks. Although compelling, these initial results are being confirmed in larger global studies before expanding the indications for TAVI in severe aortic stenosis. PMID: 27290682 [PubMed - in process]
Source: EuroIntervention - June 14, 2016 Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research

Two-Year Outcomes in Patients With Severe Aortic Valve Stenosis Randomized to Transcatheter Versus Surgical Aortic Valve Replacement: The All-Comers Nordic Aortic Valve Intervention Randomized Clinical Trial Structural Heart Disease
Conclusions— Two-year results from the NOTION trial demonstrate the continuing safety and effectiveness of TAVR in lower-risk patients. Longer-term data are needed to verify the durability of this procedure in this patient population. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01057173.
Source: Circulation: Cardiovascular Interventions - June 13, 2016 Category: Cardiology Authors: Sondergaard, L., Steinbruchel, D. A., Ihlemann, N., Nissen, H., Kjeldsen, B. J., Petursson, P., Ngo, A. T., Olsen, N. T., Chang, Y., Franzen, O. W., Engstrom, T., Clemmensen, P., Olsen, P. S., Thyregod, H. G. H. Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Structural Heart Disease 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 13, 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

5. Mitral valve replacement for mitral stenosis: 15 years single center experience
This study aimed to evaluate and compare the early and late outcome of mitral valve replacement (mechanical versus bioprosthetic) for severe mitral stenosis. A retrospective cohort study was performed on prospectively collected data involving mitral stenosis patients who have undergone MVR with either bioprosthetic (BMV) (n =50) or mechanical (MMV) (n =145) valves in our institute from 1999 to 2012. Data were analyzed for early and late mortality, NYHA functional classes, stroke, early and late valve-related complications, and survival. Chi Square test, logistic regression, Kaplan Meier curve, and dependent proportions tes...
Source: Journal of the Saudi Heart Association - June 11, 2016 Category: Cardiology Source Type: research

Echocardiographic predictors of outcomes in adults with aortic stenosis
Conclusions The most powerful echocardiographic predictors of mortality are low LVEF and low flow, whereas AS severity parameters predict valve-related events but not overall mortality. Hence, low flow should be integrated in the risk stratification and therapeutic decision-making in patients with AS.
Source: Heart - June 6, 2016 Category: Cardiology Authors: Capoulade, R., Le Ven, F., Clavel, M.-A., Dumesnil, J. G., Dahou, A., Thebault, C., Arsenault, M., O'Connor, K., Bedard, E., Beaudoin, J., Senechal, M., Bernier, M., Pibarot, P. Tags: Editor's choice, Drugs: cardiovascular system, Echocardiography, Aortic valve disease, Clinical diagnostic tests, Epidemiology Valvular heart disease Source Type: research

Transcatheter aortic valve replacement in nonagenarians: early and intermediate outcome from the OBSERVANT study and meta-analysis of the literature
Abstract The purpose of this study was to evaluate the outcome of nonagenarians after transcatheter aortic valve replacement (TAVR) from the OBSERVANT study and to pool the results of the literature on this topic. Aortic stenosis is the most common acquired valvular heart disease in the Western countries, and its prevalence is linked to the phenomenon of population aging. TAVR can be considered as a wise approach to treat nonagenarians, but data on its safety and effectiveness are scarce. Data on 80 patients aged >90 years who underwent TAVR from OBSERVANT study were analyzed. A systematic review and meta-ana...
Source: Heart and Vessels - June 1, 2016 Category: Cardiology Source Type: research

Bicuspid Aortic Insufficiency With Aortic Root Aneurysm: Root Reimplantation Versus Bentall Root Replacement.
CONCLUSIONS: In patients with bicuspid aortic valve AI with root aneurysm, primary cusp repair with root reimplantation achieves equivalent midterm outcomes compared with Bentall root replacement. PMID: 27261086 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - June 1, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Vallabhajosyula P, Szeto WY, Habertheuer A, Komlo C, Milewski RK, McCarthy F, Desai ND, Bavaria JE Tags: Ann Thorac Surg Source Type: research

