25 results match your criteria: "Philadelphia (W.Y.S.); Cleveland Clinic[Affiliation]"
Polygenic Scoring for Detection of Ascending Thoracic Aortic Dilation.
Circ Genom Precis Med
October 2024
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery (G.B., G.J.W., S.M.D.).
Background: Ascending thoracic aortic dilation is a complex heritable trait that involves modifiable and nonmodifiable risk factors. Polygenic scores (PGS) are increasingly used to assess risk for complex diseases. The degree to which a PGS can improve aortic diameter prediction in diverse populations is unknown.
View Article and Find Full Text PDFPerformance of the open-first repair strategy in type A aortic dissection with mesenteric malperfusion syndrome eligible for delayed repair.
J Thorac Cardiovasc Surg
July 2024
Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, Pa; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pa.
Article Synopsis
- The study examines the efficacy of traditional open-first surgery compared to a nontraditional approach of delayed repair for patients with type A aortic dissection complicated by mesenteric malperfusion syndrome.
- Out of 1228 patients treated, 77 had mesenteric malperfusion syndrome with an in-hospital mortality rate of 29%, which was lower than the 39% for those undergoing delayed repair.
- Despite higher early mortality in the mesenteric malperfusion group, 10-year survival rates were similar for both treatment strategies, indicating that the open-first approach may be equally effective or superior to the delayed method.
Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest Trial (GOT ICE): A Randomized Clinical Trial Comparing Outcomes After Aortic Arch Surgery.
Circulation
February 2024
Department of Anesthesiology (J.A.K., T.B., M.L.J., J.P.M.), Duke University School of Medicine, Durham, NC.
Background: Deep hypothermia has been the standard for hypothermic circulatory arrest (HCA) during aortic arch surgery. However, centers worldwide have shifted toward lesser hypothermia with antegrade cerebral perfusion. This has been supported by retrospective data, but there has yet to be a multicenter, prospective randomized study comparing deep versus moderate hypothermia during HCA.
View Article and Find Full Text PDFTranscatheter Aortic-Valve Replacement in Low-Risk Patients at Five Years.
N Engl J Med
November 2023
From Baylor Scott and White Health, Plano, TX (M.J.M., M.S.); Columbia University (M.B.L., R.T.H., S.H.K., C.R.S.) and the Cardiovascular Research Foundation (M.B.L., R.T.H., S.H.K., D.J.C., C.R.S.), New York, and St. Francis Hospital and Heart Center, Roslyn (D.J.C.) - all in New York; Marcus Heart Valve Center, Piedmont Heart Institute (V.H.T.), and Emory University (V.B.) - both in Atlanta; Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (P.B., J.G.W.) - both in Canada; Morristown Medical Center, Morristown (P.G.), and Robert Wood Johnson University Hospital, New Brunswick (M.J.R.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); London School of Hygiene and Tropical Medicine, London (S.J.P.); Edwards Lifesciences, Irvine (M.L., R.W.), and Cedars-Sinai Medical Center, Los Angeles (R.M.) - both in California; Heart Valve Unit, Haut-Lévêque Cardiological Hospital, Bordeaux University, Pessac, France (J.T.); Northwestern University, Chicago (S.C.M.); and the University of Pennsylvania, Philadelphia (H.C.H., W.Y.S.).
Article Synopsis
- * TAVR showed a lower rate of the composite end point (death, stroke, rehospitalization) at one year (22.8%) compared to surgery (27.2%), but the difference was not statistically significant.
- * Overall, while TAVR had slightly better outcomes, there were no major long-term differences in safety or effectiveness between TAVR and surgery, as indicated by the various measured endpoints.
Target Aortic Stenosis: A National Initiative to Improve Quality of Care and Outcomes for Patients With Aortic Stenosis.
Circ Cardiovasc Qual Outcomes
June 2023
Cardiovascular Division, University of Washington Medical Center, Seattle (C.M.O.).
Transcatheter Aortic Valve Replacement in Large Annuli Valves With the Supra-Annular, Self-Expandable Evolut Platform in a Real-World Registry.
Circ Cardiovasc Interv
March 2023
Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH (L.A.P.D., C.B., G.F.A.).
