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Combined carotid endarterectomy and transcatheter aortic valve replacement: Technique and outcomes 下载免费PDF全文
Robert J. Moraca MD Anil A. Shah MS Stephen H. Bailey MD Daniel Benckart MD David Lasorda DO Ramzi Khalil MD Bart Chess MD Walter McGregor Michael S. Halbreiner MD 《Journal of cardiac surgery》2018,33(5):265-269
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Steven Maximus Jeffrey C. Milliken Beate Danielsen Richard Shemin Junaid Khan Joseph S. Carey 《The Journal of thoracic and cardiovascular surgery》2018,155(4):1447-1456
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Transcatheter aortic valve replacement (TAVR) procedures were introduced in 2011. Initially, procedures were limited to patients who were not surgical candidates, but subsequently high-risk surgical candidates were considered for TAVR. The influence on aortic valve surgery in California is unknown.Methods
The California Office of Statewide Health Planning and Development hospitalized patient discharge database was queried for the years 2009 through 2014. isolated surgical aortic valve and aortic valve/coronary artery bypass graft (SAVR) and TAVR procedures were identified by International Classification of Diseases-9th revision clinical modification procedure codes. Seven TAVR programs were introduced in 2011, 12 in 2012, 3 in 2013, and 6 in 2014. SAVR procedure volumes were compared from the 2 years before institution with SAVR volumes during the year(s) after institution of the TAVR program in these 28 hospitals.Results
Overall, surgical volumes increased during the first, second, and third years after implementation of TAVR procedures. Among 7 hospitals with 4-year programs, surgical volumes increased to a maximum of 15.5% during the third year, then began to decrease. The hospital performing the largest number of TAVR procedures showed a marked decrease in SAVR volume by the fourth year, suggesting a shift of SAVR candidates to TAVR. Among all hospitals with 4-year programs, TAVR exceeded SAVR procedures by the fourth year. In California overall, SAVR increased during 2011 through 2013, due primarily to increasing volume of isolated SAVR procedures. Statewide, isolated SAVR increased from a yearly average of 3111 procedures during 2009-2010 to 3592 (+15.5%) in 2013, then decreased slightly in 2014. SAVR plus coronary artery bypass graft procedures decreased during the same time period.Conclusions
After implementation of TAVR, hospital SAVR volumes increased moderately, then began to decrease by the fourth year, when TAVR volume exceeded SAVR. Surgical candidates may be identified during evaluation for TAVR, resulting in increased SAVR volume. Increasing SAVR volume may also be related to improved patient and provider awareness of aortic valve disease. 相似文献5.
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Koichi Maeda Toru Kuratani Kazuo Shimamura Yu Yamada Koichi Toda Yoshiki Sawa 《Journal of cardiac surgery》2021,36(1):386-389
A 50‐year‐old man with decompensated aortic stenosis displayed significantly reduced ejection fraction, an ascending aortic aneurysm (55 mm in diameter), and bilateral giant bullae, and was evaluated as having extremely high surgical risk. Therefore, as a bridge to definitive treatment, he simultaneously underwent transcatheter aortic valve replacement (TAVR) and upper left lung lobectomy. His heart function recovered 6 months later and he underwent surgical aortic valve replacement (SAVR) and graft replacement of the ascending aorta. TAVR may serve as a bridge procedure before SAVR for aortic stenosis in younger patients with high surgical risk. 相似文献
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Transcatheter aortic valve replacement (TAVR) has become an attractive alternative for patients with severe aortic stenosis at high surgical risk. We describe a step-by-step approach to performing TAVR with the SAPIEN XT valve. 相似文献
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Travis J. Wilder MD Vikas Sharma MD Antigone Koliopoulou MD Stephen H. McKellar MD MSc Craig H. Selzman MD Jason P. Glotzbach MD 《Journal of cardiac surgery》2020,35(1):222-225
Reoperative aortic root replacement, following prior biologic or mechanical valved conduit aortic root prosthesis, presents a technical challenge. The rapid-deployment aortic valve prosthesis is an approved alternative to traditional bioprosthetic aortic valve replacement. We present three clinical cases in which rapid-deployment aortic valve prostheses were utilized in lieu of reoperative full aortic root replacement. All three patients recovered uneventfully. The rapid-deployment valve insertion in a prior surgical aortic root prosthesis is a safe option to avoid reoperative full aortic root replacement. 相似文献