Factors influencing quality of anticoagulation control and warfarin dosage in patients after aortic valve replacement within the 3 months of follow up.
Abstract Warfarin dosage estimation using the pharmacogenetic algorithms has been shown to improve the quality of anticoagulation control in patients with atrial fibrillation. We sought to assess the genetic, demographic and clinical factors that determine the quality of anticoagulation in patients following aortic valve replacement (AVR). We studied 200 consecutive patients (130 men) aged 63 ± 12.3 years, undergoing AVR, in whom warfarin dose was established using a pharmacogenetic algorithm. The quality of anticoagulation within the first 3 months since surgery was expressed as the time of international normali...
Source: J Physiol Pharmacol - June 1, 2016 Category: Drugs & Pharmacology Authors: Wypasek E, Mazur P, Bochenek M, Awsiuk M, Grudzien G, Plincer D, Undas A Tags: J Physiol Pharmacol Source Type: research

3-Year Outcomes in High-Risk Patients Who Underwent Surgical or Transcatheter Aortic Valve Replacement
This study sought to determine whether this clinical benefit was sustained over time.MethodsPatients with severe aortic stenosis deemed at increased risk for surgery by a multidisciplinary heart team were randomized 1:1 to TAVR or open surgical valve replacement (SAVR). Three-year clinical and echocardiographic outcomes were obtained in those patients with an attempted procedure.ResultsA total of 797 patients underwent randomization at 45 U.S. centers; 750 patients underwent an attempted procedure. Three-year all-cause mortality or stroke was significantly lower in TAVR patients (37.3% vs. 46.7% in SAVR; p = 0.006). Adver...
Source: Journal of the American College of Cardiology - May 31, 2016 Category: Cardiology Source Type: research

Simplified prediction of postoperative cardiac surgery outcomes with a novel score: R2CHADS2
Conclusion The R2CHADS2 score estimates postoperative events with acceptable accuracy and if further validated may be used as a simple preoperative risk tool calculator.
Source: American Heart Journal - May 31, 2016 Category: Cardiology Source Type: research

Conventional versus rapid-deployment aortic valve replacement: a single-centre comparison between the Edwards Magna valve and its rapid-deployment successor
CONCLUSIONS We conclude that this rapid-deployment valve probably facilitates minimally invasive surgery. Furthermore, a subgroup analysis showed reduced transvalvular gradients in smaller valve sizes compared with the conventionally implanted valve of the same type. The favourable haemodynamic profile and the potentially different spectrum of valve-related adverse events should be addressed in further clinical trials.
Source: Interactive CardioVascular and Thoracic Surgery - May 26, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Andreas, M., Wallner, S., Habertheuer, A., Rath, C., Schauperl, M., Binder, T., Beitzke, D., Rosenhek, R., Loewe, C., Wiedemann, D., Kocher, A., Laufer, G. Tags: Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

Results of surgical aortic valve replacement and transapical transcatheter aortic valve replacement in patients with previous coronary artery bypass grafting
CONCLUSIONS Reported differences in mortality and morbidity after TaTAVR and RAVR reflect differences in baseline risk profiles. Given the lower trend for renal complications, patients at higher perioperative renal risk might be better served by TaTAVR.
Source: Interactive CardioVascular and Thoracic Surgery - May 26, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., D'Onofrio, A., Biancari, F., Salizzoni, S., De Feo, M., Agrifoglio, M., Mariscalco, G., Lucchetti, V., Messina, A., Musumeci, F., Santarpino, G., Esposito, G., Santini, F., Magagna, P., Beghi, C., Aiello, M., Ratta, E. D., Savini, C., Troise, Tags: Molecular biology, Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

WITHDRAWN: Preoperative statin therapy for patients undergoing cardiac surgery.
CONCLUSIONS: Preoperative statin therapy reduces the odds of postoperative atrial fibrillation (AF) and shortens the patient's stay on the ICU and in the hospital. Statin pretreatment had no influence on perioperative mortality, stroke, myocardial infarction or renal failure, but only two of all included studies assessed mortality. As analysed studies included mainly individuals undergoing myocardial revascularisation, results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery. PMID: 27219528 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - May 24, 2016 Category: Journals (General) Authors: Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ Tags: Cochrane Database Syst Rev Source Type: research

Prognostic Importance of Diastolic Dysfunction in Relation to Post Procedural Aortic Insufficiency in Patients Undergoing Transcatheter Aortic Valve Replacement
Conclusions: Even mild post‐TAVR AI may have a negative impact on outcomes of patients with underlying severe DD. © 2016 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - May 24, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Polydoros N. Kampaktsis, Casper N. Bang, S. Chiu Wong, Nikolaos J. Skubas, Harsimran Singh, Konstantinos Voudris, Amiran Baduashvili, Kalliopi Pastella, Rajesh V. Swaminathan, Ryan K. Kaple, Robert M. Minutello, Dmitriy N. Feldman, Luke Kim, Ingrid Hrilja Tags: Valvular and Structural Heart Diseases Source Type: research

