Database : MEDLINE
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[PMID]: 29297076
[Au] Autor:Feldman TE; Reardon MJ; Rajagopal V; Makkar RR; Bajwa TK; Kleiman NS; Linke A; Kereiakes DJ; Waksman R; Thourani VH; Stoler RC; Mishkel GJ; Rizik DG; Iyer VS; Gleason TG; Tchétché D; Rovin JD; Buchbinder M; Meredith IT; Götberg M; Bjursten H; Meduri C; Salinger MH; Allocco DJ; Dawkins KD
[Ad] Address:Evanston Hospital Cardiology Division, Northshore University Health System, Evanston, Illinois.
[Ti] Title:Effect of Mechanically Expanded vs Self-Expanding Transcatheter Aortic Valve Replacement on Mortality and Major Adverse Clinical Events in High-Risk Patients With Aortic Stenosis: The REPRISE III Randomized Clinical Trial.
[So] Source:JAMA;319(1):27-37, 2018 01 02.
[Is] ISSN:1538-3598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017. Interventions: Participants were randomized in a 2:1 ratio to receive either an MEV (n = 607) or an SEV (n = 305). Main Outcomes and Measures: The primary safety end point was the 30-day composite of all-cause mortality, stroke, life-threatening or major bleeding, stage 2/3 acute kidney injury, and major vascular complications tested for noninferiority (margin, 10.5%). The primary effectiveness end point was the 1-year composite of all-cause mortality, disabling stroke, and moderate or greater paravalvular leak tested for noninferiority (margin, 9.5%). If noninferiority criteria were met, the secondary end point of 1-year moderate or greater paravalvular leak was tested for superiority in the full analysis data set. Results: Among 912 randomized patients (mean age, 82.8 [SD, 7.3] years; 463 [51%] women; predicted risk of mortality, 6.8%), 874 (96%) were evaluable at 1 year. The primary safety composite end point at 30 days occurred in 20.3% of MEV patients and 17.2% of SEV patients (difference, 3.1%; Farrington-Manning 97.5% CI, -∞ to 8.3%; P = .003 for noninferiority). At 1 year, the primary effectiveness composite end point occurred in 15.4% with the MEV and 25.5% with the SEV (difference, -10.1%; Farrington-Manning 97.5% CI, -∞ to -4.4%; P<.001 for noninferiority). The 1-year rates of moderate or severe paravalvular leak were 0.9% for the MEV and 6.8% for the SEV (difference, -6.1%; 95% CI, -9.6% to -2.6%; P < .001). The superiority analysis for primary effectiveness was statistically significant (difference, -10.2%; 95% CI, -16.3% to -4.0%; P < .001). The MEV had higher rates of new pacemaker implants (35.5% vs 19.6%; P < .001) and valve thrombosis (1.5% vs 0%) but lower rates of repeat procedures (0.2% vs 2.0%), valve-in-valve deployments (0% vs 3.7%), and valve malpositioning (0% vs 2.7%). Conclusions and Relevance: Among high-risk patients with aortic stenosis, use of the MEV compared with the SEV did not result in inferior outcomes for the primary safety end point or the primary effectiveness end point. These findings suggest that the MEV may be a useful addition for TAVR in high-risk patients. Trial Registration: ClinicalTrials.gov Identifier: NCT02202434.
[Mh] MeSH terms primary: Aortic Valve Stenosis/surgery
Aortic Valve/surgery
Heart Valve Prosthesis
Transcatheter Aortic Valve Replacement/adverse effects
[Mh] MeSH terms secundary: Aged
Aged, 80 and over
Aortic Valve Stenosis/mortality
Bioprosthesis
Cardiovascular Diseases/etiology
Cardiovascular Diseases/mortality
Female
Follow-Up Studies
Humans
Male
Postoperative Complications/etiology
Prosthesis Design
Risk Factors
Transcatheter Aortic Valve Replacement/methods
Transcatheter Aortic Valve Replacement/mortality
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1801
[Cu] Class update date: 180311
[Lr] Last revision date:180311
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180104
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19132

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[PMID]: 29505549
[Au] Autor:Yu H; Li Q; Chen C; Li T; Xiong JY; Qin Z; Luo M; Tan ZX; Liu T; Yu H; Yin XR; Yu H; Zhou RH
[Ad] Address:Department of Anesthesiology.