Background: Transcatheter aortic valve replacement is approved for treatment of patients with severe aortic stenosis across the spectrum of risk. While considering broader indications for use, transcatheter aortic valve replacement in large native annuli has become increasingly important.
Methods: Patients with tricuspid aortic stenosis undergoing transcatheter aortic valve replacement using the Evolut R or Evolut PRO+ 34 mm valves (Medtronic, Minneapolis, MN) in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry between October 2016 and September 2020 were stratified according to in range (>12%) device oversizing and below range (0%-12%) device oversizing.
Utilization, Costs, and Outcomes of Conscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement.
Circ Cardiovasc Interv
July 2021
Columbia University Medical Center, New York, NY (R.T.H., S. Kodali, M.B.L.).
[Figure: see text].
View Article and Find Full Text PDFIncidence, Predictors, and Outcomes of Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Society of Thoracic Surgeons/American College of Cardiology National Cardiovascular Data Registry-Transcatheter Valve Therapy Registry.
Circ Cardiovasc Interv
April 2021
Division of Cardiovascular Medicine (H.M.J., A.S.N., P.N.F., H.C.H., W.Y.S., N.D.D., S.A., J.G.), University of Pennsylvania, Philadelphia, PA.
[Figure: see text].
View Article and Find Full Text PDFEchocardiographic Results of Transcatheter Versus Surgical Aortic Valve Replacement in Low-Risk Patients: The PARTNER 3 Trial.
Circulation
May 2020
Cardiovascular Research Foundation, New York, NY (A.D., E.A., M.C.A., M.B.L., R.T.H.).
Background: This study aimed to compare echocardiographic findings in low-risk patients with severe aortic stenosis after surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR).
Methods: The PARTNER 3 trial (Placement of Aortic Transcatheter Valves) randomized 1000 patients with severe aortic stenosis and low surgical risk to undergo either transfemoral TAVR with the balloon-expandable SAPIEN 3 valve or SAVR. Transthoracic echocardiograms obtained at baseline and at 30 days and 1 year after the procedure were analyzed by a consortium of 2 echocardiography core laboratories.
Five-Year Outcomes of Transcatheter or Surgical Aortic-Valve Replacement.
N Engl J Med
February 2020
From Cedars-Sinai Medical Center, Los Angeles (R.R.M., S.-H.Y., A.T.), Stanford University, Stanford (D.C.M., W.F.F.), and Edwards Lifesciences, Irvine (E.R., K.X., J.W.) - all in California; the Department of Cardiovascular Surgery, Piedmont Heart Institute (V.H.T.), and Emory University (V.B.) - both in Atlanta; Baylor Scott and White Healthcare, Plano (M.J.M., D.L.B.), and Medical City Dallas Hospital, Dallas (T.M.D.) - both in Texas; Columbia University Medical Center/New York-Presbyterian Hospital (S.K.K., R.T.H., M.C.A., C.R.S., M.B.L.) and NYU Langone Medical Center (M.R.W.) - both in New York; Cleveland Clinic, Cleveland (S.K., L.G.S., W.A.J.); St. Paul's Hospital, Vancouver, BC (J.G.W.), and Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Quebec, QC (P.P.) - both in Canada; University of Pennsylvania, Philadelphia (H.C.H., W.Y.S.); Medstar Washington Hospital Center, Washington, DC (L.S.); University of Missouri-Kansas City School of Medicine, Kansas City (D.J.C.); Christ Hospital, Cincinnati (D.J.K.); Barnes-Jewish Hospital, Washington University, St. Louis (A.Z.); Mayo Clinic, Rochester, MN (K.L.G.); Intermountain Medical Center, Salt Lake City (B.K.W.); Providence St. Vincent Medical Center, Portland, OR (R.W.H.); and Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ (M.J.R.).
Background: There are scant data on long-term clinical outcomes and bioprosthetic-valve function after transcatheter aortic-valve replacement (TAVR) as compared with surgical aortic-valve replacement in patients with severe aortic stenosis and intermediate surgical risk.
Methods: We enrolled 2032 intermediate-risk patients with severe, symptomatic aortic stenosis at 57 centers. Patients were stratified according to intended transfemoral or transthoracic access (76.
