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Stroke pacemaker

Suzanne V Arnold, Yiran Zhang, Suzanne J Baron, Thomas C McAndrew, Maria C Alu, Susheel K Kodali, Samir Kapadia, Vinod H Thourani, D Craig Miller, Michael J Mack, Martin B Leon, David J Cohen
OBJECTIVES: The aim of this study was to examine the independent association of short-term complications of transcatheter aortic valve replacement (TAVR) with survival and quality of life at 1 year. BACKGROUND: Prior studies have examined the mortality and cost implications of various complications of TAVR. However, many of these complications may primarily affect patients' quality of life after TAVR, which has not been previously studied. METHODS: Among patients at intermediate or high surgical risk who underwent TAVR as part of the PARTNER (Placement of Aortic Transcatheter Valve) 2 studies and survived 30 days, the association between complications within the 30 days after TAVR and mortality and quality of life at 1 year was examined...
February 25, 2019: JACC. Cardiovascular Interventions
Agnethe May Ahnfeldt, Victoria Elizabeth de Knegt, Jesper Irving Reimers, Malene Landbo Børresen
Atrial standstill is a rare arrhythmia defined by the absence of mechanical and electrical activity in the atria. Few cases of atrial standstill have been described in children, none of which have presented with cerebral infarction confirmed by imaging. We report a unique case of a 7-year-old girl presenting with expressive aphasia, central facial palsy and irregular pulse with cerebral infarction secondary to atrial standstill. This case illustrates that cardiogenic cerebral embolism in children can be caused by rare conditions like atrial standstill and should be considered in paediatric patients undergoing evaluation for stroke...
2019: SAGE Open Medical Case Reports
Ting-Yu Wang, Ely Gracia, Susan Callahan, Thomas Bilfinger, Henry Tannous, Robert Pyo, Smadar Kort, Hal Skopicki, Jonathan Weinstein, Neal Patel, Daniel Montellese, Giridhar Korlipara, Shamim Khan, Joanna Chikwe, Puja B Parikh
The impact of gender on management and early outcomes after transcatheter aortic valve implantation (TAVI) in the setting of newer generation transcatheter heart valves (THVs) is not well known. We evaluated gender-specific differences on clinical management and in-hospital outcomes in adults who underwent TAVI with newer generation THVs. The study population included 298 consecutive patients who underwent TAVI and received a newer generation THV (Sapien 3 [Edwards Lifesciences, Irvine, California] or Corevalve Evolut R or Evolut Pro [Medtronic, Minneapolis, Minnesota]) from December 2015 to June 2018 at an academic tertiary medical center...
February 10, 2019: American Journal of Cardiology
Marco Barbanti, Martijn S van Mourik, Mark S Spence, Fortunato Icovelli, Gian Luca Martinelli, Douglas F Muir, Francesco Saia, Alessandro Santo Bortone, Cameron G Densem, Frank van der Kley, Peter Bramlage, Marije Vis, Corrado Tamburino
AIMS: Treatment pathway optimization in TAVI should include timely patient discharge with a minimized risk for out-of-hospital adverse events. METHODS AND RESULTS: We defined and validated the adequacy of a set of discharge criteria and their ability to properly predict timely and safe discharge after the intervention in a prospective, European, multicentre registry. 502 unselected patients were enrolled at 10 sites in 3 countries. The primary endpoint defined as a composite of all-cause mortality, vascular-access-related complications, permanent pacemaker implantation, stroke, re-hospitalisation due to cardiac reasons, kidney failure and major bleeding at 30 days was reached in 12...
February 19, 2019: EuroIntervention
Daniel J Blackman, Lennart Van Gils, Sabine Bleiziffer, Ulrich Gerckens, Anna Sonia Petronio, Mohamed Abdel-Wahab, Nikos Werner, Saib S Khogali, Peter Wenaweser, Jochen Wöhrle, Osama Soliman, Jean-Claude Laborde, Dominic J Allocco, Ian T Meredith, Volkmar Falk, Nicolas M Van Mieghem
AIMS: Patients with bicuspid valves represent a challenging anatomical subgroup for transcatheter aortic valve implantation (TAVI). This analysis evaluated the clinical outcomes of the fully repositionable and retrievable Lotus Valve System in patients with bicuspid aortic valves enrolled in the RESPOND post-market registry. METHODS AND RESULTS: The prospective, open-label RESPOND study enrolled 1,014 patients at 41 centers in Europe, New Zealand, and Latin America, 31 (3...
