检索结果-南通市图书馆

Journal of Geriatric Cardiology 2017年第3期14卷 204-217页

作者： Teoman Kilic Irem Yilmaz Invasive Cardiology Research and Application Unit Department of Cardiology Kocaeli University Kocaeli Turkey Department of Cardiology Kocaeli University Kocaeli Turkey

transcatheter aortic valve implantation （TAV1） represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk surgical patients with severe symptomatic aortic valve stenosis. Today, TAVI seems to play a key and a reliable role in the treatment of intermediate and maybe low-risk patients with severe aortic stenosis. TAVI has also evolved from a complex and hazardous procedure into an effective and safe therapy by the development of new generation devices. This article aims to review the background and future of TAVI, elinieal trials and registries with old and new generation TAVI devices and to focus on some open issues related to post-procedural outcomes.

关键词： High risk patients The elderly transcatheter aortic valve implantation

transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis： a meta analysis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Chinese Medical Journal 2013年第6期126卷 1171-1177页

作者： WU Yi-cheng ZHANG Jian-feng SHEN Wei-feng ZHAO Qiang Department of Cardiac Surgery Rui Jin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China Department of Cardiology Rui Jin Hospital Shanghai Jiao Tong University School of Medicine Shanghai 200025 China

Background transcatheter aortic valve implantation （TAVI） has emerged as the treatment choice for non-operable patients with severe symptomatic aortic stenosis （AS） and may be a good alternative to surgery for those at very high or prohibitive surgical risk. We performed a meta-analysis to evaluate the comparative benefits of TAVI versus surgical aortic valve replacement （SAVR） in patients with severe AS. Methods A comprehensive literature search of PubMed, Embase, ScienceDirect and Cochrane Central Register of Codtrolled trials was performed, and randomized trials as well as cohort studies with propensity score analysis were included. Results One randomized trial （n=699） and six retrospective cohort studies （n=781） were selected for meta-analysis. Mortality at 30-day and 1-year follow-up was comparable between TAVI and SAVR. Despite similar incidences of stroke, myocardial infarction, re-operation for bleeding, and renal failure requiring dialysis, TAVI was associated with a lower occurrence rate of new-onset atrial fibrillation （OR 0.51,95% CI 0.33-0.78） and shorter procedural time （mean difference -67.50 minutes, 95% CI -87.20 to -47.81 minutes）. Post-operative aortic regurgitation and permanent pacemaker implantation were more common in patients after TAVI than in those with SAVR （OR 5.53, 95% CI 3.41-8.97; OR 1.71, 95% CI 1.02-2.84, respectively）. Conclusion In patients with severe symptomatic AS, TAVI and SAVR did not differ with respect to short- and mid-term survival, but the incidence of permanent pacemaker implantation and post-procedural aortic regurgitation remain relatively high after TAVI.

关键词： aortic stenosis transcatheter aortic valve implantation surgery meta-analysis

Medical management of symptomatic severe aortic stenosis in patients non-eligible for transcatheter aortic valve implantation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2020年第11期17卷 704-709页

作者： Gabriela Silvia Gheorghe Andreea Simona Hodorogea Andrei Cristian Dan Gheorghe Ioan Tiberiu Nanea Ana Ciobanu University of Medicine and Pharmacy Carol Davila BucharestProf.Dr.Th.Burghele HospitalBucharestRomania

1 transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The preferred treatment in symptomatic severe aortic stenosis(SAS) is surgical aortic valve replacement(SAVR), but in the elderly, the surgical risk can be greater than the benefit.([3]).

关键词： Angiotensin-converting enzyme inhibitors Beta-blockers Calcium channel blockers Diuretics Symptomatic severe aortic stenosis transcatheter aortic valve implantation

The role of echocardiography and CT angiography in transcatheter aortic valve implantation patients

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2018年第1期15卷 86-94页

作者： Emmanouil Chourdakis Ioanna Koniari Nicholas G Kourlis Dimitrios Velissaris Nikolaos Koutsogiannis Grigorios Tsigkas Karl Eugen Hauptmann Bruno Sontag George Hahalis Krankenhaus der Barmherzigen Briider Trier Germany Department of Cardiology University Hospital of Patras Rion Patras Greece Department of Internal Medicine University Hospital of Patras Rion Patras Greece

