1,943 results match your criteria: "Harefield Hospital[Affiliation]"

Lipoprotein(a) (Lp(a)) is a well-recognized causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and calcific aortic valve stenosis. There are ongoing challenges with screening and management in primary and secondary prevention; however, future recommendations for clinical practice await the outcomes of clinical trials that are in progress.

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Article Synopsis
  • The study evaluated the safety and effectiveness of statins, ezetimibe, and their combination for treating children with heterozygous familial hypercholesterolaemia (HeFH), using systematic reviews and various meta-analyses from RCTs.* -
  • Results showed that all lipid-lowering therapies (LLTs) were effective in reducing cholesterol levels, with statins leading to significant reductions in low-density lipoprotein cholesterol (LDL-C), especially when combined with ezetimibe.* -
  • While no safety or tolerability issues were identified, the extent of LDL-C reduction varied by treatment dosage and type, highlighting the need for more research on long-term safety and effectiveness.*
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  • Out-of-hospital cardiac arrest (OHCA) survival rates in the UK are low, with less than 10% of patients surviving, but extracorporeal cardiopulmonary resuscitation (ECPR) can enhance survival if administered within an hour.
  • A study surveyed clinicians from Thames Valley Air Ambulance and Harefield Hospital to identify barriers and facilitators for implementing an effective ECPR transport system for OHCA patients, gathering responses on technical and non-technical aspects.
  • Key themes discovered include the importance of educational programs, teamwork, communication, and standardizing protocols, highlighting the need for collaboration and effective training across both pre-hospital and in-hospital settings.
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Gliomas, comprising nearly 80% of brain malignancies, present a formidable challenge with glioblastomas being the most aggressive subtype. Despite multidisciplinary care, including surgery and chemoradiotherapy, the prognosis remains grim, emphasizing the need for innovative treatment strategies. The blood-brain barrier complicates drug access, and the diverse histopathology hinders targeted therapies.

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: The management of patients with aortic valve pathologies can sometimes fall into a "gray zone", where the optimal treatment approach is not straightforward. The comparative benefits of sutureless aortic valve replacement (SUAVR) using the Perceval bioprosthesis versus transcatheter aortic valve implantation (TAVI) for the "gray zone" of aortic valve replacement procedures remain a topic of debate. To further explore this issue, we conducted a study with pairwise, single-arm, and Kaplan-Meier-based meta-analyses to compare the outcomes of SUAVR with the Perceval bioprosthesis versus TAVI, as well as to evaluate the efficacy, safety, and durability of SUAVR with the Perceval bioprosthesis over mid-term and long-term follow-up periods.

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Performance of balloon-expandable transcatheter bioprostheses in inoperable patients with pure aortic regurgitation of a native valve: The BE-PANTHEON international project.

Cardiovasc Revasc Med

August 2024

Clinical and Interventional Cardiology Department, I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Milan, Italy. Electronic address:

Article Synopsis
  • - The study compares the outcomes of different balloon-expandable (BE) transcatheter heart valve (THV) devices used to treat high-risk patients with severe pure native aortic valve regurgitation (NAVR), revealing suboptimal results with both device types.
  • - Out of 144 patients treated, those with the MyVal device had more frequent extra-large annuli, yet technical success rates were similar between MyVal (90%) and Sapien (81%).
  • - Overall, while BE devices might offer a treatment option for high-risk patients with NAVR, their effectiveness is limited and highlights the need for dedicated devices, as larger sizes might improve outcomes for traditionally unsuitable patients.
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Objective: The evidence underlying the efficacy and safety of minimally invasive mitral valve surgery (MIMVS) is inconclusive. We conducted a meta-analysis to evaluate whether MIMVS improves clinical outcomes compared with conventional sternotomy.

Methods: We searched MEDLINE (via PubMed), Embase, the Cochrane Library, and ClinicalTrials.

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Cardiac arrest is a hyper-acute condition with a high mortality that requires rapid diagnostics and treatment. As such, point-of-care ultrasound (POCUS) has become a valuable tool in the assessment of these patients. While transthoracic echocardiography (TTE) is the more conventional modality used to find reversible causes of cardiac arrest, transoesophageal echocardiography (TOE) has been increasingly utilised due to its superior image quality, continuous imaging, and ability to be operated away from the patient's chest.