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Gabriela Tirado‐Conte Carolina Espejo‐Paeres Luis Nombela‐Franco Pilar Jimenez‐Quevedo Javier Cobiella David Vivas Jose Alberto de Agustín Angela McInerney Eduardo Pozo Pablo Salinas Ivan Nuez‐Gil Nieves Gonzalo Enrique Villagran Alfonso de Hoyos Hernn Mejia‐Renteria Fernando Macaya Manuel Carnero Isidre Vilacosta Antonio Fernndez‐Ortiz Javier Escaned Luis Maroto Carlos Macaya 《Journal of cardiac surgery》2021,36(1):31-39
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Yasuo Kondo Tomoaki Suzuki Masahide Enomoto Noriyuki Takashima Takeshi Kinoshita 《Indian Journal of Thoracic and Cardiovascular Surgery》2022,38(2):134
PurposeThis study investigated the use of psoas muscle area index (PAI) as an indicator of mortality risk in relation to survival in elderly patients after isolated surgical aortic valve replacement (SAVR) for aortic valve stenosis (AS).MethodsBetween January 2005 and March 2015, 140 patients with AS, aged ≥ 70 years, and with preoperative abdominal computed tomography scans, underwent elective, primary, isolated SAVR. PAI showed the ratio of the psoas muscle cross-sectional area at the fourth lumbar vertebral level to body surface area, and PAI less than the gender-specific lowest 20th percentile we called “low PAI” for the purposes of this study. Patients were classified as low PAI (n = 29) or normal PAI (n = 111).ResultsThe mean age in the low-PAI group was significantly older than in the normal-PAI group (81.0 vs. 77.3 years; p = 0.001). The mean follow-up was 4.25 years. The low-PAI group had a lower survival rate than the normal-PAI group at 1 year (89.7 ± 5.7% vs. 96.3 ± 1.8%), at 3 years (71.6 ± 9.3% vs. 91.5 ± 2.7%), and overall (53.0 ± 13.4% vs. 76.0 ± 5.6%; p = 0.039). The prognostic factors of mortality included low PAI (hazard ratio 2.95; 95% confidence interval 1.084–8.079; p = 0.034).ConclusionsPAI was associated with reduced overall survival after isolated SAVR in elderly people. PAI measurement may help to predict patient risks. 相似文献
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Jelani K. Grant Joao Braghiroli Andrew Panakos Eduardo De Marchena 《Journal of cardiac surgery》2019,34(8):738-741
The Edwards Intuity Elite valve system was designed to facilitate minimally invasive surgery and streamline complex aortic valve replacements and has since gained more popularity. Despite the superior results shown with rapid deployment aortic valve replacement (RDAVR) utilizing this valve system, paravalvular leaks (PVL), as a complication, remains a concern. Currently, there is no universally agreed single treatment option. A 53‐year‐old male with a history of well‐controlled diabetes mellitus and hypertension presented to the emergency room with a 1‐month history of angina, syncope on exertion and dyspnea. On further workup, he was found to have severe aortic stenosis in the setting of a bicuspid aortic valve, with non‐obstructive coronary artery disease. He proceeded to urgent RDAVR with a 23 mm Edwards Intuity Valve. Six months post‐RDAVR he re‐presented with dyspnea on exertion and near syncopal episodes. Postoperative transthoracic and transesophageal echocardiography revealed moderate to severe PVL posterior to the prosthetic aortic valve. Balloon valvuloplasty with a 25 mm True Balloon was performed. Resolution of the PVL was confirmed postprocedure both by angiography and echocardiography. The patient was followed for 1 year and remained symptom‐free with evidence of mild PVL on surveillance echocardiography. In conclusion, multiple treatment options for RDAVR complicated by PVL exist; however mid to long‐term outcome data are lacking. We presented one such case successfully treated with balloon aortic valvuloplasty. 相似文献
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Hironori Matsuhisa Nobuhiko Mukouhara Hidefumi Obo Keitaro Nakagiri Shuichi Kozawa Tsutomu Shida 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(8):381-383
We present a 57-year-old woman with severe aortic stenosis. She was diagnosed with acute myocardial infarction by electrocardiography
and the detection of elevated creatine phosphokinase in another hospital. Soon after transfer to our hospital, this patient
developed cardiac arrest. Percutaneous cardiopulmonary support (PCPS) was established, and subsequently performed coronary
angiography revealed normal coronary arteries. However echocardiography revealed severe aortic stenosis. Emergency aortic
valve replacement (AVR) was performed, and the patient was discharged from hospital 30 days after surgery in good health.
Prompt establishment of PCPS maintained her systemic circulation, and allowed us to conduct investigations for diagnosis.
In patients with critical aortic stenosis, emergency AVR should be performed as early as possible following diagnosis. 相似文献
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Early and midterm outcomes of transcatheter aortic valve replacement in patients with bicuspid aortic valves 下载免费PDF全文
Seyed Hossein Aalaei‐Andabili MD Thomas M. Beaver MD MPH John W. Petersen MD R David Anderson MD Ashkan Karimi MD Eric Thoburn MD Ali Kabir MD MPH PhD Anthony A. Bavry MD MPH George J. Arnaoutakis MD 《Journal of cardiac surgery》2018,33(9):489-496