The transcatheter aortic valve implantation （TAVI） consist an altemative treatment in patients with severe aortic stenosis. Multimodality imaging using transthoracic echocardiography （TTE） or transesophageal echocardiography （TOE） and multislice CT （MSCT） constitute cornerstone techniques for the pre-operative management, peri-procedural guidance, follow up and recognition of possible transcatheter valve related complications. CT angiography is much more accurate regarding the total definition of aortic annulus diameter and circumferential area. Two-dimensional （2D） echocardiography, underestimates the aortic valve annulus diameter compared to 3D imaging techniques （MSCT, MRI and 3D TOE）. Three-dimensional TOE imaging provides measurements of the aortic valve annulus similar to those delivered by MSCT. The pre-procedural MSCT constitutes the gold standard modality minimizing the presence of paravalvular aortic regurgitation, one of the most frequent complications. TOE/TTE and MSCT performance could predict the possibility of pacemaker implantation post-procedural. The presence of a new transient or persisting MR can be assessed well by TOE. Both TTE and TOE, consist initially the basic examination for post TAVI evaluation. In case of transcatheter heart valve failure, the MSCT could be used as additional imaging technique.

关键词： Multi-slice computer tomography transcatheter aortic valve implantation Transthoracic echocardiography

Cardiac rehabilitation and mid-term follow-up after transcatheter aortic valve implantation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2014年第4期11卷 279-285页

作者： Renzo Zanettini Gemma Gatto Ileana Mori Maria Beatrice Pozzoni Stefano Pelenghi Luigi Martinelli Silvio Klugmann Cardiac Rehabilitation Centre Istituti Clinici di Perfezionamento Hospital via Bignami 1 20126 Milan Italy De Gasperis Cardiology and Cardiac Surgery Department Niguarda Ca' Granda Hospital Piazza Ospedale Maggiore 3 20162 Milan Italy

Background Evaluation of patient outcomes following transcatheter aortic valve implantation （TAVI） has usually been based on survival and clinical improvement. Studies on quality of life are limited, and data from comprehensive assessments after the procedure are lacking. Methods Sixty patients referred for cardiac rehabilitation after TAVI underwent in-hospital and after-discharge multidimensional assessments to evaluate clinical, functional, and nutritional statuses, degree of autonomy, cognitive impairment, depression and quality of life. Results On admission to rehabilitation, approximately half of the patients had severe functional impairment and dependence for basic activities of daily living. During their hospital stay, one-third of the patients suffered significant clinical complications and two had to be transferred to the implantation center. Despite this, the overall outcome was very good. All of the remaining patients were clinically stable at discharge and functional status, autonomy and quality of life were improved in most. During a mean follow-up of 540 days （range： 192-738 days）, five patients died from noncardiac causes, three were hospitalized for cardiac events, and nine for non cardiac reasons. Functional status and autonomy remained satisfactory in the majority of patients and most continued to live independently. Conclusions Patients referred for rehabilitation after TAVI are often very frail, with a high grade of functional impairment, dependence on others and high risk of clinical complications. During a rehabilitation programme, based on a multidimensional assessment and intervention, most patients showed significant improvement in functional status, quality of life, and autonomy, which remained stable in the majority of subjects during mid-term follow-up.

关键词： Cardiac rehabilitation Comprehensive assessment Follow-up transcatheter aortic valve implantation

Long-term follow-up of quality of life in high-risk patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2018年第4期15卷 261-267页

作者： Marjo JAG De Ronde-Tillmans Tom AJ de Jager Jeannette A Goudzwaard Nahid El Faquir Nicolas M van Mieghem Felix Zijlstra Elisabeth MWJ. Utens Francesco US Mattace-Raso MaRie J Lenzen Peter PT de Jaegere Erasmus Medical Center Department of Cardiology Thorax Center Rotterdam the Netherlands Erasmus Medical Center Section of Geriatrics Department of Internal Medicine Rotterdam the Netherlands Erasmus Medical Center Department of Child and Adolescent Psychiatry/Psychology Sophia Children 's Hospital Rotterdam the Netherlands The Netherlands Research Institute of Child Development and Education University of Amsterdam the Netherlands