[Ti] Title:Effect of intralipid on myocardial injury during valve replacement surgery with concomitant radiofrequency ablation: A randomized controlled trial.
[So] Source:Medicine (Baltimore);97(1):e9603, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: This study aimed to evaluate the effect of intralipid postconditioning (ILPC) on myocardial damage in patients undergoing valve replacement surgery with concomitant radiofrequency ablation (RFA) for atrial fibrillation (AF). METHODS: Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing valve replacement surgery with concomitant RFA. Sixty-nine patients were randomly assigned to ILPC group (n = 34) or control group (n = 35): ILPC group received an intravenous infusion of 20% intralipid (2 mL/kg) just 10 minutes before aortic cross-unclamping, and control group received an equivalent volume of normal saline. Serum cardiac troponin-T (cTnT) and creatine kinase-MB (CK-MB) was measured before surgery and at 4, 12, 24, 48, and 72 hours after surgery. The primary endpoints were the 72-hour area under the curve (AUC) for cTnT and CK-MB. RESULTS: The total 72-hour AUC of cTnT (P = .33) and CK-MB (P = .52) were comparable between 2 groups. The left ventricle ejection fraction at discharge (P = .011) was higher in the ILPC group than that in the control group, while the AF recurrence did not differ significantly between 2 groups. CONCLUSIONS: There was no observed beneficial effect of ILPC on myocardial injury documented by the cardiac biomarkers in patients undergoing valve replacement surgery with concomitant RFA, and the effect of intralipid against myocardial I/R injury is undetectable within the background of massive biomarker release following ablation owing to localized myocardial necrosis. Besides, there are no other published data about the cardioprotective role of intralipid in patients undergoing this procedure and benefits of this protection need further studies to validate.
[Mh] MeSH terms primary: Catheter Ablation/adverse effects
Fat Emulsions, Intravenous/therapeutic use
Heart Injuries/prevention & control
Phospholipids/therapeutic use
Soybean Oil/therapeutic use
[Mh] MeSH terms secundary: Adult
Atrial Fibrillation/surgery
Creatine Kinase, MB Form/blood
Emulsions/therapeutic use
Female
Heart Injuries/blood
Heart Injuries/etiology
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Prospective Studies
Troponin T/blood
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Name of substance:0 (Emulsions); 0 (Fat Emulsions, Intravenous); 0 (Phospholipids); 0 (Troponin T); 0 (soybean oil, phospholipid emulsion); 8001-22-7 (Soybean Oil); EC 2.7.3.2 (Creatine Kinase, MB Form)
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009603

  3 / 46215 MEDLINE  
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[PMID]: 29519754
[Au] Autor:Hansson NC; Leipsic J; Pugliese F; Andersen HR; Rossi A; Simonato M; Jensen KT; Christiansen EH; Terkelsen CJ; Blanke P; Tang M; Krusell LR; Klaaborg KE; Terp K; Kennon S; Dvir D; Bøtker HE; Webb J; Nørgaard BL
[Ad] Address:Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: nh@dadlnet.dk.
[Ti] Title:Aortic valve and left ventricular outflow tract calcium volume and distribution in transcatheter aortic valve replacement: Influence on the risk of significant paravalvular regurgitation.
[So] Source:J Cardiovasc Comput Tomogr;, 2018 Feb 15.
