Procedure: Heart Valve Surgery
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Commentary: Atrial fibrillation after aortic valve replacement: Predict, prevent, protect
When atrial fibrillation (AF) occurs after cardiac surgery, surgeons consider the arrhythmia a nuisance rather than a complication. This reflects natural optimism. Although perioperative AF is most often self-limited, it is associated with increased risk of stroke and death, increased hospital length of stay, and increased health care costs.1 Still, we tend not to worry too much because postoperative AF tends to resolve regardless of treatment strategy.1
Source: The Journal of Thoracic and Cardiovascular Surgery - June 14, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Marc Gillinov, Edward G. Soltesz Tags: Commentary Source Type: research
Left Atrial Thrombus Formation in a Patient With Severe Non-rheumatic Mitral Stenosis After Mitral Valve Repair Receiving Dual Antiplatelet Therapy: A Clinical Challenge
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 11, 2019 Category: Anesthesiology Authors: Michael Essandoh, Amir Elhassan, Thomas J. Papadimos, Brandon Pruett, Gregory D. Rushing Tags: Diagnostic Dilemma Source Type: research
Outcome of normal flow low gradient “severe” aortic stenosis with preserved left ventricular ejection fraction: A propensity matched study
ConclusionThis study shows that NF-LG-SAS have a comparable outcome to that of MAS when AVR was performed during follow-up according to guidelines, mostly at the stage of high-gradient AS. Rigorous echocardiographic assessment to rule out measurement errors and close follow-up are essential in NF-LG-SAS to detect progression to true severe AS. Overall survival in propensity matched population (Fig. 1).
Source: Archives of Cardiovascular Diseases Supplements - June 7, 2019 Category: Cardiology Source Type: research
Sex-Based Differences in Outcomes After Mitral Valve Surgery for Severe Ischemic Mitral Regurgitation: From the Cardiothoracic Surgical Trials Network
ConclusionsWomen with SIMR displayed different echocardiographic features and experienced higher mortality and worse QOL after MV surgery than men. There were no significant differences in the degree of reverse LV remodeling between sexes. (Comparing the Effectiveness of Repairing Versus Replacing the Heart's Mitral Valve in People With Severe Chronic Ischemic Mitral Regurgitation [Severe Ischemic Mitral Regurgitation]; NCT00807040)Central Illustration
Source: JACC: Heart Failure - May 29, 2019 Category: Cardiology Source Type: research
A Serious Diagnosis Lacking Common Symptoms
BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Transapical beating heart mitral valve repair with the NeoChord system: early outcomes of a single-center experience.
Conclusions: Trans-apical off-pump MV repair with the NeoChord system is a safe, minimally invasive procedure, with few minor complications. In well-selected candidates it provides successful treatment of degenerative MR. Results are anatomy dependent, so preoperative patient selection is crucial. PMID: 31119000 [PubMed]
Source: Videosurgery and Other Miniinvasive Techniques - May 25, 2019 Category: Surgery Tags: Wideochir Inne Tech Maloinwazyjne Source Type: research
Determinants of long-term outcome of repaired pulmonary valve stenosis
ConclusionsGood long-term outcome can be expected after PVS repair, but complications and the need for reintervention may appear. Older age and the presence of cyanosis at PVS repair emerged as predictors of cardiovascular complications and identified a population that may merit stricter control.ResumenIntroducción y objetivosAunque la estenosis de la válvula pulmonar (EVP) se considera una cardiopatía congénita de bajo riesgo, se ha descrito la aparición de complicaciones y necesidad de reintervenir durante el seguimiento. Los objetivos del estudio fueron evaluar los resultados a largo plazo de la EVP reparada e iden...
Source: Revista Espanola de Cardiologia - May 24, 2019 Category: Cardiology Source Type: research
Midterm Outcomes of Transcatheter Aortic Valve Replacement in Dialysis Patients With Aortic Valve Stenosis.