Background transcatheter aortic valve implantation （TAVI） has become the standard treatment for patients with severe symptomatic aortic stenosis （AS） considered at very high risk for surgical aortic valve replacement. The purpose of this sub-study was to evaluate long-term （〉 4 years） health-related quality of life （QoL） in octogenarians who underwent TAVI. Methods A single center observational registry in twenty patients who underwent frame analysis assessment ≥ 4 years after TAVI. Health-related QoL was evaluated, using the Short Form-36 （SF-36）, the EuroQoL-5D （EQ-5D） and the visual analogue score （EQ-VAS） questionnaires. Results The mean SF-36 subscale scores at follow-up were physical functioning 40.8 ± 26.3, role physical functioning 67.7 ± 34.9, vitality 54.6 ± 21.6, general health 52.1 ± 20.4, social functioning 63.8 ± 37.7, role emotional functioning 70.2 ± 36.0, mental health 73.2 ± 23.3 and bodily pain 80.9 ± 22.9. The mean EQ-VAS score 〉 4 years after TAVI was 64.7 ± 15.1. With respect to functional class, 80% of the patients were in NYHA class I/II at follow-up compared to 15% prior to TAVI. Conclusions This sub-study reports a significant improvement in functional class （NYHA） in a selected group of very elderly patients 〉 4 years after TAVI. Furthermore, all patients showed a satisfactory QoL despite their age and multiple comorbidities. In addition, our study reveals a lower QoL when compared with the general age matched Dutch population.

关键词： Octogenarians Quality of life transcatheter aortic valve implantation

Improvement in renal functions with transcatheter aortic valve implantation

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2013年第4期10卷 317-322页

作者： Telat Keleş Huseyin Ayhan Durmaz Sarı Aslan AN Erdoğan KE Kasapkara Bilen Bayram Akçay Bozkurt Department of Cardiology Yıldırım Beyazıt University Bilkent 06800 Ankara Turkey Department of Cardiology Ankara Ataturk Education and Research Hospital Bilkent 06800 Ankara Turkey Department of Cardiovascular Surgery Ankara Ataturk Education and Research Hospital Bilkent 06800 Ankara Turkey.

BACKGROUND & OBJECTIVES:In recent years, emerging transcatheter aortic valve implantation (TAVI) has become an alternative for surgery。 However, with advanced age, several co-morbid factors together with contrast agent usage can cause deterioration in renal function and increase in the risk of acute kidney injury (AKI) with poor prognosis in patients with AKI。 Therefore, many patients cannot benefit from this treatment。 In this study, we aim to examine the effects of TAVI on renal functions。 METHODS AND RESULTS: Seventy patients, mean age of 77.6 years, underwent TAVI between July 2011 and December 2012。 Estimated glomerular filtration rate (eGFR) was calculated by using the Cockcroft and Gault Formula。 Patients were monitored for 48 h for urine output。 Stage 1 AKI, according to the VARC-2 AKIN system, developed in only five (7.1%) of the patients after the procedure。 There was a statistically significant increase between the mean 1(st) month eGFRs before (68。2 vs。 61.0, P aortic stenosis through TAVI allows improvement of renal functions, and that AKI rates will be lower with careful patient selection, proper pre-procedural hydration, and careful use of contrast agent。

关键词： Improvement Kidney injury transcatheter aortic valve implantation

Impact of gender on outcomes after transcatheter aortic valve implantation

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2018年第6期15卷 394-400页

作者： Nooraldaem Yousif Slayman Obeid Ronald Binder Andrea Denegri Mohammady Shahin Christian Templin Thomas F Luscher Department of Cardiology University Heart Center University Hospital Zurich Switzerland and Royal Brompton & Harefield Hospital imperial College London United Kingdom