Impact of Carotid Artery Involvement in Type A Aortic Dissection.
Circulation
April 2019
Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (M.K., P.V., W.Y.S., J.E.B., N.D.D.).
Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients.
N Engl J Med
May 2019
From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).
Background: Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk.
Methods: We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery.
Standardized Definition of Structural Valve Degeneration for Surgical and Transcatheter Bioprosthetic Aortic Valves.
Circulation
January 2018
Columbia University Medical Center, New York (R.T.H., M.A.B., M.B.L.).
Bioprostheses are prone to structural valve degeneration, resulting in limited long-term durability. A significant challenge when comparing the durability of different types of bioprostheses is the lack of a standardized terminology for the definition of a degenerated valve. This issue becomes especially important when we try to compare the degeneration rate of surgically inserted and transcatheter bioprosthetic valves.
View Article and Find Full Text PDFConscious Sedation Versus General Anesthesia for Transcatheter Aortic Valve Replacement: Insights from the National Cardiovascular Data Registry Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.
Circulation
November 2017
Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia (M.C.H., H.C.H., S.A., T.K., J.G.);
Background: Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice.
Methods: The National Cardiovascular Data Registry Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry was used to characterize the anesthesia choice and clinical outcomes of all US patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014, and June 30, 2015. Raw and inverse probability of treatment-weighted analyses were performed to compare patients undergoing TAVR with general anesthesia with patients undergoing TAVR with conscious sedation on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, intensive care unit and hospital length-of-stay, and rates of discharge to home.
One-Year Clinical Outcomes With SAPIEN 3 Transcatheter Aortic Valve Replacement in High-Risk and Inoperable Patients With Severe Aortic Stenosis.
Circulation
July 2016
From Perelman School of Medicine at the University of Pennsylvania, Philadelphia (H.C.H., W.Y.S., S.A., N.D.); Emory University, Atlanta, GA (V.H.T., V.B.); Columbia University Medical Center, New York, NY (S.K.K., R.T.H., M.B.L.); Cedars-Sinai Medical Center, Los Angeles, CA (R.R.M.); University of Virginia, Charlottesville (S.L.); Northwestern University, Chicago, IL (S.C.M.); The Christ Hospital, Cincinnati, OH (D.J.K.); Ochsner Clinic, New Orleans, LA (S.R.); Mayo Clinic, Rochester, MN (K.L.G.); Cleveland Clinic, OH (S.K.); Department of Medicine, Laval University, Quebec, Canada (P.P.); Medstar Health Research Institute and Georgetown University, Washington, DC (N.J.W.); St. Paul's Hospital, Vancouver, BC, Canada (J.L., J.G.W.); Intermountain Medical Center, Salt Lake City, UT (B.K.W.); and Baylor Scott and White Health, Plano, TX (M.J.M.); and the PARTNER Trial Publication Office, New York, NY (H.C.H., V.H.T., S.K.K., R.R.M., D.J.K., S.K., V.B., R.T.H., P.P., N.J.W., J.L., J.G.W., M.J.M., M.B.L.).
Background: In the initial PARTNER trial (Placement of Aortic Transcatheter Valves) of transcatheter aortic valve replacement for high-risk (HR) and inoperable patients, mortality at 1 year was 24% in HR and 31% in inoperable patients. A recent report of the 30-day outcomes with the low-profile SAPIEN 3 transcatheter aortic valve replacement system demonstrated very low rates of adverse events, but little is known about the longer-term outcomes with this device.
Methods: Between October 2013 and September 2014, 583 HR (65%) or inoperable (35%) patients were treated via the transfemoral (84%) or transapical/transaortic (16%) access route at 29 US sites.
Pathogenesis and Risk Factors for Cerebral Infarct After Surgical Aortic Valve Replacement.
Stroke
August 2016
From the Departments of Neurology (A.M., S.R.M., S.E.K., J.T.) and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia; Division of Cardiovascular Surgery, Department of Surgery (M.A.A., M.F., W.Y.S., J.E.B.) and Department of Biostatistics and Epidemiology (S.J.R.), University of Pennsylvania, Philadelphia; Department of Psychology, Temple University, Philadelphia, PA (T.G.); and Department of Anesthesia and Critical Care, State University of New York, Stony Brook (T.F.F.).