CONCLUSIONS: Satisfactory in-hospital outcomes were achieved in dialysis patients after TAVR. Various problems, however, such as complications particular to dialysis patients and valve durability, remained at midterm follow-up. Further studies are recommended to solve these problems, and prudent preoperative assessments should be mandatory. PMID: 31118365 [PubMed - as supplied by publisher]
Source: Circulation Journal - May 23, 2019 Category: Cardiology Authors: Maeda K, Kuratani T, Mizote I, Shimamura K, Ichibori Y, Onishi T, Nakatani S, Ueno T, Toda K, Sakata Y, Sawa Y Tags: Circ J Source Type: research
Aortic valve replacement surgery improves the quality of life of octogenarians with severe aortic stenosis
ConclusionSAVR improved the physical and mental health status of octogenarians with severe AS. This improvement was evident at three months and consistent at six and 12 months.ResumoIntroduçãoA estenose aórtica (EA) é a doença valvular mais prevalente dos idosos e afeta 8.1% dos doentes com 85 anos, condicionando a qualidade de vida.ObjetivoDeterminar o impacto da cirurgia de substituição valvular aórtica (SVA) na qualidade de vida dos octogenários.MétodosEstudo unicêntrico e retrospetivo com octogenários submetidos a cirurgia de SVA por EA grave isolada entre 2011 e 2015. A qualidade de vida foi avaliada pelo ...
Source: Revista Portuguesa de Cardiologia - May 20, 2019 Category: Cardiology Source Type: research
Veterans Affairs Heart Team Experience With Transcatheter Aortic Valve Replacement and Minimally Invasive Surgical Aortic Valve Replacement.
CONCLUSIONS: The VAMC heart team offers MIAVR and TAVR to veterans with isolated aortic valve disease, and has achieved excellent outcomes despite relatively lower case volumes. Both offer excellent hemodynamic results, with low mortality in a complex population. PMID: 31088993 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - May 16, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Long-term outcomes with mechanical versus biological aortic valve prosthesis in patients >70 years
ConclusionsMechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients aged>70 years. Our results suggest caution when considering mechanical aortic valve prostheses in elderly patients.
Source: The Annals of Thoracic Surgery - May 12, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research
Long-term outcomes with mechanical versus biological aortic valve prosthesis in patients > 70 years.
CONCLUSIONS: Mechanical aortic valve prosthesis is associated with worse long-term survival and increased bleeding after SAVR in patients aged >70 years. Our results suggest caution when considering mechanical aortic valve prostheses in elderly patients. PMID: 31082357 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - May 10, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Kytö V, Myllykangas ME, Sipilä J, Niiranen TJ, Rautava P, Gunn J Tags: Ann Thorac Surg Source Type: research
Six-year single-centre experience in minimally invasive mitral valve repair - impact of the team learning curve on in-hospital clinical outcome.
Conclusions: The procedure is safe and ensures optimal perioperative results. The number of complications is low and acceptable. PMID: 31043972 [PubMed]
Source: Polish Journal of Cardio-Thoracic Surgery - May 4, 2019 Category: Cardiovascular & Thoracic Surgery Tags: Kardiochir Torakochirurgia Pol Source Type: research
Preventing brain embolism by using a modified isolation technique in transcatheter aortic valve implantation for a patient with shaggy and porcelain aorta
We report a case of TAVI in a shaggy and porcelain aorta and prevention of cerebral embolism by adopting a modified isolation technique without using conventional protection devices.>
Source: Journal of Cardiology Cases - May 2, 2019 Category: Cardiology Source Type: research
2 of Edwards & #039; Pediatric Catheters Face Class I Recall
Two of Edwards Lifesciencesâ pediatric catheters are facing a Class I recall. The Irvine, CA-based companyâs Miller Balloon Atrioseptostomy Catheter and Fogarty Dilation Atrioseptostomy Catheter are in a Class I recall because of the possibility of difficulty in balloon deflation after deployment. The balloon deflation could lead to balloon fragmentation or detachment upon attempted retrieval. Edwards said it has received reports of balloon fragmentation or detachment, which may cause serious adverse health consequences including: damage to the heart, the inferior vena cava, and/or the f...
