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Mastrobuoni S, de Kerchove L, El Khoury G. Commentary: "Details make perfection, and perfection is not a detail" (Leonardo da Vinci). J Thorac Cardiovasc Surg 2020; 161:901-902. [PMID: 32948300 DOI: 10.1016/j.jtcvs.2020.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 08/18/2020] [Accepted: 08/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Stefano Mastrobuoni
- Cardiovascular and Thoracic Surgery Unit, Saint-Luc's Hospital, Catholic University of Louvain, Brussels, Belgium.
| | - Laurent de Kerchove
- Cardiovascular and Thoracic Surgery Unit, Saint-Luc's Hospital, Catholic University of Louvain, Brussels, Belgium
| | - Gebrine El Khoury
- Cardiovascular and Thoracic Surgery Unit, Saint-Luc's Hospital, Catholic University of Louvain, Brussels, Belgium
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Pepper J, Izgi C, Golesworthy TJ, Takkenberg JJM, Treasure T. Personalised external aortic root support (PEARS) to stabilise an aortic root aneurysm. THE BRITISH JOURNAL OF CARDIOLOGY 2020; 27:22. [PMID: 35747770 PMCID: PMC9205243 DOI: 10.5837/bjc.2020.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Patients with congenitally determined aortic root aneurysms are at risk of aortic valve regurgitation, aortic dissection, rupture and death. Personalised external aortic root support (PEARS) may provide an alternative to aortic root replacement. This was a multi-centre, prospective cohort of all consecutive patients who received ExoVasc mesh implants for a dilated aortic root between 2004 and 2017. Baseline and peri-operative characteristics, as well as early postoperative outcomes are described, and time-related survival and re-operation free survival are estimated using the Kaplan-Meier method. From 2004 through 2017, 117 consecutive patients have received ExoVasc mesh implants for aortic root aneurysm. The inclusion criteria were an aortic root/sinus of Valsalva and ascending aorta with asymptomatic dilatation of between 40 and 50 mm in diameter in patients aged 16 years or more. Patients with more than mild aortic regurgitation were excluded. There was one early death. The length of stay was within seven days in 75% of patients. In conclusion, the operation achieves the objectives of valve-sparing root replacement. PEARS may be seen as a low-risk conservative operation, which can be applied earlier on in the disease process, and which is complementary to more invasive procedures, such as valve-sparing root replacement or total root replacement.
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Affiliation(s)
- John Pepper
- Consultant Cardiac Surgeon, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP
| | - Cemil Izgi
- Consultant Cardiac Radiologist, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, London, SW3 6NP
| | - Tal J Golesworthy
- Chartered Energy Engineer, Extent Ltd., Theocsbury House, 18-20 Barton Street, Tewkesbury Gloucestershire
| | - Johanna J M Takkenberg
- Cardiac Epidemiologist, Erasmus University Medical Centre, PO Box 2040, 3000 CA Rotterdam The Netherlands
| | - Tom Treasure
- Consultant Cardiothoracic Surgeon, Clinical Operational Research Unit, University College London, 4 Taviton Street, London WC1H 0BT
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Petersen J, Krogmann H, Reichenspurner H, Girdauskas E. Long-Term Outcome and Quality of Life After Biological Aortic Valve Replacement in Nonelderly Adults. Ann Thorac Surg 2020; 111:142-149. [PMID: 32526161 DOI: 10.1016/j.athoracsur.2020.04.097] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 03/24/2020] [Accepted: 04/13/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Aortic valve replacement (AVR) is a standard of care in the treatment of aortic stenosis. The aim of the study was to evaluate the long-term outcome and quality of life (QoL) after biological AVR in patients younger than 60 years of age. METHODS A total of 354 consecutive patients less than or equal to 60 years who underwent biological AVR at our institution (2005-2015) were included. The primary endpoint was actual freedom from AV reintervention, and secondary endpoints were actual freedom from major adverse cardiac and cerebrovascular events (MACCE) as well as mental and physical QoL. RESULTS Mean age was 52.3 ± 7.1 years and mean follow-up duration was 78.7 ± 38.1 months. Overall survival at 5, 10, and 12 years was 87.6%, 76.3%, and 63.5%, and actual freedom from AV reintervention was 85.5%, 67.8%, and 52.9%, respectively. Actual freedom from MACCE was 82.8%, 63.2%, and 50.4%, respectively. Cox regression revealed concomitant coronary artery disease (P < .001) and creatinine at baseline (P < .001) as independent predictors of survival, AV reintervention, and MACCE. Physical QoL was similar (P = .427) and mental QoL (P = .005) was significantly better compared with the published age-matched control subjects. CONCLUSIONS Biological AVR in patients less than or equal to 60 years of age is associated with a significant occurrence of actual AV reintervention and MACCE at 10 to 12 years. Mental QoL after biological AVR was superior compared with healthy control subjects. The effect of the most recently developed bioprosthesis, specifically for younger patients, needs to be evaluated. Therefore, a shared decision-making process in prosthetic AV selection is mandatory in AVR patients less than or equal to 60 years of age.
