1
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Eckel C, Blumenstein J, Grothusen C, Tiyerili V, Elsässer A, Dohmen G, Zeckzer A, Gaede L, Choi YH, Charitos EI, Hamm CW, Kim WK, Möllmann H, Renker M. Procedural Outcomes of a Self-Expanding Transcatheter Heart Valve in Patients with Porcelain Aorta. J Clin Med 2023; 12:jcm12030945. [PMID: 36769593 PMCID: PMC9917710 DOI: 10.3390/jcm12030945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/07/2023] [Accepted: 01/22/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Severe calcification of the ascending aorta increases the peri-operative risk for neurological complications in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) seems to be an optimal treatment option in these patients. However, the impact of the extent of aortic calcification on procedural and neurological outcomes during TAVI is unclear. METHODS Data from 3010 patients with severe native aortic valve stenosis treated with ACURATE neo/neo2 from May 2012 to July 2022 were evaluated and matched by 2-to-1 nearest-neighbor matching to identify one patient with porcelain aorta (PA) (n = 492) compared with two patients without PA (n = 984). PA was additionally subdivided into circumferential (classic PA) (n = 89; 3.0%) and non-circumferential (partial PA) (n = 403; 13.4%) calcification. We compared outcomes according to VARC-3 criteria among patients with and without PA and identified predictors for occurrence of stroke in the overall population. RESULTS Technical success (88.5% vs. 87.4%, p = 0.589) and device success at 30 days (82.3% vs. 81.5%, p = 0.755) after transcatheter ACURATE neo/neo2 implantation according to VARC-3 definition was high and did not differ between non-calcified aortas or PA. The rate of in-hospital complications according to VARC-3-definitions was low in both groups. Rates of all stroke (3.2% (n = 31) vs. 2.6% (n = 13), p = 0.705) or transitory ischemic attacks (1.1% vs. 1.2%, p = 1.000) did not differ significantly. Thirty-day all-cause mortality did not differ (3.0% vs. 3.2%, RR 1.1; p = 0.775). Overall device migration/embolization (OR 5.0 [2.10;11.87]), severe bleeding (OR 1.79 [1.11;2.89]), and major structural cardiac complications (OR 3.37 [1.32;8.57]) were identified as independent predictors for in-hospital stroke in a multivariate analysis after implantation of ACURATE neo/neo2. CONCLUSION A porcelain aorta does not increase the risk of neurological complications after transfemoral ACURATE neo/neo2 implantation. Based on these findings, transfemoral ACURATE neo/neo2 implantation is safe in these particularly vulnerable patients.
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Affiliation(s)
- Clemens Eckel
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany
| | - Johannes Blumenstein
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany
- Correspondence: ; Tel.: +49-(0)231-1843-35100
| | - Christina Grothusen
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Department of Cardiovascular Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, 24118 Kiel, Germany
| | - Vedat Tiyerili
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
- Department of Cardiology, University of Bonn, 53113 Bonn, Germany
| | - Albrecht Elsässer
- Department of Cardiology, University of Oldenburg, 26129 Oldenburg, Germany
| | - Guido Dohmen
- Department of Cardiac Surgery, St. Johannes Hospital, 44137 Dortmund, Germany
| | - Anna Zeckzer
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
| | - Luise Gaede
- Department of Cardiology, University Hospital of Erlangen, 91054 Erlangen, Germany
| | - Yeong-Hoon Choi
- Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
| | | | - Christian W. Hamm
- Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
- Department of Cardiology, Justus-Liebig University of Giessen, 35390 Giessen, Germany
| | - Won-Keun Kim
- Department of Cardiac Surgery, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
- Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
| | - Helge Möllmann
- Department of Cardiology, St. Johannes Hospital, 44137 Dortmund, Germany
| | - Matthias Renker
- Department of Cardiology, Kerckhoff Heart Center, 61231 Bad Nauheim, Germany
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2
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Pascual I, Almendárez M, Avanzas P, Álvarez R, Arboine LA, del Valle R, Hernández-Vaquero D, Alfonso F, Morís C. La técnica de superposición de cúspides en TAVI con dispositivo autoexpandible optimiza la profundidad del implante y reduce la necesidad de marcapasos permanente. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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3