Source: MDDI - April 30, 2019 Category: Medical Devices Authors: Omar Ford Tags: Cardiovascular Regulatory and Compliance Source Type: news
Minimally invasive surgical versus transcatheter aortic valve replacement: A multicenter study
ConclusionsMini-SAVR and TAVI are both safe and effective to treat aortic stenosis in elderly patients with comorbidities. A joint evaluation by the heart-team is essential to direct patients to the proper approach.
Source: IJC Heart and Vasculature - April 30, 2019 Category: Cardiology Source Type: research
Preventable Cases of Oral Anticoagulant-Induced Bleeding: Data From the Spontaneous Reporting System
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - April 30, 2019 Category: Drugs & Pharmacology Source Type: research
Single or dual antiplatelet therapy after transcatheter aortic valve replacement: an updated systemic review and meta-analysis.
Conclusions: This meta-analysis suggests that compared with DAPT, SAPT after TAVR is more likely to lead to a decline of 30-day mortality along with the reduced risk of bleeding and no increased risk of stroke. However, more clinical data and evidence from randomized controlled trials are warranted to clarify the optimal post-TAVR antiplatelet strategy. PMID: 31019786 [PubMed]
Source: Journal of Thoracic Disease - April 27, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis
Conclusion Compared with SAVR, TAVI is associated with reduction in all-cause mortality and stroke up to 2 years irrespective of baseline surgical risk and type of THV system.
Source: European Heart Journal - April 23, 2019 Category: Cardiology Source Type: research
Alternative Access Versus Transfemoral Transcatheter Aortic Valve Replacement in Nonagenarians.
CONCLUSION: There is a higher risk of adverse events following AA-TAVR compared with TF-TAVR. Therefore, TF-TAVR is recommended when feasible, with AA approach as a viable back-up option in nonagenarians. PMID: 30982779 [PubMed - as supplied by publisher]
Source: The Journal of Invasive Cardiology - April 17, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Outcome Of Patients Undergoing Transcatheter Implantation Of Aortic Valve With Previous Mitral Valve Prosthesis (OPTIMAL STUDY)
ConclusionsTAVR in patients with a previous mitral prosthesis appears safe and feasible, with good hemodynamic results at 30-day and at longer term follow-up.
Source: Canadian Journal of Cardiology - April 17, 2019 Category: Cardiology Source Type: research
Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 16, 2019 Category: Neurology Source Type: research
Prognostic value of left atrial strain in patients with moderate asymptomatic mitral regurgitation
AbstractFor patients with asymptomatic mitral regurgitation (MR), the criteria identifying the groups at higher-risk and their clinical outcome are still uncertain. Therefore, in these patients, optimal time of surgery remains controversial. The purpose of this study was to compare left atrial (LA) strain to other echocardiographic left ventricular (LV) and LA parameters for the prediction of cardiovascular outcomes in patients with moderate asymptomatic MR. We enrolled 395 patients with primary degenerative moderate asymptomatic MR. Exclusion criteria were: history of atrial fibrillation, myocardial infarction, heart fail...
Source: The International Journal of Cardiovascular Imaging - April 10, 2019 Category: Radiology Source Type: research
Current status and future perspective of structural heart disease intervention.
Abstract Valvular heart diseases are one of the most frequent causes for heart failure. Degenerative diseases of the aortic and mitral valve as well as a dysfunctional tricuspid valve disease result in a worse clinical outcome if severe. Minimal-invasive, surgical and/or catheter-based structural heart disease (SHD) interventions have recently seen a dramatic increase. Transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS) is a disruptive technology, and next generation devices and careful patient selection will minimize limitations of TAVI such as paravalvular leak, conductance disturbance...
