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Total 1211 results found since Jan 2013.

National Analysis of Short-Term Outcomes and Volume-Outcome Relationships for Transcatheter Aortic Valve Replacement in the Era of Commercialization
Conclusions: Our analysis helps to confirm the short-term safety profile of TAVR and further demonstrates that inhospital outcomes have remained acceptable as this procedure has become commercialized.Cardiology 2016;133:58-68
Source: Cardiology - October 22, 2015 Category: Cardiology Source Type: research

Causes of death and predictors of survival after aortic valve replacement in low flow vs. normal flow severe aortic stenosis with preserved ejection fraction
Conclusion Reduced SVI is associated with higher cardiac mortality after AVR. CHF is the predominant cause of cardiac mortality after AVR in patients with LF, suggesting the presence of persistent myocardial impairment in this population.
Source: European Journal of Echocardiography - October 17, 2015 Category: Cardiology Authors: Eleid, M. F., Michelena, H. I., Nkomo, V. T., Nishimura, R. A., Malouf, J. F., Scott, C. G., Pellikka, P. A. Tags: ORIGINAL ARTICLES Source Type: research

TCT 2015: Medtronic touts CoreValve TAVI real-world registry data
Update: Added data from study of new patient populations Medtronic (NYSE:MDT) said today it released the 1st real-world registry study of its CoreValve transcatheter aortic valve implant, reporting outcomes in-line with its clinical trials of the device. The medtech giant also released new data from 3 studies focusing on new patient populations with significant comorbidities today. Data from all of the CoreValve studies was presented at the annual Transcatheter Cardiovascular Therapeutics conference in San Franscisco. The 6,160-patient Society of Thoracic Surgeons and American College of Cardiology TVT registry study repo...
Source: Mass Device - October 13, 2015 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Catheters Clinical Trials Medtronic TCT 2015 Source Type: news

Medtronic touts CoreValve TAVR real-world registry data
Medtronic (NYSE:MDT) said today it released the 1st real-world registry study of its CoreValve transcatheter aortic valve replacement, reporting outcomes in-line with its clinical trials of the device. The 6,160-patient Society of Thoracic Surgeons and American College of Cardiology TVT registry study reported a 5.2% rate of all-cause mortality and 2.6% rate of stroke at 30 days. Those rates are consistent with the 6.9% and 5% rates, respectively, from the pivotal trial, Fridley, Minn.-based Medtronic said. “It is reassuring to see that the profound clinical results in the U.S. CoreValve Pivotal studies were replica...
Source: Mass Device - October 12, 2015 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Catheters Clinical Trials Medtronic Source Type: news

Cochrane corner: vitamin K for improved anticoagulation control in patients receiving warfarin
There has been a substantial increase in the use of oral anticoagulants, notably in the ageing population. This is primarily driven by the use of warfarin in people with atrial fibrillation (AF) in order to reduce the risks of thromboembolic events such as stroke.1 In elderly patients with AF, warfarin use has been shown to reduce the relative risk of stroke by >50% compared with aspirin alone.2 Warfarin is also used to treat patients with deep vein thrombosis, mechanical heart valve replacement, cardioversion, cardiomyopathy and antiphospholipid syndrome.1 The clinical benefits of warfarin must also be balanced with po...
Source: Heart - October 11, 2015 Category: Cardiology Authors: Mahtani, K. R., Nunan, D., Heneghan, C. Tags: Drugs: cardiovascular system, Cochrane Corner, Venous thromboembolism, Epidemiology Editorials Source Type: research

