排序方式: 共有33条查询结果,搜索用时 15 毫秒
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Rakesh M. Suri Brian C. Gulack J. Matthew Brennan Vinod H. Thourani Dadi Dai Alan Zajarias Kevin L. Greason Christina M. Vassileva Verghese Mathew Vuyisile T. Nkomo Michael J. Mack Charanjit S. Rihal Lars G. Svensson Rick A. Nishimura Patrick T. O’Gara David R. Holmes Jr. 《The Annals of thoracic surgery》2015,100(6):2136-2146
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Haotian Gu Sahrai Saeed Andrii Boguslavskyi Gerald Carr-White John B. Chambers Phil Chowienczyk 《JACC: Cardiovascular Imaging》2019,12(1):52-63
Objectives
This study investigated the prognostic value of first-phase ejection fraction (EF1) in patients with aortic stenosis (AS), a condition in which left ventricular dysfunction as measured by conventional indices is an indication for valve replacement.Background
EF1, the ejection fraction up to the time of maximal ventricular contraction may be more sensitive than existing markers in detecting early systolic dysfunction.Methods
The predictive value of EF1 compared to that of conventional echocardiographic indices for outcomes was assessed in 218 asymptomatic patients with at least moderate AS, including 73 with moderate, 50 with severe, and 96 with “discordant” (aortic area <1.0 cm2 and gradient <40 mm Hg) AS, all with preserved EF, followed for at least 2 years. EF1 was measured retrospectively from archived echocardiographic images by wall tracking of the endocardium. The primary outcome was a combination of aortic valve intervention, hospitalization for heart failure, and death from any cause.Results
EF1 was the most powerful predictor of events in the total population and all subgroups. A cutoff value of 25% (or EF1 of <25% compared to ≥25%) gave hazard ratios of 27.7 (95% confidence interval [CI]: 13.1 to 58.7; p < 0.001) unadjusted and 24.4 (95% CI: 11.3 to 52.7; p < 0.001) adjusted for other echocardiographic measurements including global longitudinal strain, for events at 2 years in all patients with asymptomatic AS. Corresponding hazard ratios for all-cause mortality in the total population were 17.5 (95% CI: 5.7 to 53.3) and 17.4 (95% CI: 5.5 to 55.2) unadjusted and adjusted, respectively.Conclusions
EF1 may be potentially valuable in the clinical management of patients with AS and other conditions in which there is progression from early to late systolic dysfunction. 相似文献3.
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Tolstoi AD Dzhurko BI Vashetko RV Medvedev YV Gol'tsov VR Dvoinov VG Zakharova EV 《Bulletin of experimental biology and medicine》2001,131(4):312-314
We evaluated the efficiency of perfusion with olifen in preventing oxidative stress at the early stage of acute pancreatitis. Transaortic perfusion with olifen prevented clinical and biochemical symptoms of acute pancreatitis, attenuated oxidative stress, reduced peritoneal exudation, and restricts the area of pancreatic necrosis to 6% tissue. 相似文献
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Henrique B. RibeiroAbdellaziz Dahou MD Marina UrenaJose Luis Carrasco MD Siamak MohammadiDaniel Doyle MD Florent Le VenRicardo Allende MD Ignacio Amat-SantosJean-Michel Paradis MD Robert DeLarochellièreRishi Puri MBBS PhD Omar Abdul-Jawad AltisentMaria del Trigo MD Francisco Campelo-ParadaPhilippe Pibarot DVM PhD Éric DumontJosep Rodés-Cabau MD 《The Annals of thoracic surgery》2015,99(6):2001-2009