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Affiliation(s)
- Johannes Petersen
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
| | - Henry Krogmann
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Hermann Reichenspurner
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Evaldas Girdauskas
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
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Lin ZW, Huang ST, Xu N, Cao H, Chen LW, Chen Q. Effect of Music Therapy on the Chronic Pain and Midterm Quality of Life of Patients after Mechanical Valve Replacement. Ann Thorac Cardiovasc Surg 2020; 26:196-201. [PMID: 32493872 PMCID: PMC7435134 DOI: 10.5761/atcs.oa.20-00022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To evaluate the effect of music therapy on the chronic pain and midterm quality of life of patients after mechanical valve replacement. METHODS Patients were divided into two groups according to whether or not they received music therapy. The patients in the music group received 30 minutes of music therapy every day for 6 months after the operation. The patients in the control group received standard treatment and had 30 minutes of quiet rest time every day in the same period. The short-form of McGill Pain Questionnaire (SF-MPQ) was used to evaluate the degree of postoperative chronic pain, and the SF-36 was used to evaluate the midterm quality of life of patients. RESULTS In terms of the degree of postoperative chronic pain, the score of the pain rating index (PRI) emotional item in the music group was significantly lower than that in the control group. In the evaluation of the postoperative midterm quality of life using the SF-36, the emotional function score in the music group was significantly higher than that in the control group. CONCLUSION This study preliminarily showed that music therapy can effectively reduce chronic pain and improve midterm quality of life after surgery.
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Affiliation(s)
- Ze-Wei Lin
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, the Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, the Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, the Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, the Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Liang-Wan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, the Affiliated Hospital of Fujian Medical University, Fuzhou, China.,Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
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The utility of aortic valve leaflet reconstruction techniques in children and young adults. J Thorac Cardiovasc Surg 2020; 159:2369-2378. [DOI: 10.1016/j.jtcvs.2019.09.176] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/06/2019] [Accepted: 09/22/2019] [Indexed: 12/16/2022]
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de Jaegere PPT, de Weger A, den Heijer P, Verkroost M, Baan J, de Kroon T, America Y, Brandon Bravo Bruinsma GJ. Treatment decision for transcatheter aortic valve implantation: the role of the heart team : Position statement paper of the Dutch Working Group of Transcatheter Heart Interventions. Neth Heart J 2020; 28:229-239. [PMID: 31981094 PMCID: PMC7190764 DOI: 10.1007/s12471-020-01367-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The current paper presents a position statement of the Dutch Working Group of Transcatheter Heart Valve Interventions that describes which patients with aortic stenosis should be considered for transcatheter aortic valve implantation and how this treatment proposal/decision should be made. Given the complexity of the disease and the assessment of its severity, in particular in combination with the continuous emergence of new clinical insights and evidence from physiological and randomised clinical studies plus the introduction of novel innovative treatment modalities, the gatekeeper of the treatment proposal/decision and, thus, of qualification for cost reimbursement is the heart team, which consists of dedicated professionals working in specialised centres.
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Affiliation(s)
- P P T de Jaegere
- Department of Cardiology, Erasmus University, Rotterdam, The Netherlands.
