- Impact of pre-procedural cerebrovascular events on clinical outcomes after transcatheter aortic valve implantation in patients with severe aortic stenosis. [Journal Article]
- CPCurr Pharm Des 2018 Feb 19
- CONCLUSIONS: We showed that a history of CVEs in patients with severe AS undergoing TAVI is associated with a higher long-term mortality.
- Disease progression and variation in clinical practice for isolated bicuspid aortic valve in children. [Journal Article]
- CHCongenit Heart Dis 2018 Feb 21
- CONCLUSIONS: We found little to no evidence of disease progression in children with an isolated BAV. Given the low risk, close follow-up and frequent cardiac imaging for BAV surveillance may not be warranted for children.
- Incidental findings in multislice computed tomography prior to transcatheter aortic valve implantation: frequency, clinical relevance and outcome. [Journal Article]
- IJInt J Cardiovasc Imaging 2018 Feb 21
- Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exa...
Multislice computed tomography (MSCT) has emerged as the mainstay in patients planned for transcatheter aortic valve implantation (TAVI). Incidental findings (IF) in MSCT are common. However, the exact incidence, clinical relevance and further consequences of IF are unclear and it is controversial whether IF adversely affect patients' outcome. We analyzed MSCT data of 1050 patients screened for TAVI between January 2011 and December 2014. Median follow-up of patients was 20 months. In total, 3194 IF were identified, which were classified into clinically non-relevant IF (2872, 90%) and clinically relevant IF (322, 10%). In 25% of patients (258/1050) at least one clinically relevant IF was present. Age (80 ± 7 vs. 80 ± 7 years; p = 0.198) and EuroSCORE II (3.6% [2.1-5.7] vs. 3.6% [2.1-5.9]; p = 0.874) was similar between patients with and without a clinically relevant IF. TAVI was performed less frequently in patients with a clinically relevant IF (76% vs. 85%; p < 0.001), with more patients receiving surgical aortic valve replacement in that group (14% vs. 11%; p = 0.042), possibly due to the high rate of incidental aneurysms of the ascending aorta (n = 48). If TAVI was performed mortality did not differ (30-days: 4% vs. 3%; p = 0.339, 1-year: 11% vs. 14%; p = 0.226) between patients with and without a clinically relevant IF. Our study is the largest study to analyze prevalence, clinical relevance and therapeutic consequences of IF during screening for TAVI. IF in pre-procedural MSCT are common and clinically relevant in one-quarter of patients. However, these findings had no impact on overall mortality.
- Large Calibre Self-Expanding Stents for Pulmonary Stenosis After the Arterial Switch, a Low-Risk Solution to a Low-Flow Situation. [Journal Article]
- PCPediatr Cardiol 2018 Feb 22
- Branch pulmonary artery stenosis is one of the most common complications late after the arterial switch operation. The pathophysiology of stenosis in these circumstances is very different to that enc...
Branch pulmonary artery stenosis is one of the most common complications late after the arterial switch operation. The pathophysiology of stenosis in these circumstances is very different to that encountered in with normally related great vessels. The LeCompte manoeuvre leaves the pulmonary arteries straddled and stretched over the aortic root which contributing significantly to the degree of stenosis encountered. Unilateral branch pulmonary artery stenosis rarely leads to significant symptoms in young patients with biventricular repairs; however, significant discrepancies in the split flows between right and left lung may place the patient in an unfavourable physiological position as they move in to middle age. Balloon expandable stent implantation distorts the anatomical arrangement of the LeCompte and is associated with negative interactions with the often dilated aortic root. We present three cases of the use of flexible self-expanding stents to improve the physiological flow distributions to each lung whilst hopefully decreasing the risk of erosion and perforation or fistula formation related to the pulmonary artery. All three patients had uncomplicated procedures with significant improvements in vessel diameter and flow distribution noted on follow-up MRI scans. This is the first report of the use of self-expanding stents in the context of branch pulmonary artery stenosis after the LeCompte manoeuvre. Theoretically and based on our early experience, this technique provides potential safety advantages over the use of more traditional balloon expandable stents.
- A Case of Acute Left Main Coronary Obstruction Following Transcatheter Aortic Valve Implantation. [Journal Article]
- CCureus 2017 Dec 14; 9(12):e1951
- Transcatheter aortic valve implantation (TAVI) is a highly effective procedure in selected patients with severe degenerative aortic valve stenosis at high risk for conventional surgery. Coronary occl...
Transcatheter aortic valve implantation (TAVI) is a highly effective procedure in selected patients with severe degenerative aortic valve stenosis at high risk for conventional surgery. Coronary occlusion is a periprocedural life-threatening complication that despite its low frequency (˂1%) is poorly predictable and requires immediate diagnosis and treatment. Herein, we report a coronary obstruction after transcatheter implantation of valve prosthesis, followed by coronary intervention with successful recanalization.
- Stroke as an atypical initial presentation of giant cell arteritis. [Journal Article]
- BGBMC Geriatr 2018 Feb 21; 18(1):55
- CONCLUSIONS: The initial presentation of giant cell arteritis as a stroke syndrome, especially in the posterior circulation territory, is exceedingly rare. Other atypical presenting symptoms may include chronic cough and fever of unknown origin. The elevated ESR and CRP levels were clues to the diagnosis and clinical decision-making should be driven by a high index of suspicion since no single test (ESR, CRP, temporal artery biopsy) has perfect sensitivity. Elevated CRP may have a role in increasing stroke risk. This case report illustrates that in older people clinicians must consider atypical presentations of disease more often since timely diagnosis and initiation of treatment can result in optimal outcomes.
- Concomitant mitral regurgitation: an insidious cause of lowflow, low-gradient severe aortic stenosis. [Journal Article]
- EEuroIntervention 2018 Feb 20; 13(14):1622-1625
- Dexmedetomidine versus propofol-opioid for sedation in transcatheter aortic valve implantation patients: a retrospective analysis of periprocedural gas exchange and hemodynamic support. [Journal Article]
- CJCan J Anaesth 2018 Feb 20
- CONCLUSIONS: In sedated TAVI patients, DEX was associated with lower PaCO2values and reduced requirements for vasopressor support, making it a promising alternative to PO for sedation during TAVI.
- Functional SNP in the 3'UTR of PON1 is Associated with the Risk of Calcific Aortic Valve Stenosis via MiR-616. [Journal Article]
- CPCell Physiol Biochem 2018 Feb 15; 45(4):1390-1398
- CONCLUSIONS: Our results suggest that functional SNP in the 3'UTR of PON1 regulates the expression of PON1 via miR-616, and such SNP is associated with the risk of CAVS in human.
New Search Next
- Acute Heart Failure at the Time of Transcatheter Aortic Valve Replacement Does Not Increase Mortality. [Journal Article]
- IInnovations (Phila) 2018 Feb 17
- CONCLUSIONS: Transcatheter aortic valve replacement is an appropriate and effective treatment for patients with aortic stenosis presenting with high N-terminal pro-B-type natriuretic peptide and acute on chronic heart failure.