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目的 系统评价不同路径经导管主动脉瓣置入术(TAVI)围手术期常见并发症的发生情况.方法 通过对PubMed、Embase、Ovid Medline数据库和效果评价文摘数据库(DARE)进行文献检索,获得已公开发表的行经心尖(TAp)、经股动脉(TF)及经升主动脉(TAo)3种路径TAVI的随机对照研究,统计各路径患者术后早期(30 d内)病死率、人工瓣膜瓣周漏、严重出血事件、大血管并发症、卒中、急性肾损伤及起搏器依赖型传导阻滞等手术相关或常见的严重并发症的发生情况,用Review Manager 5.3软件行meta分析.结果 研究共纳入22篇文献,总病例数11 530例.TAp组、TAo组患者术后早期人工瓣膜瓣周漏发生率均低于TF组[4.6%(63/1 384) vs 9.2%(400/4 366),P<0.000 01;6.4%(33/518) vs 9.3%(331/3 541),P=0.002],而术后早期病死率均高于TF组[10.0%(271/2 711) vs4.8% (326/6 756),P<0.000 01;8.9%(46/518) vs 4.5%(160/3 541),P=0.002].TAp组、TAo组患者的术后早期严重出血发生率均高于TF组[8.4%(186/2 204) vs 3.9%(268/6 818),P<0.000 01;6.5%(35/542) vs 1.4%(50/3 569),P=0.01].TAp组患者术后早期大血管并发症发生率低于TF组[2.3%(58/2 524) vs 6.5%(417/6 367),P<0.000 01],而TAo组与TAp组、TF组相比差异均无统计学意义.3组患者的术后早期卒中发生率差异均无统计学意义(P>0.05).TF组患者术后早期急性肾损伤发生率低于TAp组[8.3%(610/7 334) vs 22.8%(615/2 699),P<0.000 01]和TAo组[3.1%(110/3 569) vs 12.5%(68/542),P<0.000 01].TF组患者术后早期起搏器依赖型传导阻滞发生率高于TAo组[13.2%(472/3 569) vs 9.2%(50/542),P=0.003].结论 经TAp路径及经TF路径行TAVI路径较短,可以有效减少瓣周漏及大血管损伤的发生,具备独特的优势与潜在价值. 相似文献
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Thom G. Dahle Tsuyoshi Kaneko James M. McCabe 《JACC: Cardiovascular Interventions》2019,12(7):662-669
Objectives
The aim of this study was to analyze the frequency and outcomes of patients who underwent transsubclavian or transaxillary (TAx) transcatheter aortic valve replacement (TAVR) using the balloon-expandable SAPIEN 3 prosthesis compared with traditional alternative access, transapical (TA) and transaortic (TAo).Background
The transsubclavian and TAx approaches for TAVR are rapidly growing alternatives in the setting of hostile iliofemoral arteries, yet few data exist.Methods
The Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry was queried for all patients undergoing TAx TAVR with the SAPIEN 3 prosthesis from June 2015 to February 2018. Secular trends over time were evaluated. Logistic regression analyses used to assess risk-adjusted outcomes. Propensity score matching was used to compare TAx access with TA and TAo access.Results
In total, 3,628 patients (5.7%) underwent nontransfemoral access with the SAPIEN 3. Overall, TAx TAVR accounted for 1,249 of these patients (34.4%). There has been rapid recent growth in TAx TAVR (from 20.2% in the third quarter of 2015 to 49.0% in the fourth quarter of 2017; p < 0.001 for trend) and a concomitant decrease in TA and TAo access (from 61.9% in the third quarter of 2015 to 35.3% in the fourth quarter of 2017; p < 0.001 for trend). The median number of TAx TAVR cases per hospital during the study period was 2, and 78.2% of centers performed ≤5 TAx TAVR procedures. The device success rate was 97.3%, and the major vascular complication rate was 2.5%. After propensity matching, TAx access had lower 30-day mortality (5.3% vs. 8.4%; p < 0.01), shorter lengths of intensive care unit and hospital stay, but a higher stroke rate (6.3% vs. 3.1%; p < 0.05) compared with TA and TAo access.Conclusions
TAx access has become the most frequent alternative access route for balloon-expandable TAVR procedures. Outcomes following TAx TAVR appear positive despite the relatively early experience of most centers performing these cases. 相似文献10.