Addressing the challenges of integrating digital health technologies to measure patient-centred outcomes in clinical registries.

Longitudinal patient registries generate important evidence for advancing clinical care and the regulatory evaluation of health-care products. Most national registries rely on data collected as part of routine clinical encounters, an approach that does not capture real-world, patient-centred outcomes, such as physical activity, fatigue, ability to do daily tasks, and other indicators of quality of life. Digital health technologies that obtain such real-world data could greatly enhance patient registries but unresolved challenges have so far prevented their broad adoption.

Concept, Design, and Preclinical Testing of a Remote-Control Robotic System for Transesophageal Echocardiography.

Background: Interventional echocardiography (IE) plays a critical role in guiding structural heart interventions. IE specialists face challenges including high radiation exposure and unfavorable ergonomics. To address these issues, a novel remote-control robotic (RCR) system for transesophageal echocardiography (TEE) control has been developed.

Yearly Trends and In-Hospital Outcomes of Patients Undergoing Transcatheter Mitral Valve-In-Valve Replacement in Prosthetic Valve Dysfunction.

Introduction: Transcatheter mitral valve-in-valve replacement (TMVR ViV) is becoming a favorable, less invasive procedure among high-risk patients to manage mitral valve dysfunction. We aimed to investigate the trends of the predictors and outcomes of the procedure.

Methods: The national inpatient sample databases of 2016-2020 were analyzed using STATA 17 software and ICD-10 codes for TMVR ViV, with stratification for mitral stenosis (MS) or Mitral regurgitation (MR) as etiology for prosthetic valve dysfunction.

Mechanical heart valves between myths and new evidence: a systematic review and meta-analysis.

Aims: The use of mechanical valve prostheses in cardiac surgery remains a necessary and indicated intervention in a large number of patients. However, predicted results associated with their use, on which current guideline recommendations have been developed, are based on dated studies at risk of bias (e.g.

A Misdiagnosis of Brucellosis Leads to Prosthetic Valve Endocarditis Complicated by Cerebrovascular Accident.

Cardiovascular complications of Brucellosis are not common and affecting less than 2% of cases. In clinical practice, endocarditis is the most frequent cardiovascular complication and is responsible for most of the brucellosis-related mortality cases and usually diagnosed lately in the course of the disease with mostly aorta valve involvement. In this case report, we present the case of a 27-year-old woman who was admitted to the hospital with fever, sudden onset right side hemiparesis, and horizontal gaze palsy.

Brain vs Heart: Prioritizing Treatment in Left-Side Infective Endocarditis With Neurologic Complications.

A paradigmatic case is presented of subarachnoid hemorrhage as the initial sign of bacterial endocarditis on a mechanical cardiac prosthesis, in the absence of symptoms and echocardiographic evidence of infective endocarditis and vegetation. The presentation emphasizes the need to pursue a diagnostic workup for bacterial endocarditis whenever a patient with a mechanical prosthesis presents to the emergency department with focal neurologic signs. In addition, it highlights the potential use of second-level diagnostic tools to assess the extent of abscess presence and lesion extension to other cardiac structures for proper surgical planning.

Midterm survival, clinical, and hemodynamic outcomes of a novel mechanical mitral valve prosthesis.

Objective: To evaluate the midterm survival, clinical, and hemodynamic outcomes of the On-X mechanical mitral valve, based on the 5-year results of the Prospective Randomized On-X Anticoagulation Clinical Trial (PROACT).

Method: PROACT Mitral was a multicenter study evaluating 401 patients who underwent mitral valve replacement (MVR) with either Standard or Conform-X On-X mitral valves, comparing low-dose and standard-dose warfarin. Here we report prespecified secondary outcomes of survival, New York Heart Association (NYHA) functional classification, and valve hemodynamics as assessed by core lab-adjudicated echocardiography at 1, 3, and 5 years in the pooled population.

Conduction Disturbances After Transcatheter Aortic Valve Replacement: An Update on Epidemiology, Preventive Strategies, and Management.

Conduction disturbances (CDs) are common after transcatheter aortic valve replacement. Continuous improvements in preprocedural planification, implant techniques, and device design have markedly reduced periprocedural complications. However, CDs rate remains in the double-digit range.

Transcatheter Aortic Valve Implantation Bailout for Severe Aortic Insufficiency due to Aortic Root Dissection Following Ascending Aortic Aneurysm Repair.

This novel case documents the successful use of transcatheter aortic valve implantation to treat severe aortic insufficiency arising from aortic root dissection following the repair of an ascending aortic aneurysm in a 75-year-old female patient. After she presented with symptoms of congestive heart failure, investigation revealed new severe aortic insufficiency and an acute aortic dissection. Given the prohibitive risks of reoperation, a self-expanding 27-mm Portico (St Jude Medical) prosthetic aortic valve was deployed, resulting in substantial clinical improvement without procedural complications.

Debris Embolization to the Lung After a Bioprosthetic (Mitroflow®) Valve Fracture.

This case report shows a valve in valve procedure in pulmonary position of a 19-year-old male with a repaired Tetralogy of Fallot. After initial correction, a Mitroflow 23 mm bioprosthetic valve was implanted in pulmonary position. Nine years later severe degeneration of the valve occurred.