Transapical mitral valve implantation for treatment of symptomatic mitral valve disease: a real-world multicentre experience.

Aims: Transcatheter mitral valve implantation (TMVI) is a new treatment option for patients with symptomatic mitral valve (MV) disease. Real-world data have not yet been reported. This study aimed to assess procedural and 30-day outcomes of TMVI in a real-world patient cohort.

Outcomes after transaortic transcatheter aortic valve implantation: long-term findings from the European ROUTE†.

Objectives: There is lack of data regarding the longer-term outcomes of patients undergoing transaortic (TAo) transcatheter aortic valve implantation (TAVI). We aimed to provide a contemporary snapshot of the types and frequencies of events in the year following TAo-TAVI.

Methods: The Registry of the Utilization of the TAo-TAVI approach using the Edwards SAPIEN Valve (ROUTE) is a multicentre, European, prospective, observational registry of aortic stenosis patients undergoing TAo-TAVI.

EVALUATION OF OCCUPATIONAL RADIATION DOSE IN TRANSCATHETER AORTIC VALVE IMPLANTATION.

Occupational doses during fluoroscopy in interventional procedures vary largely (Kim et al. (Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys.

Morbidity outcomes after surgical aortic valve replacement.

Objective: In patients with mild to moderate operative risk, surgical aortic valve replacement (SAVR) is still the preferred treatment for patients with severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of postsurgical outcomes, this study reports a broad set of morbidity outcomes following surgical intervention.

Methods: Our cohort comprised 442 patients referred for severe AS; 351 had undergone SAVR, with the remainder (91) not operated on.

Transcatheter Mitral Valve Replacement for Patients With Symptomatic Mitral Regurgitation: A Global Feasibility Trial.

Background: Symptomatic mitral regurgitation (MR) is associated with high morbidity and mortality that can be ameliorated by surgical valve repair or replacement. Despite this, many patients with MR do not undergo surgery. Transcatheter mitral valve replacement (TMVR) may be an option for selected patients with severe MR.

Transcatheter Aortic Valve Replacement Using Transaortic Access: Experience From the Multicenter, Multinational, Prospective ROUTE Registry.

Objectives: The Registry of the Utilization of the TAo-TAVR approach using the Edwards SAPIEN Valve (ROUTE) was established to assess the effectiveness and safety of the use of transaortic (TAo) access for transcatheter aortic valve replacement (TAVR) procedures (NCT01991431).

Background: TAVR represents an alternative to surgical valve replacement in high-risk patients. Whereas the transfemoral access route is used commonly as the first-line approach, transapical access is an option for patients not suitable for transfemoral treatment mainly due to anatomic conditions.

Edwards SAPIEN XT in Native Stenotic Mitral Valve, Open Technique on Cardiopulmonary Bypass: An Option, But Safe?

A 73-year-old woman underwent open mitral valve replacement with the transcatheter Edwards SAPIEN XT valve (Edwards Lifesciences, Corp, Irvine, CA USA) on cardiopulmonary bypass in a native, stenotic mitral valve. Because of left ventricular outflow tract obstruction, the patient died 25 days after implantation. There are previous reports of transcatheter valve implantation in native mitral valve with procedural success.

Long-term outcomes after transcatheter aortic valve implantation: the impact of intraoperative tissue Doppler echocardiography.

Objectives: Transcatheter aortic valve implantation improves survival in patients with severe aortic stenosis who are ineligible for surgical valve replacement; however, not all patients benefit from the procedure. We endeavoured to identify these patients using intraoperative echocardiography and hypothesized that intraoperative left ventricular function in response to the acute afterload reduction during the procedure was related to long-term outcomes.

Methods: We prospectively included 64 patients who were scheduled for transcatheter aortic valve implantation and divided them into responders and non-responders based on their left ventricular intraoperative responses to the acute afterload reduction after valve deployment.

Intraoperative improvement in left ventricular peak systolic velocity predicts better short-term outcome after transcatheter aortic valve implantation.

Objectives: Left ventricular function is expected to improve after transcatheter aortic valve implantation due to the acute reduction in afterload, but does not occur in all patients. We hypothesized that the immediate intraoperative response in systolic left ventricular longitudinal motion during the procedure could be a predictor of short-term outcome.

Methods: Sixty-four patients treated with transcatheter aortic valve implantation for severe aortic stenosis were included.

Transcatheter aortic valve implantation and intraoperative left ventricular function: a myocardial tissue Doppler imaging study.

Objective: Transcatheter aortic valve implantation in patients turned down for surgical aortic valve replacement is a high-risk procedure. Severe aortic stenosis is associated with impaired left ventricular longitudinal motion, and myocardial peak systolic velocity is a measure of left ventricular function in these patients. The present study aimed to quantify the acute changes in left ventricular function during the procedure by using myocardial tissue Doppler imaging and transthoracic cardiac output measurements.

Transcatheter valve-in-ring implantation after failure of surgical mitral repair.

Objectives: Redo surgery after failed mitral valve repair may be high risk, or contraindicated in patients with comorbidities. Because of this high risk, other interventional possibilities like transcatheter valve implantation might be of benefit. We report our experience with transcatheter mitral valve-in-ring implantation (TVIR) in high-risk patients after failure of surgical ring annuloplasty.

Innovative technology-transcatheter aortic valve implantation: cost and reimbursement issues.