Backgound The influence of gender on clinical outcomes following transcatheter aortic valve implantation （TAVI） was considerably discrepant in previous studies. We aimed to investigate the impact of gender in our registry. Methods The study is a retrospective observational analysis of a prospectively designed cohort （546 consecutive patients treated at the University Hospital Zurich who were enrolled in Swiss TAVI Cohort from May 2008 to April 2014）. The Study took place in University Heart Centre at University Hospital Zurich, Switzerland. Results Both genders were equally represented with 51.5 % （n = 281） of the populations being females, who were significantly older and had a more pronounced history of hypertension （P 〈 0.001 ）. Males on the other hand showed a higher incidence of diabetes （P = 0.004）, coronary artery disease （P 〈 0.001）, chronic obstructive pulmonary disease （P 〈 0.001） and renal failure requiring renal replacement therapy （P = 0.018）. Patients were followed up for a median of 391 days with a 100% complete follow-up at one year. The primary outcome （all-cause mortality） occurred in 6.8% （n = 37） and 15% （n = 82） of patients at 30 days and one year, respectively. The 30-day all-cause mortality outcome did not significantly differ between females （7.5%） and males （6.0%）（P = 0.619）, but one year all-cause mortality occurred significantly more in males than in females （18.7% vs. 11.7%, P 〈 0.037）. Conclusion After TAVI implantation for severe aortic stenosis, males have a less favorable long-term （one year） mortality outcome than females.

关键词： aortic stenosis aortic valve Gender transcatheter aortic valve implantation

Impact of age on transcatheter aortic valve implantation outcomes：a comparison of patients aged≤ 80 years versus patients ＆gt; 80 years

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2016年第1期13卷 31-36页

作者： Frank van der Kley Philippe J van Rosendael Spyridon Katsanos Vasileios Kamperidis Nina A Marsan Ioannis Karalis Arend de Weger Meindert Palmen Jeroen J Bax Martin J Schalij Victoria Delgado Heart Lung Center Leiden University Medical Center Leiden the Netherlands

ObjectiveTo investigate the procedural outcomes and the long-term survival of patients undergoing transcatheter aortic valve implantation （TAVI） and compare study results of patients≤ 80 years and patients ＆gt; 80 years *** total of 240 patients treated with TAVI were divided into two groups according to age≤ 80 years （n = 105; 43.8%） and ＆gt; 80 years （n= 135; 56.2%）. The baseline characteristics and the pro-cedural outcomes were compared between these two groups of *** the exception of peripheral artery disease and hypercho-lesterolemia, which were more frequently observed in the older age group, baseline characteristics were comparable between groups. Complica-tion rates did not differ significantly between patients≤ 80 years and patients ＆gt; 80 years. There were no differences in 30-day mortality rates be-tween patients aged≤ 80 years and patients ＆gt; 80 years old （9.5%vs. 7.4%, respectively;P = 0.557）. After a median follow-up of 28 months （in-terquartile range： 16-42 months）, 50 （47.6%） patients aged≤ 80 years died compared to 57 （42%） deaths in the group of patients ＆gt; 80 years old （P= 0.404）.ConclusionThe results of the present single center study showed that age did not significantly impact the outcomes of TAVI.

关键词： Age Survival rate transcatheter aortic valve implantation

Conduction abnormalities after transcatheter aortic valve implantation

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2018年第1期15卷 105-112页

作者： Panagiotis Karyofillis Anna Kostopoulou Sofia Thomopoulou Martha Habibi Efthimios Livanis George Karavolias Vassilis Voudris Department of Invasive Cardiology Onassis Cardiac Surgery Centre Athens Greece

In the last few years, transcatheter aortic valve implantation （TAVI） has become an alternative procedure in patients with severe aortic stenosis and high risk for surgical aortic replacement. Due to the anatomic correlation between aortic valve structure and conduction system of the heart, one of the most common complications after TAVI is conduction system disturbances which including bundle branch block, complete heart block and need for permanent pacemaker implantation. Although these disturbances are usually not lethal, they may have a great influence on patients＇ state and long term-survival. Several risk factors for conduction disturbances have been identified which including age, anatomy of the heart, periprocedural factors, type of implanted valve, preexisting abnormalities and comorbidities. As this technique becomes more familiar to physicians, patients should be carefully screened for risk factors for the development of conduction abnormalities after TAVI in order to provide effective prevention and proper treatment.

关键词： Atrioventricular block Bundle branch block Pacemaker transcatheter aortic valve implantation