Background And Aim: Surgical valve replacement is the most commonly performed for aortic stenosis. Randomized trials comparing stentless to stented bioprostheses for aortic valve replacement in elderly are scarce. The aim of our study was comparing and evaluating the early hemodynamic performances of Hancock™ stented and FreeStyle™ stentless xenograft aortic valves in aortic valve replacement in elderly patients.
Patients And Methods: The study involved 40 patients (27 females and 13 males) older than 75 years old. The study was done during the postoperative period. Aortic valve replacements of stented and stentless xenografts were performed to the patients in Group I and Group II, respectively. Investigations for the echocardiographic results were completed on the postoperative 8-10th days. Parameters for the evaluation of hemodynamics were peak pressure gradient, mean pressure gradient and effective orifice area. The parameters were calculated with Doppler echocardiography by using specific formulas.
Results: Peak pressure gradients in patients with stented valves were significantly higher than in stentless valves [Stented valve group 32.45 ± 7.58 vs Stentless valve group 21.50 ± 4.77 mmHg] (p < 0.05). Mean pressure gradients were found to be significantly higher in stented group compared with stented group [Stented valve group 11.050 ± 3.2521 vs Stentless valve group 19.350 ± 6.6036 mmHg] (p < 0.05). The effective orifice area index of implanted valve was significantly greater in the stentless group, as well [Stentless valve group 2.5050 ± 0.6022 vs Stented valve group 1.3050 ± 0.3316 cm2] (p < 0.05).
Conclusions: In early postoperative period, effective orifice areas and pressure gradients were found higher in stentless valve group.
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Eur J Cardiothorac Surg
January 2025
Department of Cardiac Surgery, University Hospital Quironsalud Madrid, Spain.
Objectives: The Ross procedure for aortic regurgitation (AR) and abnormal aortic valve morphologies is associated with an increased risk of autograft dilatation. Autograft support may ameliorate this problem. We analyzed the results for all haemodynamic lesions and the effect of autograft support.
View Article and Find Full Text PDFEur Heart J
January 2025
Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Background And Aims: The association between periprocedural change in tricuspid regurgitation (TR) and outcomes in patients undergoing mitral transcatheter edge-to-edge repair (M-TEER) is unclear. This study aimed to examine the prognostic value of TR before and after M-TEER.
Methods: Patients in the OCEAN-Mitral registry were divided into four groups according to baseline and post-procedure echocardiographic assessments: no TR/no TR (no TR), no TR/significant TR (new-onset TR), significant TR/no TR (normalized TR), and significant TR/significant TR (residual TR) (all represents before/after M-TEER).
Cochrane Database Syst Rev
January 2025
Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.
Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.
Drug Des Devel Ther
January 2025
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Introduction: Sedation practices for colonoscopy indeed vary widely around the globe. Due to a lack of data on intravenous paracetamol, we aimed to investigate the clinical efficacy of intravenous paracetamol compared to intravenous fentanyl under propofol deep sedation for colonoscopy.
Methods: A total of 225 patients who underwent colonoscopy at Siriraj Hospital were randomly assigned to two groups.
Eur J Cardiothorac Surg
January 2025
Department of Cardiothoracic Surgery, Division of Heart and Lung Disease, Utrecht University Medical Center, Utrecht, The Netherlands.
Objective: Aortic valve repair/sparing have been established as effective treatments for aortic regurgitation and/or aortic aneurysms. However, concerns remain regarding long-term durability, reproducibility, and patient selection. This study aims to asses long-term clinical and echocardiographic outcomes, with a focus on aortic regurgitation grade and left ventricular ejection fraction evolution, in adults undergoing these procedures.
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