Procedural Results and Clinical Outcomes of Transcatheter Aortic Valve Implantation in Switzerland: An Observational Cohort Study of Sapien 3 Versus Sapien XT Transcatheter Heart Valves Structural Heart Disease
Conclusions— The use of the new generation S3 balloon-expandable THV reduced the risk of more than mild paravalvular regurgitation and vascular complications but was associated with an increased permanent pacemaker rate compared with the XT. Transcatheter aortic valve implantation using the newest generation balloon-expandable THV is associated with a low risk of stroke and favorable clinical outcomes. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01368250.
Source: Circulation: Cardiovascular Interventions - October 9, 2015 Category: Cardiology Authors: Binder, R. K., Stortecky, S., Heg, D., Tueller, D., Jeger, R., Toggweiler, S., Pedrazzini, G., Amann, F. W., Ferrari, E., Noble, S., Nietlispach, F., Maisano, F., Raber, L., Roffi, M., Grunenfelder, J., Juni, P., Huber, C., Windecker, S., Wenaweser, P. Tags: Catheter-based coronary and valvular interventions: other, CV surgery: valvular disease Structural Heart Disease Source Type: research

Replicating Patient-Specific Severe Aortic Valve Stenosis With Functional 3D Modeling Valvular Heart Disease
Conclusions— By combing the technologies of high-spatial resolution computed tomography, computer-aided design software, and fused dual-material 3D printing, we demonstrate that patient-specific models can replicate both the anatomic and functional properties of severe degenerative aortic valve stenosis.
Source: Circulation: Cardiovascular Imaging - October 8, 2015 Category: Radiology Authors: Maragiannis, D., Jackson, M. S., Igo, S. R., Schutt, R. C., Connell, P., Grande-Allen, J., Barker, C. M., Chang, S. M., Reardon, M. J., Zoghbi, W. A., Little, S. H. Tags: Catheter-based coronary and valvular interventions: other, CT and MRI, Echocardiography, CV surgery: valvular disease Valvular Heart Disease Source Type: research

Outcomes of Transcatheter Aortic Valve Implantation in High Surgical Risk and Inoperable Patients with Aortic Stenosis ‐ A Single Australian Centre Experience
ConclusionsTAVI with various valve systems, delivered via a number of approaches, is feasible in high surgical risk and inoperable patients with severe aortic stenosis, with acceptable outcomes at short‐ and intermediate‐term follow‐up.
Source: Internal Medicine Journal - October 1, 2015 Category: Internal Medicine Authors: Vijayakumar Subban, Dale Murdoch, Michael L Savage, James Crowhurst, Ramakrishna Saireddy, Karl K Poon, Alexander Incani, Nicholas Bett, Darryl J Burstow, Gregory M Scalia, Andrew Clarke, Owen Christopher Raffel, Constantine N Aroney, Darren L Walters Tags: Original Article Source Type: research

Transcatheter or Surgical Aortic Valve Replacement in Patients With Prior Coronary Artery Bypass Grafting.
CONCLUSIONS: For patients with prior coronary artery bypass graft surgery and aortic stenosis, TAVR offers a significant morbidity advantage and a strong trend toward improved survival over SAVR at 1 year. PMID: 26433523 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - September 30, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Conte JV, Gleason TG, Resar JR, Adams DH, Deeb GM, Popma JJ, Hughes GC, Zorn GL, Reardon MJ Tags: Ann Thorac Surg Source Type: research

Beating Heart Minimally Invasive Mitral Valve Surgery in Patients with Patent Coronary Bypass Grafts
Conclusion Redo mitral surgery in patients with patent bypass grafts can safely be performed via minimally invasive mini-thoracotomy on a beating heart. The main benefits of this approach are to avoid the sternotomy and decrease the amount of postoperative blood loss. Teaser The aim of this study was to compare early outcomes of patients undergoing a beating heart minimally invasive mitral valve redo procedure and mitral redo surgery via sternotomy in the presence of patent bypass grafts. Beating mitral surgery can be safely done with comparable outcomes to the standard sternotomy approach.
Source: Canadian Journal of Cardiology - September 29, 2015 Category: Cardiology Source Type: research

Exploring the Role of Transcatheter Aortic Valve Replacement as the Preferred Treatment for Lower-Risk Patients
The investigators of the NOTION (Nordic Aortic Valve Intervention) trial showed that in an all-comers population of patients with severe aortic stenosis, transcatheter aortic valve replacement (TAVR) using the CoreValve self-expanding bioprosthesis (Medtronic Inc., Minneapolis, Minnesota) yielded similar rates of the composite endpoint of all-cause death, stroke, or myocardial infarction at 1 year compared with surgical bioprosthetic aortic valve replacement (1). Their study is the first to assess in a randomized trial the results of TAVR in a population including a high proportion of patients with low surgical risk (81.8...
Source: Journal of the American College of Cardiology: Cardiovascular Imaging - September 28, 2015 Category: Radiology Source Type: research