| | - A de Weger
- Department of Cardiothoracic Surgery, University Hospital Leiden, Leiden, The Netherlands
| | - P den Heijer
- Department of Cardiology, Amphia Ziekenhuis, Breda, The Netherlands
| | - M Verkroost
- Department of Cardiothoracic Surgery, University Hospital Nijmegen, Nijmegen, The Netherlands
| | - J Baan
- Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
| | - T de Kroon
- Department of Cardiothoracic Surgery, Antonius Ziekenhuis Nieuwegein, Nieuwegein, The Netherlands
| | - Y America
- Department of Cardiology, Rijnstate Ziekenhuis Arnhem, Arnhem, The Netherlands
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Schneider AW, Hazekamp MG, Versteegh MIM, de Weger A, Holman ER, Klautz RJM, Bruggemans EF, Braun J. Reinterventions after freestyle stentless aortic valve replacement: an assessment of procedural risks. Eur J Cardiothorac Surg 2019; 56:1117-1123. [PMID: 31424504 PMCID: PMC6911150 DOI: 10.1093/ejcts/ezz222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 07/04/2019] [Accepted: 07/10/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Repeat aortic valve interventions after previous stentless aortic valve replacement (AVR) are considered technically challenging with an increased perioperative risk, especially after full-root replacement. We analysed our experience with reinterventions after stentless AVR. METHODS A total of 75 patients with previous AVR using a Freestyle stentless bioprosthesis (31 subcoronary, 15 root-inclusion and 29 full-root replacement) underwent reintervention in our centre from 1993 until December 2018. Periprocedural data were retrospectively collected from the department database and follow-up data were prospectively collected. RESULTS Median age was 62 years (interquartile range 47-72 years). Indications for reintervention were structural valve deterioration (SVD) in 47, non-SVD in 13 and endocarditis in 15 patients. Urgent surgery was required in 24 (32%) patients. Reinterventions were surgical AVR in 16 (21%), root replacement in 51 (68%) and transcatheter AVR in 8 (11%) patients. Early mortality was 9.3% (n = 7), but decreased to zero in the past decade in 28 patients undergoing elective reoperation. Per indication, early mortality was 9% for SVD, 8% for non-SVD and 13% for endocarditis. Aortic root replacement had the lowest early mortality rate (6%), followed by surgical AVR (13%) and transcatheter AVR (25%, 2 patients with coronary artery obstruction). Pacemaker implantation rate was 7%. Overall survival rate at 10 years was 69% (95% confidence interval 53-81%). CONCLUSIONS Repeat aortic valve interventions after stentless AVR carry an increased, but acceptable, early mortality risk. Transcatheter valve-in-valve procedures after stentless AVR require careful consideration of prosthesis leaflet position to prevent obstruction of the coronary arteries.
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Affiliation(s)
| | - Mark G Hazekamp
- Department of Cardiothoracic Surgery, LUMC, Leiden, Netherlands
| | | | - Arend de Weger
- Department of Cardiothoracic Surgery, LUMC, Leiden, Netherlands
| | | | | | | | - Jerry Braun
- Department of Cardiothoracic Surgery, LUMC, Leiden, Netherlands
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Taramasso M, Gavazzoni M, Nickenig G, Maisano F. Transcatheter mitral repair and replacement: which procedure for which patient? EUROINTERVENTION 2019; 15:867-874. [PMID: 31746753 DOI: 10.4244/eij-d-19-00743] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Given the complexity and the heterogeneity of mitral valve anatomy and pathology, different technologies and approaches (including repair and replacement methods) are potentially required to allow specific patient-tailored approaches, addressing each anatomy with the most appropriate device. Since we are still far from having an unbiased and evidence-supported process to select the best treatment for each patient, this review will provide an overview of the elements that should be taken into consideration when selecting the best procedure for each patient.
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Affiliation(s)
- Maurizio Taramasso
- Department of Cardiac Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
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Youssefi P, Zacek P, Debauchez M, Lansac E. Isolated Tricuspid Aortic Valve Repair With Double Annuloplasty: How I Teach It. Ann Thorac Surg 2019; 108:987-994. [DOI: 10.1016/j.athoracsur.2019.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/28/2019] [Indexed: 11/16/2022]
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Whitlock RP, Bhatt DL, Eikelboom JW. Reduced-Intensity Anticoagulation for Mechanical Aortic Valve Prostheses. J Am Coll Cardiol 2019; 71:2727-2730. [PMID: 29903345 DOI: 10.1016/j.jacc.2018.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 04/09/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Richard P Whitlock
- Population Health Research Institute, Hamilton, Ontario, Canada; Department of Clinical Epidemiology and Biostatistics and Division of Cardiac Surgery, McMaster University, Hamilton, Ontario, Canada.
| | - Deepak L Bhatt
- Brigham and Women's Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts. https://twitter.com/DLBHATTMD
| | - John W Eikelboom
- Population Health Research Institute, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada
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Veen KM, Etnel JRG, Quanjel TJM, Mokhles MM, Huygens SA, Rasheed M, Oei FBS, ten Cate FJ, Bogers AJJC, Takkenberg JJM. Outcomes after surgery for functional tricuspid regurgitation: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2019; 6:10-18. [DOI: 10.1093/ehjqcco/qcz032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/04/2019] [Accepted: 07/05/2019] [Indexed: 11/13/2022]
Abstract
Abstract
Aims
This study aims to provide a contemporary overview of outcomes after tricuspid valve (TV) surgery for functional tricuspid regurgitation (TR).
