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    Impact of right ventricular function on outcome of severe aortic stenosis patients undergoing transcatheter aortic valve replacement.
    Am Heart J 2017 Feb 29;184:141-147. Epub 2016 Oct 29.
    Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Electronic address:
    Background: Right ventricular (RV) dysfunction was shown to be associated with adverse outcomes in a variety of cardiac patients and is considered a risk factor for adverse outcome according to the updated Valve Academic Research Consortium criteria.

    Objective: Our goal was to assess the impact of RV function at baseline on 1-year mortality among patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).

    Methods: All patients with severe AS treated with TAVR from May 2007 to March 2015 at our center were included in the present study, and baseline and procedural characteristics were recorded for each patient. Read More

    Transcatheter Aortic Valve-in-Valve Implantation Using Lotus Valve for Failed Surgical Bioprostheses.
    Ann Thorac Surg 2017 Feb 18. Epub 2017 Feb 18.
    Cardiovascular Unit, Maria Cecilia Hospital, GVM Care and Research, Cotignola, Ravenna, Italy.
    Background: Patients with failed bioprostheses are an increasing population at high risk for redo surgery. Valve-in-valve transcatheter aortic valve implantation is a promising alternative but a limited number of first-generation devices have proven efficacy in all cases.

    Methods: Patients with degenerated bioprostheses at high risk for redo surgery were included in the registry after being assigned to valve-in-valve intervention by a local heart team. Read More

    Valved Conduit Attached to Left Ventricular Outflow Tract for Valve Detachment in Behçet's Disease.
    Ann Thorac Surg 2017 Mar;103(3):e301-e303
    Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China.
    Standard aortic valve replacement for aortic regurgitation caused by Behçet's disease is frequently complicated by postoperative recurrent prosthetic valve detachment. To prevent this, we have developed a modified Bentall procedure, in which the valved conduit is proximally attached to the left ventricular outflow tract instead of to the fragile annulus, based on the fact that the left ventricular outflow tract myocardium is rarely involved in Behçet's disease. This modified Bentall procedure was performed in 5 Behçet's disease patients with prosthetic valve detachment after primary aortic valve replacement, and satisfactory results were achieved. Read More

    Long-term cardiac (valvulopathy) safety of cabergoline in prolactinoma.
    Indian J Endocrinol Metab 2017 Jan-Feb;21(1):154-159
    Department of Endocrinology, Seth G S Medical College and KEM Hospital, Mumbai, Maharashtra, India.
    Background: Clinical relevance of association of cabergoline use for hyperprolactinemia and cardiac valvulopathy remains unclear.

    Objective: The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking cabergoline for the treatment of prolactinoma and to explore any associations with the cumulative dose of drug used.

    Design: A cross-sectional echocardiographic study was performed in patients who were receiving cabergoline therapy for prolactinoma. Read More

    Surgical Correction of Aberrant Right Coronary Anomalies Stranding an Aortic Commissure with and Without Unroofing.
    Pediatr Cardiol 2017 Feb 18. Epub 2017 Feb 18.
    Division of Cardiothoracic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
    The technique for successful surgical correction of an anomalous origin of the right coronary artery from the opposite aortic cusp with an aberrant course between the aorta and pulmonary artery is illustrated in a symptomatic 62-year-old woman. The intramural course of the right coronary artery traversed the tip of the commissure between the anterior and posterior leaflets, and its repair entailed unroofing of the intramural segment from inside the aortic intima. This technique required resuspension of the overlying commissure to maintain optimal aortic valve leaflet coaptation and prevent aortic insufficiency. Read More

    Pre-Implantation Balloon Aortic Valvuloplasty and Clinical Outcomes Following Transcatheter Aortic Valve Implantation: A Propensity Score Analysis of the UK Registry.
    J Am Heart Assoc 2017 Feb 18;6(2). Epub 2017 Feb 18.
    Health e-Research Centre, University of Manchester, Manchester, United Kingdom
    Background: Aortic valve predilation with balloon aortic valvuloplasty (BAV) is recommended before transcatheter aortic valve implantation (TAVI), despite limited data around the requirement of this preprocedural step and the potential risks of embolization. This study aimed to investigate the trends in practice and associations of BAV on short-term outcomes in the UK TAVI registry.