Trans-aortic, Video-Assisted Removal of a Mobile Left Ventricular Apical Thrombus in a Patient with Aortic Stenosis and Severe Left Ventricular Dysfunction
We describe the removal of a mobile and protruding left ventricular thrombus using a video-assisted technique during an aortic valve replacement and coronary artery bypass procedure.
Source: The Journal of Thoracic and Cardiovascular Surgery - September 27, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Christina Williamson, Lori B. Sheehan, David M. Venesy, Richard S. D’Agostino Source Type: research

Glomerular filtration rate and association to stroke, major bleeding, and death in patients with mechanical heart valve prosthesis
Conclusion In patients with MHV on anticoagulation, eGFR is an independent predictor of major bleeding and death and not TE.
Source: American Heart Journal - September 15, 2015 Category: Cardiology Source Type: research

2-Year Outcomes After Iliofemoral Self-Expanding Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery
ConclusionsPatients with severe AS at extreme surgical risk treated with self-expanding TAVR continued to show good clinical outcomes and hemodynamic valve performance at 2 years. The presence of comorbid conditions rather than valve performance affected 2-year outcomes in these patients. (Safety and Efficacy Study of the Medtronic CoreValve System in the Treatment of Symptomatic Severe Aortic Stenosis in High Risk and Very High Risk Subjects Who Need Aortic Valve Replacement; NCT01240902)
Source: Journal of the American College of Cardiology - September 14, 2015 Category: Cardiology Source Type: research

Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass
Conclusions TAVR and AVB relieve aortic stenosis and have similar and acceptable procedural mortality rates. AVB-treated patients had 1.75 times the STS risk score when compared with the TAVR cohort. Hospital charges for TAVR were nearly twofold those of AVB. Hospital reimbursement was similar, but AVB had two to four times the profit margin of TAVR. Longer follow-up for the TAVR cohort will determine whether survival is comparable to that after AVB at 3 and 5 years.
Source: The Annals of Thoracic Surgery - September 12, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Are We Going Backwards or Forwards in Minimally Invasive Mitral Valve Surgery? Three Eras of Perfusion Strategy
In this issue of Seminars, Bedeir et al. examine 57 minimally invasive mitral operations performed with retrograde femoral arterial cannulation between 2004 and 2012 at the Methodist DeBakey Heart and Vascular Center and compared them to 327 case-matched patients with central cannulation performed during the same 8-year period. Upon observing an elevated stroke rate in their femorally perfused patients, the authors elegantly and provocatively reactivate the once quelled debate on whether or not femoral arterial cannulation is to blame for complications in minimally invasive mitral valve surgery.
Source: Seminars in Thoracic and Cardiovascular Surgery - September 11, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Vinay Badhwar Source Type: research

Transcatheter Aortic Valve Replacement Versus Aortic Valve Bypass: A Comparison of Outcomes and Economics.
CONCLUSIONS: TAVR and AVB relieve aortic stenosis and have similar and acceptable procedural mortality rates. AVB-treated patients had 1.75 times the STS risk score when compared with the TAVR cohort. Hospital charges for TAVR were nearly twofold those of AVB. Hospital reimbursement was similar, but AVB had two to four times the profit margin of TAVR. Longer follow-up for the TAVR cohort will determine whether survival is comparable to that after AVB at 3 and 5 years. PMID: 26365675 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - September 11, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Brown JW, Boyd JH, Patel PM, Baker ML, Syed A, Ladowski J, Corvera J Tags: Ann Thorac Surg Source Type: research