[Is] ISSN:1876-861X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: We sought to determine the impact of aortic root calcium on the risk of significant paravalvular regurgitation (sPAR) in transcatheter aortic valve replacement (TAVR). METHODS: In 302 consecutive patients from 3 centers, aortic root calcium was quantified volumetrically on pre-TAVR multidetector computed tomography (MDCT) in three regions: 1) the aortic valve region, 2) the overall left ventricular outflow tract (LVOT) and 3) the upper LVOT. Transcathether heart valve (THV) oversizing was calculated as (THV nominal area/MDCT annular area-1) × 100. The study endpoint sPAR was a composite of post-dilatation (PD) and PAR > mild. RESULTS: sPAR occurred in 15% (46/302) of patients. Upper LVOT calcium volume was more predictive of sPAR than overall LVOT calcium volume, with an area under the receiver operating curve (AUC) (95% confidence interval [CI]) of 0.80 (0.67-0.89) vs. 0.60 (0.51-0.70); p = 0.0001. The optimal cut-off calcium volume thresholds determined from receiver operating curves were 21 mm and 30 mm for upper LVOT and overall LVOT calcium, respectively. Upper LVOT calcium ≥ 21 mm , but not overall LVOT calcium ≥ 30 mm , independently predicted sPAR, odds ratio (95%CI): 9.5 (4.1-22.3) vs 1.6 (0.6-2.7). Upper LVOT calcium was more predictive of sPAR in patients with THV oversizing ≥ 13% compared to patients with THV oversizing <13%, AUC (95% CI): 0.83 (0.72-0.93) vs. 0.67 (0.51-0.74); p < 0.0001. CONCLUSIONS: Upper LVOT calcium predicts more-than-mild paravalvular regurgitation following TAVR or the need for postdilatation. Upper LVOT calcium is most predictive of paravalvular regurgitation in the event of THV oversizing ≥ 13%.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:Publisher

  4 / 46215 MEDLINE  
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[PMID]: 29452357
[Au] Autor:Kim WK; Kim HR; Kim JB; Jung SH; Choo SJ; Chung CH; Lee JW
[Ad] Address:Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
[Ti] Title:del Nido cardioplegia in adult cardiac surgery: beyond single-valve surgery.
[So] Source:Interact Cardiovasc Thorac Surg;, 2018 Feb 14.
[Is] ISSN:1569-9285
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: In recent years, the use of del Nido (DN) cardioplegia has been reported in single-valve surgery or isolated coronary artery bypass surgery with acceptable outcomes. The reports of its use in more complex adult cardiac procedures, however, have been scarce. METHODS: We enrolled a total of 149 adult patients who underwent heart valve surgery with the use of DN cardioplegia between May 2014 and December 2016. For a benchmark comparison, 892 patients who underwent cardiac valve surgery with blood cardioplegia during the same period served as controls. To reduce selection bias, propensity score matching was used; the inverse probability of treatment weighting method was performed for further validations. RESULTS: Overall, 57.7% of patients in the DN group underwent multiple or complex cardiac procedures. Early mortality rates were 0.7% and 2.4% in the DN and blood groups, respectively (P = 0.31). Propensity score matching yielded 111 pairs of patients who were well balanced for all 23 measured baseline covariates. In the matched cohort, the postoperative peak troponin I levels (P = 0.004) and the aortic clamping times (P < 0.001) were significantly lower and shorter compared with those in the blood group. There were no significant differences in early mortality rates (1.9% vs 0%, P > 0.99), low cardiac output (P = 0.57) and neurological events (P = 0.21). The quantities of postoperative transfusions (P = 0.008) and fluid supplements (P < 0.001) were significantly lower in the matched DN group compared with the blood group. CONCLUSIONS: The use of DN in adult valve surgery including complex procedures may confer acceptable outcomes comparable to or even superior to those obtained with the use of blood cardioplegia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/icvts/ivy028

  5 / 46215 MEDLINE  
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[PMID]: 29420710
[Au] Autor:Stella S; Italia L; Geremia G; Rosa I; Ancona F; Marini C; Capogrosso C; Giglio M; Montorfano M; Latib A; Margonato A; Colombo A; Agricola E
[Ad] Address:Echocardiography Laboratory, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
[Ti] Title:Accuracy and reproducibility of aortic annular measurements obtained from echocardiographic 3D manual and semi-automated software analyses in patients referred for transcatheter aortic valve implantation: implication for prosthesis size selection.
