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Daniel J. Blackman Smriti Saraf Philip A. MacCarthy Aung Myat Simon G. Anderson Christopher J. Malkin Michael S. Cunnington Kathryn Somers Paul Brennan Ganesh Manoharan Jessica Parker Omar Aldalati Stephen J. Brecker Cameron Dowling Stephen P. Hoole Stephen Dorman Michael Mullen Simon Kennon David Hildick-Smith 《Journal of the American College of Cardiology》2019,73(5):537-545
Background
Very little is known about long-term valve durability after transcatheter aortic valve replacement (TAVR).Objectives
This study sought to evaluate the incidence of structural valve degeneration (SVD) 5 to 10 years post-procedure.Methods
Demographic, procedural, and in-hospital outcome data on patients who underwent TAVR from 2007 to 2011 were obtained from the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) registry. Patients in whom echocardiographic data were available both at baseline and ≥5 years post-TAVR were included. Hemodynamic SVD was determined according to European task force committee guidelines.Results
A total of 241 patients (79.3 ± 7.5 years of age; 46% female) with paired post-procedure and late echocardiographic follow-up (median 5.8 years, range 5 to 10 years) were included. A total of 149 patients (64%) were treated with a self-expandable valve and 80 (34.7%) with a balloon-expandable valve. Peak aortic valve gradient at follow-up was lower than post-procedure (17.1 vs. 19.1 mm Hg; p = 0.002). More patients had none/trivial aortic regurgitation (AR) (47.5% vs. 33%), and fewer had mild AR (42.5% vs. 57%) at follow-up (p = 0.02). There was 1 case (0.4%) of severe SVD 5.3 years after implantation (new severe AR). There were 21 cases (8.7%) of moderate SVD (mean 6.1 years post-implantation; range 4.9 to 8.6 years). Twelve of these (57%) were due to new AR and 9 (43%) to restenosis.Conclusions
Long-term transcatheter aortic valve function is excellent. In the authors’ study, 91% of patients remained free of SVD between 5 and 10 years post-implantation. The incidence of severe SVD was <1%. Moderate SVD occurred in 1 in 12 patients. 相似文献55.
Mary Mashicharan Ian Loke Viktor Zlocha Jeffrey Khoo 《Echocardiography (Mount Kisco, N.Y.)》2019,36(6):1219-1221
We report a patient admitted with acute pulmonary edema 3 months after mitral valve repair, with no history of inter‐current febrile illness. Transesophageal echocardiography (TEE) demonstrated severe mitral regurgitation (MR) and an abnormally positioned annuloplasty ring, suggestive of dehiscence. The extreme extent of ring dehiscence was visualized on 3‐dimensional TEE (3D), with near‐complete separation of the ring. Strept.Mitis and Cristatus were isolated from the ring following redo mitral valve surgery, confirming endocarditis as the mechanism for dehiscence. This report highlights the additive role and superior ability of 3D TEE in the identification and anatomic delineation of mitral ring dehiscence. 相似文献
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Manuel R Cervetti Mariano Camporrotondo Paz Ricapito Juan C Espinoza Fernando Piccinini Mariano Vrancic Daniel Navia 《Journal of cardiac surgery》2019,34(4):214-215
A 67‐year‐old man presented with chest pain. Clinical examination revealed hypertension (160/90 mm Hg). Electrocardiogram indicated no acute coronary syndrome and cardiac enzymes were normal. Catheterization was performed owing to the patient’s continuing chest pain and ascending aortogram revealed irregular aortic wall. A computed tomography image showed the shape of penetrating ulcer. The patient was taken to the operating room and intraoperative examination confirmed the diagnosis of penetrating atherosclerotic ulcer (PAU). Coronary artery bypass graft and bovine pericardial patch repair of PAU was performed. A bovine pericardial patch was done as aortic root was heavily calcified and was easy to handle and more hemostatic. 相似文献
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罗明先 《中华老年病研究电子杂志》2022,9(2):31-34
目的探讨基于PDCA循环的过渡期护理对老年人瓣膜置换术后重症监护室(ICU)出科时期的干预效果。 方法选取2020年10月至2021年9月在遵义医科大学附属医院行瓣膜置换术的老年患者60例,其中30例在ICU出科过渡期采用常规护理(对照组),余30例采用基于PDCA循环的过渡期护理(观察组)。观察两组患者干预前后超声心动图相关指标左室射血分数(LVEF)和左心室舒张末期容积(LVEDV)、医院焦虑抑郁评分量表(HADS)评分、中文版Mishel疾病不确定感量表(MUIS)评分,以及日常生活能力评估量表(ADL)评分变化情况。计数资料的比较采用χ2检验,计量资料的比较采用t检验。 结果护理后,观察组LVEF和LVEDV指数均高于对照组(t=3.286、2.035,P<0.05),HADS-A、HADS-D和MUIS评分均低于对照组(t=3.873、3.873、6.076,P<0.01),ADL评分高于对照组(t=6.076,P<0.01)。 结论基于PDCA循环的过渡期护理可明显改善老年人瓣膜置换术后从ICU转入普通病房期间的焦虑情绪和疾病不确定感,促进心功能恢复,提高自理能力。 相似文献
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《Foot and Ankle Surgery》2022,28(8):1163-1169
The post-operative results of a total ankle replacement are not determined solely by an optimal surgical technique, but by an appropriate anesthesiological and rehabilitative post-operative approach. Enhanced functional recovery often depends on a multidisciplinary approach based on a correct framework of the patient and his needs, requests, and characteristics.Extensive bibliographical research has been performed on Pubmed, Google Scholar, Scopus.This comprehensive and inclusive review of the literature aims to examine the state of the art of “fast-track” protocols employed in total ankle replacement (TAR), considering pre-operative preparation, anesthetic management, intraoperative and surgical factors, post-operative rehabilitative care and reduction of hospitalization time. 相似文献