2,136 results match your criteria: "Cardiothoracic Centre[Affiliation]"

Article Synopsis
  • - Transcatheter aortic valve implantation (TAVI) is a treatment for severe aortic stenosis patients, particularly high-risk individuals like those with prior kidney transplants, who may face complications.
  • - An 88-year-old male with severe aortic stenosis and declining renal function was successfully treated with TAVI using a single access point and no contrast media.
  • - The study suggests that single-access, non-contrast TAVI can be effective for renal transplant patients, but it should be reserved for select cases due to the risks involved.
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Objectives: While current data show a clear trend towards the use of bioprosthetic valves during aortic valve replacement (AVR), durability of bioprosthetic valves remains the most important concern. We conducted a 1st systematic review of all available evidence that analysed early and mid-term outcomes after AVR using the Inspiris RESILIA™ bioprosthesis.

Methods: A systematic literature search was performed to identify all relevant studies evaluating early and mid-term outcomes after AVR using the Inspiris RESILIA bioprosthesis and including at least 20 patients with no restriction on the publication date.

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Measuring Absolute Coronary Flow and Microvascular Resistance by Thermodilution: JACC Review Topic of the Week.

J Am Coll Cardiol

February 2024

Cardiovascular Center Aalst, OLV-Clinic, Aalst, Belgium; Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland. Electronic address:

Diagnosing coronary microvascular dysfunction remains challenging, primarily due to the lack of direct measurements of absolute coronary blood flow (Q) and microvascular resistance (R). However, there has been recent progress with the development and validation of continuous intracoronary thermodilution, which offers a simplified and validated approach for clinical use. This technique enables direct quantification of Q and R, leading to precise and accurate evaluation of the coronary microcirculation.

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Transcatheter aortic valve implantation (TAVI) is now well established as the treatment of choice for patients with native aortic valve stenosis who are high or intermediate risk for surgical aortic valve replacement. Recent data has also supported the use of TAVI in patients at low surgical risk and also in anatomical subsets that were previously felt to be contra-indicated including bicuspid aortic valves and aortic regurgitation. With advancements and refinements in procedural techniques, the application of this technology has now been further expanded to include the management of degenerated bioprosthesis.

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Aims: To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing transcatheter aortic valve implantation (TAVI).

Methods And Results: We followed the European Society of Cardiology (ESC) methodology for the development of QIs. Key domains were identified by constructing a conceptual framework for the delivery of TAVI care.

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The coronary sinus Reducer (CSR) is an hourglass-shaped device which creates an artificial stenosis in the coronary sinus. Whilst placebo-controlled data show an improvement in angina, these results are unreplicated and are the subject of further confirmatory research. The mechanism of action of this unintuitive therapy is unknown.

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Article Synopsis
  • * A study involving 315 patients found that after 1 year, only 4.9% experienced serious events like cardiac death or stent thrombosis, which was better than the pre-set safety target.
  • * The results indicate that a 1-month DAPT is sufficient for patients with stable angina, and some acute coronary syndrome patients had DAPT extended to 3 months, with very low rates of complications.
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Catheter ablation is the treatment of choice for patients with symptomatic accessory pathways (APs) causing recurrent atrioventricular reciprocating tachycardia or in situations where APs conduct rapidly, posing a risk of sudden cardiac death. Conventional AP mapping relies on point-by-point assessment of local electrograms looking closely for pathway electrograms or early atrial or ventricular electrograms, which may be challenging and time consuming. Recently, open window mapping (OWM) using 3D navigational systems has emerged as a novel technique to help localise and ablate APs.

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Aims: Diabetes mellitus (diabetes) is common amongst patients with non-ST-segment elevation myocardial infarction (NSTEMI). We describe presentation, care, and outcomes of patients admitted with NSTEMI by diabetes status.

Methods And Results: Prospective cohort study including 2928 patients (1104 with prior diabetes, 1824 without) admitted to hospital with NSTEMI from 287 centres in 59 countries.

