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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] Endereço:Evanston Hospital Cardiology Division, Northshore University Health System, Evanston, Illinois.
[Ti] Título: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] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo: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] Termos MeSH primário: Estenose da Valva Aórtica/cirurgia
Valva Aórtica/cirurgia
Próteses Valvulares Cardíacas
Substituição da Valva Aórtica Transcateter/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Estenose da Valva Aórtica/mortalidade
Bioprótese
Doenças Cardiovasculares/etiologia
Doenças Cardiovasculares/mortalidade
Feminino
Seguimentos
Seres Humanos
Masculino
Complicações Pós-Operatórias/etiologia
Desenho de Prótese
Fatores de Risco
Substituição da Valva Aórtica Transcateter/métodos
Substituição da Valva Aórtica Transcateter/mortalidade
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180311
[Lr] Data última revisão:
180311
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180104
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19132


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[PMID]:29384600
[Au] Autor:Kondov S; Siepe M; Beyersdorf F; von Samson-Himmelstjern P; Czerny M
[Ad] Endereço:Department of Cardiovascular Surgery, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Germany.
[Ti] Título:Thoracoabdominal aortic replacement with a bovine pericardial tube graft for aortobronchial fistulation 10 years after TEVAR.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Dec 20.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Aortobronchial fistula after thoracic endovascular aortic repair is usually a late complication. It is associated with high mortality and its surgical management is technically challenging. This tutorial illustrates the steps involved in removing an infected stent graft and replacing it with a bovine pericardial tube graft.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Doenças da Aorta/cirurgia
Implante de Prótese Vascular/efeitos adversos
Fístula Brônquica/cirurgia
Infecções Relacionadas à Prótese/cirurgia
Fístula Vascular/cirurgia
[Mh] Termos MeSH secundário: Animais
Doenças da Aorta/etiologia
Bioprótese
Prótese Vascular/efeitos adversos
Fístula Brônquica/etiologia
Bovinos
Remoção de Dispositivo
Procedimentos Endovasculares/efeitos adversos
Seres Humanos
Pericárdio/transplante
Infecções Relacionadas à Prótese/etiologia
Reoperação
Stents/efeitos adversos
Fístula Vascular/etiologia
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.027


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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] Endereço:Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz-Institute Aachen, RWTH Aachen University, Aachen, Germany.
[Ti] Título: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] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo: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] Termos MeSH primário: Valva Aórtica/cirurgia
Bioprótese
Implante de Prótese de Valva Cardíaca/métodos
Próteses Valvulares Cardíacas
[Mh] Termos MeSH secundário: Valva Aórtica/fisiopatologia
Seres Humanos
Hidrodinâmica
Desenho de Prótese
Falha de Prótese
Reoperação/instrumentação
Reoperação/métodos
Resultado do Tratamento
Gravação em Vídeo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1093/ejcts/ezw317


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[PMID]:29300074
[Au] Autor:Schneider A; Klautz RJM; Hazekamp M
[Ad] Endereço:Department of Cardiothoracic Surgery Leiden University Medical Center Leiden, The Netherlands.
[Ti] Título:The Ross reimplantation technique.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Sep 25.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo: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] Termos MeSH primário: Valva Aórtica/cirurgia
Implante de Prótese de Valva Cardíaca/métodos
[Mh] Termos MeSH secundário: Bioprótese
Implante de Prótese Vascular
Seres Humanos
Reoperação
Reimplante
Seio Aórtico/cirurgia
Transplante Autólogo
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.019


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[PMID]:29178215
[Au] Autor:Rene AG; Desai N; Wald J; Rame JE; Frogel JK; Anwaruddin S
[Ad] Endereço:Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:Transfemoral transcatheter aortic valve replacement with a self-expanding valve for severe aortic regurgitation in a patient with left ventricular assist device.
[So] Source:J Card Surg;32(11):741-745, 2017 Nov.
[Is] ISSN:1540-8191
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Aortic insufficiency following left ventricular assist device implantation (LVAD) has been reported in up to 40% of patients and is associated with a worse prognosis. We describe the case of a successful transfemoral transcatheter aortic valve replacement with a self-expanding bioprosthesis for aortic insufficiency following destination LVAD implantation.
[Mh] Termos MeSH primário: Insuficiência da Valva Aórtica/cirurgia
Valva Aórtica/cirurgia
Bioprótese
Próteses Valvulares Cardíacas
Ventrículos do Coração
Coração Auxiliar
Substituição da Valva Aórtica Transcateter/métodos
[Mh] Termos MeSH secundário: Adulto
Insuficiência da Valva Aórtica/diagnóstico por imagem
Insuficiência da Valva Aórtica/terapia
Ecocardiografia Transesofagiana
Artéria Femoral
Seres Humanos
Masculino
Índice de Gravidade de Doença
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1111/jocs.13238