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Pascual I, Almendárez M, Avanzas P, Álvarez R, Arboine LA, Del Valle R, Hernández-Vaquero D, Alfonso F, Morís C. Cusp-overlapping TAVI technique with a self-expanding device optimizes implantation depth and reduces permanent pacemaker requirement. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:412-420. [PMID: 34226165 DOI: 10.1016/j.rec.2021.05.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/20/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES This study aimed to determine the safety and efficacy of modifying the classic implantation technique for aortic transcatheter heart valve (THV) implantation to a cusp-overlap-projection (COP) technique to achieve a higher implantation depth and to reduce the burden of new permanent pacemaker implantation (PPMI) at 30 days. Aortic self-expanding THV carries an elevated risk for PPMI. A higher implantation depth minimizes the damage in the conduction system and may reduce PPMI rates. METHODS From March 2017, 226 patients were consecutively included: 113 patients were treated using the COP implantation technique compared with the previous 113 consecutive patients treated using the classic technique. In all patients, implantation depth was assessed by 3 methods (noncoronary cusp to the THV, mean of the noncoronary cusp and the left coronary cusp to the THV, and the deepest edge from the left coronary cusp and the noncoronary cusp to the THV). RESULTS The COP group had a lower implantation depth than the group treated with the classic technique (4.8 mm± 2.2 vs 5.7 mm± 3.1; P=.011; 5.8 mm± 3.1 vs 6.5 mm± 2.4; P=.095; 7.1 mm± 2.8 vs 7.4 mm±3.2; P=.392). Forty patients (17.7%) required a new PPMI after the 30-day follow-up but this requirement was significantly lower in the COP group (12.4% vs 23%, P=.036). The COP implantation technique consistently protected against the main event (OR, 0.45; 95%CI, 0.21-0.97; P=.043), with similar procedural success rates and complications. CONCLUSIONS The COP implantation technique is a simple modification of the implantation protocol and provides a higher implantation depth of self-expanding-THV with lower conduction disturbances and PPMI rates.
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Affiliation(s)
- Isaac Pascual
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación del Principado de Asturias, Oviedo, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Marcel Almendárez
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación del Principado de Asturias, Oviedo, Spain
| | - Pablo Avanzas
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación del Principado de Asturias, Oviedo, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain.
| | - Rut Álvarez
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Luis A Arboine
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Raquel Del Valle
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Daniel Hernández-Vaquero
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación del Principado de Asturias, Oviedo, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
| | - Fernando Alfonso
- Departamento de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain; Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain
| | - César Morís
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain; Instituto de Investigación del Principado de Asturias, Oviedo, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
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4
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Drakopoulou M, Soulaidopoulos S, Oikonomou G, Stathogiannis K, Latsios G, Synetos A, Tousoulis D, Toutouzas K. Novel Perspective for Antithrombotic Therapy in TAVI. Curr Pharm Des 2020; 26:2789-2803. [DOI: 10.2174/1381612826666200413083746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 03/16/2020] [Indexed: 12/29/2022]
Abstract
:
While surgical aortic valve replacement (SAVR) was for years the only available treatment for symptomatic
aortic stenosis, the introduction of transcatheter aortic valve implantation (TAVI) in 2002 and the improvement
of its technical aspects in the following years, has holistically changed the synchronous therapeutic
approach of aortic valve stenosis. Recent evidence has expanded the indication of TAVI from high to lower surgical
risk populations with symptomatic aortic stenosis. The administration of antithrombotic therapy periprocedurally
and its maintenance after a successful TAVI is crucial for the prevention of complications and affects
postprocedural survival. Randomized controlled trials investigating the appropriate combination and the
duration of antithrombotic treatment after TAVI are for the moment scarce. This review article sheds light on the
underlying pathogenetic mechanisms contributing in periprocedural TAVI thrombotic complications and discuss
the efficacy of current antithrombotic policies as evaluated in randomized trials.
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Affiliation(s)
- Maria Drakopoulou
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - George Oikonomou
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Konstantinos Stathogiannis
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - George Latsios
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Andreas Synetos
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Dimitrios Tousoulis
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
| | - Konstantinos Toutouzas
- First Department of Cardiology, Hippokration Hospital, Medical School of Athens University, Athens, Greece
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5
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Kumar V, Rastogi V, Seth A. Transcatheter aortic valve replacement will be standard of treatment for severe aortic stenosis with porcelain aorta. Indian Heart J 2018; 70:943-947. [PMID: 30580872 PMCID: PMC6306360 DOI: 10.1016/j.ihj.2018.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/27/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Vijay Kumar
- Fortis Escorts Heart Institute, New Delhi, India.
| | | | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi, India
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6
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Nakasu A, Greason KL, Nkomo VT, Eleid MF, Pochettino A, King KS, Sandhu GS, Williamson EE, Holmes DR. Transcatheter aortic valve insertion in patients with hostile ascending aorta calcification. J Thorac Cardiovasc Surg 2018; 156:1028-1034. [DOI: 10.1016/j.jtcvs.2018.03.125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 03/15/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
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7
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Osaka S, Tanaka M. Strategy for Porcelain Ascending Aorta in Cardiac Surgery. Ann Thorac Cardiovasc Surg 2018; 24:57-64. [PMID: 29491196 DOI: 10.5761/atcs.ra.17-00181] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Shunji Osaka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
| | - Masashi Tanaka
- Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan
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8
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González-Ferreiro R, Muñoz-García AJ, López-Otero D, Avanzas P, Pascual I, Alonso-Briales JH, Trillo-Nouche R, Pun F, Jiménez-Navarro MF, Hernández-García JM, Morís C, González Juanatey JR. Prognostic value of body mass index in transcatheter aortic valve implantation: A “J”-shaped curve. Int J Cardiol 2017; 232:342-347. [DOI: 10.1016/j.ijcard.2016.12.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 11/10/2016] [Accepted: 12/16/2016] [Indexed: 12/11/2022]
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9
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Castrodeza J, Amat-Santos IJ, Serra V, Nombela-Franco L, Brinster DR, Gutiérrez-Ibanes E, Rojas P, Tornos P, Carnero M, Cortes C, Tobar J, Di Stefano S, Gomez I, San Román JA. Therapeutic alternatives after aborted sternotomy at the time of surgical aortic valve replacement in the TAVI Era-Five centre experience and systematic review. Int J Cardiol 2016; 223:1019-1024. [PMID: 27592044 DOI: 10.1016/j.ijcard.2016.08.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era. METHODS Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed. RESULTS A total of 31 patients (71% males, 74±8years, LogEuroSCORE 11.9±7.4%) suffered an AbS (0.19% of all sternotomies). Main reasons for Abs included previously unknown porcelain aorta (PAo) in 83.9%, mediastinal fibrosis due to radiotherapy in 12.9%, and chronic mediastinitis in 3.2%. Median time between AbS and next intervention was 2.3months (IQR: 0.7-5.8) with no mortality within this period. Only a case was managed with open surgery. In 30 patients (96.8%) TAVI was performed with a rate of success of 86.7%. Three patients (9.7%) presented in-hospital death and 17 (54.8%) had in-hospital complications including heart failure (9.6%), major bleeding (6.9%), and acute kidney injury (9.6%). Older patients (76±8 vs. 70±8years, p=0.045), previous cardiac surgery (60% vs. 15.4%, p=0.029), and shorter time from AbS to next intervention (5.1±5 vs. 1±0.7months, p=0.001) were related to higher six-month mortality (22.6%). CONCLUSIONS The main reason for AbS was PAo. This entity was associated to a higher rate of complications and mortality, especially in older patients and with prior cardiac surgery. A preventive strategy in these subgroups might be based on imaging evaluation. TAVI was the most extended therapy.
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Affiliation(s)
- Javier Castrodeza
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Ignacio J Amat-Santos
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain.
| | - Vicenç Serra
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Luis Nombela-Franco
- Cardiology Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | | | | | - Paol Rojas
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Pilar Tornos
- Cardiology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - Manuel Carnero
- Cardiac Surgery Department, Hospital Clínico Universitario San Carlos, Madrid, Spain
| | - Carlos Cortes
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Javier Tobar
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Salvatore Di Stefano
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Itziar Gomez
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - José A San Román
- Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
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10
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Sahiner L, Asil S, Kaya EB, Ozer N, Aytemir K. Percutaneous Implantation of the self-expanding valve Prosthesis a patient with homozygous familial hypercholesterolemia severe aortic stenosis and porcelain aorta. Int J Cardiol 2016; 220:661-4. [PMID: 27393846 DOI: 10.1016/j.ijcard.2016.06.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/28/2016] [Indexed: 11/30/2022]
Abstract
Transcatheter aortic valve implantation (TAVI) has shown favorable outcomes in patients with severe symptomatic aortic valve stenosis who are at high surgical risk or inappropriate for open heart surgery. However, concerns exist over treating patients who have porcelain aorta and familial hypercholesterolemia, due to the potential complications of aortic root and aortic annulus. In this case report, we present a patient with familial hypercholesterolemia, symptomatic severe aortic stenosis, previous coronary artery bypass grafting and porcelain aorta, who was successfully treated with TAVI using a CoreValve.