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Article Synopsis
  • The analysis evaluated the impact of 1-month versus 3-month dual antiplatelet therapy (DAPT) in older patients after percutaneous coronary intervention (PCI), focusing on those with high bleeding risk.
  • In a study of 3,364 patients, they found similar rates of all-cause death or myocardial infarction for both therapy durations, regardless of whether patients were ≥75 years or <75 years old.
  • However, patients aged ≥75 experienced significantly less bleeding with the 1-month DAPT compared to the 3-month treatment, suggesting a clearer benefit in reducing bleeding risk without increasing heart-related complications.
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Hospitalisation patterns in interstitial lung diseases: data from the EXCITING-ILD registry.

Respir Res

January 2024

Mainz Center for Pulmonary Medicine, Departments of Pneumology, ZfT, Mainz University Medical Center and of Pulmonary, Critical Care & Sleep Medicine, Marienhaus Clinic Mainz, Mainz, Germany.

Background: Interstitial lung diseases (ILD) comprise a heterogeneous group of mainly chronic lung diseases with more than 200 entities and relevant differences in disease course and prognosis. Little data is available on hospitalisation patterns in ILD.

Methods: The EXCITING-ILD (Exploring Clinical and Epidemiological Characteristics of Interstitial Lung Diseases) registry was analysed for hospitalisations.

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Background: Status Epilepticus (SE) is a common neurological emergency associated with a high rate of functional decline and mortality. Large randomized trials have addressed the early phases of treatment for convulsive SE. However, evidence regarding third-line anesthetic treatment and the treatment of nonconvulsive status epilepticus (NCSE) is scarce.

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Efficacy of human experts and an automated segmentation algorithm in quantifying disease pathology in coronary computed tomography angiography: A head-to-head comparison with intravascular ultrasound imaging.

J Cardiovasc Comput Tomogr

March 2024

Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, UK; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University London, UK; Institute of Cardiovascular Sciences, University College London, London, UK. Electronic address:

Article Synopsis
  • - The study compares the accuracy of automated coronary computed tomography angiography (CCTA) analysis with expert evaluations, using near-infrared spectroscopy-intravascular ultrasound imaging (NIRS-IVUS) as a standard for reference.
  • - In a test with 51 participants and 150 vessels, results indicated that both the expert and automated methods performed similarly at the segment level, but the experts were better at identifying specific lesions.
  • - Despite similarities in overall performance, both methods exhibited poor reliability in assessing certain metrics (like minimal lumen area), suggesting automated segmentation can still speed up CCTA analysis in clinical settings.
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Transcatheter aortic valve implantation (TAVI) is a common practice for severe aortic stenosis, but the choice between general (GA) and local anesthesia (LA) remains uncertain. We conducted a comprehensive literature review until April 2023, comparing the safety and efficacy of LA versus GA in TAVI procedures. Our findings indicate significant advantages of LA, including lower 30-day mortality rates (RR: 0.

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This meta-analysis aimed to compare the midterm clinical outcomes of reimplantation versus remodeling techniques for valve-sparing aortic root replacement (VSARR) in patients with connective tissue disorders (CTDs). Studies were screened and identified after the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines from the PubMed, Web of Science, and Embase databases. Forest plots were produced using Review Manager 5.

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Contemporary review on spontaneous coronary artery dissection: insights into the angiographic finding and differential diagnosis.

Front Cardiovasc Med

November 2023

Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.

Spontaneous coronary artery dissection (SCAD), although in the majority of cases presents as an acute coronary syndrome (ACS), has different pathophysiology from atherosclerosis that influences specific angiography findings and enables most patients to be solved by optimal medical therapy rather than percutaneous coronary intervention (PCI). Therefore, accurate diagnosis is essential for adequate treatment of each patient as management of SCAD differs from that of ACS of atherosclerotic aetiology. So far, invasive coronary angiography remains the most important diagnostic tool in suspected SCAD.

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Testing ChatGPT ability to answer laypeople questions about cardiac arrest and cardiopulmonary resuscitation.

Resuscitation

January 2024

Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon, United Kingdom; Medical Technology Research Centre, Anglia Ruskin School of Medicine, Chelmsford, United Kingdom. Electronic address:

Introduction: Cardiac arrest leaves witnesses, survivors, and their relatives with a multitude of questions. When a young or a public figure is affected, interest around cardiac arrest and cardiopulmonary resuscitation (CPR) increases. ChatGPT allows everyone to obtain human-like responses on any topic.

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Tailoring antiplatelet therapy in older patients with coronary artery disease.

Platelets

December 2023

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK and.