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[PMID]:29338037
[Au] Autor:Schaefer A; Dickow J; Schoen G; Westhofen S; Kloss L; Al-Saydali T; Reichenspurner H; Philipp SA; Detter C
[Ad] Endereço:Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
[Ti] Título:Stentless vs. stented bioprosthesis for aortic valve replacement: A case matched comparison of long-term follow-up and subgroup analysis of patients with native valve endocarditis.
[So] Source:PLoS One;13(1):e0191171, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). METHODS: From 2004 through 2014, 77 consecutive patients (study group, 59.7% male, 68.9 ± 12.5 years, logEuroSCORE II 7.6 ± 12.3%) received surgical aortic valve replacement (SAVR) with the SFS. A control group of patients after SAVR with the CEP was retrieved from our database and matched to the study group regarding 15 parameters including preoperative endocarditis. Acute perioperative outcomes and follow-up data (mean follow-up time 48.7±29.8 months, 95% complete) were retrospectively analyzed. RESULTS: No differences in early mortality occurred during 30-day follow up (3/77; 3.9% vs. 4/77; 5.2%; p = 0.699). Echocardiographic findings revealed lower postprocedural transvalvular pressure gradients (max. 17.0 ± 8.2 vs. 24.5 ± 9.2 mmHg, p< 0.001/ mean pressure of 8.4 ± 4.1 vs. 13.1 ± 5.9 mmHg, p< 0.001) in the SFS group. Structural valve degeneration (SVD) (5.2% vs. 0%; p = 0.04) and valve explantation due to SVD or prosthetic valve endocarditis (PVE) (9.1% vs. 1.3%; p = 0.04) was more frequent in the SFS group. All-cause mortality during follow-up was 20.8% vs. 14.3% (p = 0.397). When patients were divided into subgroups of NVE and respective utilized bioprosthesis, the SFS presented impaired outcomes regarding mortality in NVE cases (p = 0.031). CONCLUSIONS: The hemodynamic superiority of the SFS was confirmed in this comparison. However, clinical outcomes in terms of SVD and PVE rates, as well as survival after NVE, were inferior in this study. Therefore, we are reluctant to recommend utilization of the SFS for treatment of NVE.
[Mh] Termos MeSH primário: Valva Aórtica/cirurgia
Bioprótese
Endocardite/cirurgia
Doenças das Valvas Cardíacas/cirurgia
Próteses Valvulares Cardíacas
Desenho de Prótese
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Valva Aórtica/diagnóstico por imagem
Valva Aórtica/fisiopatologia
Bioprótese/efeitos adversos
Estudos de Casos e Controles
Ecocardiografia
Endocardite/diagnóstico por imagem
Endocardite/fisiopatologia
Feminino
Seguimentos
Doenças das Valvas Cardíacas/diagnóstico por imagem
Doenças das Valvas Cardíacas/fisiopatologia
Próteses Valvulares Cardíacas/efeitos adversos
Hemodinâmica
Seres Humanos
Masculino
Meia-Idade
Desenho de Prótese/efeitos adversos
Falha de Prótese
Stents/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191171