Source: Journal of Cardiology - April 4, 2019 Category: Cardiology Authors: Tabata N, Sinning JM, Kaikita K, Tsujita K, Nickenig G, Werner N Tags: J Cardiol Source Type: research
Outcomes of Isolated Tricuspid Valve Surgery Have Improved in the Modern Era
ConclusionsIn the current era with careful patient selection and periprocedural management, isolated TV surgery can be performed with lower morbidity and mortality than has traditionally been reported with good long term survival. These outcomes can also serve as a benchmark for catheter-based tricuspid valve intervention outcomes.
Source: The Annals of Thoracic Surgery - April 2, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research
Clinical outcomes of self-expandable vs. balloon-expandable TAVI for severe aortic stenosis.
CONCLUSIONS: This real-world retrospective analysis demonstrates higher rates of ≥ moderate PAR, stroke and pacemaker insertion with SEV compared to BEV at 30 d post-TAVI for severe symptomatic AS. PMID: 30931804 [PubMed - as supplied by publisher]
Source: Acta Cardiologica - April 2, 2019 Category: Cardiology Tags: Acta Cardiol Source Type: research
Outcomes of Isolated Tricuspid Valve Surgery Have Improved in the Modern Era.
CONCLUSIONS: In the current era with careful patient selection and periprocedural management, isolated TV surgery can be performed with lower morbidity and mortality than has traditionally been reported with good long term survival. These outcomes can also serve as a benchmark for catheter-based tricuspid valve intervention outcomes. PMID: 30951698 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - April 2, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Hamandi M, Smith RL, Ryan WH, Grayburn PA, Vasudevan A, George TJ, DiMaio JM, Hutcheson KA, Brinkman W, Szerlip M, Moore DO, Mack MJ Tags: Ann Thorac Surg Source Type: research
Prognostic significance of preoperative ECG Strain after Transcatheter Aortic Valve Replacement for severe Aortic Stenosis
ConclusionPreoperative ECG Strain was associated with higher risk of ME onset after TAVR for severe AS.
Source: Archives of Cardiovascular Diseases Supplements - March 22, 2019 Category: Cardiology Source Type: research
ACC 2019: Medtronic, Edwards low-risk TAVR trial data could pave way to new indications
Results from trials of both Medtronic‘s (NYSE:MDT) and Edwards Lifesciences‘ (NYSE:EW) transcatheter aortic valve replacement systems exploring their use in low-risk patients indicated that the devices were as safe as open surgery, paving the way for possible new indications for TAVR technology. Data from the trials were presented over the weekend at the American College of Cardiology 68th Annual Scientific Session 2019 in New Orleans and simultaneously published in the New England Journal of Medicine. Currently, TAVR devices are only approved by the FDA for treating severe aortic valve stenosis in patients at inte...
Source: Mass Device - March 18, 2019 Category: Medical Devices Authors: Fink Densford Tags: Cardiac Implants Cardiovascular Clinical Trials Featured Replacement Heart Valves Edwards Lifesciences Medtronic Source Type: news
Myocardial Protection During Minimally Invasive Mitral Valve Surgery: Is Retrograde Cardioplegia Alone Enough?