Methods and results
The literature was systematically searched for papers published between January 2005 and December 2017 reporting on clinical/echocardiographic outcomes after TV surgery for functional TR. A random effects meta-analysis was conducted for outcome variables, and late outcomes are visualized by pooled Kaplan–Meier curves. Subgroup analyses were performed for studies with a within-study comparison of suture vs. ring repair and flexible vs. rigid ring repair. Eighty-seven publications were included, encompassing 13 184 patients (mean age: 62.1 ± 11.8 years, 55% females). A mitral valve procedure was performed in 92% of patients. Pooled mean follow-up was 4.0 ± 2.8 years. Pooled early mortality was 3.9% (95% CI: 3.2–4.6), and late mortality rate was 2.7%/year (95% CI: 2.0–3.5), of which approximately half was cardiac-related 1.2%/year (95% CI: 0.8–1.9). Pooled risk of early moderate-to-severe TR at discharge was 9.4% (95% CI: 7.0–12.1). Late moderate-to-severe TR rate after discharge was 1.9%/year (95% CI: 1.0–3.5). Late reintervention rate was 0.3%/year (95% CI: 0.2–0.4). Mortality and overall (early and late) TR rate were comparable between suture vs. ring annuloplasty (14 studies), whereas overall TR rate was higher after flexible ring vs. rigid ring annuloplasty (6 studies) (7.5%/year vs. 3.9%/year, P = 0.002).
Conclusion
This study shows that patients undergoing surgery for functional tricuspid regurgitation (FTR) have an acceptable early and late mortality. However, TR remains prevalent after surgery. The results of this study can be used to inform patients and clinicians about the expected outcome after surgery for FTR and can results serve as a benchmark for the performance of emerging transcatheter TV interventions.
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Affiliation(s)
- Kevin M Veen
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Jonathan R G Etnel
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Thijs J M Quanjel
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Mostafa M Mokhles
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Simone A Huygens
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Moniba Rasheed
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Frans B S Oei
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Folkert J ten Cate
- Department of Cardiology, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Ad J J C Bogers
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
| | - Johanna J M Takkenberg
- Department of Cardiothoracic Surgery, Thoraxcenter, Rg-619, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, GD Rotterdam, Netherlands
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Lansac E, Youssefi P, de Heer F, Bavaria J, De Kerchove L, El-Hamamsy I, Elkhoury G, Enriquez-Sarano M, Jondeau LDG, Kluin J, Pibarot P, Schäfers HJ, Vanoverschelde JL, Takkenberg JJM. Aortic Valve Surgery in Nonelderly Patients: Insights Gained From AVIATOR. Semin Thorac Cardiovasc Surg 2019; 31:643-649. [PMID: 31229691 DOI: 10.1053/j.semtcvs.2019.05.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/02/2019] [Indexed: 11/11/2022]
Abstract
Aortic valve surgery in non-elderly patients represents a very challenging patient population. The younger the patient is at the point of aortic valve intervention, the longer their anticipated life expectancy will be, with longer exposure to valve-related complications and risk for re-operation. Although the latest international guidelines recommend aortic valve repair in patients with aortic valve insufficiency, what we see in the real world is that the vast majority of these aortic valves are replaced. However, current prosthetic valves has now been shown to lead to significant loss of life expectancy for non-elderly patients up to 50% for patients in their 40s undergoing mechanical aortic valve replacement. Bioprostheses carry an even worse long-term survival, with higher rates of re-intervention. The promise of trans-catheter valve-in-valve technology is accentuating the trend of bioprosthetic implantation in younger patients, without yet the appropriate evidence. In contrast, aortic valve repair has shown excellent outcomes in terms of quality of life, freedom from re-operation and freedom from major adverse valve-related events with similar life expectancy to general population as it is also found for the Ross procedure, the only available living valve substitute. We are at a time when the paradigm of aortic valve surgery needs to change for the better. To better serve our patients, we must acquire high quality real-world evidence from multiple centers globally - this is the vision of the AVIATOR registry and our common responsibility.