    Methods And Results: Eleven clinical endpoints were investigated, including 30-day mortality, myocardial infarction, aortic regurgitation, valve dysfunction, and composite early safety. Read More

    Left ventricular non-compaction in a patient with ankylosing.
    J Cardiovasc Thorac Res 2016 30;8(4):188-189. Epub 2016 Dec 30.
    University at Buffalo, Buffalo, New York, 14214, USA.
    A 58 years old male with a long-standing history of HLA-B27 positive ankylosing spondylitis presented with increasing fatigue and dyspnea on exertion. He had left ventricular dysfunction and enlargement, flail right coronary leaflet of aortic valve with severe eccentric aortic insufficiency along with left ventricular non-compaction in echocardiography. The most common cardiac manifestations of ankylosing spondylitis are aortic insufficiency and conduction disturbances. Read More

    Robotic trans-atrial and trans-mitral ventricular septal resection.
    Ann Cardiothorac Surg 2017 Jan;6(1):54-59
    Department of Cardiovascular Sciences, East Carolina Heart Institute, East Carolina University & Vidant Medical Center, Greenville, North Carolina, USA.
    Localized ventricular septal hypertrophy, also known as idiopathic hypertrophic subaortic stenosis or idiopathic hypertrophic subaortic septal obstruction (IHSS), can create severe ventricular outflow obstruction. This often results in a high sub-aortic pressure gradient with potentially lethal symptoms. In 1960, Braunwald described the hemodynamic characteristics of IHSS, and thereafter, Morrow developed a trans-aortic approach to resect a large part of the ventricular septum, enlarging the outflow tract. Read More

    Robotic mitral valve repair for degenerative posterior leaflet prolapse.
    Ann Cardiothorac Surg 2017 Jan;6(1):27-32
    Background: Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center.

    Methods: We reviewed the first 623 patients (mean age 56±9. Read More

    Diagnosis of mitral valve cleft using real-time 3-dimensional echocardiography.
    J Thorac Dis 2017 Jan;9(1):159-165
    Department of Medical Ultrasound, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
    Background: Mitral valve cleft (MVC) is the most common cause of congenital mitral insufficiency, and MVC may occur alone or in association with other congenital heart lesions. Direct suture and valvuloplasty are the major and effective treatments for mitral regurgitation (MR) caused by MVC. Therefore, it is important to determine the location and magnitude of the pathological damage due to MVC when selecting a surgical procedure for treatment. Read More

    The importance of age and weight on cavopulmonary shunt (stage II) outcomes after the Norwood procedure: Planned versus unplanned surgery.
    J Thorac Cardiovasc Surg 2017 Jan 17. Epub 2017 Jan 17.
    Department of Cardiac Surgery, Birmingham Children's Hospital, Birmingham, United Kingdom.
    Objective: The study objective was to evaluate the outcomes of the cavopulmonary shunt after the Norwood procedure with a particular focus on age, weight, and whether surgery was planned or expedited by clinical findings.

    Methods: We studied 297 consecutive patients with hypoplastic left heart syndrome undergoing the cavopulmonary shunt operation between 2002 and 2014. All patients underwent the Norwood procedure with a right ventricle to pulmonary artery conduit. Read More

    Does pre-existing aortic regurgitation protect from death in patients who develop paravalvular leak after TAVI?
    Int J Cardiol 2017 Feb 4. Epub 2017 Feb 4.
    Division of Cardiac Surgery, San Giovanni Battista Hospital 'Molinette', University of Turin, Turin, Italy.
    Objective: The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes.

    Methods And Results: We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe. Read More

    Remodeling root repair with an external aortic ring annuloplasty.
    J Thorac Cardiovasc Surg 2017 Jan 11. Epub 2017 Jan 11.
    Department of Cardiac Pathology, Institut Mutualiste Montsouris, Paris, France.
    Objective: Although the remodeling technique provides the most dynamic valve-sparing root replacement, a dilated annulus (>25 mm) is a risk factor for failure. Aortic annuloplasty aims to reduce the annulus diameter, thus increasing coaptation height to protect the repair. The results of 177 patients with remodeling and external aortic ring annuloplasty were studied. Read More

    Bicuspid Aortic Valve Morphotype Correlates With Regional Antioxidant Gene Expression Profiles in the Proximal Ascending Aorta.
    Ann Thorac Surg 2017 Feb 6. Epub 2017 Feb 6.
    Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Bioengineering, McGowan Institute for Regenerative Medicine, and Center for Vascular Remodeling and Regeneration, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address:
    Background: Bicuspid aortic valve (BAV) is associated with asymmetric dilatation of the proximal ascending aorta. We previously demonstrated increased susceptibility of smooth muscle cells to oxidative stress in the BAV-aneurysmal aorta and hypothesized that antioxidant expression is regionally defined and influenced by the BAV morphotype.