Objective: Transcatheter aortic valve implantation (TAVI) offers a new treatment option for patients with severe symptomatic aortic valve stenosis, classified as "inoperable". The purpose of the study was to reveal the association between ascertained hospital costs with the actual patient Diagnosis-Related Group (DRG).

Method: We examined 50 consecutive patients who underwent either transapical TAVI, (TAVI-TA) or transfemoral TAVI (TAVI-TF) with the Edwards SAPIEN valve and CoreValve(®) between September 2009 and August 2011.

Long-term follow-up of patients operated with the symmetry proximal connector device.

Objective: : The Symmetry proximal connector device was introduced as a facilitator for construction of proximal anastomosis in coronary bypass surgery. Use of the connector made it unnecessary to clamp the ascending aorta. Early results were promising, but a controlled study performed in our center demonstrated poor angiographic patency of saphenous veins attached with the connector.

Clinical and echocardiographic assessment of the Medtronic Advantage aortic valve prosthesis: the Scandinavian multicentre, prospective study.

Objective: The aim of this report is the prospective, multicentre evaluation of clinical results and haemodynamic performance of the Medtronic Advantage aortic valve prosthesis.

Methods: From April 2001 to June 2003, 166 patients (male:female 125:41; mean (SD) age 61.8 (11.

Clinical and radiologic outcome of off-pump coronary surgery at 12 months follow-up: a prospective randomized trial.

Background: After more than a decade of experience with off-pump coronary bypass surgery, still no consensus exists concerning its benefit on clinical outcome compared to the on-pump technique. In this 12-month follow-up, we compare off-pump and on-pump surgery on the appearance of graft patency, myocardial function, and clinical outcome.

Methods: One hundred twenty patients were randomized to off-pump or on-pump coronary surgery.

A life-threatening complication of the Nuss procedure for pectus excavatum.

We describe a delayed, life-threatening complication in a boy operated on using the Nuss-procedure 2 months earlier. On admittance he was in shock with cardiac tamponade. An immediate needle aspiration of blood from the pericardium was done before a median sternotomy.

Cerebral microembolization during off-pump coronary artery bypass surgery with the Symmetry aortic connector device.

Objective: The use of aortic connector systems for proximal vein grafts in off-pump coronary artery bypass grafting might minimize aortic manipulation by eliminating the need for partial aortic clamping. The objective of this study was to asses whether use of a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) reduced intraoperative cerebral embolization.

Methods: Thirty-two consecutive patients underwent off-pump coronary artery bypass grafting.

Cerebral ischemic injury and cognitive impairment after off-pump and on-pump coronary artery bypass grafting surgery.

Background: Off-pump coronary artery bypass grafting surgery reduces the intraoperative cerebral embolic load and may therefore cause less brain injury. The main aim of this study was to compare off-pump and on-pump surgery with regard to the frequency of new postoperative cerebral ischemic lesions and the prevalence of postoperative cognitive impairment. We also assessed whether preoperative cerebral ischemic injury predicts the risk for cognitive dysfunction after surgery.

Patient-reported outcome after randomization to on-pump versus off-pump coronary artery surgery.

Background: Clinical experience with off-pump coronary artery bypass surgery raises the question of a patient experienced benefit compared with on-pump surgery. This prospective and randomized study compared patient-reported outcome between surgical groups, as change scores at 3 months after surgery and longitudinally as time-averaged change from baseline through the first year after surgery.

Methods: In all, 120 patients were randomly assigned to on- or off-pump coronary artery surgery.

Detection of ischemia and new insight into left ventricular physiology by strain Doppler and tissue velocity imaging: assessment during coronary bypass operation of the beating heart.

Background And Objectives: Detection of myocardial ischemia in humans by strain Doppler and tissue velocity imaging was validated in a novel, experimentally designed study model during coronary bypass operation of the beating heart.

Methods: Assessment of ischemia was made with an opened chest and pericardium inherent in the operative procedure. Longitudinal strain and tissue velocity of interventricular septal regions were measured by transesophageal echocardiography during occlusion of the left anterior descending coronary artery (LAD).

Intraoperative and intermediate-term angiographic results of coronary artery bypass surgery with Symmetry proximal anastomotic device.

Objective: The objective of this study was to investigate the patency in saphenous vein coronary bypass grafts in which the proximal anastomoses were performed with automatic connector devices or with a traditional suture technique.

Methods: Forty-six patients underwent coronary artery bypass grafting without cardiopulmonary bypass by using one thoracic graft and one or more saphenous vein grafts. Grafts were attached to the aorta with a Symmetry connector (St Jude Medical, Inc, St Paul, Minn) in 23 patients, and partial occlusion of the aorta and sutured anastomoses were used in 23 other patients.

Intraoperative angiography leads to graft revision in coronary artery bypass surgery.

Background: Graft anastomosis quality in coronary artery bypass surgery can be assessed by intraoperative angiography. The aim of the present study was to quantify the on-table revision rate initiated by intraoperative angiography.

Methods: Intraoperative angiography was carried out in 186 patients undergoing coronary artery bypass surgery, with a total of 427 grafts.

Clinical and Angiographic Outcome of Coronary Surgery with and without Cardiopulmonary Bypass: A Prospective Randomized Trial.

Abstract Background: Off-pump coronary artery bypass surgery has emerged as an alternative technique to traditional onpump surgery. The aim of this randomized study was to compare perioperative morbidity and mortality and intraoperative and short-term graft patency in off-pump and on-pump coronary artery bypass grafting. Methods: One hundred twenty patients were randomized for coronary revascularization with or without cardiopulmonary bypass.