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Affiliation(s)
- Emmanuel Lansac
- Department of Cardiac Surgery, Institut Mutualiste Montsouris, Paris, France.
| | - Pouya Youssefi
- Department of Cardiac Surgery, Institut Mutualiste Montsouris, Paris, France
| | - Frederiek de Heer
- Department of Cardiothoracic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Joseph Bavaria
- Department of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Laurent De Kerchove
- Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | - Ismail El-Hamamsy
- Department of Cardiac Surgery, Montreal Heart Institute, Montréal, Canada
| | - Gebrine Elkhoury
- Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
| | | | | | - Jolanda Kluin
- Department of Cardiothoracic Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Philippe Pibarot
- Department of Cardiology, Quebec Heart and Lung Institute, Quebec City, Quebec, Canada
| | - Hans-Joachim Schäfers
- Department of Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany
| | - Jean-Louis Vanoverschelde
- Department of Cardiovascular and Thoracic Surgery, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
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Gökalp AL, de Heer F, Etnel JRG, Kluin J, Takkenberg JJM. Clinical and quality of life outcomes after aortic valve replacement and aortic root surgery in adult patients <65 years old. Ann Cardiothorac Surg 2019; 8:372-382. [PMID: 31240181 DOI: 10.21037/acs.2019.04.07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Selecting the optimal surgical treatment strategy in patients below the age of 65 years (i.e., non-elderly patients) with aortic valve or aortic root disease remains challenging. The objective of the current study is to summarize contemporary research on clinical and quality of life outcomes after aortic valve replacement (AVR) and aortic root surgery in non-elderly patients. Recent systematic reviews on clinical outcome after biological and mechanical AVR, the Ross procedure and aortic root surgery show that event occurrence is considerable after any type of AVR or aortic root surgery and-with the exception of the Ross procedure-survival is suboptimal. Although thromboembolism and bleeding events are more common after mechanical AVR and root surgery, these events are also considerably present after biological AVR, the Ross procedure and valve-sparing aortic root surgery (VSRR). Similarly, reoperation is more common after biological AVR, the Ross procedure and VSRR, but also occurs frequently after mechanical AVR and root replacement. Published evidence in AVR patients points to the direction of better health-related quality of life (HRQoL) outcomes with a biological solutions, while the HRQoL after aortic root surgery is limited and contradictory. This review illustrates that treatment for non-elderly aortic valve and aortic root disease patients needs to be tailored to the individual patient, considering both clinical and HRQoL outcomes as crucial factors to reach a treatment decision that best reflects the patient's values and goals in life.
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Affiliation(s)
- Arjen L Gökalp
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Jonathan R G Etnel
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolanda Kluin
- Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Johanna J M Takkenberg
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
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Huygens SA, van der Kley F, Bekkers JA, Bogers AJJC, Takkenberg JJM, Rutten-van Mölken MPMH. Beyond the clinical impact of aortic and pulmonary valve implantation: health-related quality of life, informal care and productivity†. Eur J Cardiothorac Surg 2019; 55:751-759. [PMID: 30496373 DOI: 10.1093/ejcts/ezy382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/05/2018] [Accepted: 09/20/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Our aim was to provide estimates of patient-reported health-related quality of life (HRQoL), use of informal care and productivity in patients after surgical aortic and pulmonary valve replacement and transcatheter aortic valve implantation. METHODS Consecutive cohorts of 1239 adult patients who had surgical aortic valve replacement or surgical pulmonary valve replacement and 433 patients who had transcatheter aortic valve implantation at 2 Dutch heart centres were cross-sectionally surveyed at a median time of 2.9 and 3.2 years after the intervention, respectively. The survey included questions on HRQoL (EQ-5D-5L and SF-12-v2), use of informal care and productivity in paid and unpaid work. All outcomes were compared with age and sex-matched individuals from the general population. RESULTS The response rate was 56% (n = 687) of patients who had surgical valve replacement and 59% (n = 257) of those who had transcatheter aortic valve implantation. Compared with the general population, patients reported poorer HRQoL on physical health domains, whereas their scores were comparable for mental health domains. After a heart valve implantation, patients reported using informal care more frequently than the general population, but labour participation was comparable. Patients with late complications [antibiotic treatment for endocarditis (n = 4), stroke (n = 11), transient ischaemic attack (n = 15)] reported lower HRQoL, greater use of informal care and greater productivity loss than patients without complications. CONCLUSIONS Patients who had aortic and pulmonary valve implantations experience relatively mild limitations in daily life compared to the general population. The consequences of a heart valve implantations beyond clinical outcomes should be considered to create realistic patient expectations of life after a heart valve implantation and unbiased resource allocation decisions at national levels.