Free-floating left atrial ball thrombus after mitral valve replacement with patent coronary artery bypass grafts: successful removal by a right minithoracotomy approach without aortic cross-clamp
We describe a case in a 79-year-old woman with chronic atrial fibrillation and a recent stroke who had undergone mitral valve replacement 25 years previously and coronary artery bypass grafting 5 years previously. Redo cardiac surgery represents a clinical challenge due to a higher rate of peri-operative morbidity and mortality. Median re-sternotomy can be particularly difficult in patients with functioning coronary artery grafts, where the risk of graft injury is a significant concern. Prompt surgical intervention was carried out, and to avoid the challenge of re-sternotomy in this patient with two prior thoracotomies, ...
Source: General Thoracic and Cardiovascular Surgery - May 22, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Transcatheter Valve-in-Valve Implantation for Failed Mitral Bioprostheses: Gradient, Symptoms, and Functional Status in 18 High-Risk Patients Up to 5 Years
Conclusions Mitral valve-in-valve implantation allows good clinical and hemodynamic results. In our series, the appearance of a significant gradient at follow-up was not associated with echocardiographic signs of structural deterioration, and was possibly related to the size of the transcatheter and recipient valve.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Does a Higher Society of Thoracic Surgeons Score Predict Outcomes in Transfemoral and Alternative Access Transcatheter Aortic Valve Replacement?
Conclusions As expected, non-TF patients were at a higher risk than TF patients for procedural morbidity and death. Although no differences were observed in 30-day deaths or morbidity in different STS PROM subgroups, those undergoing non-TF TAVR at a higher STS PROM (>8%) had higher 1-year mortality. When applicable, TF TAVR remains the procedure of choice in high- or extreme-risk patients undergoing TAVR.
Source: The Annals of Thoracic Surgery - May 19, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical Transcatheter Valve-in-Valve Implantation for Failed Mitral Bioprostheses: Gradient, Symptoms, and Functional Status in 18 High-Risk Patients Up to 5 Years.
CONCLUSIONS: Mitral valve-in-valve implantation allows good clinical and hemodynamic results. In our series, the appearance of a significant gradient at follow-up was not associated with echocardiographic signs of structural deterioration, and was possibly related to the size of the transcatheter and recipient valve. PMID: 27209614 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - May 18, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Cerillo AG, Gasbarri T, Celi S, Murzi M, Trianni G, Ravani M, Solinas M, Berti S Tags: Ann Thorac Surg Source Type: research

Safety and Use of Anticoagulation After Aortic Valve Replacement With Bioprostheses: A Meta-Analysis Original Articles
Conclusions— Contrary to the current guidelines, a meta-analysis of previous studies suggests that anticoagulation in the setting of an aortic bioprosthesis significantly increases bleeding risk without a favorable effect on thromboembolic events. Larger, randomized controlled studies should be performed to further guide this clinical practice.
Source: Circulation: Cardiovascular Quality and Outcomes - May 17, 2016 Category: Cardiology Authors: Riaz, H., Alansari, S. A. R., Khan, M. S., Riaz, T., Raza, S., Luni, F. K., Khan, A. R., Riaz, I. B., Krasuski, R. A. Tags: Anticoagulants, Aortic Valve Replacement/Transcatheter Aortic Valve Implantation Original Articles Source Type: research

Vancouver Transcatheter Aortic Valve Replacement Clinical Pathway: Minimalist Approach, Standardized Care, and Discharge Criteria to Reduce Length of Stay Innovations in Care
We describe the development, implementation, and evaluation of a standardized clinical pathway to facilitate safe discharge home at the earliest time after transfemoral transcatheter aortic valve replacement. Between May 2012 and October 2014, the Heart Team developed a clinical pathway suited to the unique requirements of transfemoral transcatheter aortic valve replacement in contemporary practice. The components included risk-stratified minimalist periprocedure approach, standardized postprocedure care with early mobilization and reconditioning, and criteria-driven discharge home. Our aim was to reduce variation in care,...
Source: Circulation: Cardiovascular Quality and Outcomes - May 17, 2016 Category: Cardiology Authors: Lauck, S. B., Wood, D. A., Baumbusch, J., Kwon, J.-Y., Stub, D., Achtem, L., Blanke, P., Boone, R. H., Cheung, A., Dvir, D., Gibson, J. A., Lee, B., Leipsic, J., Moss, R., Perlman, G., Polderman, J., Ramanathan, K., Ye, J., Webb, J. G. Tags: Treatment, Quality and Outcomes Innovations in Care Source Type: research

