Surgical Management of Aortic Regurgitation in Takayasu's Arteritis: A Systematic Review of Techniques and Outcomes.

IntroductionTakayasu's arteritis (TA) is an inflammatory condition that affects large vessels and frequently involves the aortic valve causing valve regurgitation. Surgical management is recommended for symptomatic severe aortic regurgitation (AR); however, the optimal surgical approach is yet unclear. This study aims to review surgical treatment options for AR in TA and determine which procedure has a lower chance of late postoperative events and/or mortality.

Using Hybrid Change Strategies to Improve the Patient Experience in Outpatient Specialty Care.

The emerging changes in healthcare impose significant burdens on integrated outpatient specialty services with respect to setting patient expectations, handling outside medical records; and coordinating specialty appointments scheduling. Moreover, because of the evolution of the electronic health record and its widespread use, it is critical that patient and physician interaction is maintained and clerical tasks are minimized. In the context of increased government regulation, declining reimbursement, and the rise of new payment models, outpatient practices need to be reimagined so that they are more efficient for the patient and the provider.

Preventive PCI versus culprit lesion stenting during primary PCI in acute STEMI: a systematic review and meta-analysis.

Aim: The benefit of preventive percutaneous coronary intervention (PCI) in ST elevation myocardial infarction (STEMI) has been shown in randomised trials. However, all the randomised trials are underpowered to detect benefit in cardiac death. We aim to systematically review evidence on the cardiac mortality benefit of preventive PCI in patients presenting with acute STEMI in randomised patient populations.

Vitamin D levels and left ventricular diastolic function.

Objective: To determine the association between serum vitamin D level and left ventricular (LV) diastolic dysfunction.

Background: Vitamin D deficiency has been shown in observational and prospective studies to be associated with cardiovascular diseases including coronary artery disease, LV hypertrophy and systolic heart failure. Even though diastolic LV dysfunction is an early manifestation of cardiac disease, there is no study that examines whether a deficiency of vitamin D is associated with LV diastolic dysfunction.

Amplatzer PFO occluder device may prevent recurrent stroke in patients with patent foramen ovale and cryptogenic stroke: a meta-analysis of randomised trials.

Objective: To review efficacy of percutaneous closure of patent foramen ovale compared with medical therapy in prevention of recurrent strokes in patients with cryptogenic stroke.

Methods And Results: Electronic databases; PUBMED, EMBASE, Cochrane registry and web of knowledge were searched for relevant studies. In three randomised clinical trials involving 2303 participants, risk of the recurrent strokes (pooled HR 0.

Predictors of severe tricuspid regurgitation in patients with permanent pacemaker or automatic implantable cardioverter-defibrillator leads.

Patients with permanent pacemaker or automatic implantable cardioverter-defibrillator (AICD) leads have an increased prevalence of tricuspid regurgitation. However, the roles of cardiac rhythm and lead-placement duration in the development of severe tricuspid regurgitation are unclear. We reviewed echocardiographic data on 26 consecutive patients who had severe tricuspid regurgitation after permanent pacemaker or AICD placement; before treatment, they had no organic tricuspid valve disease, pulmonary hypertension, left ventricular dysfunction, or severe tricuspid regurgitation.

Cangrelor versus clopidogrel in percutaneous coronary intervention: a systematic review and meta-analysis.

Aims: Cangrelor is a new antiplatelet agent that has been used in percutaneous coronary intervention (PCI) with mixed results. We aimed to review the evidence on the efficacy of cangrelor in comparison to clopidogrel in reducing ischaemic endpoints at 48 hours in patients undergoing PCI in large randomised trials.

Methods And Results: In three large clinical trials involving 25,107 participants, the risk of the primary composite efficacy endpoint of death, MI and ischaemia-driven revascularisation at 48 hours, (pooled OR 0.

Valvular heart disease in patients with osteogenesis imperfecta.

Osteogenesis imperfecta (OI) or "brittle bone disease" is a rare connective tissue hereditary disorder. The most common clinical presentation of OI is bone fractures. OI also involves extraskeletal structures; however, cardiovascular manifestations are rare.

Predictors for the development of severe tricuspid regurgitation with anatomically normal valve in patients with atrial fibrillation.

Background And Aims: Atrial fibrillation (AF) may be a risk factor for severe functional tricuspid valve regurgitation (FTR). We aimed to determine the predictors of severe FTR in patients with AF.

Methods And Results: From our echocardiographic laboratory database, we searched for and reviewed the medical records of consecutive patients with severe FTR and AF seen at Mayo Clinic in Arizona from 2002 through 2009.

Occurrence of left-sided heart valve involvement before right-sided heart valve involvement in carcinoid heart disease.

Carcinoids are rare neuroendocrine tumours that occur primarily in the gastrointestinal tract. Carcinoid heart disease is characterized by fibrous plaque deposition on the endocardial surface of the cardiac valves and chambers. It affects the right heart valves in 85% of cases and the left heart valves in 15%.

Anterolateral papillary muscle rupture: an unusual complication of septic coronary embolism.

In most cases, acute mitral valve regurgitation in the setting of infective endocarditis is caused by the destruction of either the mitral valve leaflets or the chordal apparatus. A 54-year-old woman had development of respiratory failure due to pulmonary oedema from severe acute mitral valve regurgitation in the setting of acute bacterial endocarditis. She was found to have a ruptured anterolateral papillary muscle from occlusion of the circumflex artery by embolic vegetations arising from the aortic valve.

Activation of coagulation during routine diagnostic coronary angiography.

Aims: The role of anticoagulation during percutaneous coronary intervention has been well established. However, the role of anticoagulation during diagnostic coronary angiography remains unclear. Prothrombin fragment1+2 (PF1+2) and D-dimer (DD) have been reported to be useful in evaluating thrombotic phenomena.