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Affiliation(s)
- Levent Sahiner
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Serkan Asil
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
| | - Ergün Baris Kaya
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Necla Ozer
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
| | - Kudret Aytemir
- Hacettepe University Faculty of Medicine, Department of Cardiology, Ankara, Turkey
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11
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Lindsay AC, Harron K, Jabbour RJ, Kanyal R, Snow TM, Sawhney P, Alpendurada F, Roughton M, Pennell DJ, Duncan A, Di Mario C, Davies SW, Mohiaddin RH, Moat NE. Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Patients Undergoing Transcatheter Aortic Valve Implantation. Circ Cardiovasc Interv 2016; 9:CIRCINTERVENTIONS.115.003486. [DOI: 10.1161/circinterventions.115.003486] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 06/09/2016] [Indexed: 01/19/2023]
Abstract
Background—
Cardiovascular magnetic resonance (CMR) can provide important structural information in patients undergoing transcatheter aortic valve implantation. Although CMR is considered the standard of reference for measuring ventricular volumes and mass, the relationship between CMR findings of right ventricular (RV) function and outcomes after transcatheter aortic valve implantation has not previously been reported.
Methods and Results—
A total of 190 patients underwent 1.5 Tesla CMR before transcatheter aortic valve implantation. Steady-state free precession sequences were used for aortic valve planimetry and to assess ventricular volumes and mass. Semiautomated image analysis was performed by 2 specialist reviewers blinded to patient treatment. Patient follow-up was obtained from the Office of National Statistics mortality database. The median age was 81.0 (interquartile range, 74.9–85.5) years; 50.0% were women. Impaired RV function (RV ejection fraction ≤50%) was present in 45 (23.7%) patients. Patients with RV dysfunction had poorer left ventricular ejection fractions (42% versus 69%), higher indexed left ventricular end-systolic volumes (96 versus 40 mL), and greater indexed left ventricular mass (101 versus 85 g/m
2
;
P
<0.01 for all) than those with normal RV function. Median follow-up was 850 days; 21 of 45 (46.7%) patients with RV dysfunction died, compared with 43 of 145 (29.7%) patients with normal RV function (
P
=0.035). After adjustment for significant baseline variables, both RV ejection fraction ≤50% (hazard ratio, 2.12;
P
=0.017) and indexed aortic valve area (hazard ratio, 4.16;
P
=0.025) were independently associated with survival.
Conclusions—
RV function, measured on preprocedural CMR, is an independent predictor of mortality after transcatheter aortic valve implantation. CMR assessment of RV function may be important in the risk stratification of patients undergoing transcatheter aortic valve implantation.
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Affiliation(s)
- Alistair C. Lindsay
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Katie Harron
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Richard J. Jabbour
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Ritesh Kanyal
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Thomas M. Snow
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Paramvir Sawhney
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Francisco Alpendurada
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Michael Roughton
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Dudley J. Pennell
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Alison Duncan
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Carlo Di Mario
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Simon W. Davies
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Raad H. Mohiaddin
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
| | - Neil E. Moat
- From the Department of Cardiology (A.C.L., R.J.J., R.K., T.M.S., P.S., M.R., A.D., C.D.M., S.W.D.), Department of Cardiovascular Magnetic Resonance (F.A., D.J.P., R.H.M.), and Department of Surgery (N.E.M.), Royal Brompton and Harefield NHS Trust, London, United Kingdom; Department of Statistics, London School of Hygiene and Tropical Medicine, University College London, United Kingdom (K.H.); and Department of Cardiovascular Medicine, Imperial College, London, United Kingdom (D.J.P., R.H.M.)