The Impact of Prior Stroke on the Outcome of Patients with Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement
The present study aimed to evaluate the impact of prior cardiovascular events (CVE) on outcome in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
Source: Cardiovascular Revascularization Medicine - May 13, 2016 Category: Cardiology Authors: Romain Didier, Edward Koifman, Sarkis Kiramijyan, Smita I. Negi, Rebecca Torguson, Petros Okubagzi, Augusto D. Pichard, Ron Waksman Source Type: research

The impact of prior stroke on the outcome of patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
The present study aimed to evaluate the impact of prior cardiovascular events (CVE) on outcome in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
Source: Cardiovascular Revascularization Medicine - May 13, 2016 Category: Cardiology Authors: Romain Didier, Edward Koifman, Sarkis Kiramijyan, Smita I. Negi, Rebecca Torguson, Petros Okubagzi, Augusto D. Pichard, Ron Waksman Tags: Clinical Source Type: research

Transcatheter Aortic Valve Implantation Compared With Surgical Aortic Valve Replacement in Low-Risk Patients Structural Heart Disease
Conclusions— In patients with low operative risk, significantly better 3-year survival and freedom from major adverse cardiac and cerebrovascular events were observed after SAVR compared with TAVI. Further studies on new-generation valve prostheses are necessary before expanding indications of TAVI toward lower-risk patients.
Source: Circulation: Cardiovascular Interventions - May 6, 2016 Category: Cardiology Authors: Rosato, S., Santini, F., Barbanti, M., Biancari, F., DErrigo, P., Onorati, F., Tamburino, C., Ranucci, M., Covello, R. D., Santoro, G., Grossi, C., Ventura, M., Fusco, D., Seccareccia, F., on behalf of the OBSERVANT Research Group Tags: Aortic Valve Replacement/Transcatheter Aortic Valve Implantation, Mortality/Survival Structural Heart Disease 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 4, 2016 Category: Cardiovascular & Thoracic Surgery Source Type: research

Sex‐Based Differences In Outcomes With Bivalirudin Or Unfractionated Heparin For Transcatheter Aortic Valve Replacement: Results From The BRAVO 3 Randomized Trial
Conclusions: There was no difference in early outcomes with bivalirudin versus UFH in men or women undergoing contemporary TAVR. This article is protected by copyright. All rights reserved.
Source: Catheterization and Cardiovascular Interventions - May 1, 2016 Category: Cardiovascular & Thoracic Surgery Authors: A Asgar, J Chandrasekhar, G Mikhail, J Webb, T Lefevre, C Tamburino, D Hildick‐Smith, R Hambrecht, E Van Belle, J Widder, N Dumonteil, U Hink, R Jeger, A Linke, E Dellargyris, P Gao, R Mehran, C Hengstenberg, P Anthopoulos, G Dangas, Tags: Original Studies Source Type: research

Prediction of Postoperative Cardiac Surgery Outcomes With a Novel Score: R2CHADS2
Conclusion The R2CHADS2 score estimates postoperative events with acceptable accuracy and if validated can be used as a simple preoperative drisk tool calculator.
Source: American Heart Journal - April 30, 2016 Category: Cardiology Source Type: research

Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience ADULT CARDIAC
CONCLUSIONS ReMVS still carries the risk of significant early mortality and major morbidity. Major lesion to cardiovascular structures is the most dreadful iatrogenic complication, and injury of a previous LIMA graft identifies patients at higher risk of operative mortality. Prolonged cross-clamp times, extracellular crystalloid cardioplegia and massive transfusions have profound impact on early outcome, as well as the development of perioperative AMI, eventually requiring IABP and prolonged intubation. The combination of antegrade and retrograde cardioplegia seems to offer a better myocardial protection in these high-risk patients.
Source: European Journal of Cardio-Thoracic Surgery - April 29, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., Perrotti, A., Reichart, D., Mariscalco, G., Della Ratta, E., Santarpino, G., Salsano, A., Rubino, A., Biancari, F., Gatti, G., Beghi, C., De Feo, M., Mignosa, C., Pappalardo, A., Fischlein, T., Chocron, S., Detter, C., Santini, F., Faggian, G Tags: Basic research vascular ADULT CARDIAC Source Type: research