A Meta-Analysis of Transfemoral versus Transapical Transcatheter Aortic Valve Implantation on 30-Day and 1-Year Outcomes.
CONCLUSIONS: TF-TAVI had a higher 30-day and 1-year survival rate compared with TA-TAVI, but these differences might be because of the higher Logistic EuroSCORE in TA group. Stroke and major vascular complications rates were higher in TF-TAVI patients at ≤30 days. PMID: 26334854 [PubMed - in process]
Source: The Heart Surgery Forum - September 6, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Zhao A, Minhui H, Li X, Zhiyun X Tags: Heart Surg Forum Source Type: research

A novel approach to extraction of a large thrombus on the intraventricular guide‐wire during transcatheter aortic valve replacement
We report a case where a large guide‐wire thrombus identified during TAVR was successfully removed using a novel approach, preventing a potentially major stroke in this high‐risk patient. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 2, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Thomas Chin, Padmanabhan Priyesh, Ashequl M. Islam Tags: Valvular and Structural Heart Diseases Source Type: research

A novel approach to extraction of a large thrombus on the intraventricular guide ‐wire during transcatheter aortic valve replacement
We report a case where a large guide‐wire thrombus identified during TAVR was successfully removed using a novel approach, preventing a potentially major stroke in this high‐risk patient. © 2015 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - September 2, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Thomas Chin, Padmanabhan Priyesh, Ashequl M. Islam Tags: Valvular and Structural Heart Diseases Source Type: research

Prophylactic Subclavian Artery Intraaortic Balloon Counter-Pulsation is Safe in High-Risk Cardiac Surgery Patients
The objective of this study was to determine the safety of prophylactic subclavian artery intraaortic balloon pumps (SCA-IABP) in high-risk cardiac surgery patients as a bridge to recovery (BTR). From November 2011 to January 2013, 11 consecutive patients at three institutions underwent prophylactic insertion of a SCA-IABP as a BTR. All patients (n = 11) had preoperative ejection fractions of 30% or less. Patients concurrently underwent one or a combination of the following procedures: coronary artery bypass grafting, mitral valve surgery, aortic valve replacement, left ventricular aneurysm resection, and ventricular/atria...
Source: ASAIO Journal - September 1, 2015 Category: Medical Equipment Tags: Case Series Source Type: research

Experience of transcatheter aortic valve implantation in the Central Military Hospital.
CONCLUSIONS: In patients with high surgical risk or inoperable, TAVI is a treatment option that improves life quality, survival and diminsh the need of hospitalizations. There can be some complications and even death, so that a proper patient selection and a multidisciplinary team is needed and fundamental for a successful procedure. PMID: 26337913 [PubMed - as supplied by publisher]
Source: Archivos de Cardiologia de Mexico - September 1, 2015 Category: Cardiology Authors: Martín-Hernández P, Gutiérrez-Leonard H, Ojeda-Delgado JL, Fagoaga-Valdivia J, Barrios-Nanni R, Rodríguez-Somarriba ME, Páez-Lizárraga LM, Berúmen-Domínguez LE, Hernández-Jiménez L, Rebollo-Hurtado V, Blázquez-Cruz MD Tags: Arch Cardiol Mex Source Type: research

Outcomes in Nonagenarians Undergoing Transcatheter Aortic Valve Replacement in the PARTNER-I Trial
Conclusions A TAVR can be performed in nonagenarians with acceptable short- and mid-term outcomes. Although TF- and TA-TAVR outcomes are not directly comparable, TA-TAVR appears to carry a higher risk of early death without a difference in intermediate-term mortality. Age alone should not preclude referral for TAVR in nonagenarians.
Source: The Annals of Thoracic Surgery - September 1, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Platelet activation is less enhanced in the new balloon expandable Edwards Sapien 3 valve compared to its predecessor model (Edwards Sapien XT).
Abstract Stroke and thromboembolic events after transfemoral aortic valve replacement (TAVR) continue to be a problem. The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) observed with two different catheter valves, the ESV-XT and the newer ESV-3 valve in patients (pts) undergoing TAVR on dual antiplatelet therapy (DAPT). A total of 174 patients with severe aortic stenosis and high surgical risk successfully underwent TAVR (60 ESV-XT; 114 ESV-3). Platelet Agg and PA (CD62P expression) were evaluated before and for the following three days after TAVR under DAPT. Platelet Agg ...
Source: Thrombosis and Haemostasis - August 27, 2015 Category: Hematology Authors: Fateh-Moghadam S, Voesch S, Htun P, Jorbenadze R, Geisler T, Gawaz M, Bocksch W Tags: Thromb Haemost Source Type: research