    Methods: BAV valve morphology was defined according to number of raphes: type 0 (0 raphes), type 1 (1 raphe), or type 2 (2 raphes) and by the raphe location among the left (L), right (R) or non (N) coronary cusps. Read More

    Bicuspid aortic valve aortopathy: mechanistic and clinical insights from recent studies.
    Curr Opin Cardiol 2017 Mar;32(2):111-116
    aSection of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AlbertabDivision of Cardiac Surgery, Li Ka Shing Knowledge Institute of St Michael's Hospital, University of Toronto, Toronto, Ontario, CanadacMartha and Richard Melman Family Bicuspid Aortic Valve Program, Bluhm Cardiovascular Institute, Northwestern University, Chicago, Illinois, USA.
    Purpose Of Review: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy.

    Recent Findings: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Read More

    [Double Valve Replacement and Tricuspid Annuloplasty in a Patient with Situs Inversus Totalis and Mirror-image Dextrocardia;Report of a Case].
    Kyobu Geka 2017 Feb;70(2):135-137
    Department of Cardiovascular Surgery, Northern Okinawa Cardiovascular Center, Nago, Japan.
    Situs inversus totalis and mirror-image dextrocardia is a rare congenital anomaly. A 79-year-old man with a history of atrial fibrillation presented to our hospital with chest oppression. Chest X-ray and computed tomography showed mirror-image dextrocardia and situs inversus totalis. Read More

    Transcatheter JenaValve Implantation in a Stentless Prosthesis: A Challenging Case After 4 Previous Aortic Procedures.
    Can J Cardiol 2016 Nov 11. Epub 2016 Nov 11.
    Cardiothoracic Department, University Hospital of Udine, Udine, Italy.
    A 40-year-old man underwent 4 aortic surgeries because of endocarditis and subsequent prosthesis dehiscence. At the last recurrence he presented with acute severe aortic regurgitation of a Pericarbon Freedom (LivaNova plc, London, UK) stentless bioprosthesis and a morphologically disarranged aortic root. He also presented with left ventricular dysfunction and a very low origin of the left coronary artery. Read More

    Transcatheter aortic valve implantation using the ACURATE TA™ and ACURATE neo valves: a 4-year single-center experience.
    EuroIntervention 2017 Feb 7. Epub 2017 Feb 7.
    Department of Cardiology, Cardiovascular Center Bad Neustadt, Bad Neustadt a. d. Saale, Germany.
    Aims: Long-term outcomes are available for first-generation transcatheter heart valves, but data on second-generation devices are scarce. We aim to provide an oversight of all patients implanted with a second-generation valve in our center.

    Methods And Results: From April 2012 to July 2016, 219 patients were enrolled in this prospective single-center experience; they received either the transapical ACURATE TA™ (n=99) or the transfemoral ACURATE neo™ (n=120) prosthesis. Read More

    Two decades of experience with root remodeling and valve repair for bicuspid aortic valves.
    J Thorac Cardiovasc Surg 2017 Jan 10. Epub 2017 Jan 10.
    Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg/Saar, Germany. Electronic address:
    Objective: Bicuspid aortic valve anatomy is associated with ascending aortic aneurysm in approximately 50% of individuals and may lead to severe aortic regurgitation with aortic dilatation. Both entities may be treated by valve repair and root remodeling. The objective was to review the cumulative experience of 20 years. Read More

    Hopscotch technique: A novel method for percutaneous closure of paravalvular leaks.
    Catheter Cardiovasc Interv 2017 Feb 7. Epub 2017 Feb 7.
    North Shore LIJ Health System, Lenox Hill Heart and Vascular Institute of New York, New York.
    Objectives: To describe the feasibility and safety of the Hopscotch Technique, a novel method to close paravalvular leaks.

