检索结果-南通市图书馆

transcatheter aortic valve replacement in low-risk young population:A double edge sword?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Cardiology 2024年第4期16卷 177-180页

作者： Sukhdeep Bhogal Akash Batta Department of Cardiology Sovah HealthMartinsvilleVA 24112United States Department of Cardiology Dayanand Medical College and HospitalLudhiana 141001India

Since the advent of transcatheter aortic valve replacement(TAVR)in 2002,it has now become the default interventional strategy for symptomatic patients presenting with severe aortic stenosis,particularly in intermediate to highsurgical risk *** 2019,the United States Food and Drug Administration approved TAVR in low-risk patients based on two randomized ***,these breakthrough trials excluded patients with certain unfavorable anatomies and odd *** currently there is no randomized study of TAVR in young patients,it may be preferred by the young population given the benefits of early discharge,shorter hospital stay,and expedite ***,it is important to ruminate various factors including lifetime expectancy,risk of pacemaker implantation,and the need for future valve or coronary interventions in young cohorts before considering TAVR in these ***,the data on long-term durability(>10 years)of TAVR is still unknown given most of the procedures were initially performed in the high or prohibitive surgical risk ***,this editorial aims to highlight the importance of considering an individualized approach in young patients with consideration of various factors including lifetime expectancy while choosing TAVR against surgical aortic valve replacement.

关键词： transcatheter aortic valve replacement Surgical aortic valve replacement Pacemaker implantation Coronary re-access Structural deterioration

transcatheter aortic valve replacement in elderly patients

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 2012年第2期9卷 78-82页

作者： Dimytri Siqueira Alexandre Abizaid Magaly Arrais J. Eduardo Sousa institute Dante Pazzanese of Cardiology Av. Dr Dante Pazzanese 500 Ibirapuera S~o Paulo CEP 04012080 Brazil Heart Hospital Rua Desembargador Eliseu Guilherme 147 Paralso Sao Paulo CEP 040004030 Brazil

aortic stenosis is the most common native valve disease, affecting up to 5% of the elderly population. Surgical aortic valve replacement reduces symptoms and improves survival, and is the definitive therapy in patients with symptomatic severe aortic stenosis. However, despite the good results of classic surgery, risk is markedly increased in elderly patients with co-morbidities. transcatheter aortic valve replacement （TAVR） allows implantation of a prosthetic heart valve within the diseased native aortic valve without the need for open heart surgery and cardiopulmonary bypass, offering a new therapeutic option to elderly patients considered at high surgical risk or with contraindications to surgery. To date, several multicenter registries and a randomized trial have confirmed the safety and efficacy of TAVR in those patients. In this chapter, we review the background and clinical applications of TAVR in elderly patients.

关键词： aortic stenosis Elderly patients transcatheter aortic valve replacement Percutaneous valve therapies

Early mortality and safety after transcatheter aortic valve replacement using the SAPIEN 3 in nonagenarians

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6期15卷 387-393页

作者： Eiji Ichimoto Adam Arnofsky Michael Wilderman Richard Goldweit Joseph De Gregorio Department of Invasive Cardiology Englewood Hospital and Medical Center Englewood N J United States Department of Cardiothoracic Surgery Englewood Hospital and Medical Center Englewood N J United States Department of Vascular Surgery Englewood Hospital and Medical Center Englewood N J United States Department of Interventional Cardiology Englewood Hospital and Medical Center Englewood NJ United States