Contemporary Outcomes of Coronary Artery Bypass Grafting Among Patients With Insulin-Treated and Non–Insulin-Treated Diabetes
Conclusions Patients with diabetes undergoing CABG have substantially increased risk of major adverse events. Patients with ITDM represent an especially high-risk group.
Source: The Annals of Thoracic Surgery - August 25, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contemporary Outcomes of Coronary Artery Bypass Grafting Among Patients With Insulin-Treated and Non-Insulin-Treated Diabetes.
CONCLUSIONS: Patients with diabetes undergoing CABG have substantially increased risk of major adverse events. Patients with ITDM represent an especially high-risk group. PMID: 26319487 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - August 25, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Li Z, Amsterdam EA, Young JN, Hoegh H, Armstrong EJ Tags: Ann Thorac Surg Source Type: research

The Expanding Role of Endoscopic Robotics in Mitral Valve Surgery: 1,257 Consecutive Procedures
Conclusions Mitral valve repair or replacement, including concomitant procedures, can be performed safely and effectively using the LEAR technique. With a dedicated robotic team, the vast majority of patients with MV disorders, either isolated or with concomitant problems, can be treated using the LEAR technique.
Source: The Annals of Thoracic Surgery - August 19, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

The Expanding Role of Endoscopic Robotics in Mitral Valve Surgery: 1,257 Consecutive Procedures.
CONCLUSIONS: Mitral valve repair or replacement, including concomitant procedures, can be performed safely and effectively using the LEAR technique. With a dedicated robotic team, the vast majority of patients with MV disorders, either isolated or with concomitant problems, can be treated using the LEAR technique. PMID: 26296272 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - August 18, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Murphy DA, Moss E, Binongo J, Miller JS, Macheers SK, Sarin EL, Herzog AM, Thourani VH, Guyton RA, Halkos ME Tags: Ann Thorac Surg Source Type: research

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

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: 26270008 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - August 13, 2015 Category: Journals (General) Authors: Kuhn EW, Slottosch I, Wahlers T, Liakopoulos OJ Tags: Cochrane Database Syst Rev Source Type: research

Watchful observation versus early aortic valve replacement for symptomatic patients with normal flow, low-gradient severe aortic stenosis
Conclusions Early AVR and watchful observation strategy show similar survival in symptomatic patients with normal flow, low-gradient severe AS and preserved LVEF. Watchful observation with timely performance of AVR should be considered a therapeutic option.
Source: Heart - August 12, 2015 Category: Cardiology Authors: Kang, D.-H., Jang, J. Y., Park, S.-J., Kim, D.-H., Yun, S.-C., Song, J.-M., Park, S. W., Chung, C.-H., Song, J.-K., Lee, J.-W. Tags: Drugs: cardiovascular system, Aortic valve disease, Epidemiology Valvular heart disease Source Type: research

Study: Edwards’ Sapien and Medtronic’s CoreValve outcomes are similar
A new study published in the Journal of the American College of Cardiology found that patients treated with Edwards Lifesciences‘s (NYSE:EW) and Medtronic‘s (NYSE:MDT) CoreValve showed similar results after 1 year. The 241-patient trial examined high-risk patients with symptomatic severe aortic stenosis 1 year after being treated with either Edwards’s Sapien balloon expanding or Medtronic’ self-expanding transcatheter heart valve. The rates of all-cause death and cardiovascular death were not statistically different between the groups, with a 3-5% difference between the 2 devices, according to the ...
Source: Mass Device - August 11, 2015 Category: Medical Equipment Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Clinical Trials Edwards Lifesciences medtronic Source Type: news