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[PMID]:29178903
[Au] Autor:Ma X; He Z; Li L; Liu G; Li Q; Yang D; Zhang Y; Li N
[Ad] Endereço:Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang, 150086, China.
[Ti] Título:Development and in vivo validation of tissue-engineered, small-diameter vascular grafts from decellularized aortae of fetal pigs and canine vascular endothelial cells.
[So] Source:J Cardiothorac Surg;12(1):101, 2017 Nov 25.
[Is] ISSN:1749-8090
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tissue engineering has emerged as a promising alternative for small-diameter vascular grafts. The aim of this study was to determine the feasibility of using decellularized aortae of fetal pigs (DAFPs) to construct tissue-engineered, small-diameter vascular grafts and to test the performance and application of DAFPs as vascular tissue-engineered scaffolds in the canine arterial system. METHODS: DAFPs were prepared by continuous enzymatic digestion. Canine vascular endothelial cells (ECs) were seeded onto DAFPs in vitro and then the vascular grafts were cultured in a custom-designed vascular bioreactor system for 7 days of dynamic culture following 3 days of static culture. The grafts were then transplanted into the common carotid artery of the same seven dogs from which ECs had been derived (two grafts were prepared for each dog with one as a backup; therefore, a total of 14 tissue-engineered blood vessels were prepared). At 1, 3, and 6 months post-transplantation, ultrasonography and contrast-enhanced computed tomography (CT) were used to check the patency of the grafts. Additionally, vascular grafts were sampled for histological and electron microscopic examination. RESULTS: Tissue-engineered, small-diameter vascular grafts can be successfully constructed using DAFPs and canine vascular ECs. Ultrasonographic and CT test results confirmed that implanted vascular grafts displayed good patency with no obvious thrombi. Six months after implantation, the grafts had been remodeled and exhibited a similar structure to normal arteries. Immunohistochemical staining showed that cells had evenly infiltrated the tunica media and were identified as muscular fibroblasts. Scanning electron microscopy showed that the graft possessed a complete cell layer, and the internal cells of the graft were confirmed to be ECs by transmission electron microscopy. CONCLUSIONS: Tissue-engineered, small-diameter vascular grafts constructed using DAFPs and canine vascular ECs can be successfully transplanted to replace the canine common carotid artery. This investigation potentially paves the way for solving a problem of considerable clinical need, i.e., the requirement for small-diameter vascular grafts.
[Mh] Termos MeSH primário: Aorta Torácica/ultraestrutura
Bioprótese
Prótese Vascular
Prenhez
Engenharia Tecidual/métodos
Tecidos Suporte
[Mh] Termos MeSH secundário: Animais
Artéria Carótida Primitiva
Modelos Animais de Doenças
Cães/embriologia
Células Endoteliais/citologia
Feminino
Fibroblastos/ultraestrutura
Microscopia Eletrônica de Varredura
Gravidez
Sus scrofa/embriologia
Suínos/embriologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1186/s13019-017-0661-x


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[PMID]:29235147
[Au] Autor:Gualis J; Estevez-Loureiro R; Alonso D; Castaño M
[Ad] Endereço:Deparment of Cardiac Surgery, Complejo Asistencial Universitario de León, León, Spain.
[Ti] Título:Transapical mitral valve-in-valve ring implantation with the Edwards Sapien 3 prosthesis.
[So] Source:J Card Surg;32(12):791-793, 2017 Dec.
[Is] ISSN:1540-8191
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We present the case of a high-risk patient with symptomatic severe mitral regurgitation following a surgical annuloplasty ring. An inverted aortic Edwards Sapien 3 bioprosthesis (Edwards Lifesciences, Irvine, CA) was successfully implanted through a transapical approach inside the previously implanted annuloplasty ring.
[Mh] Termos MeSH primário: Bioprótese
Implante de Prótese de Valva Cardíaca/métodos
Próteses Valvulares Cardíacas
Anuloplastia da Valva Mitral/métodos
Insuficiência da Valva Mitral/cirurgia
Valva Mitral/cirurgia
Reoperação/métodos
[Mh] Termos MeSH secundário: Idoso
Implante de Prótese de Valva Cardíaca/instrumentação
Seres Humanos
Masculino
Anuloplastia da Valva Mitral/instrumentação
Recidiva
Reoperação/instrumentação
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1111/jocs.13506