Recent TAVR approvals prompt changes to Direct Flow’s Salus trial
Direct Flow Medical said today that recent FDA approvals for transcatheter aortic valve replacements prompted it to make changes to the Salus trial of its own TAVR entry. Salus, originally aimed at enrolling 1,262 patients, is now expected to enroll a little more than half that number, 648 subjects, the company said. Santa Rosa, Calif.-based Direct Flow is also adding best practices and comparisons to TAVRs that are already on the U.S. market, which include the Sapien line from market leader Edwards Lifesciences (NYSE:EW) and the Medtronic (NYSE:MDT) CoreValve device. The 30-patient feasibility phase of for Salus in 20...
Source: Mass Device - April 28, 2016 Category: Medical Equipment Authors: Brad Perriello Tags: Clinical Trials Replacement Heart Valves Wall Street Beat Direct Flow Medical Inc. Source Type: news

Four-year clinical results of transcatheter self-expanding Medtronic CoreValve implantation in high-risk patients with severe aortic stenosis
Conclusion: our study demonstrated favourable long-term (4 years) outcomes after successful TAVI using the third-generation Medtronic CoreValve device.
Source: Age and Ageing - April 27, 2016 Category: Geriatrics Authors: Thomopoulou, S., Vavuranakis, M., Karyofyllis, P., Kariori, M., Karavolias, G., Balanika, M., Smyrli, A., Stefopoulos, C., Sbarouni, E., Moldovan, C., Khoury, M., Stefanadis, C., Voudris, V. Tags: Short Reports Source Type: research

Transient occlusion of the right coronary artery by a calcific bicuspid aortic valve mass – An interesting case of inferior STEMI
We report the case of a myocardial infarction caused by transient occlusion of the right coronary artery, secondary to a mobile calcified lesion attached to a bicuspid aortic valve. <Learning objective: The purpose of this article is to demonstrate the importance of echocardiography in patients presenting with an acute myocardial infarction, without significant coronary artery disease. Urgent echocardiography in this case ensured identification of a calcified bicuspid valve and mobile lesion that had transiently occluded the right coronary artery. Subsequent urgent surgery ensured an excellent outcome.>
Source: Journal of Cardiology Cases - April 24, 2016 Category: 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 18, 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

CoreValve High-Risk Study at 3 Years: TAVR Advantage SustainedCoreValve High-Risk Study at 3 Years: TAVR Advantage Sustained
In this high-risk population with severe aortic stenosis, patients were less likely to die or have a stroke within 3 years if they had percutaneous rather than surgical valve replacement. Heartwire from Medscape
Source: Medscape Medical News Headlines - April 15, 2016 Category: Consumer Health News Tags: Cardiology News Source Type: news

MassDevice.com +5 | The top 5 medtech stories for April 13, 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. Toshiba partners with UCI to study potential brain damage in HS football players Toshiba said yesterday it is partnering with the University of California, Irvine to study possible brain damage incurred in high school football ...
Source: Mass Device - April 13, 2016 Category: Medical Equipment Authors: MassDevice Tags: News Well Plus 5 Source Type: news

The spectrum of low-output low-gradient aortic stenosis with normal ejection fraction
Low-flow, low-gradient (LF/LG) severe aortic stenosis (AS) with preserved ejection fraction refers to the condition of AS with aortic valve area ≤1 cm2, stroke volume index <35 mL/m2, mean aortic valve gradient <40 mm Hg and left ventricular ejection fraction ≥50%. This mismatch of aortic valve area suggesting severe stenosis and ‘low’ gradient in some patients has led to confusion as to the severity of stenosis. Conditions previously labelled as LF/LG severe AS include a spectrum, with measurement error probably being the most common cause of marked inconsistency between gradien...
Source: Heart - April 12, 2016 Category: Cardiology Authors: Pislaru, S. V., Pellikka, P. A. Tags: Review articles Reviews Source Type: research