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Affiliation(s)
- Simone A Huygens
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.,Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands.,Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Netherlands
| | - Frank van der Kley
- Department of Cardiology, Leiden University Medical Centre, Leiden, Netherlands
| | - Jos A Bekkers
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Ad J J C Bogers
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Johanna J M Takkenberg
- Department of Cardio-Thoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Maureen P M H Rutten-van Mölken
- Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands.,Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Netherlands
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Sibilio S, Koziarz A, Belley‐Côté EP, McClure GR, MacIsaac S, Reza SJ, Um KJ, Lengyel A, Mendoza P, Alsagheir A, Alraddadi H, Gupta S, Schneider AW, Patel PM, Brown JW, Chu MWA, Peterson MD, Ouzounian M, Paparella D, El‐Hamamsy I, Whitlock RP. Outcomes after Ross procedure in adult patients: A meta‐analysis and microsimulation. J Card Surg 2019; 34:285-292. [DOI: 10.1111/jocs.14020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/20/2019] [Accepted: 02/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Serena Sibilio
- Facoltá di Medicina e ChirugiaUniversity of Bari “Aldo Moro”Bari Italy
| | - Alex Koziarz
- Faculty of MedicineUniversity of TorontoToronto Ontario Canada
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Emilie P. Belley‐Côté
- Department of MedicineMcMaster UniversityHamilton Ontario Canada
- Population Health Research InstituteHamilton Ontario Canada
| | - Graham R. McClure
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
- Population Health Research InstituteHamilton Ontario Canada
| | - Sarah MacIsaac
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
- School of Medicine, Faculty of Medicine and Health SciencesRoyal College of Surgeons in IrelandDublin Ireland
| | - Seleman J. Reza
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Kevin J. Um
- Department of MedicineMcMaster UniversityHamilton Ontario Canada
| | - Alexandra Lengyel
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Pablo Mendoza
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Ali Alsagheir
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamilton Ontario Canada
| | - Hatim Alraddadi
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Saurabh Gupta
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
| | - Adriaan W. Schneider
- Department of Cardiothoracic SurgeryLeiden University Medical CenterLeiden Netherlands
| | - Parth M. Patel
- Department of Cardiothoracic SurgeryEmory UniversityAtlanta Georgia
| | - John W. Brown
- Section of Cardiothoracic SurgeryIndiana University School of MedicineIndianapolis Indiana
| | - Michael W. A. Chu
- Department of Surgery, Division of Cardiac Surgery, London Health Sciences CentreWestern UniversityLondon Ontario Canada
| | - Mark D. Peterson
- Division of Cardiac SurgerySt. Michael's Hospital, University of TorontoToronto Ontario Canada
| | - Maral Ouzounian
- Division of Cardiac Surgery, Peter Munk Cardiac CenterUniversity of TorontoToronto Ontario Canada
| | - Domenico Paparella
- Department of Emergency and Organ Transplant, Division of Cardiac Surgery and Santa Maria Hospital, GVM Care & ResearchUniversity of Bari “Aldo Moro”Bari Italy
| | - Ismail El‐Hamamsy
- Division of Cardiac SurgeryMontreal Heart Institute, Université de MontréalMontreal Quebec Canada
| | - Richard P. Whitlock
- Department of SurgeryDivision of Cardiac Surgery, McMaster UniversityHamilton Ontario Canada
- Population Health Research InstituteHamilton Ontario Canada
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Hutcheson JD, Goergen CJ, Schoen FJ, Aikawa M, Zilla P, Aikawa E, Gaudette GR. After 50 Years of Heart Transplants: What Does the Next 50 Years Hold for Cardiovascular Medicine? A Perspective From the International Society for Applied Cardiovascular Biology. Front Cardiovasc Med 2019; 6:8. [PMID: 30838213 PMCID: PMC6382669 DOI: 10.3389/fcvm.2019.00008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 01/24/2019] [Indexed: 12/24/2022] Open
Abstract
The first successful heart transplant 50 years ago by Dr.Christiaan Barnard in Cape Town, South Africa revolutionized cardiovascular medicine and research. Following this procedure, numerous other advances have reduced many contributors to cardiovascular morbidity and mortality; yet, cardiovascular disease remains the leading cause of death globally. Various unmet needs in cardiovascular medicine affect developing and underserved communities, where access to state-of-the-art advances remain out of reach. Addressing the remaining challenges in cardiovascular medicine in both developed and developing nations will require collaborative efforts from basic science researchers, engineers, industry, and clinicians. In this perspective, we discuss the advancements made in cardiovascular medicine since Dr. Barnard's groundbreaking procedure and ongoing research efforts to address these medical issues. Particular focus is given to the mission of the International Society for Applied Cardiovascular Biology (ISACB), which was founded in Cape Town during the 20th celebration of the first heart transplant in order to promote collaborative and translational research in the field of cardiovascular medicine.
