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Holfeld J, Nägele F, Stoessel L, Graber M, Zellmer B, Hirsch J, Pölzl L, Ruttmann-Ulmer E, Bonaros N, Oezpeker CU, Semsroth S, Grimm M, Gollmann-Tepeköylü C. Different Calcification Patterns of Tricuspid and Bicuspid Aortic Valves and Their Clinical Impact. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gasser S, Zujs V, Lukas S, Kofler M, Krapf C, Semsroth S, Grimm M, Dumfarth J. Antegrade stengraft Delivery in Acute Type-A Dissection: The Good, the Bad, and the Ugly. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Barbieri F, Senoner T, Holfeld J, Semsroth S, Lambert T, Zweiker D, Theurl T, Rainer PP, Schmidt A, Feuchtner GM, Steinwender C, Hoppe U, Mueller S, Grimm M, Dichtl W. P4665High sensitivity troponin t and n-terminal pro brain natriuretic peptide plasma levels predict long-term postoperative survival in patients with severe aortic stenosis admitted for valve implantation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aims
Optimal timing of valve implantation in patients with severe aortic stenosis (AS) is under debate, considering the subjective nature of symptom onset. We aimed to investigate the pre-procedural value of routinely available cardiac biomarkers in predicting postoperative long-term outcome in a large cohort undergoing either surgical or transcatheter aortic valve implantation.
Methods
The Tyrolean Aortic Stenosis Study-2 (TASS-2) group, a consortium of four university hospital centers in Austria, analysed pre-procedural high-sensitivity troponin T (hsTnT) and N-terminal pro brain natriuretic peptide (NT-proBNP) plasma levels in 3595 patients admitted for valve implantation because of severe aortic stenosis since 2007.
Results
Transcatheter aortic valve implantation was performed in 1517 (42.2%) of patients. During a median follow-up of 2.93 (1.91–4.92) years, 919 patients (25.6%) died, among them 556 (15.5%) due to cardiovascular causes. In multivariate cox regression analysis - adjusting for STS risk score (intermediate risk 4–8%, high risk >8%), degree of left ventricular systolic dysfunction (ejection fraction 30–50% and <30%), atrial fibrillation, sex, age, renal function, COPD, arterial hypertension, diabetes mellitus, concomitant significant coronary artery disease and type of procedure (surgical aortic valve replacement or transcatheter aortic valve implantation) - pre-procedural hsTnT as well as NT-proBNP plasma levels were strong independent predictors for postoperative survival: hazard ratio [HR] 1.82, 95% confidence interval [CI] 1.07–3.11, P=0.028 for mildly to moderately elevated hsTnT (14–50 ng/l); HR 2.80, CI 1.61–4.89, P<0.001 for severely elevated hsTnT (>50 ng/l); HR 1.38, CI 1.06–1.81, P=0.018 for mildly to moderately elevated NT-proBNP (defined by an increase of up to threefold of age- and sex-corrected normal range); HR 1.68, CI 1.29–2.18, P<0.001 for severely elevated NT-proBNP (defined by an increase of more than threefold of age- and sex-corrected normal range). For direct comparison of these two biomarkers a second cox regression model was conducted including only hsTnT and NT-proBNP revealing the strength of hsTnT as a predictive biomarker: HR 2.20, 95% CI 1.29–3.77, P=0.004 for minimally elevated hsTnT (5–13.99 ng/l); HR 4.05, CI 2.41–6.82, P<0.001 for mildly to moderately elevated hsTnT (14–50 ng/l); HR 8.63, CI 5.07–14.70, P<0.001 for severely elevated hsTnT (>50 ng/l); HR 1.47, CI 1.13–1.91, P=0.004 for mildly to moderately elevated NT-proBNP; HR 1.96, CI 1.54–2.51, P<0.001 for severely elevated NT-proBNP.
Conclusion
hsTNT and NT-proBNP strongly predict long-term postoperative survival in patients with severe AS admitted for valve implantation.
Acknowledgement/Funding
This work was supported by the Tiroler Wissenschaftsförderung: grant number TWF-2017-1-5, GZ: UNI-0404-2104
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Affiliation(s)
- F Barbieri
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - T Senoner
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - J Holfeld
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - S Semsroth
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - T Lambert
- General Hospital (AKH) of Linz, Department of cardiology, Linz, Austria
| | - D Zweiker
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - T Theurl
- Paracelsus Private Medical University, University clinic of Internal Medicine II, Salzburg, Austria
| | - P P Rainer
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - A Schmidt
- Medical University of Graz, Department of cardiology, Graz, Austria
| | - G M Feuchtner
- Innsbruck Medical University, Department of radiology, Innsbruck, Austria
| | - C Steinwender
- General Hospital (AKH) of Linz, Department of cardiology, Linz, Austria
| | - U Hoppe
- Paracelsus Private Medical University, University clinic of Internal Medicine II, Salzburg, Austria
| | - S Mueller
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
| | - M Grimm
- Innsbruck Medical University, Department of cardiac surgery, Innsbruck, Austria
| | - W Dichtl
- Innsbruck Medical University, Department of cardiology and angiology, Innsbruck, Austria
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Gasser S, Stastny L, Kofler M, Semsroth S, Krapf C, Bonaros N, Schachner T, Plaikner M, Grimm M, Dumfarth J. Nighttime Surgery for Acute Aortic Dissection Type A—A 18-Year Single-Center Experience. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- S. Gasser
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - L. Stastny
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - M. Kofler
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - S. Semsroth
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - C. Krapf
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - N. Bonaros
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - T. Schachner
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - M. Plaikner
- Department for Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - M. Grimm
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
| | - J. Dumfarth
- Medical University Innsbruck, University Clinic for Cardiac Surgery, Innsbruck, Austria
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Dumfarth J, Gasser S, Stastny L, Kofler M, Krapf C, Semsroth S, Schachner T, Bonaros N, Grimm M. Preoperative Neurologic Dysfunction in Acute Type A Dissection: Predictor for Neurologic Injury and Impaired Survival. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J. Dumfarth