    Background: Successful closure of paravalvular leaks requires the complete seal of irregular defects, frequently interrupted by remaining sutures or tissue that converts a large defect into a complex series of contiguous smaller defects. Successful treatment with devices placed in a single space is impossible with constrained appearance and significant residual leak; therefore, new techniques to deploy smaller devices in the correct location are needed. Read More

    Isolated rupture of bicuspid aortic valve following blunt chest trauma: a case report and systematic review of literature.
    Cardiovasc Diagn Ther 2017 Feb;7(1):89-91
    1 Department of Cardiovascular Fellowship, 2 Department of Cardiothoracic Surgery, Mercy St Vincent Medical Center and Hospital, Toledo, OH, USA.
    Blunt trauma to chest cause injury to various cardiac structures. Isolated rupture of aortic valve without aortic dissection is rare complication of blunt chest trauma and can be caused by a tear or avulsion of the valve. We report a case of a 35-year-old male who presented with severe aortic insufficiency due to rupture of a non-infected congenital bicuspid aortic valve following non-penetrating chest trauma. Read More

    Henoch-Schonlein purpura, post-streptococcal glomerulonephritis and acute rheumatic carditis after Group A β-haemolytic streptococcal infection.
    Paediatr Int Child Health 2017 Feb 6:1-3. Epub 2017 Feb 6.
    a Division of Pediatric Nephrology, Department of Pediatrics , Medical Faculty of Dokuz Eylul University , Izmir , Turkey.
    Besides association with acute rheumatic fever (ARF) and acute glomerulonephritis (APSGN), in up to 40% of cases, Group A β-haemolytic streptococcal (GABHS) infections are also implicated as a trigger for Henoch-Schonlein purpura (HSP). A 7-year-old girl with GABHS throat infection who developed HSP, APSGN and rheumatic carditis is reported. She presented with palpable purpura and arthritis in both ankles and later developed carditis characterised by mitral/aortic regurgitation and glomerulonephritis characterised by mixed nephritic/nephrotic syndrome. Read More

    IgG4-positive cell infiltration in various cardiovascular disorders - results from histopathological analysis of surgical samples.
    BMC Cardiovasc Disord 2017 Feb 3;17(1):52. Epub 2017 Feb 3.
    Department of Cardiology, Osaka Medical College, Daigaku-machi 2-7, Takatsuki, Osaka, 569-8686, Japan.
    Background: The diagnosis of Immunoglobulin G4 (IgG4)-related disease (IgG4-RD), in general, depends on serum IgG4 concentrations and histopathological findings; therefore, diagnosis of IgG4-RD in cardiovascular organs/tissues is often difficult owing to the risk of tissue sampling.

    Methods: Prevalence of IgG4-positive lymphoplasmacytic infiltration in 103 consecutive cardiovascular surgical samples from 98 patients with various cardiovascular diseases was analyzed immunohistochemically.

    Results: The diagnoses of the enrolled patients included aortic aneurysm (abdominal, n = 8; thoracic, n = 9); aortic dissection (n = 20); aortic stenosis (n = 24), aortic regurgitation (n = 10), and mitral stenosis/regurgitation (n = 17). Read More

    Comparison of Outcomes of Balloon-Expandable Versus Self-Expandable Transcatheter Heart Valves for Severe Aortic Stenosis.
    Am J Cardiol 2017 Jan 5. Epub 2017 Jan 5.
    Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Ontario, Canada.
    Transcatheter aortic valve implantation (TAVI) is the treatment of choice for inoperable and high-risk patients with severe aortic stenosis. Our objectives were to elucidate potential differences in clinical outcomes and safety between balloon-expandable versus self-expandable transcatheter heart valves (THV). We performed a retrospective cohort study of all transfemoral TAVI procedures in Ontario, Canada, from 2007 to 2013. Read More

    Cardiac Magnetic Resonance Imaging Versus Transthoracic Echocardiography for Prediction of Outcomes in Chronic Aortic or Mitral Regurgitation.
    Am J Cardiol 2017 Jan 5. Epub 2017 Jan 5.
    Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
    In subjects with aortic regurgitation (AR) or mitral regurgitation (MR), transthoracic echocardiography (TTE) is recommended for surveillance. Few prospective studies have directly compared the ability of TTE and cardiac magnetic resonance (CMR) to predict clinical outcomes in AR and MR. We hypothesized that, given its higher reproducibility, CMR would predict the need for valve surgery or heart failure (HF) hospitalization better than TTE. Read More

    Procedural and 30-day clinical outcomes following transcatheter aortic valve replacement with lotus valve: Results of the RELEVANT study.
    Catheter Cardiovasc Interv 2017 Feb 1. Epub 2017 Feb 1.
    Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy.
    Objectives: We report procedural and 30-day clinical outcomes following transcatheter aortic valve replacement (TAVR) with Lotus Valve system in a high-risk population.

