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Transcatheter valve-in-valve implantation versus redo surgical aortic valve replacement in patients with failed aortic bioprostheses
CONCLUSIONS Despite a higher risk profile in the ViV group, early mortality rates were not different compared with those of surgery. Although ViV resulted in elevated transvalvular gradients and therefore a lower rate of device success, mortality rates were similar to those with redo-SAVR. At present, both techniques serve as complementary approaches, and allow individualized patient care with excellent outcomes.
Source: Interactive CardioVascular and Thoracic Surgery - January 3, 2017 Category: Cardiovascular & Thoracic Surgery Authors: Silaschi, M., Wendler, O., Seiffert, M., Castro, L., Lubos, E., Schirmer, J., Blankenberg, S., Reichenspurner, H., Schäfer, U., Treede, H., MacCarthy, P., Conradi, L. Tags: History, Basic research vascular ADULT CARDIAC Source Type: research

Incidence and causes of silent and symptomatic stroke following surgical and transcatheter aortic valve replacement: a comprehensive review
Stroke associated with aortic valve replacement in calcific aortic stenosis, either via transcatheter implantation (TAVR) or via surgical replacement (SAVR), is one of the most devastating complications. However, data concerning the clinical impact and incidence of clinical and silent stroke complicating SAVR and TAVR are varying. This comprehensive review of the literature explores the genuine incidence of neurological events after these procedures. Additionally, potential factors responsible for the discrepancies in stroke rates in the current literature are analysed and a lack of uniform neurological definitions and sta...
Source: Interactive CardioVascular and Thoracic Surgery - August 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Grabert, S., Lange, R., Bleiziffer, S. Tags: Extracorporeal circulation, History Adult Cardiac 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 25, 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 25, 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

Medtronic Freestyle aortic bioprosthesis: a potential option for haemodialysis patients
CONCLUSIONS Aortic bioprostheses are a good option for haemodialysis patients requiring AVR, offering acceptable mid-term survival. The Medtronic Freestyle aortic bioprostheses could allow the implantation of larger bioprostheses inferring consequently lower mean gradients, with a potentially higher resistance to calcification and sclerosis in haemodialysis patients.
Source: Interactive CardioVascular and Thoracic Surgery - March 21, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Hegazy, Y. Y., Rayan, A., Sodian, R., Hassanein, W., Ennker, J. Tags: Basic research vascular ADULT CARDIAC Source Type: research

Brachiocephalic artery access in transcatheter aortic valve implantation: a valuable alternative: 3-year institutional experience
CONCLUSIONS TAVI implantation through the brachiocephalic artery is safe and feasible. The distance between the point of access and the aortic valve annulus is short, improving catheter stability and implant site accuracy. We consider it to be a valuable alternative in patients without femoral access.
Source: Interactive CardioVascular and Thoracic Surgery - November 17, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Philipsen, T. E., Collas, V. M., Rodrigus, I. E., Salgado, R. A., Paelinck, B. P., Vrints, C. M., Bosmans, J. M. Tags: Adult Cardiac Source Type: research

Full sternotomy versus right anterior minithoracotomy for isolated aortic valve replacement in octogenarians: a propensity-matched study
CONCLUSIONS Minimally invasive AVR through right anterior minithoracotomy can be safely performed in patients aged ≥80 years with acceptable morbidity and mortality rates. It is an expeditious and effective alternative to full sternotomy AVR and might be associated with lower postoperative stroke incidence, earlier extubation and shorter hospital stay.
Source: Interactive CardioVascular and Thoracic Surgery - May 28, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Gilmanov, D., Farneti, P. A., Ferrarini, M., Santarelli, F., Murzi, M., Miceli, A., Solinas, M., Glauber, M. Tags: Myocardial protection, Transplantation - heart Adult Cardiac Source Type: research

What is the best approach in a patient with a failed aortic bioprosthetic valve: transcatheter aortic valve replacement or redo aortic valve replacement?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether transcatheter aortic valve-in-valve replacement (viv-TAVR) or redo aortic valve replacement (rAVR) is the best strategy in a patient with a degenerative bioprosthetic aortic valve. Altogether, 162 papers were found using the reported search, of which 12 represented the best evidence to answer the question. The authors, journal, date, country of publication, patient group, study type, outcomes and results of papers are tabulated. The results of the studies provided interesting results. All the studies ...
Source: Interactive CardioVascular and Thoracic Surgery - May 28, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Tourmousoglou, C., Rao, V., Lalos, S., Dougenis, D. Tags: Lung - cancer, Trachea and bronchi, Congestive Heart Failure, Transplantation - heart, Valve disease, Vascular malformations Adult Cardiac Source Type: research