[So] Source:Eur Heart J Cardiovasc Imaging;, 2018 Feb 06.
[Is] ISSN:2047-2412
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Aims: A 3D transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced. The system automatically configures a geometric model of the aortic root and performs quantitative analysis of these structures. We compared the measurements of the aortic annulus (AA) obtained by semi-automated 3D-TOE quantitative software and manual analysis vs. multislice computed tomography (MSCT) ones. Methods and results: One hundred and seventy-five patients (mean age 81.3 ± 6.3 years, 77 men) who underwent both MSCT and 3D-TOE for annulus assessment before transcatheter aortic valve implantation were analysed. Hypothetical prosthetic valve sizing was evaluated using the 3D manual, semi-automated measurements using manufacturer-recommended CT-based sizing algorithm as gold standard. Good correlation between 3D-TOE methods vs. MSCT measurements was found, but the semi-automated analysis demonstrated slightly better correlations for AA major diameter (r = 0.89), perimeter (r = 0.89), and area (r = 0.85) (all P < 0.0001) than manual one. Both 3D methods underestimated the MSCT measurements, but semi-automated measurements showed narrower limits of agreement and lesser bias than manual measurements for most of AA parameters. On average, 3D-TOE semi-automated major diameter, area, and perimeter underestimated the respective MSCT measurements by 7.4%, 3.5%, and 4.4%, respectively, whereas minor diameter was overestimated by 0.3%. Moderate agreement for valve sizing for both 3D-TOE techniques was found: Kappa agreement 0.5 for both semi-automated and manual analysis. Interobserver and intraobserver agreements for the AA measurements were excellent for both techniques (intraclass correlation coefficients for all parameters >0.80). Conclusion: The 3D-TOE semi-automated analysis of AA is feasible and reliable and can be used in clinical practice as an alternative to MSCT for AA assessment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/ehjci/jey013

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[PMID]: 29420704
[Au] Autor:van Rosendael PJ; Delgado V; Bax JJ
[Ad] Address:Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
[Ti] Title:Pacemaker implantation rate after transcatheter aortic valve implantation with early and new-generation devices: a systematic review.
[So] Source:Eur Heart J;, 2018 Feb 06.
[Is] ISSN:1522-9645
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Aims: The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) with new-generation prostheses remains debated. This systematic review analyses the incidence of PPI after TAVI with new-generation devices and evaluates the electrical, anatomical, and procedural factors associated with PPI. In addition, the incidence of PPI after TAVI with early generation prostheses was reviewed for comparison. Methods and results: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, this systematic review screened original articles published between October 2010 and October 2017, reporting on the incidence of PPI after implantation of early and new-generation TAVI prostheses. Of the 1406 original articles identified in the first search for new-generation TAVI devices, 348 articles were examined for full text, and finally, 40 studies (n = 17 139) were included. The incidence of a PPI after the use of a new-generation TAVI prosthesis ranged between 2.3% and 36.1%. For balloon-expandable prostheses, the PPI rate remained low when using an early generation SAPIEN device (ranging between 2.3% and 28.2%), and with the new-generation SAPIEN 3 device, the PPI rate was between 4.0% and 24.0%. For self-expandable prostheses, the PPI rates were higher with the early generation CoreValve device (16.3-37.7%), and despite a reduction in PPI rates with the new Evolut R, the rates remained relatively higher (14.7-26.7%). When dividing the studies according to the highest (>26.0%) and the lowest (<12.1%) quintile of PPI rate, patients within the highest quintile were more frequently women when compared with the lowest quintile group (50.9% vs. 46.3%, P < 0.001). Pre-existent conduction abnormalities (electrical factor), calcification of the left ventricular outflow tract (anatomical factor), and balloon valvuloplasty and depth of implantation (procedural factors) were associated with increased risk of PPI. Conclusion: The rate of PPI after TAVI with new-generation devices is highly variable. Specific recommendations for implantation of each prosthesis, taking into consideration the presence of pre-existent conduction abnormalities and anatomical factors, may be needed to reduce the risk of PPI.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/eurheartj/ehx785

  7 / 46215 MEDLINE  
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[PMID]: 27773869
[Au] Autor:Doose C; Kütting M; Egron S; Farhadi Ghalati P; Schmitz C; Utzenrath M; Sedaghat A; Fujita B; Schmitz-Rode T; Ensminger S; Steinseifer U
[Ad] Address:Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz-Institute Aachen, RWTH Aachen University, Aachen, Germany.