Background transcatheter aortic valve replacement （TAVR） has been performed for many elderly patients with severe aortic stenosis （AS）. The SAPIEN 3 is one of the latest balloon-expandable prosthesis. This study aimed to investigate the early clinical outcomes after TAVR using the SAPIEN 3 in nonagenarians. Methods A total of 97 consecutive patients underwent TAVR for severe AS between De- cember 2015 and December 2016. Of these, 85 consecutive patients who underwent TAVR using the SAPIEN 3 were included. According to the age, patients were classified into age 〉 90 years group （17 patients） or age 〈 90 years group （68 patients）. The clinical outcomes in- cluding all-cause mortality and composite endpoint of early safety at 30 days were evaluated. Results The Society of Thoracic Surgeons score in age 〉 90 years group was higher than age 〈 90 years group （12.3 ±6.1% vs. 8.5 ± 5.1%, P 〈 0.01）. There was no significant difference in 30-day mortality between the two groups. However, the life-threatening bleeding and major vascular complications in age 〉 90 years group were greater than age 〈 90 years group （11.8% vs. 1.5%, P = 0.04 and 11.8% vs. 1.5%, P = 0.04, respectively）. The composite endpoint of early safety at 30 days was similar between the two groups. Multivariate logistic regression analysis showed that prior myocardial infarction was an independent predictor of the composite endpoint of early safety （odds ratio： 4.76, 95% confidence interval： 1.02-22.21, P = 0.047）. Conclusions The early mortality and safety after TAVR using the SAPIEN 3 in nonagenarians were similar and acceptable despite of higher operative risk.

关键词： Nonagenarians SAPIEN 3 transcatheter aortic valve replacement

Use of the reported Edmonton frail scale in the assessment of patients for transcatheter aortic valve replacement： a possible selection tool in very high-risk 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6期15卷 463-466页

作者： Louis Koizia Sarosh Khan Angela Frame Ghada W Mikhail Sayan Sen Neil Ruparelia Geriatric Medicine St Mary's Hospital Praed Street London UK Department of Cardiology Western Sussex Hospitals NHS Foundation Trust West Sussex UK Department of Cardiology lmperial College Healthcare NHS Trust London UK

transcatheter aortic valve replacement （TAVR） has revolutionised the treatment of patients with aortic stenosis （AS） over the last 15 *** is a well-established procedure for the treatment of patients considered high risk for open surgery. Results from the PARTNER （Placement of aortic transcatheter） trial showed that inoperable patients randomly assigned to TAVR, had a 20% reduction in all-cause mortality, as well as hospitalisation, at one year compared to best medical management.

关键词： Edmonton frail scale Frailty transcatheter aortic valve replacement

Anemia and risk of periprocedural cerebral injury detected by diffusion-weighted magnetic resonance imaging in patients undergoing transcatheter aortic valve replacement

在线全文

学校读者我要写书评

暂无评论

World Journal of Emergency Medicine 2022年第1期13卷 32-39页

作者： Stella Ng Qi-feng Zhu Ju-bo Jiang Chun-hui Liu Jia-qi Fan Ye-ming Xu Xian-bao Liu Jian-an Wang Department of Cardiology the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China Zhejiang University School of Medicine Hangzhou 310058China

BACKGROUND: Anemia is prevalent in patients undergoing transcatheter aortic valve replacement(TAVR) and has been linked to impaired outcomes after the procedure. Few studies have evaluated the impact of anemia and new ischemic lesions post ***: We prospectively enrolled 158 patients who received TAVR in our center. Anemia was defined according to the World Health Organization criteria as hemoglobin <12 g/dL in women and <13 g/dL in men. All patients underwent diffusion-weighted magnetic resonance imaging(DW-MRI) procedure before and within 4–7 days after TAVR. RESULTS: Anemia was present in 85(53.8%) patients who underwent TAVR, and 126(79.7%) patients had 718 new DW-MRI positive lesions with a mean of 4.54±5.26 lesions per patient. The incidence of new ischemic lesions was 81.2% in patients with anemia versus 78.1% in patients without anemia(P=0.629). Moreover, anemic patients had bigger total volume/lesions in the anterior cerebral artery/middle cerebral artery(ACA/MCA) and MCA regions compared to the non-anemic patients(31.89±55.78 mm^(3) vs. 17.08±37.39 mm^(3), P=0.049;and 54.54±74.72 mm^(3) vs. 33.75±46.03 mm^(3), P=0.034). Anemia was independently associated with the volume/lesion in the ACA/MCA(β=16.796, 95% confidence interval [95% CI] 2.001 to 31.591, P=0.026) and in the MCA zone(β=0.020, 95% CI 0.001 to 0.040, P=0.041). CONCLUSIONS: Patients with pre-procedural anemia may have bigger total volume/lesions in the ACA/MCA and MCA regions compared to the non-anemic patients. Whether the consequences of bigger total volume/lesions impact neurological and cognitive outcomes remains to be investigated.