February 17, 2019: Catheterization and Cardiovascular Interventions
Pavel Overtchouk, Thierry Folliguet, Frédéric Pinaud, Oliver Fouquet, Mathieu Pernot, Guillaume Bonnet, Maxime Hubert, Joël Lapeze, Jean Philippe Claudel, Said Ghostine, Alexandre Azmoun, Christophe Caussin, Konstantinos Zannis, Majid Harmouche, Jean-Philippe Verhoye, Antoine Lafont, Chekrallah Chamandi, Vito Giovanni Ruggieri, Alessandro Di Cesare, Florence Leclercq, Thomas Gandet, Thomas Modine
OBJECTIVES: This study sought to describe the procedural and clinical outcomes of patients undergoing transcarotid (TC) transcatheter aortic valve replacement (TAVR) with the Edwards Sapien 3 device. BACKGROUND: The TC approach for TAVR holds the potential to become the optimal alternative to the transfemoral gold standard. Limited data exist regarding safety and efficacy of TC-TAVR using the Edwards Sapien 3 device. METHODS: The French Transcarotid TAVR prospective multicenter registry included patients between 2014 and 2018...
February 7, 2019: JACC. Cardiovascular Interventions
Monica L Chen, Neal S Parikh, Alexander E Merkler, Dawn O Kleindorfer, Prashant D Bhave, Emily B Levitan, Elsayed Z Soliman, Hooman Kamel
Background Black individuals in the United States experience higher rates of ischemic stroke than other racial groups but have lower rates of clinically apparent atrial fibrillation ( AF ). It is unclear whether blacks truly have less AF or simply more undiagnosed AF . Methods and Results We performed a retrospective cohort study using inpatient and outpatient claims from 2009 to 2015 for a 5% nationally representative sample of Medicare beneficiaries. We included patients aged ≥66 years with at least 1 documented Current Procedural Terminology code for interrogation of an implantable pacemaker, cardioverter-defibrillator, or loop recorder and no documented history of AF , atrial flutter, or stroke before their first device interrogation...
February 19, 2019: Journal of the American Heart Association
Bernhard Wernly, Sarah Eder, Eliano P Navarese, Daniel Kretzschmar, Marcus Franz, Brunilda Alushi, Frederik Beckhoff, Christian Jung, Michael Lichtenauer, Christian Datz, Paul Christian Schulze, Ulf Landmesser, Uta C Hoppe, Volkmar Falk, Alexander Lauten
INTRODUCTION: Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for aortic stenosis in patients with high surgical risk. Pure aortic regurgitation (PAR) is considered a relative contraindication for TAVR; however, TAVR is increasingly performed in PAR patients with unfavorable risk profile. Herein, we aim to summarize available data on TAVR for PAR with special emphasis on "on-label" versus "off-label" TAVR devices. METHODS AND RESULTS: Pubmed was searched for studies of patients undergoing TAVR for PAR...
February 8, 2019: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Hans Gustav Hørsted Thyregod, Nikolaj Ihlemann, Troels Højsgaard Jørgensen, Henrik Nissen, Bo Juel Kjeldsen, Petur Petursson, Yanping Chang, Olaf Walter Franzen, Thomas Engstrøm, Peter Clemmensen, Peter Bo Hansen, Lars Willy Andersen, Daniel Andreas Steinbrüchel, Peter Skov Olsen, Lars Søndergaard
BACKGROUND: The Nordic Aortic Valve Intervention (NOTION) was designed to compare transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients 70 years or older with isolated severe aortic valve stenosis. Clinical and echocardiographic outcomes are presented after 5 years. METHODS: Patients were enrolled at three Nordic centers and randomized 1:1 to TAVR using the self-expanding CoreValve prosthesis (n=145) or SAVR using any stented bio-prostheses (n=135)...