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Ventriculoaortic junction remodeling-Holy Grail of bicuspid repair.

JTCVS Tech

August 2024

Clinical Department of Cardiac Surgery, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.

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Background: Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery. While thyroid dysfunction can predict POAF, the association between preoperative serum free triiodothyronine (FT3) levels and POAF in patients undergoing off-pump coronary artery bypass (OPCAB) grafting remains unclear. This study aimed to investigate the relationship between preoperative FT3 levels and POAF in OPCAB patients.

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Mechanical life support algorithm for the emergency management of patients with left-sided Impella.

Br J Cardiol

August 2023

Consultant Interventional Cardiologist Cardiovascular Sciences, National Heart and Lung Institute, Imperial College London, London, SW7 2BX.

We sought to remedy the limited guidance that is available to support the resuscitation of patients with the Impella Cardiac Power (CP) and 5.0 devices during episodes of cardiac arrest or life-threatening events that can result in haemodynamic decompensation. In a specialist tertiary referral centre we developed, by iteration, a novel resuscitation algorithm for Impella emergencies, which we validated through simulation and assessment by our multi- disciplinary team.

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Aims: To assess whether left ventricular (LV) global longitudinal strain (GLS), derived from cardiovascular magnetic resonance (CMR), is associated with (i) progressive heart failure (HF), and (ii) sudden cardiac death (SCD) in patients with dilated cardiomyopathy with mildly reduced ejection fraction (DCMmrEF).

Methods And Results: We conducted a prospective observational cohort study of patients with DCM and LV ejection fraction (LVEF) ≥40% assessed by CMR, including feature-tracking to assess LV GLS and late gadolinium enhancement (LGE). Long-term adjudicated follow-up included (i) HF hospitalization, LV assist device implantation or HF death, and (ii) SCD or aborted SCD (aSCD).

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Background And Aims: Catheter ablation is superior to pharmacological therapy in controlling atrial fibrillation (AF). There are few data on the long-term outcome of AF ablation in octogenarian patients. This analysis aims to evaluate the outcome of AF ablation in octogenarians vs.

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The Current Landscape of Transcatheter Tricuspid Valve Intervention.

J Soc Cardiovasc Angiogr Interv

December 2023

Section of Cardiovascular Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.

Tricuspid regurgitation (TR) is common, and its prevalence increases with age. It was previously estimated that there are 1.6 million patients in the United States with moderate or worse TR, and more contemporary data suggest the age-adjusted prevalence of TR is 0.

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The "International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024" updates and replaces the "Listing Criteria for Heart Transplantation: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates-2006" and the "2016 International Society for Heart Lung Transplantation Listing Criteria for Heart Transplantation: A 10-year Update." The document aims to provide tools to help integrate the numerous variables involved in evaluating patients for transplantation, emphasizing updating the collaborative treatment while waiting for a transplant. There have been significant practice-changing developments in the care of heart transplant recipients since the publication of the International Society for Heart and Lung Transplantation (ISHLT) guidelines in 2006 and the 10-year update in 2016.

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Study Question: In large multinational patient surveys, spirometry (which requires repeated, reproducible maximal efforts) can be associated with cough, breathlessness and tiredness, particularly in those with idiopathic pulmonary fibrosis (IPF). Oscillometry is an effort-independent test of airways resistance and reactance. We hypothesised that oscillometry would take less time to perform and would be associated with reduced symptom burden than spirometry.

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Pulmonary vein isolation (PVI) with catheter ablation (CA) represents an effective therapy for atrial fibrillation (AF). Unfortunately, it is still not exempt from severe complications. The balance of risks and benefits should be assessed, and a patient-tailored approach is desirable.

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Aims: Myocardial response to stress echocardiography may be elicited physiologically, through exercise, or pharmacologically, often with dobutamine. Both have advantages but also limitations due to reduced exercise capacity or side-effects to stressor agent/lack of closeness to true pathophysiology of ischaemic cascade. We have combined low-dose dobutamine and exercise, creating a 'hybrid' protocol to utilize the advantages of both techniques and limit the drawbacks.

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Comparative Prognostic Value of Echocardiographic Parameters of the Subpulmonary Left Ventricle in Adults With a Systemic Right Ventricle.

J Am Soc Echocardiogr

November 2024

Department of Echocardiography, Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom; National Heart and Lung Institute, Imperial College London, United Kingdom.

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