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[PMID]:29195573
[Au] Autor:Conte JV; Hermiller J; Resar JR; Deeb GM; Gleason TG; Adams DH; Popma JJ; Yakubov SJ; Watson D; Guo J; Zorn GL; Reardon MJ
[Ad] Endereço:Departments of Surgery and Medicine, Johns Hopkins University, Baltimore, Maryland. Electronic address: jconte@jhmi.edu.
[Ti] Título:Complications After Self-expanding Transcatheter or Surgical Aortic Valve Replacement.
[So] Source:Semin Thorac Cardiovasc Surg;29(3):321-330, 2017 Autumn.
[Is] ISSN:1532-9488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Procedural complications following transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) are usually reported as retrospective analyses. We report the first comparison of complications following SAVR or self-expanding TAVR from a prospectively randomized study of high-risk SAVR patients. Three hundred ninety-five TAVR and 402 SAVR patients were prospectively enrolled and randomized 1:1 to TAVR with a CoreValve bioprosthesis or a surgical bioprosthetic valve. The rates of major procedural and vascular complications occurring (periprocedurally (0-3 days) and early (4-30 days)) were compared for TAVR vs SAVR patients. All-cause mortality, stroke, myocardial infarction, and major infection were similar in both periods post procedure. Within 0-3 days, the major vascular complication rate was significantly higher with TAVR (P = 0.003). Life-threatening or disabling bleeding (P < 0.001), encephalopathy (P = 0.02), atrial fibrillation (P < 0.001), and acute kidney injury (P < 0.001) were significantly higher with SAVR. Non-iliofemoral TAVR approaches had a higher incidence of major or life-threatening or disabling bleeding at 0-3days (P < 0.05). Procedural complications unique to TAVR included coronary occlusion 0.5% (2) and TAVR pop outs 2.8% (11) with no valve embolizations. Pop outs were similar between iliofemoral 2.8% (9/324) and non-iliofemoral approaches 3.0% (2/66). Procedural complications unique to SAVR included aortic dissection 0.8% (3/357) and injury to other heart structures 2.0% (7/357). The procedural complication profiles of TAVR and SAVR are unique. Intraoperative deaths were seen in TAVR only. Mortality at 3 and 30 days was similar. The higher incidence of some complications likely reflects the greater invasiveness of SAVR in this aged high-risk population.
[Mh] Termos MeSH primário: Estenose da Valva Aórtica/cirurgia
Valva Aórtica/cirurgia
Bioprótese
Implante de Prótese de Valva Cardíaca/efeitos adversos
Implante de Prótese de Valva Cardíaca/instrumentação
Próteses Valvulares Cardíacas
Complicações Pós-Operatórias/etiologia
Substituição da Valva Aórtica Transcateter/efeitos adversos
Substituição da Valva Aórtica Transcateter/instrumentação
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Valva Aórtica/diagnóstico por imagem
Valva Aórtica/fisiopatologia
Estenose da Valva Aórtica/diagnóstico por imagem
Estenose da Valva Aórtica/mortalidade
Estenose da Valva Aórtica/fisiopatologia
Feminino
Implante de Prótese de Valva Cardíaca/mortalidade
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/mortalidade
Estudos Prospectivos
Desenho de Prótese
Fatores de Risco
Índice de Gravidade de Doença
Fatores de Tempo
Substituição da Valva Aórtica Transcateter/mortalidade
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE


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[PMID]:28942392
[Au] Autor:Andrews JPM; Cruden NL; Moss AJ
[Ad] Endereço:Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, UK.
[Ti] Título:Progressive breathlessness following transcatheter aortic valve replacement.
[So] Source:Heart;103(21):1703, 2017 Nov.
[Is] ISSN:1468-201X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:: An 84-year-old man presented urgently to the cardiology clinic with rapid onset exertional dyspnoea while walking on the flat. Five months previously, he underwent implantation of a balloon-expandable 26 mm transcatheter heart valve (SAPIEN 3, Edwards Lifesciences) for severe aortic stenosis. On clinical examination, the jugular venous pressure was elevated and a mid-late ejection systolic murmur was audible in the aortic region. ECG demonstrated sinus rhythm with a left ventricular (LV) strain pattern. Transthoracic echocardiography and cardiac CT were performed (figure 1). heartjnl;103/21/1703/F1F1F1Figure 1(A) Transthoracic continuous wave Doppler through the transcatheter AV. ECG-gated cardiac CT oblique reconstruction of the LV outflow tract and aortic root in mid-diastole (B) with axial reconstruction of the transcatheter AV in end-systole (inset). AT, acceleration time; AV, aortic valve; LV, left ventricular. QUESTION: Which aetiology best explains this presentation?Pannus formationTranscatheter bioprosthetic valve endocarditisPatient-prosthesis mismatchTranscatheter bioprosthetic valve leaflet thrombosisStructural valve degeneration.
[Mh] Termos MeSH primário: Estenose da Valva Aórtica/cirurgia
Bioprótese
Dispneia/etiologia
Próteses Valvulares Cardíacas
Trombose/etiologia
Substituição da Valva Aórtica Transcateter/efeitos adversos
Substituição da Valva Aórtica Transcateter/instrumentação
[Mh] Termos MeSH secundário: Administração Oral
Idoso de 80 Anos ou mais
Anticoagulantes/administração & dosagem
Estenose da Valva Aórtica/diagnóstico
Ecocardiografia Doppler
Seres Humanos
Masculino
Desenho de Prótese
Índice de Gravidade de Doença
Trombose/diagnóstico por imagem
Trombose/tratamento farmacológico
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Varfarina/administração & dosagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants); 5Q7ZVV76EI (Warfarin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170925
[St] Status:MEDLINE
[do] DOI:10.1136/heartjnl-2017-312008



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