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Affiliation(s)
- Joshua D Hutcheson
- Department of Biomedical Engineering, Florida International University, Miami, FL, United States
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Frederick J Schoen
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Masanori Aikawa
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Peter Zilla
- Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa
| | - Elena Aikawa
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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69
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Tissue versus mechanical aortic valve replacement in younger patients: A multicenter analysis. J Thorac Cardiovasc Surg 2019; 158:1529-1538.e2. [PMID: 30929984 DOI: 10.1016/j.jtcvs.2019.02.076] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/23/2019] [Accepted: 02/05/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The goal of this study was to examine the long-term survival of patients between the ages of 50 and 65 years who underwent tissue versus mechanical aortic valve replacement (AVR) in a multicenter cohort. METHODS A multicenter, retrospective analysis of all AVR patients (n = 9388) from 1991 to 2015 among 7 medical centers reporting to a prospectively maintained clinical registry was conducted. Inclusion criteria were: patients aged 50 to 65 years who underwent isolated AVR. Baseline comorbidities were balanced using inverse probability weighting for a study cohort of 1449 AVRs: 840 tissue and 609 mechanical. The primary end point of the analysis was all-cause mortality. Secondary end points included in-hospital morbidity, 30-day mortality, length of stay, and risk of reoperation. RESULTS During the study period, there was a significant shift from mechanical to tissue valves (P < .001). There was no significant difference in major in-hospital morbidity, mortality, or length of hospitalization. Also, there was no significant difference in adjusted 15-year survival between mechanical versus tissue valves (hazard ratio, 0.87; 95% confidence interval [CI], 0.67-1.13; P = .29), although tissue valves were associated with a higher risk of reoperation with a cumulative incidence of 19.1% (95% CI, 14.4%-24.3%) versus 3.0% (95% CI, 1.7%-4.9%) for mechanical valves. The reoperative 30-day mortality rate was 2.4% (n = 2) for the series. CONCLUSIONS Among patients 50 to 65 years old who underwent AVR, there was no difference in adjusted long-term survival according to prosthesis type, but tissue valves were associated with a higher risk of reoperation.
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Patel HJ. Look at the Valve but Listen to the Patient. Circ Cardiovasc Qual Outcomes 2019; 12:e005498. [PMID: 30760005 DOI: 10.1161/circoutcomes.119.005498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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71
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Etnel JR, Huygens SA, Grashuis P, Pekbay B, Papageorgiou G, Roos Hesselink JW, Bogers AJ, Takkenberg JJ. Bioprosthetic Aortic Valve Replacement in Nonelderly Adults. Circ Cardiovasc Qual Outcomes 2019; 12:e005481. [DOI: 10.1161/circoutcomes.118.005481] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jonathan R.G. Etnel
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Simone A. Huygens
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands (S.A.H.)