    Background: Lotus valve is a second-generation TAVR fully repositionable and retrievable device. RELEVANT (REgistry of Lotus valvE for treatment of aortic VAlve steNosis with Tavr) study is an Italian prospective multicentre registry. Read More

    [New and established aspects of cardiological diagnostics using TEE : Do we need 3D technology in clinical routine?]
    Herz 2017 Jan 31. Epub 2017 Jan 31.
    Department für Innere Medizin, Neurologie und Dermatologie, Abteilung für Kardiologie und Angiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland.
    In comparison to transthoracic echocardiography (TTE) transesophageal echocardiography (TEE) enables an acquisition of images with better spatial resolution due to the use of higher ultrasound frequencies. Thus, the morphology and function of cardiac structures can principally be analyzed better and more accurately with TEE than with TTE. In addition, using three-dimensional (3D) TEE data sets standardized sectional planes can be constructed by post-processing, which enables quantitative assessment of the target structures. Read More

    Intraoperative diagnosis of a quadricuspid aortic valve.
    Asian Cardiovasc Thorac Ann 2017 Jan 1:218492317692467. Epub 2017 Jan 1.
    3 Department of Pediatric Cardiology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
    Quadricuspid aortic valve is a rare anomaly, and most patients require surgery for aortic regurgitation in the 5th or 6th decades of life; only a few cases of aortic valve repair in childhood have been reported. A 3-year-old boy was scheduled for ventricular septal defect closure and aortic valve repair. Quadricuspid aortic valve was an incidental finding at operation; it was repaired by joining the left anterior and right anterior cusps. Read More

    Cohort profile: prevalence of valvular heart disease in community patients with suspected heart failure in UK.
    BMJ Open 2017 Jan 27;7(1):e012240. Epub 2017 Jan 27.
    Cardiology Clinical Academic Group, St. George's University Hospitals NHS Foundation Trust, London, UK.
    Purpose: The aim of this study was to evaluate the proportion of suspected heart failure patients with significant valvular heart disease. Early diagnosis of valve disease is essential as delay can limit treatment and negatively affect prognosis for undiagnosed patients. The prevalence of unsuspected valve disease in the community is uncertain. Read More

    Differences in Aortic Valve and Left Ventricular Parameters Related to the Severity of Myocardial Fibrosis in Patients with Severe Aortic Valve Stenosis.
    PLoS One 2017 27;12(1):e0170939. Epub 2017 Jan 27.
    Department of Thoracic Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
    Objective: This study investigated the morphological and functional characteristics of the aortic valve and the left ventricular (LV) systolic functional parameters and myocardial mass related to the severity of myocardial fibrosis (MF) in patients with severe aortic valve stenosis (AS).

    Materials And Methods: We retrospectively enrolled 81 patients (48 men; mean age: 59±12 years) with severe AS who underwent transthoracic echocardiography (TTE), cardiac computed tomography (CCT), and cardiovascular magnetic resonance (CMR) within 1 month and subsequent aortic valve surgery. Degree of MF was determined on delayed contrast-enhanced CMR with visual sub-segmental analysis-based quantification and was classified into three groups (no, mild, and severe) for identifying the differences in LV function and characteristics of the aortic valve. Read More

    Determinants of aortic regurgitation after transcatheter aortic valve implantation. An observational study using Multi Slice Computed Tomography (MSCT) guided sizing.
    J Cardiovasc Surg (Torino) 2017 Jan 27. Epub 2017 Jan 27.
    Department of Cardiology and Radiology, Erasmus Medical Center, Rotterdam, The Netherlands -
    Background: To explore the determinants of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) using Multi Slice Computed Tomography (MSCT) instead of echocardiography-guided sizing.