关键词： aortic stenosis Anemia Cerebral ischemic lesions transcatheter aortic valve replacement

transcatheter aortic valve replacement(TAVR) for severe aortic valve stenosis with left main artery disease:A case report

在线全文

学校读者我要写书评

暂无评论

South China Journal of Cardiology 2022年第3期23卷 240-243页

作者： WANG Pei-ning Maimaitishawuti Yimamu Abudureyimu Alimujiang LI Guang DONG Hao-jian The Cardiovascular Department The First People's Hospital of KashiXinjiang 844099China TheC ardiovascular Department the Guangdong Provincial People's HospitalGuangzhouGuangdong510100China

Introduction: This is the first case of transcatheter aortic valve replacement(TAVR) in the prefecture level hospital of Xinjiang Province in China. It also proves that severe left main coronary artery disease(LM)is not the contraindication to this operation of TAVR. Patient concerns:The patient had dyspnea for two years, with the 4/6 spurious murmur at the aortic valve. The cardiac ultrasound revealed a severe aortic valve stenosis(AS) and severe mitral regurgitation(MR). Coronary angiography(CAG)showed 80% stenosis of the left main artery. Diagnosis: The severe aortic valve stenosis(AS). Interventions: He received the TAVR, which also is the first case in the First People's Hospital of Kashi Prefecture. Outcomes: The patient's symptoms were significantly improved. The cardiac ultrasound showed that no obvious regurgitation was found in the implanted artificial aortic valve and the MR was significantly reduced. So far, the patient has recovered well for five months after TAVR. Conclusion:TAVR is an effective method for the severe AS patients with serve LM and loss of surgical opportunity.

关键词： transcatheter aortic valve replacement left main coronary artery disease aortic valve stenosis

transcatheter aortic valve replacement in Patients With Pure Native aortic Regurgitation:Results From a Multicenter Registry Study

在线全文

学校读者我要写书评

暂无评论

Cardiology Discovery 2024年第2期4卷 134-141页

作者： Xiaofei Gao Juan Zhang Xiangquan Kong Jing Chen Xiang Chen Longyan Zhang Xinyong Cai Jiancheng Zhui Nailiang Tian Zhen Ge Bin Wang Qing Zhou Xi Su Lang Hong Yan Wang Hong Jiang Junjie Zhang Shaoliang Chen Department of Cardiology Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu 210000China Department of Cardiology Renmin Hospital of Wuhan UniversityWuhan UniversityWuhanHubei 430000China Department of Cardiology Xiamen Cardiovascular HospitalXiamen UniversityXiamenFujian 361000China Department of Cardiology Wuhan Asian Heart HospitalWuhanHubei 430000China Department of Cardiology Jiangxi Provincial People's HospitalNanchang UniversityJiangxi 330000China

Objective:Patients with untreated severe aortic regurgitation(AR)have a high risk of *** transcatheter aortic valve replacement(TF-TAVR)is a treatment option for AR;however,the safety and efficacy of this technique have not been sufficiently *** study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure ***:Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese *** primary endpoint was device success at 1 month after *** secondary endpoint was the composite of major adverse cardiovascular events(MACE)at 6 months,including all-cause death,ischemic stroke,emergency conversion to cardiac surgery,and permanent pacemaker *** was used to analyze the left ventricular function before the TAVR procedure and during *** logistic regression and Cox regression analyses were performed to find relevant independent risk ***:Between September 2019 and February 2022,79 patients with AR were enrolled in the *** 1 month,device success was achieved in 60(75.9%)*** 6 months,29(36.7%)patients had *** revealed improved left ventricular function after *** regression analysis demonstrated that the Society of Thoracic Surgeons risk score(odds ratio 0.760,95%confidence interval(Cl):0.584-0.989;P=0.041)and annulus perimeter(odds ratio 0.888,95%Cl:0.796-0.992;P=0.035)were 2 predictors of device ***,annulus perimeter(valve system appears to be a safe and feasible treatment for patients with pure native severe AR,particularly those with a less enlarged annulus.