Aortic Stenosis Valve Replacement or Valve Implantation? ∗
In this issue of the Journal, Tamburino et al. (1) have published a study that compares the clinical outcomes of aortic valve replacement (AVR) with transcatheter aortic valve replacement (TAVR) at 1 year from the OBSERVANT (Observational Study of Effectiveness of SAVR–TAVR Procedures for Severe Aortic Stenosis Treatment) registry, which investigates the management of aortic stenosis (AS) in 93 institutions in Italy. The registry had 7,618 patients with AS (5,707 treated with AVR and 1,991 with TAVR). The investigators excluded 2,150 patients because of combined procedures, porcelain aortas, “hostile thorax,” nonfem...
Source: Journal of the American College of Cardiology - August 10, 2015 Category: Cardiology Source Type: research

Aortic valve replacement for severe aortic stenosis in octogenarians: Patient outcomes and comparison of operative risk scores
Conclusions These results suggest that AVR can be performed safely in selected octogenarians. EuroSCORE II and STS demonstrated superior calibration and should be the preferred tools for risk assessment, at least for this population.
Source: Revista Portuguesa de Cardiologia - August 5, 2015 Category: Cardiology Source Type: research

Intraaortic Protection From Embolization in Patients Undergoing Transaortic Transcatheter Aortic Valve Implantation.
CONCLUSIONS: The intraaortic protection device seems to reduce both the incidence and the volume of new cerebral lesions (ClinicalTrials.gov number, NCT01735513). PMID: 26234838 [PubMed - in process]
Source: The Annals of Thoracic Surgery - August 1, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Wendt D, Kleinbongard P, Knipp S, Al-Rashid F, Gedik N, El Chilali K, Schweter S, Schlamann M, Kahlert P, Neuhäuser M, Forsting M, Erbel R, Heusch G, Jakob H, Thielmann M Tags: Ann Thorac Surg Source Type: research

Outcomes in Nonagenarians Undergoing Transcatheter Aortic Valve Replacement in the PARTNER-I Trial.
CONCLUSIONS: A TAVR can be performed in nonagenarians with acceptable short- and mid-term outcomes. Although TF- and TA-TAVR outcomes are not directly comparable, TA-TAVR appears to carry a higher risk of early death without a difference in intermediate-term mortality. Age alone should not preclude referral for TAVR in nonagenarians. PMID: 26242213 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - August 1, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Thourani VH, Jensen HA, Babaliaros V, Kodali SK, Rajeswaran J, Ehrlinger J, Blackstone EH, Suri RM, Don CW, Aldea G, Williams MR, Makkar R, Svensson LG, McCabe JM, Dean LS, Kapadia S, Cohen DJ, Pichard AD, Szeto WY, Herrmann HC, Devireddy C, Leshnower BG, Tags: Ann Thorac Surg Source Type: research

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States
Conclusions Patients undergoing TAo TAVR are older, more likely female, and have significantly higher STS predicted risk of mortality scores than patients operated on by TA access. There were no risk-adjusted differences between TA and TAo access in mortality, stroke, or readmission rates as long as 1 year after TAVR.
Source: The Annals of Thoracic Surgery - July 30, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Transapical and Transaortic Transcatheter Aortic Valve Replacement in the United States.
CONCLUSIONS: Patients undergoing TAo TAVR are older, more likely female, and have significantly higher STS predicted risk of mortality scores than patients operated on by TA access. There were no risk-adjusted differences between TA and TAo access in mortality, stroke, or readmission rates as long as 1 year after TAVR. PMID: 26233276 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - July 29, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Thourani VH, Jensen HA, Babaliaros V, Suri R, Vemulapalli S, Dai D, Brennan JM, Rumsfeld J, Edwards F, Tuzcu EM, Svensson L, Szeto WY, Herrmann H, Kirtane AJ, Kodali S, Cohen DJ, Lerakis S, Devireddy C, Sarin E, Carroll J, Holmes D, Grover FL, Williams M, Tags: Ann Thorac Surg Source Type: research