| | - Pepijn Grashuis
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Begüm. Pekbay
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Grigorios Papageorgiou
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Biostatistics (G.P.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jolien W. Roos Hesselink
- Department of Cardiology (J.W.R.H.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Ad J.J.C. Bogers
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Johanna J.M. Takkenberg
- Department of Cardiothoracic Surgery (J.R.G.E., S.A.H., P.G., B.P., G.P., A.J.J.C.B., J.J.M.T.), Erasmus University Medical Center, Rotterdam, The Netherlands
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Etnel JR, Grashuis P, Huygens SA, Pekbay B, Papageorgiou G, Helbing WA, Roos-Hesselink JW, Bogers AJ, Mokhles MM, Takkenberg JJ. The Ross Procedure: A Systematic Review, Meta-Analysis, and Microsimulation. Circ Cardiovasc Qual Outcomes 2018; 11:e004748. [DOI: 10.1161/circoutcomes.118.004748] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jonathan R.G. Etnel
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
| | - Pepijn Grashuis
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
| | - Simone A. Huygens
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
- Erasmus School of Health Policy & Management, ErasmusUniversity Rotterdam, The Netherlands (S.A.H.)
| | - Begüm Pekbay
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
| | - Grigorios Papageorgiou
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
- Department of Biostatistics, Erasmus University Medical Center, Rotterdam, The Netherlands (G.P.)
| | - Willem A. Helbing
- Division of Cardiology, Department of Pediatrics, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, The Netherlands (W.A.H.)
| | - Jolien W. Roos-Hesselink
- Department of Cardiology, Erasmus University Medical Center, Rotterdam, The Netherlands (J.W.R.-H.)
| | - Ad J.J.C. Bogers
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
| | - M. Mostafa Mokhles
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
| | - Johanna J.M. Takkenberg
- Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands (J.R.G.E., P.G., S.A.H., B.P., G.P., A.J.J.C.B., M.M.M., J.J.M.T.)
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73
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Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Aged 50 Years and Younger. Ann Thorac Surg 2018; 106:1113-1120. [DOI: 10.1016/j.athoracsur.2018.05.073] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 11/20/2022]
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74
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Lüscher TF. Anticoagulation in clinically difficult situations: insights into safe and effective management. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Thomas F Lüscher
- Consultant and Director of Research, Education & Development, Royal Brompton and Harefield Hospital Trust, London, UK
- Chairman, Center for Molecular Cardiology, University of Zurich, Switzerland
- EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, 8032 Zurich, Switzerland
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75
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Brink J, 'Udekem YD. Should We Push the Frontier? Easier Said Than Done. Heart Lung Circ 2018; 27:533-534. [PMID: 29602493 DOI: 10.1016/j.hlc.2018.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Johann Brink
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Vic, Australia
| | - Yves D 'Udekem
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Children's Research Institute, Heart Research Group, Melbourne, Vic, Australia; Department of Paediatrics, Faculty of Medicine, The University of Melbourne, Melbourne, Australia.
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Etnel JRG, Suss PH, Schnorr GM, Veloso M, Colatusso DF, Balbi Filho EM, Costa FDAD. Fresh decellularized versus standard cryopreserved pulmonary allografts for right ventricular outflow tract reconstruction during the Ross procedure: a propensity-matched study†. Eur J Cardiothorac Surg 2018; 54:434-440. [DOI: 10.1093/ejcts/ezy079] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/01/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Paula Hansen Suss
- Department of Cardiovascular Surgery, Santa Casa de Misericórdia, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Gabriela Miotto Schnorr
- Department of Cardiovascular Surgery, Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, Paraná, Brazil
| | - Myriam Veloso
- Department of Cardiovascular Surgery, Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, Paraná, Brazil
| | - Daniele Fornazari Colatusso
- Department of Cardiovascular Surgery, Santa Casa de Misericórdia, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
- Department of Cardiovascular Surgery, Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, Paraná, Brazil
| | - Eduardo Mendel Balbi Filho
- Department of Cardiovascular Surgery, Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, Paraná, Brazil
| | - Francisco Diniz Affonso da Costa
- Department of Cardiovascular Surgery, Santa Casa de Misericórdia, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
- Department of Cardiovascular Surgery, Instituto de Neurologia e Cardiologia de Curitiba, Curitiba, Paraná, Brazil
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77
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Søndergaard L, Saraste A, Christersson C, Vahanian A. The year in cardiology 2017: valvular heart disease. Eur Heart J 2018; 39:650-657. [DOI: 10.1093/eurheartj/ehx772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/15/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Lars Søndergaard
- Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Antti Saraste
- Heart Center, Turku University Hospital and University of Turku, 20520 Turku, Finland
| | - Christina Christersson
- Department of Medical Science, Cardiology, Uppsala University, Akademiska Sjukhuset, 751 85 Uppsala, Sweden
| | - Alec Vahanian
- Department of Cardiology, Bichat Hospital, University Paris VII, Paris 75018, France
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