Minimally invasive mitral valve surgery is a commonly performed procedure in contemporary cardiac surgery.1-3 The surgical exposure for minimally invasive mitral valve surgery (right anterolateral minithoracotomy) provides very limited access to the aorta and makes myocardial protection with antegrade cardioplegia challenging.1,3 Early experiences used an endo-aortic balloon to administer antegrade cardioplegia, and retrograde cardioplegia was administered through a coronary sinus catheter.3 The endo-aortic balloon approach was associated with complications such as aortic dissection and stroke and has fallen out of favor in some centers.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 18, 2019 Category: Anesthesiology Authors: Michael Essandoh Tags: Letter to the Editor Source Type: research
PARTNER 3: TAVR Success in Low-Risk Patients PARTNER 3: TAVR Success in Low-Risk Patients
The procedure using the SAPIEN 3 valve showed a significantly lower rate of death, stroke, and rehospitalization at 1 year vs surgery in patients with severe aortic stenosis at low surgical risk.Medscape Medical News
Source: Medscape Medical News Headlines - March 16, 2019 Category: Consumer Health News Tags: Cardiology News Source Type: news
Rationale and design of the randomized, controlled early valve replacement guided by biomarkers of left ventricular decompensation in asymptomatic patients with severe aortic stenosis (EVOLVED) trial
ConclusionThe EVOLVED trial is the first multicenter randomized controlled trial to compare early aortic valve replacement to routine care in asymptomatic patients with severe aortic stenosis and mid-wall LGE.
Source: American Heart Journal - March 15, 2019 Category: Cardiology Source Type: research
Transcarotid Versus Transapical and Transaortic Access for Transcatheter Aortic Valve Replacement
ConclusionsTranscarotid compared to transapical and transaortic access for TAVR is associated with shorter length of stay, fewer transfusions, more frequent discharge to home and better 2-year survival.
Source: The Annals of Thoracic Surgery - March 15, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research
Transcatheter, sutureless and conventional aortic-valve replacement: a network meta-analysis of 16,432 patients.
Conclusions: In selected patients, minimally invasive surgical interventions including TAVI and SL-AVR for severe AS are viable alternatives to conventional surgery. However, TAVI is associated with increased paravalvular regurgitation, whereas TAVI and SL-AVR are associated with increased conduction disturbances compared to CAVR. PMID: 30863588 [PubMed]
Source: Journal of Thoracic Disease - March 14, 2019 Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Outcomes after Ross procedure in adult patients: A meta ‐analysis and microsimulation
ConclusionsRoss procedure in nonelderly adults is associated with low mortality and low risk of adverse events both at short ‐ and long‐term follow‐up. The surgical community must prioritize a large, expertize‐based randomized controlled trial to definitively address the risks and benefits of the Ross procedure compared to conventional aortic valve replacement.
Source: Journal of Cardiac Surgery - March 13, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Serena Sibilio, Alex Koziarz, Emilie P. Belley ‐Côté, Graham R. McClure, Sarah MacIsaac, Seleman J. Reza, Kevin J. Um, Alexandra Lengyel, Pablo Mendoza, Ali Alsagheir, Hatim Alraddadi, Saurabh Gupta, Adriaan W. Schneider, Parth M. Patel, Tags: ORIGINAL ARTICLE Source Type: research
Study of Boston Scientific ’s Lotus, Medtronic’s CoreValve shows similar outcomes at 2 years
Two-year results from a head-to-head study comparing transcatheter aortic heart valve replacement devices from both Boston Scientific (NYSE:BSX) and Medtronic (NYSE:MDT) indicated similar outcomes for the competing products. The study, published recently in the journal JAMA Cardiology, compared Marlborough, Mass.-based Boston Scientific’s Lotus valve to Fridley, Minn.-based Medtronic’s CoreValve system. Investigators in the study compared outcomes for 912 patients with high or extreme risk and severe, symptomatic aortic stenosis after treatment with one of the two devices. Patients, treated between September 22, 2014...
Source: Mass Device - February 28, 2019 Category: Medical Devices Authors: Fink Densford Tags: Cardiovascular Clinical Trials Featured Replacement Heart Valves Boston Scientific Medtronic Source Type: news
Postoperative thrombotic effects of tranexamic acid in open heart surgery
ConclusionsIn patients receiving tranexamic acid infusion at 50 mg/kg dose, reexploration rates remained at 4.1% even after major cardiac surgeries. No thrombosis, stroke, or seizure were reported. Our findings support that tranexamic acid is a safe drug which has positive effect on reducing perioperative bleeding.