Clinical Value of Ankle-Brachial Index in Asymptomatic Aortic Stenosis Patients.
CONCLUSION: Among asymptomatic AS patients, 35.8% had an abnormal ABI and this was related to previous diabetes. These patients walked less in the 6MWT but did not have a worse prognosis at follow up. PMID: 26204678 [PubMed - in process]
Source: Journal of Heart Valve Disease - July 25, 2015 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Paradoxical Low Flow/Low Gradient Severe Aortic Stenosis: an Emerging Phenotype in Older Adults with Valve Disease
Abstract Aortic stenosis is a common disorder in older adults and is the second most common reason for open heart surgery. Paradoxical low flow/low gradient severe aortic stenosis, defined by a stroke volume index ≤35 mL/m2 with an left ventricular ejection fraction (EF) (LVEF) ≥50 %, is a recently recognized subset of aortic stenosis. It presents a unique challenge in diagnosis and management particularly in the elderly population. Physiologic changes of aging contribute to the development of this phenotype and its prevalence and true prognosis remains in dispute. Management options have expanded from surgi...
Source: Current Geriatrics Reports - July 25, 2015 Category: Geriatrics Source Type: research

Post TAVI complications – a pictorial review
Transcatheter aortic valve implantation (TAVI) has emerged for treating aortic stenosis in patients who are poor candidates for surgical aortic valve replacement. Although a promising approach for high-risk patients, the indication may be expanded to intermediate- and eventually low-risk patients in the future; however, doing so will require a better understanding of potential complications.In the current presentation, we present our institutional experience of postoperative complications such as myocardial infarction, stroke, bleeding, vascular complications and valve performance.
Source: Clinical Radiology - July 24, 2015 Category: Radiology Authors: Santo Chakraborti, Tinu Purayil, Vikram Raju, Gareth Morgan-Hughes, Carl Roobottom Source Type: research

Bypass surgery an “uncommon” cause of memory loss, cognitive decline
Coronary artery bypass surgery (CABG) offers a new lease on life for thousands of people each year whose hearts aren’t getting the blood they need to work properly. But it has also been blamed for “brain fog,” a loss of memory and thinking skills that follows the procedure in some people. Such brain problems are often called cognitive impairment. The operation itself may not be to blame, according to a review in today’s Annals of Internal Medicine. For the review, a team of researchers—mostly from the U. S. Department of Veteran’s Affairs—synthesized data from 17 clinical trials and four w...
Source: New Harvard Health Information - July 22, 2015 Category: Consumer Health News Authors: Howard LeWine, M.D. Tags: Heart Health bypass surgery Coronary artery bypass surgery memory loss Source Type: news

Contemporary Outcomes of Repeat Aortic Valve Replacement: A Benchmark for Transcatheter Valve-in-Valve Procedures
Conclusions Re-AVR is now performed with an acceptable operative mortality, which is higher than primary AVR. The overall incidence of stroke, vascular complication, and postoperative aortic insufficiency was low although higher than primary AVR. These results may serve as a benchmark for future analysis of valve-in-valve transcatheter aortic valve replacement and may have an effect on future choice of transcatheter aortic valve replacement vs re-AVR.
Source: The Annals of Thoracic Surgery - July 22, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Contemporary Outcomes of Repeat Aortic Valve Replacement: A Benchmark for Transcatheter Valve-in-Valve Procedures.
CONCLUSIONS: Re-AVR is now performed with an acceptable operative mortality, which is higher than primary AVR. The overall incidence of stroke, vascular complication, and postoperative aortic insufficiency was low although higher than primary AVR. These results may serve as a benchmark for future analysis of valve-in-valve transcatheter aortic valve replacement and may have an effect on future choice of transcatheter aortic valve replacement vs re-AVR. PMID: 26209480 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - July 21, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Kaneko T, Vassileva CM, Englum B, Kim S, Yammine M, Brennan M, Suri RM, Thourani VH, Jacobs JP, Aranki S Tags: Ann Thorac Surg Source Type: research