    Methods: Determinants of AR were assessed in 313 consecutive patients who underwent TAVI with the Medtronic(MCS, n=259) or Edwards Sapien or XT(ESV, n=54) using MSCT- guided sizing. AR was assessed by angiography immediately after TAVI (n=313, Sellers) and by echocardiography at discharge (n=285, VARC-2). Read More

    Advanced imaging in valvular heart disease.
    Nat Rev Cardiol 2017 Jan 27. Epub 2017 Jan 27.
    Department of Cardiology, Heart and Lung Center, Leiden University Medical Center, Leiden, Albinusdreef 2, 2300 RC Leiden, Netherlands.
    Although echocardiography remains the mainstay imaging technique for the evaluation of patients with valvular heart disease (VHD), innovations in noninvasive imaging in the past few years have provided new insights into the pathophysiology and quantification of VHD, early detection of left ventricular (LV) dysfunction, and advanced prognostic assessment. The severity grading of valve dysfunction has been refined with the use of Doppler echocardiography, cardiac magnetic resonance (CMR), and CT imaging. LV ejection fraction remains an important criterion when deciding whether patients should be referred for surgery. Read More

    Rheumatic Heart Disease and Myxomatous Degeneration: Differences and Similarities of Valve Damage Resulting from Autoimmune Reactions and Matrix Disorganization.
    PLoS One 2017 25;12(1):e0170191. Epub 2017 Jan 25.
    Heart Institute (InCor), School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
    Autoimmune inflammatory reactions leading to rheumatic fever (RF) and rheumatic heart disease (RHD) result from untreated Streptococcus pyogenes throat infections in individuals who exhibit genetic susceptibility. Immune effector mechanisms have been described that lead to heart tissue damage culminating in mitral and aortic valve dysfunctions. In myxomatous valve degeneration (MXD), the mitral valve is also damaged due to non-inflammatory mechanisms. Read More

    Intramural Coronary Artery in Truncus Arteriosus.
    World J Pediatr Congenit Heart Surg 2017 Jan 1:2150135116682453. Epub 2017 Jan 1.
    1 Division of Cardiology, Department of Pediatrics, Oklahoma University Children Hospital, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.
    Coronary artery anomalies are known to be associated with truncus arteriosus (common arterial trunk). Delineation of coronary anatomy preoperatively is important to avoid complications intraoperatively and postoperatively. We report the case of a 12-year-old boy with repaired truncus arteriosus who presented with moderate to severe truncal valve regurgitation and severe conduit stenosis. Read More

    Safety and efficacy of the percutaneous transaxillary access for transcatheter aortic valve implantation using various transcatheter heart valves in 100 consecutive patients.
    Int J Cardiol 2017 Apr 7;232:247-254. Epub 2017 Jan 7.
    Department of Cardiovascular Surgery, University Heart Center, University Hospital Hamburg-Eppendorf, Germany.
    Objectives: Transcatheter Aortic Valve Implantation (TAVI) can be performed via the transaxillary approach, but data about complications and procedural outcome is limited.

    Introduction: TAVI is an established treatment option for patients at high risk for conventional aortic valve replacement. Nowadays, the transfemoral approach is the most commonly used access for TAVI. Read More

    Noteworthy Literature Published in 2016 for the Cardiothoracic Anesthesiologist.
    Semin Cardiothorac Vasc Anesth 2017 Mar 24;21(1):8-16. Epub 2017 Jan 24.
    1 Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
    Clinical research and outcome studies dominated the publication spectrum for the cardiothoracic anesthesiologist in 2016. Echocardiography is an important tool in the armamentarium of the cardiothoracic anesthesiologist. Technology is advancing at a fast pace: A new method to quantify the regurgitant volume in mitral regurgitation has been described in an experimental model and been validated in humans. Read More

    Initial experience with xenograft bioconduit for the treatment of complex prosthetic valve endocarditis.
    Perfusion 2017 Jan 1:267659117690250. Epub 2017 Jan 1.
    1 Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK.
    Introduction: The treatment of complex prosthetic valve endocarditis (PVE) with aortic root abscess remains a surgical challenge. Several studies support the use of biological tissues to minimize the risk of recurrent infection. We present our initial surgical experience with the use of an aortic xenograft conduit for aortic valve and root replacement. Read More

    Exploratory assessment of left ventricular strain-volume loops in severe aortic valve diseases.
    J Physiol 2017 Jan 24. Epub 2017 Jan 24.
    Research institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
    Objectives The purpose of this study was to examine left ventricular (LV) strain (ԑ)-volume loops to provide novel insight into the haemodynamic cardiac consequences of aortic valve stenosis (AS) and aortic valve regurgitation (AR). Methods 27 participants were retrospectively recruited: AR (n = 7), AS (n = 10) and controls (n = 10). Standard transthoracic echocardiography was utilised to obtain apical 4 chamber images to construct ԑ-volume relationships were assessed by: Early systolic ԑ (ԑ_ES), slope of ԑ-volume relation during systole (Sslope), End-systolic peak ԑ (peak ԑ), Diastolic uncoupling (systolic ԑ-diastolic ԑ at same volume) during early diastole (UNCOUP_ED) and late diastole (UNCOUP_LD). Read More