Background And Purpose: Stroke is a potentially devastating complication of cardiac surgery. Identifying predictors of radiographic infarct may lead to improved stroke prevention for surgical patients.
Methods: We reviewed 129 postoperative brain magnetic resonance imagings from a prospective study of patients undergoing surgical aortic valve replacement.
Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients.
N Engl J Med
April 2016
From the Columbia University Medical Center (M.B.L., C.R.S., S.K.K., D.D., J.W.M., R.T.H., M.C.A.) and New York University Langone Medical Center (M.R.W.) - both in New York; Baylor Scott and White Healthcare, Plano, TX (M.J.M., D.L.B.); Cedars-Sinai Medical Center, Los Angeles (R.R.M., A.T.), Stanford University, Stanford (D.C.M., W.F.F.), and independent consultant (W.N.A.), Lake Forest - all in California; Cleveland Clinic, Cleveland (L.G.S., E.M.T., S.K., W.A.J.); Emory University, Atlanta (V.H.T., V.B.); University of Pennsylvania, Philadelphia (H.C.H., W.Y.S.); St. Luke's Mid America Heart Institute, Kansas City (D.J.C.), and Washington University, St. Louis (A.Z.) - both in Missouri; Medstar Washington Hospital Center, Washington, DC (A.D.P.); HCA Medical City Dallas Hospital, Dallas (T.D.); Christ Hospital, Cincinnati (D.K.); Mayo Clinic, Rochester, MN (K.L.G.); Intermountain Medical Center, Salt Lake City (B.K.W.); Providence St. Vincent Hospital, Portland, OR (R.W.H.); and Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, Vancouver, BC (J.G.W.) - both in Canada.
Background: Previous trials have shown that among high-risk patients with aortic stenosis, survival rates are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. We evaluated the two procedures in a randomized trial involving intermediate-risk patients.
Methods: We randomly assigned 2032 intermediate-risk patients with severe aortic stenosis, at 57 centers, to undergo either TAVR or surgical replacement.
Atrial Fibrillation Is Associated With Increased Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement: Insights From the Placement of Aortic Transcatheter Valve (PARTNER) Trial.
Circ Cardiovasc Interv
January 2016
From the Department of Medicine (A.B.B., T.N., J.D., H.G., J.F., D.H., M.B.L., S. Kodali) and Department of Surgery (C.R.S.), Columbia University Medical Center, New York Presbyterian Hospital, NY; Department of Cardiovascular Medicine, Cleveland Clinic, OH (S. Kapadia); Division of Cardiology, Emory University, Atlanta, GA (V.B.); Cardiovascular Research Foundation, New York, NY (K.X., R.P., M.B.L.); Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada (J.R.-C.); Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.); Department of Medicine (W.F.F.) and Department of Cardiovascular Surgery (D.C.M.), Stanford University, CA; Department of Medicine, Division of Cardiology, St. Paul's Hospital, Vancouver, BC, Canada (D.D., J.G.W.); Thoracic Surgery, Medical City Dallas, TX (T.D.); Department of Cardiothoracic Medicine and Department of Medicine, NYU Langone Medical Center, New York, NY (M.W.); Cardiothoracic Surgery, Baylor Scott & White Health, Plano, TX (M.J.M.).
Background: This study sought to evaluate the impact of atrial fibrillation (AF) on clinical outcomes in patients undergoing transcatheter aortic valve replacement.
Methods And Results: Data were evaluated in 1879 patients with baseline and discharge ECGs who underwent transcatheter aortic valve replacement in the Placement of AoRTic TraNscathetER Valve (PARTNER) trial. A total of 1262 patients manifested sinus rhythm (SR) at baseline/SR at discharge, 113 SR baseline/AF discharge, and 470 AF baseline/AF discharge.
Temporal Trends in Quality of Life Outcomes After Transapical Transcatheter Aortic Valve Replacement: A Placement of AoRTic TraNscathetER Valve (PARTNER) Trial Substudy.