The older population represents a unique subset of patients due to a higher rate of comorbidities and risk factors, which can lead to a higher rate of ischemic and bleeding events. As a result, older adults are mainly underrepresented or excluded from randomized trials. Although the advancement in the percutaneous coronary intervention field with the development of new technologies, techniques, and potent antiplatelet therapy led to a reduction of ischemic risk, there is still a concern regarding bleeding hazards.

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Incomplete vascular ring of the aortic arch presenting with dysphagia in an adult: case report.

Pan Afr Med J

December 2023

Division of Cardiothoracic Surgery, National Cardiothoracic Centre of Excellence, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.

Anomalies of the arterial branches of the arch of the aorta are rare, with the aberrant right subclavian artery being the most common of this anomaly. Majority of the anomalies are asymptomatic and often discovered as incidental findings. In the great majority of the symptomatic cases, the presentation may be either with breathlessness or dysphagia or both.

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A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina.

N Engl J Med

December 2023

From Imperial College London (C.A.R., M.J.F., F.A.-J., F.A.S., S.G., R.K., R.P., G.D.C., J.P.H., D.P.F., M.J.S.-S., R.K.A.-L.), Imperial College Healthcare NHS Trust (C.A.R., M.J.F., F.A.-J., F.A.S., S.S.N., S.G., R.K., R.P., S.S., G.D.C., J.P.H., D.P.F., M.J.S.-S., R.K.A.-L.), Barking Havering and Redbridge University Hospitals NHS Trust (A.N.N., A.S.), Royal Free London NHS Foundation Trust (T. Kotecha), St. George's University Hospitals NHS Foundation Trust (R.W., J.C.S.), St. George's University of London (J.C.S.), Queen Mary University of London (D.J.C., A.S.), and Barts Health NHS Trust (A.S.), London, Essex Cardiothoracic Centre, Mid and South Essex NHS Foundation Trust, Basildon (J.R.D., R.G., G.C., J.N.D., T.R.K.), Anglia Ruskin University, Chelmsford (J.R.D., G.C., T.R.K.), University Hospitals Dorset NHS Foundation Trust, Poole (P.D.O., J.D.), Portsmouth Hospitals University NHS Trust, Portsmouth (P.H.), Worcestershire Acute Hospitals NHS Trust, Worcester (H.R., L.M.), University Hospital Southampton NHS Foundation Trust and the University of Southampton, Southampton (N.C.), Royal Berkshire NHS Foundation Trust, Reading (N.R.), Salisbury NHS Foundation Trust, Salisbury (M.S.), Cardiff and Vale University Health Board, Cardiff (T. Kinnaird), Keele University, Keele (T. Kinnaird), Buckinghamshire Healthcare NHS Trust, Amersham (R.P.), and West Hertfordshire Hospitals NHS Trust, Watford (J.S.) - all in the United Kingdom.

Article Synopsis
  • A study was done to see if a procedure called PCI helps people with stable angina (chest pain) feel better than a fake (placebo) procedure.
  • 301 patients were divided into two groups: one had the PCI and the other had the fake procedure for 12 weeks.
  • The results showed that those who had PCI had better scores for their angina symptoms, meaning they felt less pain compared to the placebo group.
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Low Transvalvular Flow Rate in Patients Undergoing Transcatheter Aortic Valve Implantation (TAVI) Is a Predictor of Mortality: The TFR-TAVI Study.

Heart Lung Circ

December 2023

Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK. Electronic address:

Background: Transvalvular flow rate (TFR) represents a better reflection of transvalvular flow than the stroke volume index (SVi), and has recently emerged as a useful prognostic tool in patients undergoing surgical aortic valve replacement. There is a paucity of data investigating the role of TFR and its relationship with other clinical or echocardiographic factors in patients undergoing transcatheter aortic valve implantation (TAVI).

Method: This was a retrospective single-centre study of 629 consecutive patients who underwent TAVI between March 2009 and September 2020.

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A tale of tears and healing.

J Invasive Cardiol

September 2023

Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle, UK. Email:

A 78-year-old woman with a background of hypertension and osteoarthritis presented with a history of syncope secondary to severe aortic stenosis. She underwent a computed tomography (CT) scan that showed a heavily calcific trileaflet aortic valve.

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