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12
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. REVISTA ESPAÑOLA DE CARDIOLOGÍA. Estado actual y perspectiva futura. Rev Esp Cardiol 2016. [DOI: 10.1016/j.recesp.2016.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Ferreira-González I, Abu-Assi E, Arias MA, Gallego P, Sánchez-Recalde Á, Avanzas P, Bayes-Genis A, de Isla LP, Sanchis J. Revista Española de Cardiología: Current Position and Future Directions. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:327-336. [PMID: 26927537 DOI: 10.1016/j.rec.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 01/22/2016] [Indexed: 06/05/2023]
Affiliation(s)
| | | | | | | | | | - Pablo Avanzas
- Former Associate Editor, Revista Española de Cardiología
| | | | | | - Juan Sanchis
- Former Editor-in-Chief, Revista Española de Cardiología
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14
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Vymazal T. Minimally invasive approach to calcified aortic valve replacement: Anaesthetic considerations. Indian J Anaesth 2015. [PMID: 26195828 PMCID: PMC4481751 DOI: 10.4103/0019-5049.158731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
For symptomatic patients with severe calcified aortic valve stenosis, open heart surgery for aortic valve replacement remains the gold standard. However, elderly patients with an increased risk profile can be treated by using transcatheter approaches (transcatheter aortic valve implantation [TAVI]). The major considerations related to use of general and local anaesthesia for TAVI are discussed in this review.
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Affiliation(s)
- Tomas Vymazal
- Department of Anesthesiology and Intensive Care Medicine, 2 School of Medicine, Charles University, V Úvalu 84, 15000 Prague 5, Czech Republic
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15
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Affiliation(s)
- Yigal Abramowitz
- From Cedars-Sinai Heart Institute, Los Angeles, California (Y.A., H.J., T.C., R.R.M.); and Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Health Care System, Plano, TX (M.J.M.)
| | - Hasan Jilaihawi
- From Cedars-Sinai Heart Institute, Los Angeles, California (Y.A., H.J., T.C., R.R.M.); and Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Health Care System, Plano, TX (M.J.M.)
| | - Tarun Chakravarty
- From Cedars-Sinai Heart Institute, Los Angeles, California (Y.A., H.J., T.C., R.R.M.); and Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Health Care System, Plano, TX (M.J.M.)
| | - Michael J Mack
- From Cedars-Sinai Heart Institute, Los Angeles, California (Y.A., H.J., T.C., R.R.M.); and Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Health Care System, Plano, TX (M.J.M.)
| | - Raj R Makkar
- From Cedars-Sinai Heart Institute, Los Angeles, California (Y.A., H.J., T.C., R.R.M.); and Department of Cardiovascular Surgery, Heart Hospital Baylor Plano, Baylor Health Care System, Plano, TX (M.J.M.).
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16
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Barón-Esquivias G, Manito N, López Díaz J, Martín Santana A, García Pinilla JM, Gómez Doblas JJ, Gómez Bueno M, Barrios Alonso V, Lambert JL. Actualización 2014 en cardiología clínica, cardiología geriátrica e insuficiencia cardiaca y trasplante. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.12.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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17
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Pascual I, Muñoz-García AJ, López-Otero D, Avanzas P, Alonso-Briales JH, Morís C. Evolución a largo plazo de pacientes cirróticos con estenosis aórtica grave tratados con implante valvular aórtico transcatéter. Rev Esp Cardiol 2015. [DOI: 10.1016/j.recesp.2014.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Barón-Esquivias G, Manito N, López Díaz J, Martín Santana A, García Pinilla JM, Gómez Doblas JJ, Gómez Bueno M, Barrios Alonso V, Lambert JL. Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation. ACTA ACUST UNITED AC 2015; 68:317-23. [PMID: 25758161 DOI: 10.1016/j.rec.2014.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/11/2014] [Indexed: 11/19/2022]
Abstract
In the present article, we review publications from the previous year in the following 3 areas: clinical cardiology, geriatric cardiology, and heart failure and transplantation. Among the new developments in clinical cardiology are several contributions from Spanish groups on tricuspid and aortic regurgitation, developments in atrial fibrillation, syncope, and the clinical characteristics of heart disease, as well as various studies on familial heart disease and chronic ischemic heart disease. In geriatric cardiology, the most relevant studies published in 2014 involve heart failure, degenerative aortic stenosis, and data on atrial fibrillation in the geriatric population. In heart failure and transplantation, the most noteworthy developments concern the importance of multidisciplinary units and patients with preserved systolic function. Other notable publications were those related to iron deficiency, new drugs, and new devices and biomarkers. Finally, we review studies on acute heart failure and transplantation, such as inotropic drugs and ventricular assist devices.