Circ Cardiovasc Qual Outcomes
July 2015
From the Rutgers - Robert Wood Johnson Medical School, New Brunswick, NJ (H.G.); Columbia University Medical Center/New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY (A.J.K., S.K., T.P.V., M.B.L.); Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine (K.W., Y.L., E.M., S.V.A., D.J.C.); Lahey Hospital & Medical Center, Burlington, MA and Harvard Clinical Research Institute, Boston, MA (M.R.R.); NYU Langone Medical Center, New York, NY (M.R.W.); Emory University School of Medicine, Atlanta, GA (V.T.); and University of Pennsylvania School of Medicine, Philadelphia (W.Y.S.).
Background: In the Placement of AoRTic TraNscathetER Valve (PARTNER) randomized controlled trial (RCT), which represented the first exposure to transapical transcatheter aortic valve replacement (TA-TAVR) for many clinical sites, high-risk patients undergoing TA-TAVR derived similar health-related quality of life (HRQoL) outcomes when compared with surgical aortic valve replacement (SAVR). With increasing experience, it is possible that HRQoL outcomes of TA-TAVR may have improved.
Methods And Results: We evaluated HRQoL outcomes at 1-, 6-, and 12-month follow-ups among 875 patients undergoing TA-TAVR in the PARTNER nonrandomized continued access (NRCA) registry and compared these outcomes with those of the TA-TAVR and SAVR patients in the PARTNER RCT.
Propensity-matched comparisons of clinical outcomes after transapical or transfemoral transcatheter aortic valve replacement: a placement of aortic transcatheter valves (PARTNER)-I trial substudy.
Circulation
June 2015
From Cleveland Clinic, Cleveland, OH (E.H.B., J.R., S.K., E.M.T., L.G.S.); Mayo Clinic, Rochester, MN (R.M.S.); Emory University, Atlanta, GA (V.B., V.H.T.); Duke University Clinical Research Institute and Duke University Medical Center, Durham, NC (P.S.D.); Stanford University Medical Center, Stanford, CA (W.F.F., D.C.M.); Columbia University Medical Center/New York-Presbyterian Hospital, New York (R.T.H., A.J.K., S.K.K., M.B.L.); Baylor Scott & White Health, Plano, TX (M.M.); Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.); and New York University Langone Medical Center, New York (M.R.W.). J.J. Akin is self-employed.
Background: The higher risk of adverse outcomes after transapical (TA) versus transfemoral (TF) transcatheter aortic valve replacement (TAVR) could be attributable to TA-TAVR being an open surgical procedure or to clinical differences between TA- and TF-TAVR patients. We compared outcomes after neutralizing patient differences using propensity score matching.
Methods And Results: From April 2007 to February 2012, 1100 Placement of Aortic Transcatheter Valves (PARTNER)-I patients underwent TA-TAVR and 1521 underwent TF-TAVR with Edwards SAPIEN balloon-expandable bioprostheses.
Impact of aortic annulus size on valve hemodynamics and clinical outcomes after transcatheter and surgical aortic valve replacement: insights from the PARTNER Trial.
Circ Cardiovasc Interv
October 2014
From the Quebec Heart and Lung Institute, Quebec City, Quebec, Canada (J.-R.C., P.P., E.D.); Mayo Clinic, Rochester, MN (R.M.S.); Columbia University Medical Center/NewYork Presbyterian Hospital (S.K., R.T.H., M.B.L.); Emory University School of Medicine, Atlanta, GA (V.H.T.); Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.); Cleveland Clinic, OH (L.G.S.); and Cardiovascular Research Foundation, New York, NY (K.X.).
Background: The objective was to evaluate the effects of aortic annulus size on valve hemodynamics and clinical outcomes in those patients included in the Placement of Aortic Transcatheter Valves (PARTNER) randomized controlled trial cohort A and the nonrandomized continued access cohort.
Methods And Results: Patients included the randomized controlled trial (n=574) and nonrandomized continued access (n=1358) cohorts were divided in tertiles according to aortic annulus diameter (small aortic annulus tertile, medium aortic annulus tertile, and large aortic annulus tertile [LAA], respectively) as measured by transthoracic echocardiography. Severe prosthesis-patient mismatch was defined as an effective aortic orifice area of <0.
Factors associated with vascular complications in patients undergoing balloon-expandable transfemoral transcatheter aortic valve replacement via open versus percutaneous approaches.