Source: Irish Journal of Medical Science - February 28, 2019 Category: General Medicine Source Type: research
Determining Which Prosthetic to Use During Aortic Valve Replacement in Patients Aged Younger than 70 Years: A Systematic Review of the Literature.
CONCLUSIONS: Published literature does not preclude the use of bioprostheses for AVR in younger patients. As new valves are developed, the use of bioprosthetic aortic valves in younger patients will likely continue to expand. Clinical trials are needed to provide surgeons with more accurate guidelines. PMID: 31013214 [PubMed - in process]
Source: The Heart Surgery Forum - February 28, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Borger P, Charles EJ, Smith ED, Mehaffey JH, Hawkins RB, Kron IL, Ailawadi G, Teman N Tags: Heart Surg Forum Source Type: research
Cerebral Embolic Protection in TAVI: Friend or Foe
Since its introduction in 2002, transcatheter aortic valve implantation (TAVI) has provided an alternative to surgical aortic valve replacement (SAVR) in patients considered inoperable or either at high or intermediate risk for SAVR.1 However, one of the most feared complications of TAVI are cerebrovascular accidents (CVA) including stroke or transient ischaemic attack.
Source: Radcliffe Cardiology - February 26, 2019 Category: Cardiology Authors: mehul Source Type: research
Scientists discover new type of immune cells that are essential for forming heart valves
UCLA researchers have identified for the first time the origin of an immune cell that plays a critical role in the formation of healthy heart valves. The findings could pave the way for new treatments for heart valve disorders, which can be caused by congenital defects, aging or disease.Their study, led by Dr. Atsushi “Austin” Nakano, a UCLA associate professor of molecular, cell and developmental biology and member of theEli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA, was published in the journal Developmental Cell.Building on previous research by Nakano, which showed that the embr...
Source: UCLA Newsroom: Health Sciences - February 21, 2019 Category: Universities & Medical Training Source Type: news
Percutaneous Coronary Artery Revascularization and Transcatheter Aortic Valve Replacement: Is There a Who, Why, and When?
WITH A PREVALENCE in aortic stenosis (AS) patients of 25% to 50%, concomitant coronary artery disease (CAD) has proven to be an independent risk factor for patients undergoing transcatheter aortic valve replacement (TAVR).1 Currently there is no standard- or guideline-driven approach for these patients, and many new challenges have emerged in this population. In this issue of the Journal of Cardiothoracic and Vascular Anesthesia, Bacigalupo et al.2 report a case of a patient with recent percutaneous coronary intervention (PCI) for obstructive CAD who underwent TAVR complicated by in-stent thrombosis and an ischemic stroke ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 20, 2019 Category: Anesthesiology Authors: Oscar D. Aljure, Michael Fabbro Tags: Editorial Source Type: research
Aortic root enlargement is safe and reduces the incidence of patient-prosthesis mismatch: A Meta-analysis of early and late outcomes
ConclusionsSurgical ARE is a safe adjunct to AVR in selected patients that does not increase early adverse events and results in less patient-prosthesis mismatch. This strategy allows for a larger valve size at the time of implantation – an important consideration for potential future valve-in-valve procedures in the era of TAVR.
Source: Canadian Journal of Cardiology - February 13, 2019 Category: Cardiology Source Type: research
Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery: Evidence from the Canadian Thoracic Aortic Collaborative.
CONCLUSIONS: Women experience worse outcomes following thoracic aortic surgery with hypothermic circulatory arrest. Further investigation is required to better delineate which measures may reduce sex-related outcome differences following complex aortic surgery. PMID: 30755026 [PubMed - as supplied by publisher]
Source: Circulation - February 13, 2019 Category: Cardiology Authors: Chung J, Stevens LM, Ouzounian M, El-Hamamsy I, Bouhout I, Dagenais F, Cartier A, Peterson M, Boodhwani M, Guo MH, Bozinovski J, Yamashita MH, Lodewyks C, Atoui R, Bittira B, Payne D, Tarola C, Chu MWA, Canadian Thoracic Aortic Collaborative Tags: Circulation Source Type: research
Transcatheter aortic valve replacement for pure aortic valve regurgitation: “on-label” versus “off-label” use of TAVR devices
ConclusionBased on this summary of available observational data TAVR for PAR is feasible and safe in patients deemed inoperable. First-generation TAVR devices are associated with inferior outcome and should be avoided. The “on-label” use of PAR-certified TAVR devices is associated with a significantly higher procedural success rate and might be favorable compared to other second-generation devices.