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Affiliation(s)
- Gonzalo Barón-Esquivias
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
| | - Nicolás Manito
- Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Javier López Díaz
- Servicio de Insuficiencia Cardiaca y Trasplante Cardiaco, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain
| | - Antonio Martín Santana
- Servicio de Cardiología, Hospital de Jerez de la Frontera, Jerez de la Frontera, Cádiz, Spain
| | | | - Juan José Gómez Doblas
- Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Victoria, Málaga, Spain
| | - Manuel Gómez Bueno
- Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - José Luis Lambert
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo Asturias, Spain
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Pascual I, Muñoz-García AJ, López-Otero D, Avanzas P, Alonso-Briales JH, Morís C. Long-term outcome of cirrhotic patients with severe aortic stenosis treated with transcatheter aortic valve implantation. ACTA ACUST UNITED AC 2015; 68:353-4. [PMID: 25707902 DOI: 10.1016/j.rec.2014.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 11/28/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Isaac Pascual
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Diego López-Otero
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Pablo Avanzas
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Juan H Alonso-Briales
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - César Morís
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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20
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LeMaire SA. Individualized treatment strategies for patients with aortic valve disease and porcelain aorta. J Thorac Cardiovasc Surg 2014; 149:134-6. [PMID: 25454923 DOI: 10.1016/j.jtcvs.2014.10.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Scott A LeMaire
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Cardiovascular Research Institute, Baylor College of Medicine, and Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Tex.
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21
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Matsumoto K, Hisashi Y, Imoto Y. Replacement of the heavily calcified ascending aorta in aortic valve replacement. Asian Cardiovasc Thorac Ann 2014; 23:349-52. [PMID: 24928643 DOI: 10.1177/0218492314539949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A totally calcified ascending aorta prevents aortic crossclamping and aortotomy during aortic valve replacement, and replacement of the ascending aorta is a valid option in these cases. We describe a simple technique for calcified ascending aorta replacement using the Cavitron Ultrasonic Surgical Aspirator. This can be used in aortic endarterectomy for removal of the calcified plaque in the anastomotic part.
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Affiliation(s)
- Kazuhisa Matsumoto
- Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yosuke Hisashi
- Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yutaka Imoto
- Department of Cardiovascular and Gastroenterological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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23
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Pascual I, López-Otero D, Muñoz-García AJ, Alonso-Briales JH, Avanzas P, Morís C. Safety and efficacy of transcatheter aortic valve implantation in nonagenarian patients. ACTA ACUST UNITED AC 2014; 67:583-4. [PMID: 24952404 DOI: 10.1016/j.rec.2014.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 02/24/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Isaac Pascual
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Diego López-Otero
- Servicio de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | | | - Juan H Alonso-Briales
- Servicio de Cardiología, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Pablo Avanzas
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - César Morís
- Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
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24
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Porcelain aorta and severe aortic stenosis: is transcatheter aortic valve implantation the new standard? ACTA ACUST UNITED AC 2014; 66:765-7. [PMID: 24773854 DOI: 10.1016/j.rec.2013.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 05/13/2013] [Indexed: 11/23/2022]
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25
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Hernández Hernández F, Rumoroso Cuevas JR, García Del Blanco B, Trillo Nouche R. Update on interventional cardiology 2013. ACTA ACUST UNITED AC 2014; 67:305-11. [PMID: 24774593 DOI: 10.1016/j.rec.2013.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 10/23/2013] [Indexed: 10/25/2022]
Abstract
The present article reviews the most important publications and studies in the field of interventional cardiology in 2013. Coronary interventions for ST-segment elevation myocardial infarction are among the most important, with studies that assess different devices and pharmacologic and mechanical strategies in primary angioplasty. Increasingly large groups of patients (with diabetes, of advanced age) and the best coronary revascularization strategy are also the focus of exhaustive research. Percutaneous procedures in the left main coronary artery continue to give rise to a significant number of publications, both because of the results of using different types of stent and because of the intravascular imaging techniques used to guide procedures and the results of their use. New bioabsorbable polymer-coated drug-eluting stents or bioresorbable drug-eluting scaffolds are being compared with second-generation drug-eluting stents to show their efficacy in preventing restenosis and reducing incidence of late thrombosis. Percutaneous treatment of structural heart disease continues to produce many publications, especially regarding percutaneous aortic prostheses, but also on closure of foramen ovale and of left atrial appendage. Finally, renal denervation continues to arouse much interest in the medical literature.
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Affiliation(s)
| | | | | | - Ramiro Trillo Nouche
- Departamento de Cardiología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
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Van Mieghem NM, Van Der Boon RM. Aorta de porcelana y estenosis aórtica grave: ¿la implantación percutánea de válvula aórtica es el nuevo tratamiento estándar? Rev Esp Cardiol 2013. [DOI: 10.1016/j.recesp.2013.05.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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