关键词： aortic valve aortic regurgitation transcatheter aortic valve replacement Device success Self-expanding valve

Comparison of in-hospital outcomes between octogenarians and nonagenarians undergoing transcatheter aortic valve replacement： a propensity matched 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

Journal of Geriatric Cardiology 2018年第2期15卷 123-130页

作者： Rajkumar Doshi Vaibhav Patel Priyank Shah Department of Cardiology North Shore University Hospital Northwell Health Manhasset New York USA Department of Cardiology Medical College of Georgia Southwest Clinical Campus Albany Georgia USA

Background aortic valve stenosis （AS） is very common in the elderly patients above 80 years. transcatheter aortic valve replacement （TAVR） in such patients is being increasingly performed. This study sought to assess in-hospital outcome differences between octogenarians and nonagenarians and predictors of mortality in nonagenarians undergoing TAVR with severe AS. Method The study population was derived from the National Inpatient Sample （MS） for the years 2012-2014 using ICD-9 CM procedure codes 35.05 and 35.06 for TAVR. Hospitalizations below 80 years of age were excluded. After performing propensity score matching （1： 2）, in-hospital outcomes were compared in matched cohorts. Then, multivariate model was developed to analyze predictors of in-hospital mortality in nonagenarians. Results There were 11,630 hospitalizations in the octogenarian and 5815 hospitalizations in the nonagenarian group. Primary outcome of in-hospital mortality （6% vs. 4.1%, P ≤ 0.001） was higher in nonagenarians compared to octogenarians. Secondary outcomes including stroke （3.4% vs. 2.8%, P ≤ 0.001）, renal failure （18.9% vs. 17.3%, P ≤0.001）, blood transfusion （35% vs. 32.6%, P ≤ 0.001）, vascular complications （4.5% vs. 3.5%, P ≤ 0.001）, and pacemaker implantation （27.8% vs. 24.8%, P ≤ 0.001） were higher in nonagenarians. There was no difference in their length of stay. Median cost （70,3745 vs. 65,3815, P ≤ 0.001） was slightly higher with nonagenarian. Conclusions Although in-hospital mortality is slightly higher in nonagenarians, it is acceptable. This difference in mortality is at least partly explained by higher complications in nonagenarians. Efforts should be made to decrease the complications which can further narrow the difference in in-hospital mortality between the groups.

关键词： Nonagenarian Octogenarian Quality of Life transcatheter aortic valve replacement

Measuring frailty in patients with severe aortic stenosis:a comparison of the edmonton frail scale with modified fried frailty assessment in patients undergoing transcatheter aortic valve replacement

在线全文

学校读者我要写书评

暂无评论

Journal of Geriatric Cardiology 2020年第7期17卷 441-446页

作者： Francisco J Romeo Maximiliano Smietniansky Mariela Cal Cristian Garmendia Juan M Valle Raleigh Ignacio MSeropian Mariano Falconi Pablo Oberti Vadim Kotowicz Carla RAgatiello Daniel H Berroca Division of Interventional Cardiology Hospital Italiano de Buenos AiresBuenos AiresArgentina Division of Internal Medicine and Geriatrics Hospital Italiano de Buenos AiresBuenos AiresArgentina Division Cardiology Hospital Italiano de Buenos AiresBuenos AiresArgentina Division of Cardiovascular Surgery Hospital Italiano de Buenos AiresBuenos AiresArgentina

Frailty is generally defined as a clinical syndrome of decreased physiologic reserve which drives to increased vulnerability and susceptibility to different stressors together with poor recovery to homeostasis.[1]The relevance of frailty status in a wide range of prospective cohorts is mostly related to an increasing burden in both mortality,hospital readmissions,disability,and falls.

关键词： aortic stenosis Frailty transcatheter aortic valve replacement