February 1, 2019: Circulation
Q Xu, X Liu, J Jiang, Y He, Q Zhu, F Gao, F Du, W He, J Cheng, M Kong, Z Pu, Q Zhou, R Gooley, J Wang
BACKGROUND: In the West, the safety and efficacy of the Lotus valve have been demonstrated; however, data in the Chinese population are still lacking. Few studies have compared the clinical outcomes of transcatheter aortic valve replacement (TAVR) with the Lotus valve in patients with bicuspid or tricuspid aortic valve stenosis. Our aim was to assess TAVR outcomes with the Lotus aortic valve in a Chinese patient cohort. METHODS: In total, 23 symptomatic, high-surgical risk patients with severe aortic valve stenosis were enrolled...
January 29, 2019: Herz
Bjørn Erik Neerland, Torgeir Bruun Wyller, Vegard Bruun Bratholm Wyller
BACKGROUND: Alterations in autonomic nervous system (ANS) activity might be involved in the pathophysiology of delirium. The aim was to explore autonomic cardiovascular control in older patients with and without delirium. METHODS: Fourteen patients (five with delirium) acutely admitted to the geriatric ward with an infection were enrolled in the study. Patients with atrial fibrillation, a pacemaker, or on treatment with beta-blockers, calcium channel blockers or acetylcholinesterase inhibitors were not eligible...
January 25, 2019: BMC Geriatrics
Arturo Giordano, Nicola Corcione, Paolo Ferraro, Pietro Pieri, Raffaella Avellino, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Giuseppe Biondi-Zoccai
AIMS: Transcatheter aortic valve implantation has become an established treatment for severe aortic stenosis, thanks to key improvements achieved by new-generation devices. Their comparative effectiveness and safety are, however, still uncertain. METHODS: We queried a prospective registry on transcatheter aortic valve implantation to compare Evolut and Portico devices, focusing on procedural, in-hospital, and mid-term outcomes. Unadjusted and propensity-adjusted analyses were carried out...
January 22, 2019: Journal of Cardiovascular Medicine
Siyuan P Sheng, Paula D Strassle, Sameer Arora, Dhaval Kolte, Cassandra J Ramm, Kranthi Sitammagari, Avirup Guha, Madhu B Paladugu, Matthew A Cavender, John P Vavalle
Background Octogenarians have low physiologic reserve and may benefit more from transcatheter aortic valve replacement ( TAVR ) than surgical aortic valve replacement ( SAVR ). Methods and Results This retrospective cohort study based on the National Inpatient Sample included octogenarians who underwent TAVR or SAVR from 2012 to 2015. Crude and standardized-morbidity-ratio-weighted regression models were used to compare in-hospital outcomes. Among 19 145 TAVR and 9815 SAVR hospitalizations, TAVR patients had higher Charlson Comorbidity Index ( CCI ) scores (2...
January 22, 2019: Journal of the American Heart Association
A Justin Rucker, Kevin L Anderson, Michael S Mulvihill, Babatunde A Yerokun, Andrew S Barbas, Matthew G Hartwig
Background: Simultaneous heart-liver (SHL) transplantation is an efficacious therapeutic modality for patients with combined heart and liver failure. However, the extent to which heart transplantation followed by sequential liver transplantation (LAH) can match the benefit of simultaneous transplantation has not previously been examined. Our objective was to determine if LAH offers comparable survival to SHL. Methods: The Organ Procurement and Transplantation Network/United Network for Organ Sharing Standard Transplant Analysis and Research file was queried for adult recipients waitlisted for both heart and liver transplantation...
January 2019: Transplantation Direct
Xiaocheng Cheng, Qiongwen Hu, Hanru Zhao, Shu Qin, Dongying Zhang
OBJECTIVE: The aim of this meta-analysis was to compare the clinical outcomes of transcatheter aortic valve replacement (TAVR) with those of surgical aortic valve replacement (SAVR) in patients with chronic kidney disease (CKD). DESIGN: Meta-analysis of 10 observational studies. SETTING: Hospital. PARTICIPANTS: Patients with CKD (9,619) undergoing aortic valve replacement. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The Medline, Cochrane Library, and Embase databases were searched for clinical studies published from January 2000 to October 2018...