[Ti] Title:Valve-in-valve outcome: design impact of a pre-existing bioprosthesis on the hydrodynamics of an Edwards Sapien XT valve.
[So] Source:Eur J Cardiothorac Surg;51(3):562-570, 2017 03 01.
[Is] ISSN:1873-734X
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Objectives: Bioprosthetic aortic heart valves are increasingly implanted in younger patients. Therefore, a strategy for potential valve failure should be developed before implanting the 'first valve'. The goal of this in vitro study was to provide insight into the effects of the design of a bioprosthesis on a valve-in-valve implanted Sapien XT valve. Methods: The hydrodynamic performance of a 23-mm Sapien XT valve implanted in Vascutek Aspire, Edwards Perimount, Medtronic Mosaic and St. Jude Medical Trifecta heart valves was investigated in a left heart simulator. In addition to the hydrodynamic results, the leaflet dynamics were analysed in high-speed video recordings of the tests. Results: All valve-in-valve combinations in this study fulfilled the minimum acceptance criteria defined by relevant approval standards (e.g. ISO 5840) but displayed significant differences in their performances. Small inner diameters of the bioprostheses were associated with increased mean pressure gradients, decreased effective orifice areas and geometric opening areas as well as with pin-wheeling and uneven leaflet motion. In addition, implantation in bioprostheses with internally mounted leaflets was associated with lower paravalvular leakage. Conclusions: The results of this study suggest that a surgical bioprosthesis with a large inner diameter and internally mounted leaflets improves the heamodynamics and potentially the durability of a valve-in-valve combination. These results should give the attending physicians critical information to consider when deciding on a bioprosthesis for younger patients.
[Mh] MeSH terms primary: Aortic Valve/surgery
Bioprosthesis
Heart Valve Prosthesis Implantation/methods
Heart Valve Prosthesis
[Mh] MeSH terms secundary: Aortic Valve/physiopathology
Humans
Hydrodynamics
Prosthesis Design
Prosthesis Failure
Reoperation/instrumentation
Reoperation/methods
Treatment Outcome
Video Recording
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[Js] Journal subset:IM
[Da] Date of entry for processing:161025
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw317

  8 / 46215 MEDLINE  
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[PMID]: 29292939
[Au] Autor:Kastengren M; Dalén M; Källner G; Liska J; Gunnarsson L; Svenarud P
[Ad] Address:Karolinska Universitetssjukhuset - Tema Hjärta & Kärl Stockholm, Sweden Karolinska Universitetssjukhuset - Tema Hjärta & Kärl Stockholm, Sweden.
[Ti] Title:Minimalinvasiv mitraliskirurgi bra alternativ till konventionell kirurgi - Mindre kirurgiskt trauma kan ge färre komplikationer och snabbare återhämtning.
[So] Source:Lakartidningen;114, 2017 Nov 24.