From FRANCE 2 to FRANCE TAVI: Are indications, technique and results of transcatheter aortic valve replacement the same?
Abstract Transcatheter aortic valve implantation (TAVI) is indicated in patients with severe symptomatic aortic stenosis who are not suitable for surgery or should be considered when there is a high surgical risk as assessed by a heart team. There is a decrease in mean logistic EuroSCORE since January 2010, which translates a gradual evolution in patients' selection. Expertise of geriatricians to further assess frailty is a key step in the risk stratification process of this elderly population (mean age: 83.4±7.3 years). Femoral access is used in 80% of cases with a procedural success rate higher than 95%. In-hos...
Source: Presse Medicale - July 21, 2015 Category: Journals (General) Authors: Auffret V, Bedossa M, Boulmier D, Verhoye JP, Ruggieri VG, Koning R, Laskar M, Van Belle É, Leprince P, Collet JP, Iung B, Lefèvre T, Eltchaninoff H, Gilard M, Le Breton H Tags: Presse Med Source Type: research

Outcomes for Transcatheter Aortic Valve Replacement in Nonagenarians
Conclusions Extreme-aged nonagenarian patients may have excellent outcomes from TAVR at 30-day and midterm follow-up. Alternative access TAVR is associated with higher morbidity and mortality than transfemoral TAVR. Referral for TAVR of nonagenarians should not be precluded based on age alone.
Source: The Annals of Thoracic Surgery - July 17, 2015 Category: Cardiovascular & Thoracic Surgery Source Type: research

Is Transcatheter Aortic Valve Implantation as Cost-effective as Surgical Aortic Valve Replacement?
Transcatheter aortic valve implantation (TAVI) has emerged as an efficacious and cost-effective treatment for inoperable patients with severe aortic stenosis.1 For high-risk patients, existing evidence suggests that TAVI has similar peri-procedural mortality and stroke outcomes compared to surgical aortic valve replacement (AVR), with higher incidences of paravalvular leak, permanent pacemaker requirement and vascular injuries after TAVI and higher incidences of major bleeding after AVR.2 Regarding the cost-effectiveness of TAVI, a recent systematic review examining its incremental cost effectiveness ratio in relation to A...
Source: The American Journal of Cardiology - July 16, 2015 Category: Cardiology Authors: Christopher Cao Source Type: research

Invasive hemodynamic assessments during transcatheter aortic valve implantation: comparison of patient outcomes in higher vs. lower transvalvular gradients with respect to left ventricular ejection fraction
Conclusion The higher mortality in patients with CLFLG AS reflects an advanced disease state, possibly indicating a futile condition before TAVI. Nevertheless, high procedural success rates and a functional improvement in nearly all survivors support the concept of TAVI.
Source: Clinical Research in Cardiology - July 16, 2015 Category: Cardiology Source Type: research

Outcomes for Transcatheter Aortic Valve Replacement in Nonagenarians.
CONCLUSIONS: Extreme-aged nonagenarian patients may have excellent outcomes from TAVR at 30-day and midterm follow-up. Alternative access TAVR is associated with higher morbidity and mortality than transfemoral TAVR. Referral for TAVR of nonagenarians should not be precluded based on age alone. PMID: 26188971 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - July 15, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Kayatta MO, Thourani VH, Jensen HA, Condado JC, Sarin EL, Kilgo PD, Devireddy CM, Leshnower BG, Mavromatis K, Li C, Guyton RA, Stewart JP, Simone A, Keegan P, Block P, Lerakis S, Babaliaros VC Tags: Ann Thorac Surg Source Type: research

The Heart and the Head Neurological Implications of Transcatheter Aortic Valve Replacement ∗
In this issue of the Journal, Bosmans et al. (1) report much-awaited stroke outcomes from the ADVANCE study, a multicenter, prospective, nonrandomized cohort of patients undergoing transcatheter aortic valve replacement (TAVR) with the CoreValve prosthesis (Medtronic Inc., Minneapolis, Minnesota) at 44 mostly European sites between March 2010 and July 2011. In this real-world cohort of patients with severe aortic stenosis, the investigators observed stroke rates of 3.0% at 30 days post-TAVR and 5.6% at 2 years. They reported no significant predictors of periprocedural stroke or transient ischemic attack (TIA) occurring ...
Source: Journal of the American College of Cardiology - July 13, 2015 Category: Cardiology Source Type: research