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Impact of gender on outcomes after transcatheter aortic valve implantation

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

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Subclavian Impella 5.0 to the rescue in a non-ST elevation myocardial infarction patient requiring unprotected left main rotablation: A case report

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World Journal of Cardiology 2020年第4期12卷 155-160页

作者： Vasileios Panoulas María Monteagudo-Vela Konstantinos Kalogeras Andre Simon Department of Cardiology Harefield HospitalRoyal Brompton and Harefield NHS Foundation TrustLondon UB96JHUnited Kingdom Cardiovascular Sciences National Heart and Lung InstituteImperial CollegeLondon SW72BUUnited Kingdom Department of Cardiothoracic Transplantation and Mechanical Circulatory Support Harefield HospitalRoyal Brompton and Harefield NHS Foundation TrustLondon UB96JHUnited Kingdom

BACKGROUND Often in patients with significant three-vessel or left main disease there is coexistent significant peripheral disease rendering them poor candidates for percutaneous left ventricular support during *** on the management of such cases is *** SUMMARY We describe a case of such a patient with critical distal left main disease and chronically occluded right coronary artery who presented with chest pain and a non-ST elevation myocardial infarction and had significantly impaired left ventricular *** the aid of our cardiothoracic surgeons a cut down subclavian Impella 5.0 was inserted and high risk rotablation percutaneous coronary intervention carried out *** This case highlights the need for cross-specialty collaborations in such high-risk cases were alternative access is needed for insertion of large bore mechanical circulatory support devices.

关键词： Impella Subclavian Rotablation Left main Percutaneous coronary intervention Case report

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Transcatheter Valve-in-Valve implantation after late migration of balloon expandable Sapien- XT prosthesis in a severe pure aortic regurgitation case

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Journal of Geriatric Cardiology 2017年第12期14卷 763-765页

作者： Emmanouil Chourdakis Ioanna Koniari George Hahalis Nicholas Kounis Karl Eugen Hauptmann Krankenhaus der Barmherzigen Briider Trier Germany Department of InterventionalElectriphysiology Royal Brompton Hospital London United Kingdom Cardiology Department Patras University Hospital Rio Patras Greece

A 76-year old female, was admitted in our cardiac surgery clinic to perform surgical aortic valve replacement due to a severe aortic regurgitation with symptoms of congestive heart failure. Her past medical history in... 详细信息

关键词： Native aortic regurgitation Prosthetic valve migration Valve in Valve

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慢性后负荷增加对先天性左室流出道梗阻患者左室心肌功能的影响

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世界核心医学期刊文摘(心脏病学分册) 2007年第9期 32-33页

作者： Lam Y.-Y. Kaya M.G. Li W. 杜媛 adultcongenital heart unit royal brompton hospital london united kingdom

本研究观察了压力超负荷距离对先天性主动脉缩窄和主动脉瓣狭窄(AS)患者左室(LV)功能的影响。利用M型超声和组织多普勒成像(TDI)技术测定连续46例LV流出道梗阻患者(23例主动脉缩窄和23例AS)

关键词：患者 AS 主动脉缩窄主动脉狭窄先天性心脏病后负荷压力负荷收缩幅度收缩速度功能

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Risk factors associated with pancreatic fistula after distal pancreatectomy, which technique of pancreatic stump closure is more beneficial?

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World Journal of Gastroenterology 2007年第38期13卷 5096-5100页

作者： Marco Pericoli Ridolfini Sergio Alfieri Stavros Gourgiotis Dario Di Miceli Fabio Rotondi Giuseppe Quero Roberta Manghi Giovanni Battista Doglietto Department of Surgical Sciences Gemelli University Hospital Catholic University of the Sacred Heart School of Medicine Rome Italy Hepatobiliary and Pancreatic Surgery Department Royal London Hospital United Kingdom