[Is] ISSN:1652-7518
[Cp] Country of publication:Sweden
[La] Language:swe
[Ab] Abstract:Minimally invasive mitral valve surgery Conventional mitral valve surgery is performed through a full median sternotomy. Minimal invasive mitral valve surgery was introduced in the mid 1990s and is performed through a right mini-thoracotomy. Minimal access mitral valve surgery has grown in popularity and by reducing surgical trauma potential benefits include decreased postoperative bleeding and pain, reduced incidence of sternal wound infections and shortened recovery period after surgery. We report our experience in 97 patients operated during one year where mitral valve surgery was performed through a minimally invasive technique.
[Mh] MeSH terms primary: Minimally Invasive Surgical Procedures/methods
Mitral Valve Annuloplasty/methods
Mitral Valve/surgery
[Mh] MeSH terms secundary: Aged
Female
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Minimally Invasive Surgical Procedures/adverse effects
Mitral Valve Annuloplasty/adverse effects
Postoperative Complications
Recovery of Function
Thoracotomy/methods
Time Factors
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180306
[Lr] Last revision date:180306
[Js] Journal subset:IM
[Da] Date of entry for processing:180103
[St] Status:MEDLINE

  9 / 46215 MEDLINE  
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[PMID]: 29457259
[Au] Autor:Moorthy N; Ananthakrishna R; Rao DPV; Manjunath SC; Nanjappa MC
[Ad] Address:Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, India.
[Ti] Title:Prosthetic mitral valve thrombosis, malfunction, and paroxysmal mitral regurgitation.
[So] Source:Echocardiography;35(3):388-390, 2018 Mar.
[Is] ISSN:1540-8175
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Intermittent dysfunction of mechanical mitral valve prosthesis is an uncommon condition. It carries serious clinical implications if unrecognized. Here, we present a case of a 28-year-old female with a history of rheumatic multivalvular disease, for which she had undergone double valve replacement and tricuspid annuloplasty. Six months later, she presented with heart failure. Clinical examination revealed intermittent loss of closing clicks followed by a pansystolic murmur at the apex, suggestive of mitral prosthetic valve dysfunction. We highlight the echocardiographic findings of paroxysmal mitral valvular regurgitation secondary to prosthetic valve malfunction secondary to prosthetic valve thrombosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:In-Data-Review
[do] DOI:10.1111/echo.13831

  10 / 46215 MEDLINE  
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[PMID]: 29300074
[Au] Autor:Schneider A; Klautz RJM; Hazekamp M
[Ad] Address:Department of Cardiothoracic Surgery Leiden University Medical Center Leiden, The Netherlands.
[Ti] Title:The Ross reimplantation technique.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Sep 25.
[Is] ISSN:1813-9175
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Pulmonary autograft replacement of a diseased aortic valve (the Ross procedure) is effective in children, where growth is essential, and in young patients for whom a biological solution is preferred. Long-term outcomes are generally good. However eventual autograft dilatation may necessitate reoperation. In order to diminish the risk of autograft dilatation, several 'wrapping' techniques have been developed. Here, we present our technique of choice: the reimplantation of the pulmonary autograft in a vascular tube graft, scalloping the sinuses of Valsalva. This leaves no bulky tissue inside the vascular tube graft and makes autograft dilatation impossible.
[Mh] MeSH terms primary: Aortic Valve/surgery
Heart Valve Prosthesis Implantation/methods
[Mh] MeSH terms secundary: Bioprosthesis
Blood Vessel Prosthesis Implantation
Humans
Reoperation
Replantation
Sinus of Valsalva/surgery
Transplantation, Autologous
[Pt] Publication type:VIDEO-AUDIO MEDIA
[Em] Entry month:1803
[Cu] Class update date: 180302
[Lr] Last revision date:180302
[Js] Journal subset:IM
[Da] Date of entry for processing:180105
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.019


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