    Prognostic Impact of Invasive Hemodynamic Measurements in Combination with Clinical and Echocardiographic Characteristics on 2-year Clinical Outcomes of Patients undergoing Transcatheter Aortic Valve Implantation.
    EuroIntervention 2017 Jan 25. Epub 2017 Jan 25.
    Department of Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Swizerland.
    Aims: To evaluate the prognostic utility of right heart catheterization (RHC)-derived measures among patients undergoing transcatheter aortic valve implantation (TAVI).

    Methods And Results: Data of 469 patients included in the Bern TAVI Registry between August 2007 and December 2012 and undergoing pre-operative RHC were analyzed. The relationship between hemodynamic parameters and survival was evaluated with Cox proportional hazard models. Read More

    Computational Analysis of Pumping Efficacy of a Left Ventricular Assist Device according to Cannulation Site in Heart Failure with Valvular Regurgitation.
    Comput Math Methods Med 2016 26;2016:6930482. Epub 2016 Dec 26.
    Department of IT Convergence Engineering, Kumoh National Institute of Technology, Gumi-si, 39253, Republic of Korea.
    Mitral valve regurgitation (MR) causes blood to flow in two directions during contraction of the left ventricle (LV), that is, forward into the aorta and backward into the left atrium (LA). In aortic valve regurgitation (AR), leakage occurs from the aorta into the LV during diastole. Our objective is to analyze the contribution of a left ventricular assist device (LVAD) to MR and AR for the following two different cannulation sites: from the LA to the aorta (LAAO) and from the LV to the aorta (LVAO). Read More

    Circulatory support using the impella device in fontan patients with systemic ventricular dysfunction: A multicenter experience.
    Catheter Cardiovasc Interv 2017 Jan 23. Epub 2017 Jan 23.
    Division of Cardiology, Seattle Children's Hospital, Seattle, Washington.
    Background: There are limited mechanical circulatory support options for patients with single ventricle (SV) anatomy. This is a multicenter, retrospective study of the Impella pump to support the systemic ventricle in a cohort of SV patients with Fontan circulation.

    Methods: Patients with SV anatomy supported with an Impella device from 2012 to 2015 were included. Read More

    Triple valve surgery through a less invasive approach: early and mid-term results.
    Interact Cardiovasc Thorac Surg 2017 Jan 22. Epub 2017 Jan 22.
    Department of Thoracic and Cardiovascular Surgery, Johann Wolfgang Goethe University Hospital, Frankfurt am Main, Germany.
    Objectives: A partial upper sternotomy has become established as a less invasive approach mainly for single and double valve surgery. This report evaluates the clinical outcomes of triple valve surgery performed through a partial upper sternotomy.

    Methods: We reviewed the medical records of 37 consecutive patients (28 men, 76%) who underwent triple valve surgery through a partial upper sternotomy between 2005 and 2015. Read More

    A two-stage hybrid approach for complex aortic coarctation combined with ascending-descending aorta dilatation and concomitant aortic valve regurgitation.
    J Card Surg 2017 Feb 22;32(2):148-150. Epub 2017 Jan 22.
    Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
    We present a case of aortic coarctation combined with ascending-descending aorta dilatation and concomitant aortic valve regurgitation. The technique involved using endovascular stenting, a two-stage balloon dilation procedure post-stent implantation and a Bentall procedure. Read More

    Echocardiographic Assessment of Left Ventricular Function in Healthy Horses and in Horses with Heart Disease Using Pulsed-Wave Tissue Doppler Imaging.
    J Vet Intern Med 2017 Jan 21. Epub 2017 Jan 21.
    Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
    Background: Assessment of left ventricular (LV) function by tissue Doppler imaging (TDI) is not well established in horses with heart disease.

    Objectives: To describe the use of pulsed-wave (PW) TDI for the assessment of LV function, establish reference intervals, investigate effects of mitral regurgitation (MR), aortic regurgitation (AR), and primary myocardial disease (MD), and provide proof of concept for the use of PW TDI in Warmblood horses with heart disease.

    Animals: Thirty healthy horses, 38 horses with MR, 25 with AR, 8 with MD. Read More

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