The safety of deep hypothermic circulatory arrest in aortic valve replacement with unclampable aorta in non-octogenarians
CONCLUSIONS Postoperative neurological events and operative mortality were, respectively, 3- and 4-fold higher in octogenarians undergoing AVR using DHCA. Such patients may represent suitable candidates for TAVR if favourable outcomes are demonstrated in patients with atherosclerotic aortas. Surgical AVR remains the standard treatment option with excellent outcomes for patients <80 years old with unclampable aortas.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Kaneko, T., Neely, R. C., Shekar, P., Javed, Q., Asghar, A., McGurk, S., Gosev, I., Byrne, J. G., Cohn, L. H., Aranki, S. F. Tags: Cerebral protection, Great vessels, Valve disease Adult Cardiac Source Type: research

Does concomitant tricuspid annuloplasty increase perioperative mortality and morbidity when correcting left-sided valve disease?
In conclusion, there is good evidence to support that tricuspid annuloplasty is a low-risk procedure and concomitant TV repair does not significantly increase the perioperative mortality and morbidity when correcting left-sided valve disease.
Source: Interactive CardioVascular and Thoracic Surgery - December 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Zhu, T.-Y., Wang, J.-G., Meng, X. Tags: Basic research vascular Adult Cardiac Source Type: research

Transcatheter aortic valve implantation using a direct aortic approach: a single-centre Heart Team experience
CONCLUSIONS The TAo TAVI approach is feasible and offers a safe alternative for patients in whom a transfemoral approach is not feasible or desirable.
Source: Interactive CardioVascular and Thoracic Surgery - October 24, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Amrane, H., Porta, F., van Boven, A. J., Boonstra, P. W., Hofma, S. H., Head, S. J., Kappetein, A. P. Tags: Transplantation - heart, Basic research vascular Adult Cardiac Source Type: research

013 * european multicentre experience with sutureless perceval valve: clinical and haemodynamic outcomes up to 5 years in over 700 patients
Conclusion: This European multicentre experience with the largest cohort of patients with sutureless valves to date shows excellent clinical and haemodynamic results that remain stable even up to 5 years follow-up. Even in this elderly patient cohort with 40% octogenarians, both early and late mortality were very low. There were no valve migrations, structural valve degeneration or valve thrombosis in follow-up. The sutureless technique is a promising alternative to biological AVR.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Shrestha, M., Laborde, F., Carrel, T., Fischlein, T., Meuris, B., Madonna, F., Misfeld, M., Haverich, A. Tags: Small incisions and sutureless valves: A perfect marriage Source Type: research

017 * aortic valve replacement through an anterior right mini-thoracotomy with central aortic cannulation is safe
Conclusion: MIAVR via an anterior right mini-thoracotomy with central cannulation results in similar perioperative mortality and stroke rates as compared to standard sternotomy. In addition, the MIAVR technique resulted in earlier extubation, fewer wound infections, reduced intraoperative transfusions, and shorter ICU and hospital stays. As compared to standard sternotomy AVR, our technique of MIAVR with preferential central cannulation appears safe.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Hui, D., Bowdish, M., Cleveland, J., Ranjan, R., Sinha, R., Baker, C. J., Cunningham, M. J., Starnes, V. A. Tags: Small incisions and sutureless valves: A perfect marriage Source Type: research

044 * open aortic arch replacement in high risk patients: the gold standard
Conclusion: Open TAR can be performed with low mortality and morbidity and excellent long-term results even in high-risk patients. Total endovascular repair may represent an option for patients not suitable for open surgery.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Iafrancesco, M., Ranasinghe, A., Dronavalli, V., Adam, D., Claridge, M., Riley, P., McCafferty, I., Mascaro, J. Tags: Part I: Aortic arch interventions: Debranching, rebranching, stenting and beyond Source Type: research

048 * safety and feasibility of a new adjustable mitral annuloplasty ring: a multicentre european experience
Conclusion: We conclude that implantation of this new adjustable annuloplasty ring is safe and effective. Late adjustment of this ring is feasible and may allow addressing recurrent MR. Additional experience and long-term follow-up are required to establish the clinical value of this technology.
Source: Interactive CardioVascular and Thoracic Surgery - September 23, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Andreas, M., Kocher, A., Livesey, S., Castella, M., Casselman, F., Doll, N., Laufer, G., Czesla, M. Tags: Part II: Understanding the mitral valve Source Type: research

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