AIM: To identify risk factors related to pancreatic fistula in patients undergoing distal pancreatectomy (DP) and to determine the effectiveness of using a stapled and a sutured closed of pancreatic stump. METHODS: Sixty-four patients underwent DP during a 10-year period. Information regarding diagnosis, operative details, and perioperative morbidity or mortality was collected. Eight risk factors were examined. RESULTS: Indications for DP included primary pancreatic disease (n = 38, 59%) and non-pancreatic malignancy (n = 26, 41%). Postoperative mortality and morbidity rates were 1.5% and 37% respectively; one patient died due to sepsis and two patients required a reoperation due to postoperative bleeding. Pancreatic fistula was developed in 14 patients (22%); 4 of fistulas were classified as Grade A, 9 as Grade B and only 1 as Grade C. Incidence of pancreatic fistula rate was significantly associated with four risk factors: pathology, use of prophylactic octreotide therapy, concomitant splenectomy, and texture of pancreatic parenchyma. The role that technique (either stapler or suture) of pancreatic stump closure plays in the development of pancreatic leak remains unclear. CONCLUSION: The pancreatic fistula rate after DP is 22%. This is reduced for patients with non-pancreatic malignancy, fibrotic pancreatic tissue, postoperative prophylactic octreotide therapy and concomitant splenectomy.

关键词： Pancreas Distal pancreatectomy Pancreatic fistula

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扩张型心肌病的心血管磁共振成像、纤维化和预后

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世界核心医学期刊文摘（心脏病学分册） 2007年第4期3卷 54-55页

作者： Assomull R.G. Prasad S.K. Lyne J. D.J.Pennell 刘少伟 Cardiovascular Magnetic Resonance unit Royal Brompton HospitalLondonUnited Kingdom Dr.

目的:在一项前瞻性纵向研究中评价室壁中层纤维化对判断扩张型心肌病(DCM)预后的价值。背景:在植入装置时代,对非缺血性DCM患者进行风险分层尚存在问题。近30%的DCM患者经晚期钆增强(LGE)

关键词：扩张型心肌病磁共振成像室壁联合终点心室重构全因死亡射血分数纵向研究预后指标易患性

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稳定型心绞痛治疗和临床预后的性别差异

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 42-43页

作者： Daly C. Clemens F. Lopez Sendon J.L. 刘宇 royal brompton hospital Sydney St London SW3 6 NP United Kingdom

Background -We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results -The Euro heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42%were female. Women were less likely to undergo an exercise ECG(odds ratio, 0.81; 95%CI, 0.69 to 0.95) and less likely to be referred for coronary angiography(odds ratio, 0.59; 95%CI, 0.48 to 0.72). Antiplatelet and statin therapies were used significantly less in women than in men, both at initial assessment and at 1 year, even in those in whom coronary disease had been confirmed. Women with confirmed coronary disease were less likely to be revascularized than their male counterparts and were twice as likely to suffer death or nonfatal myocardial infarction during the 1-year follow-up period(hazard ratio, 2.09; 95%CI, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions -Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease.

关键词：稳定型心绞痛性别差异运动试验病变严重程度非致死性他汀类药物心脏病专家心室功能临床诊断

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室间隔完整的肺动脉瓣闭锁患者早中期预后的预测因素:一项人群研究

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世界核心医学期刊文摘(心脏病学分册) 2006年第3期 60-61页

作者： Daubeney P.E.F. Delany D.J. 张步升 Daubeney Royal Brompton Hospital Sydney St London SW3 6NP United Kingdom

Objectives: Pulmonary atresia with intact ventricular septum is a form of congenital heart disease usually associated with right-heart hypoplasia, with considerable morphologic heterogeneity and often poor outlook. Ascertainment of risk factors for poor outcome is an important step if an improvement in outcome is to be achieved. Methods: The UK and Ireland Collaborative study of Pulmonary Atresia with Intact Ventricular Septum is an ongoing population-based study of all patients born with this disease from 1991 through 1995. All available clinical, morphologic, and investigative variables were directly reviewed, and risk factor analysis was performed for poor outcome. Results: One hundred eighty-three patients presented with pulmonary atresia with intact ventricular septum. Fifteen underwent no procedure, and all died. Of the remainder, 67 underwent a right ventricular outflow tract procedure(catheter or surgical), 18 underwent an outflow tract procedure with shunt, and 81 underwent a systemic-to-pulmonary shunt alone. One and 5-year survival was 70.8% and 63.8% , respectively. Results from Cox proportional hazards model analysis showed that low birth weight(P=.024), unipartite right ventricular morphology(P=.001), and the presence of a dilated right ventricle(P< .001) were independent risk factors for death. The presence of coronary artery fistulae, right ventricular dependence, or the trcuspid valvar z score did not prove to be risk factors for death. After up to 9 years of follow-up, 29% have achieved a biventricular repair, 3% a so-called one-and-a-half ventricular repair, and 10.5% a univentricular repair, with 16.5% still having a mixed circulation(41% died). Conclusions: This population based study has shown which features at presentation place an infant in a high-risk group. This is important information for counseling in fetal life and for surgical strategy after birth.