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - S. Gasser
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - L. Stastny
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - M. Kofler
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - C. Krapf
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - S. Semsroth
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - T. Schachner
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - N. Bonaros
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
| | - M. Grimm
- Universitätsklinik für Herzchirurgie Innsbruck, Innsbruck, Austria
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Dumfarth J, Kofler M, Stastny L, Plaikner M, Krapf C, Semsroth S, Grimm M. Stroke after Emergent Surgery for Acute Type A Aortic Dissection: Predictors, Outcome, and Neurologic Recovery. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- J. Dumfarth
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - M. Kofler
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - L. Stastny
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - M. Plaikner
- Universitätsklinik für Radiologie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - C. Krapf
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - S. Semsroth
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
| | - M. Grimm
- Universitätsklinik für Herzchirurgie, Universitätsklinik Innsbruck, Innsbruck, Austria
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Födinger A, Wöss C, Semsroth S, Stadlbauer KH, Wenzel V. [Drowning versus cardiac ischemia: Cardiac arrest of an 11-year-old boy at a swimming lake]. Anaesthesist 2015; 64:839-42. [PMID: 26423258 DOI: 10.1007/s00101-015-0088-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/18/2015] [Accepted: 08/20/2015] [Indexed: 11/27/2022]
Abstract
This report describes a case of sudden cardiac arrest and subsequent attempted cardiopulmonary resuscitation of an 11-year-old child on the shores of a swimming lake. Reports of eyewitnesses excluded the obviously suspected diagnosis of a drowning accident. The result of the autopsy was sudden cardiac death due to a congenital coronary anomaly (abnormal left coronary artery, ALCA). Favored by vigorous physical activity, this anomaly can lead to malignant arrhythmias because the ectopic coronary artery with its intramural course through the aortic wall is compressed during every systole. This pathology was not known to the boy or his family; in fact he liked sports but had suffered of a syncope once which was not followed up. Without a strong suspicion it is difficult to diagnose a coronary artery anomaly and it is often missed even in college athletes. Tragically, sudden cardiac arrest may be the first symptom of an undiagnosed abnormal coronary artery. Following syncope or chest pain during exercise with a normal electrocardiogram (ECG) cardiac imaging, such as computed tomography (CT) or angiography should be initiated in order to enable surgical repair of an abnormal coronary artery.
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Affiliation(s)
- A Födinger
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - C Wöss
- Institut für Rechtsmedizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - S Semsroth
- Univ.-Klinik für Herzchirurgie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - K H Stadlbauer
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - V Wenzel
- Univ.-Klinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
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Semsroth S, Heinz A, Dumfarth J, Mueller L, Grimm M, Ruttmann-Ulmer E. 317 * COMPARISON OF ANTEROLATERAL MINITHORACOTOMY VERSUS HEMISTERNOTOMY IN MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT: A SINGLE-CENTRE STUDY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Semsroth S, Dumfarth J, Edlinger M, Müller L, Grimm M. The influence of prosthesis-patient mismatch (PPM) on survival among impaired LV-function patients after aortic valve replacement (AVR). Thorac Cardiovasc Surg 2012. [DOI: 10.1055/s-0031-1297661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Semsroth S, Ruttmann-Ulmer E, Müller L. The incidence of prosthesis-patient mismatch in different types of aortic valve prostheses. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lemieux H, Semsroth S, Gnaiger E. S12.21 Respiratory control and mitochondrial defects in the failing human heart. Biochimica et Biophysica Acta (BBA) - Bioenergetics 2008. [DOI: 10.1016/j.bbabio.2008.05.316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Wiedemann D, Schneeberger S, Friedl P, Wick N, Zacharowski K, Petzelbauer P, Margreiter R, Laufer G, Semsroth S. 413: The Fibrin Derived Peptide B-beta15-42 Ameliorates Ischemia-Reperfusion Injury after Heart Transplantation in Rats. J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Müller L, Ruttmann-Ulmer E, Hangler H, Semsroth S, Müller S, Laufer G. Patient selection for minimally invasive mitral valve surgery. Thorac Cardiovasc Surg 2008. [DOI: 10.1055/s-2008-1037936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hallstrom S, Franz M, Gasser H, Vodrazka M, Semsroth S, Losert UM, Haisjackl M, Podesser BK, Malinski T. S-nitroso human serum albumin reduces ischaemia/reperfusion injury in the pig heart after unprotected warm ischaemia. Cardiovasc Res 2007; 77:506-14. [DOI: 10.1093/cvr/cvm052] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bernecker O, Stigler R, Semsroth S, Bonatti J, Laufer G. Enhanced virus-mediated endoluminal gene transfer to human vein grafts. Thorac Cardiovasc Surg 2005. [DOI: 10.1055/s-2005-922358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Gottardi R, Szerafin T, Semsroth S, Hallstroem S, Gasser H, Seitelberger R, Wolner E, Podesser B. S-nitroso-human serum albumin improves organ preservation in orthotopic heart transplantation in the pig. J Heart Lung Transplant 2004. [DOI: 10.1016/j.healun.2003.11.386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Podesser BK, Trescher K, Bernecker O, Fellner B, Semsroth S, Gy�ngy�si M, Strehblow C, DeMartin R, Wolner E. Reduction of nuclear factor kappa b activity post myocardial infarction improves ventricular remodeling by attenuating the inflammatory response. Thorac Cardiovasc Surg 2004. [DOI: 10.1055/s-2004-816726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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