Circ Cardiovasc Interv
August 2014
From the Divisions of Cardiovascular Medicine (M.B.K., H.C.H., J.O., S.A., D.J., R.L., J.G.) and Cardiovascular Surgery (N.D.D., Z.F., J.E.B., W.Y.S., P.V., R.M., D.M.K.), Perelman School of Medicine at the University of Pennsylvania, Philadelphia.
Background: Vascular complications after transfemoral transcatheter aortic valve replacement are common and associated with significant morbidity and mortality. Little is known about the effect of access approach on vascular complications.
Methods And Results: Between 2007 and 2013, 331 patients underwent transfemoral transcatheter aortic valve replacement via open surgical (OS) or fully percutaneous (PC) approaches.
Stroke after aortic valve surgery: results from a prospective cohort.
Circulation
June 2014
From the Departments of Neurology (S.R.M., S.E.K.), Surgery (M.A.A., M.F., W.Y.S., J.E.B., W.C.H.), and Radiology (M.B.), and Section of Vascular Medicine, Cardiovascular Division, Department of Medicine (E.R.M.), Hospital of the University of Pennsylvania, Philadelphia, PA; Department of Psychology, Temple University, Philadelphia, PA (T.G.); Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA (S.J.R.); Department of Anesthesia and Critical Care, State University of New York, Stony Brook, NY (T.F.F.).
Background: The incidence and impact of clinical stroke and silent radiographic cerebral infarction complicating open surgical aortic valve replacement (AVR) are poorly characterized.
Methods And Results: We performed a prospective cohort study of subjects ≥65 years of age who were undergoing AVR for calcific aortic stenosis. Subjects were evaluated by neurologists preoperatively and postoperatively and underwent postoperative magnetic resonance imaging.
Type A aortic dissection in Marfan syndrome: extent of initial surgery determines long-term outcome.
Circulation
April 2014
Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania in Philadelphia (BR., J.E.B., E.B., N.D.D., R.K.M., W.Y.S., P.V.); and Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany (B.R., F.B., M.S., F.A.K.).
Background: Data on outcomes after Stanford type A aortic dissection in patients with Marfan syndrome are limited. We investigated the primary surgery and long-term results in patients with Marfan syndrome who suffered aortic dissection.
Methods And Results: Among 1324 consecutive patients with aortic dissection type A, 74 with Marfan syndrome (58% men; median age, 37 years [first and third quartiles, 29 and 48 years]) underwent surgical repair (85% acute dissections; 68% DeBakey I; 55% composite valved graft, 30% supracoronary ascending replacement, 15% valve-sparing aortic root replacement; 12% total arch replacement; 3% in-hospital mortality) at 2 tertiary centers in the United States and Europe over the past 25 years.
Impact of preoperative moderate/severe mitral regurgitation on 2-year outcome after transcatheter and surgical aortic valve replacement: insight from the Placement of Aortic Transcatheter Valve (PARTNER) Trial Cohort A.
Circulation
December 2013
From St. Paul's Hospital, Vancouver, BC, Canada (M.B., J.G.W., R.H.B., C.R.T.); Columbia University Medical Center/New York-Presbyterian Hospital, New York (R.T.H., C.R.S., S.K., P.G., T.M., I.H., M.B.L.); NorthShore University Health System, Evanston, IL (T.F.); Washington University, St. Louis, MO (A.Z.); Emory University Hospital, Atlanta, GA (V.B.); Cedars-Sinai Medical Center, Los Angeles, CA (R.R.M.); University of Pennsylvania, Philadelphia (W.Y.S.); Duke University Medical Center, Durham, NC (P.S.D.); and Stanford University, Stanford, CA (D.C.M.).
Background: The effect of preoperative mitral regurgitation (MR) on clinical outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) is controversial. This study sought to examine the impact of moderate and severe MR on outcomes after TAVR and surgical aortic valve replacement (SAVR).
Methods And Results: Data were drawn from the randomized Placement of Aortic Transcatheter Valve (PARTNER) Trial cohort A patients with severe, symptomatic aortic stenosis undergoing either TAVR (n=331) or SAVR (n=299).