关键词：室间隔室中隔肺动脉瓣闭锁人群研究患者预后

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Giant schwannoma of thoracic vertebra: A case report

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World Journal of Clinical Cases 2021年第36期9卷 11448-11456页

作者： Yu Zhou Chao-Zong Liu Shan-Yong Zhang Hao-Yu Wang Swastina Nath Varma Lan-Qing Cao Ting-Ting Hou Xin Li Bao-Jin Yao College of Traditional Chinese Medicine Changchun University of Chinese MedicineChangchun 130000Jilin ProvinceChina Division of Surgery and Interventional Science University College LondonRoyal National Orthopaedic HospitalLondon Stanmore HA74LPUnited Kingdom Department of Spinal Surgery The Second Affiliated Hospital of Jilin UniversityChangchun 130000Jilin ProvinceChina Department of Pathology The Second Affiliated Hospital of Jilin UniversityChangchun 130041Jilin ProvinceChina Jilin Ginseng Academy Changchun University of Chinese MedicineChangchun 130000Jilin ProvinceChina

BACKGROUND It is relatively rare for schwannomas to invade bone,but it is very rare for a large mass to form concurrently in the paravertebral *** resection is the only effective *** of the extensive tumor involvement and the many important surrounding structures,the tumor needs to be fully *** of the tumors are completely removed by posterior combined open-heart surgery to relieve spinal cord compression,restore the stability of the spine and maximize the recovery of nerve and spinal cord *** main objective of this article is to present a schwannoma that had invaded the T5 and T6 vertebral bodies and formed a large paravertebral mass with simultaneous invasion of the spinal canal and compression of the spinal *** SUMMARY A 40-year-old female suffered from intermittent chest and back pain for 8 *** tomography and magnetic resonance imaging scans showed a paravertebral tumor of approximately 86 mm×109 mm×116 mm,where the adjacent T5 and T6 vertebral bodies were invaded by the tumor,the right intervertebral foramen was enlarged,and the tumor had invaded the spinal canal to compress the thoracic *** preoperative puncture biopsy diagnosed a benign *** resection of the tumor was achieved by a two-step *** the first step,the thoracic surgeon adopted a lateral approach to separate the thoracic tumor from the *** the second step,a spine surgeon performed a posterior midline approach to dissect the tumor from the vertebral junction through removal of the tumor from the posterior side and further resection of the entire T5 and T6 vertebral *** large bone defect was reconstructed with titanium mesh,and the posterior root arch was *** to the large amount of intraoperative bleeding,we performed tumor angioembolization before surgery to reduce and avoid large intraoperative *** postoperative diagnosis of benign schwannoma was confirmed by histochemical exam

关键词： Giant schwannoma Neurilemmoma Spinal tumor Surgery Case report

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不同步的节段和整体指标预测患者对心脏再同步化治疗反应的比较

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世界核心医学期刊文摘（心脏病学分册） 2007年第3期3卷 55-56页

作者： Duncan A.M. Lim E. Clague J. 黄浙勇 Department of Echocardiography Royal Brompton Hospital Imperial College Sydney Street London SW3 6NP United Kingdom

目的:心脏再同步化治疗(CRT)可减少心室内和心室间的不同步,缩短总体等容时间(t-IVT)。本研究比较心室不同步和t-IVT预测CRT临床疗效的程度。方法和结果:评价39例心力衰竭患者在CRT之前和CRT后6个月的心室不同步。

关键词：心脏再同步化指标预测临床疗效射血时间心输出量心脏协会室壁运动充盈时间速度峰值临床反

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