- Transcatheter Aortic Valve Replacement as a Bridge to Left Ventricular Assist Device Implantation. [Journal Article]
- IInnovations (Phila) 2018 Feb 14
- We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to ...
We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to left ventricular assist device implantation. The use of this strategy can not only medically optimize patients before left ventricular assist device implantation but also provide a minimally invasive bridge to left ventricular assist device support, avoiding concomitant surgical aortic valve replacement or closure.
- Home Inotropes in Patients Supported with Left Ventricular Assist Devices. [Journal Article]
- AJASAIO J 2018 Feb 15
- There is little data outlining the use of outpatient inotropic medications in patients with existing left ventricular assist devices (LVADs). This case series explores this patient population and see...
There is little data outlining the use of outpatient inotropic medications in patients with existing left ventricular assist devices (LVADs). This case series explores this patient population and seeks to define the indications, complications, and safety of dual support. A retrospective chart review was conducted for all patients on LVAD and then subsequently started on home inotropes post device implant. Eight patients met inclusion criteria. The indications for inotropes were right ventricular failure, aortic insufficiency with biventricular failure, LVAD thrombosis with contraindication to device exchange, and cannula malposition with elevated pulmonary vascular resistance. Mean duration of combined support was 273±170 days. Cardiac index improved from 1.96 ± 0.24 to 2.31 ±0.35L/min/m after inotropes (p = 0.02). There was no change in hospital admissions. The most common reason for readmission was heart failure symptoms, followed by bleeding. Five patients died during the study period, one underwent heart transplant, and two remain on inotropic support. Home inotropes may be indicated in selected CF-LVAD patients with refractory right ventricular failure or impaired LVAD function. Inotropes can improve hemodynamics and provide palliation of symptoms. However, long-term inotrope use does not reduce hospital readmissions and is associated with multiple complications related to the need for an indwelling intravenous line.
- [Robot-assisted atrial septal defect closure in adults: first experience in Russia]. [Journal Article]
- KKhirurgiia (Mosk) 2018; (2):4-20
- CONCLUSIONS: In view of favorable course of postoperative period, no significant specific complications and encouraging immediate results we can talk about endoscopic robot-assisted ASD closure in adults as a safe and effective alternative to surgical treatment.
- Maternal and fetal outcomes in pregnancies with pulmonary hypertension: Experience of a tertiary center. [Journal Article]
- TJTaiwan J Obstet Gynecol 2018; 57(1):13-17
- CONCLUSIONS: The care of the pregnant women with PHT necessitates a well-planned, multidisciplinary approach focusing on close monitoring before, during and after delivery. This approach may contribute to reduction of poor maternal and fetal outcomes.
- Polytetrafluoroethylene conduits versus homografts for right ventricular outflow tract reconstruction in infants and young children: An institutional experience. [Journal Article]
- JTJ Thorac Cardiovasc Surg 2018 Jan 31
- CONCLUSIONS: Bicuspid valved polytetrafluoroethylene conduits are a satisfactory choice for right ventricular outflow tract reconstruction in patients aged less than 2 years. Their availability, low cost, and lack of potential sensitization make them an appealing alternative to homograft conduits.
- Reimplantation versus remodelling with ring annuloplasty: comparison of mid-term outcomes after valve-sparing aortic root replacement. [Journal Article]
- EJEur J Cardiothorac Surg 2018 Feb 08
- CONCLUSIONS: Despite a higher prevalence of bicuspid aortic valves and larger aortic annular diameters, mid-term outcomes after remodelling with extra-aortic annuloplasty and reimplantation are comparable. Extra-aortic ring annuloplasty is effective at stabilizing annular dimensions.
- Anomalous Coronary Artery Origin in a Young Patient with Marfan Syndrome. [Journal Article]
- CRCase Rep Cardiol 2017; 2017:3861923
- Marfan syndrome is an autosomal dominant genetic disorder that affects connective tissue and is caused by mutations in the fibrillin 1 gene present at chromosome 15. Aortic aneurysm is its main compl...
Marfan syndrome is an autosomal dominant genetic disorder that affects connective tissue and is caused by mutations in the fibrillin 1 gene present at chromosome 15. Aortic aneurysm is its main complication, and along the dilation of the aorta root and its descending portion (60-100%), with secondary aortic insufficiency, it increases risk of acute aortic dissection and death. Coronary artery anomalies affect between 0.3% and 1.6% of the general population and are the second leading cause of sudden death in young adults, especially if the anomalous coronary passes through aorta and pulmonary artery. The anomalous origin of the left main coronary artery in the right Valsalva sinus has a prevalence of 0.02%-0.05% and is commonly related to other congenital cardiac anomalies, such as transposition of great vessels, coronary fistulas, bicuspid aortic valve, and tetralogy of Fallot. Its association with Marfan syndrome is not known, and there is no previous report in the literature. We describe here a case of a female with Marfan syndrome diagnosed with symptomatic anomalous origin of the left coronary artery in the right Valsalva sinus.
- The Association of Aortic Valve Pathology with Renal Resistive Index as a Kidney Injury Biomarker. [Journal Article]
- ATAnn Thorac Surg 2018 Feb 07
- CONCLUSIONS: Patients with aortic insufficiency and combined insufficiency/stenosis had higher median RRI values compared to normal patients. For these individuals, diastolic flow differences related to AI may explain why their pre-surgery RRI values often exceeded postoperative thresholds typically associated with AKI. Strategies to account for the potentially confounding effects of aortic insufficiency on renal flow patterns, independent of renal injury, may add to the value of RRI as an early AKI biomarker.
- Rapid deployment aortic valve replacement in a minimal access setting: intermediate clinical and echocardiographic outcomes. [Journal Article]
- EJEur J Cardiothorac Surg 2018 Feb 06
- CONCLUSIONS: Rapid deployment aortic valve replacement can be performed safely in a minimal access setting with low complication rates and good haemodynamic results. Therefore, rapid deployment valves are a relevant option in minimal access surgery.
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- Aortic dissection masquerading as a bicuspid aortic valve. [Journal Article]
- JAJ Anaesthesiol Clin Pharmacol 2017 Oct-Dec; 33(4):541-543
- A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a b...
A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a bicuspid aortic valve (BAV). In addition, he was noted to have a dilated thoracic aorta concerning for a dissection, severe aortic insufficiency (AI), and both a pericardial and pleural effusion. Magnetic resonance imaging revealed a Type A ascending aortic dissection. He was taken emergently to the operating room for repair. An intraoperative transesophageal echocardiography examination was performed which revealed a normal trileaflet AV with a Type A aortic dissection flap masquerading as a BAV. The dissection flap interfered with both the valve's function, causing severe AI, as well as the valve's appearance, causing it to look bicuspid on echocardiography.