December 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Babikir Kheiri, Mohammed Osman, Hossam Abubakar, Ahmed Subahi, Adam Chahine, Sahar Ahmed, Ghassan Bachuwa, Mohammad L Alkotob, Mustafa Hassan, Deepak L Bhatt
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a valid option for patients with high or intermediate surgical risk. However, clinical outcomes of TAVR in low-risk patients are lacking. Our aim was to evaluate the efficacy and safety of TAVR versus surgical aortic valve replacement (SAVR) in low-surgical-risk patients. METHODS: Electronic database review was conducted for all randomized clinical trials (RCTs) that compared TAVR versus SAVR in low-risk patients...
January 4, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Nicolas M Van Mieghem, Jochen Wöhrle, David Hildick-Smith, Sabine Bleiziffer, Daniel J Blackman, Mohamed Abdel-Wahab, Ulrich Gerckens, Axel Linke, Hüseyin Ince, Peter Wenaweser, Dominic J Allocco, Ian T Meredith, Volkmar Falk
OBJECTIVES: The authors sought to evaluate 1-year clinical outcomes with the Lotus valve (Boston Scientific, Marlborough, Massachusetts) in a large international, multicenter prospective registry including patients eligible for transcatheter aortic valve replacement (TAVR) based on heart team consensus. BACKGROUND: TAVR is a safe and effective treatment for severe aortic valve stenosis; however, limited data are available on TAVR with the repositionable and fully retrievable Lotus valve in unrestricted contemporary clinical practice...
January 14, 2019: JACC. Cardiovascular Interventions
Yoshiyasu Aizawa, Yoko Tanimoto, Yoshiko Hirata, Taishi Fujisawa, Ryoma Fukuoka, Kazuaki Nakajima, Yoshinori Katsumata, Takahiko Nishiyama, Takehiro Kimura, Shinsuke Yuasa, Takashi Kohno, Shun Kohsaka, Mitsushige Murata, Yuichiro Maekawa, Yoshiko Furukawa, Seiji Takatsuki, Keiichi Fukuda
Some patients with hypertrophic cardiomyopathy (HCM) develop systolic dysfunction, called the dilated phase of HCM (d-HCM), which is associated with increased morbidity and mortality. We conducted a retrospective study using an HCM database to clarify the incidence, clinical characteristics, and long-term outcomes of d-HCM. We analyzed an HCM cohort consisting of 434 patients (273 with apical HCM and 161 with non-apical HCM; 18 had obstructive HCM, 16 had dilated HCM, and 127 had other HCM) diagnosed by echocardiography in our hospital between 1991 and 2010...
December 29, 2018: Keio Journal of Medicine
Wieneke Vlastra, Jaya Chandrasekhar, Antonio J Muñoz-Garcia, Didier Tchétché, Fabio S de Brito, Marco Barbanti, Ran Kornowski, Azeem Latib, Augusto D'Onofrio, Flavio Ribichini, Jan Baan, Jan G P Tijssen, Ramiro Trillo-Nouche, Nicolas Dumonteil, Alexandre Abizaid, Samantha Sartori, Paola D'Errigo, Giuseppe Tarantini, Mattia Lunardi, Katia Orvin, Matteo Pagnesi, Raquel Del Valle, Thomas Modine, George Dangas, Roxana Mehran, Jan J Piek, Ronak Delewi
Aims: The aim of this study was to compare clinical outcomes of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) with balloon-expandable (BE) valves vs. self-expandable (SE) valves. Transcatheter aortic valve implantation is a minimally invasive and lifesaving treatment in patients with aortic valve stenosis. Even though BE-valves and SE-valves are both commonly used on a large scale, adequately sized trials comparing clinical outcomes in patients with severe aortic valve stenosis treated with BE-valves compared with SE-valves are lacking...
December 24, 2018: European Heart Journal
Mohinder R Vindhyal, Paul Ndunda, Sinan Khayyat, Venkata Subbarao Boppana, Zaher Fanari
BACKGROUND: Dialysis is associated with higher rate of aortic valve calcification and higher cardiovascular mortality. Transcatheter aortic valve replacement (TAVR) is an established alternative for surgical aortic valve replacement (SAVR) in patients with higher and intermediate co-morbidities including dialysis. METHODS: Two independent investigators systematically searched Medline, Cochrane, and Web of Science. The ROBINS-I tool was used to analyze and assess the bias from the selected studies...
December 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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