Source: Clinical Research in Cardiology - February 8, 2019 Category: Cardiology Source Type: research
Predicting the future of TAVR: an obituary to open aortic valve replacement?
Purpose of review Transcatheter aortic valve replacement (TAVR) has become the cornerstone for aortic valve intervention since the first implantation in 2002. Recent advances with novel devices and introduction into lower risk cohorts have been successful. In this review, we discuss the ongoing limitations to transcatheter aortic valve therapy and whether it will replace surgical aortic valve replacement in the foreseeable future. Recent findings A better understanding of valve durability, high-grade heart block, and stroke post TAVR has led to practice changes that improve patient outcome. Summary Although there h...
Source: Current Opinion in Cardiology - February 6, 2019 Category: Cardiology Tags: VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby Yanagawa Source Type: research
Short-Term and Long-Term Outcomes of Patients Undergoing Urgent Transcatheter Aortic Valve Replacement Under a Minimalist Strategy.
CONCLUSIONS: Urgent minimalist TAVR can be safely performed with favorable in-hospital outcomes, while increased 30-day and 1-year mortality rates suggest the importance of appropriate diagnosis and timely treatment of severe aortic stenosis. PMID: 30700628 [PubMed - in process]
Source: The Journal of Invasive Cardiology - February 2, 2019 Category: Cardiology Tags: J Invasive Cardiol Source Type: research
Use of left atrial appendage occlusion among older cardiac surgery patients with preoperative atrial fibrillation: a national cohort study
ConclusionsSubstantial variability in use of S-LAAO exists. In many instances, the procedure is being deferred in the patients that may be poised to benefit the most (i.e., those with increased CHA2DS2-VASc score-defined stroke risk).
Source: Journal of Interventional Cardiac Electrophysiology - February 2, 2019 Category: Cardiology Source Type: research
Five-Year Clinical and Echocardiographic Outcomes from the Nordic Aortic Valve Intervention (NOTION) Randomized Clinical Trial in Lower Surgical Risk Patients.
CONCLUSIONS: These are currently the longest follow-up data comparing TAVR and SAVR in lower risk patients, demonstrating no statistical difference for major clinical outcomes 5 years after TAVR with a self-expanding prosthesis compared to SAVR. Higher rates of prosthetic regurgitation and pacemaker implantation were seen after TAVR. CLINICAL TRIAL REGISTRATION: URL: http://www.ClinicalTrials.gov. Unique identifier: NCT01057173. PMID: 30704298 [PubMed - as supplied by publisher]
Source: Circulation - February 1, 2019 Category: Cardiology Authors: Thyregod HGH, Ihlemann N, Jørgensen TH, Nissen H, Kjeldsen BJ, Petursson P, Chang Y, Franzen OW, Engstrøm T, Clemmensen P, Hansen PB, Andersen LW, Steinbrüchel DA, Olsen PS, Søndergaard L Tags: Circulation Source Type: research
Feasibility and Outcomes of Transcatheter Aortic Valve Implantation Using the Left Axillary Artery as Primary Access Site
ConclusionsThis is the first study reporting outcome after transcatheter aortic valve implantation using the LAA as default access. We conclude that it is highly feasible and safe with low rates of major vascular complications, bleeding, and stroke.Visual Abstract
Source: The Annals of Thoracic Surgery - January 26, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research