Background: Percutaneous mitral valve repair (MVR) using the Evalve MitraClip has been recently introduced as a potential alternative to surgical MVR. Objective: To assess immediate haemodynamic changes after percutaneous MVR using right heart catheterisation. Heart 2012;98:126-132. doi:10.1136/heartjnl-2011-300705
Objective To assess the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared with medical management in patients with severe aortic stenosis who are ineligible for conventional aortic valve replacement (SAVR) from the perspective of the UK National Health Service. Heart 2012;98:370e376. doi:10.1136/heartjnl-2011-300444
Objective To assess the cost-effectiveness of dabigatran etexilate, a new oral anticoagulant, versus warfarin and other alternatives for the prevention of stroke and systemic embolism in UK patients with atrial fibrillation (AF). Heart 2012;98:573e578. doi:10.1136/heartjnl-2011-300646
Background —Percutaneous repair has emerged as a potential therapy for patients with prosthetic paravalvular regurgitation. However, there is a relative paucity of data on the feasibility and outcome of this procedure. Copyright © 2011. American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.
Background —To assess the results of transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve System (MCS), through the transarterial approach, in high-risk patients with degenerated surgically implanted aortic bioprostheses (SP). Copyright © 2011. American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632
With an aging population, improvement in life expectancy, and significant increase in the use of bioprosthetic valves, structural valve deterioration will become more and more prevalent. The operative mortality for an elective redo aortic valve surgery is reported to range from 2% to 7%, but this percentage can increase to more than 30% in high-risk and nonelective patients. Because transcatheter aortic valve (TAV)-in-surgical aortic valve (SAV) implantation represents a minimally invasive alternative to conventional redo surgery, it may prove to be safer and just as effective as redo surgery. Of course, prospective comparisons with a large number of patients and long-term follow-up are required to confirm these potential advantages. It is axiomatic that knowledge of the basic construction and dimensions, radiographic identification, and potential failure modes of SAV bioprostheses is fundamental in understanding key principles involved in TAV-in-SAV implantation. The goals of this paper are: 1) to review the classification, physical characteristics, and potential failure modes of surgical bioprosthetic aortic valves; and 2) to discuss patient selection and procedural techniques relevant to TAV-in-SAV implantation. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 7, 2011 Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC.
The PARTNER (Placement of Aortic Transcatheter Valves) trial, recently published (1) and presented at the 2010 Transcatheter Cardiovascular Therapeutics conference, investigated the safety and efficacy of transcatheter aortic-valve implantation (TAVI) in patients deemed unsuitable for surgical aortic valve replacement. Severe calcific aortic stenosis (AS) is an increasingly prevalent disease in elderly persons, with a high and rapid rate of mortality in untreated patients, approaching 50% mortality over the first 2 years (2). Aortic valve replacement is the current gold standard of treatment and has been proven to prolong and improve quality of life in good operative candidates; however, in patients with multiple or severe comorbidities and high operative risk, surgery is often prohibitive (3,4). Transcatheter aortic-valve implantation is a newer and less invasive alternative approach that has demonstrated favorable results and low mortality in these highsurgical-risk patients in the PARTNER trial. JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 1, 2011 Copyright © 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC.
Atherothrombosis remains one of the main causes of morbidity and mortality in the western countries. Human atherothrombotic disease begins early in life in relation to circulating lipid retention in the inner vascular wall. Risk factors enhance the progression towards clinical expression: dyslipidaemia, diabetes, smoking, hypertension, ageing, etc. The evolution from the initial lipid retention in the arterial wall to clinical events is a continuum of increasingly complex biological processes. Current strategies to fight the consequences of atherothrombosis are orientated either towards the promotion of a healthy life style 1 and preventive treatment of risk factors, or towards late interventional strategies. 2 Despite this therapeutic arsenal, the incidence of clinical events remains dramatically high, 3 dependent, at least in part, on the increasing frequency of type 2 diabetes and ageing. But some medical treatments, focusing only on prevention of the metabolic risk, have failed to reduce cardiovascular mortality, thus illustrating that our understanding of the pathophysiology of human atherothrombosis leading to clinical events remain incomplete. New paradigms are now emerging which may give rise to novel experimental strategies to improve therapeutic efficacy and prediction of disease progression. Recent studies strengthen the concept that the intraplaque neovascularization and bleeding (Figure 1, upper panel) are events that could play a major role in plaque progression and leucocyte infiltration, and may also serve as a measure of risk for the development of future events. The recent advances in our understanding of IntraPlaque Hemorrhage as a critical event in triggering acute clinical events have important implications for clinical research and possibly future clinical practice. European Heart Journal (2011) 32, 1977–1985. Published on behalf of the European Society of Cardiology. All rights reserved. Copyright © The Author 2011.
Transfemoral aortic valve implantation (TAVI) has become an important interventional technique for patients with severe aortic stenosis (AS) and very high surgical risks. Several studies have demonstrated the feasibility and clinical success of TAVI procedures. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.
RFCA has been established as an effective and curative therapy for severely symptomatic PVC from the outflow tract in structurally normal hearts. However, it is unknown whether PVCs originating from the left ventricular septum, are effectively eliminated by RFCA. This study aimed to investigate electrophysiologic characteristics and effects of Radiofrequency catheter ablation (RFCA) for patients with symptomatic premature ventricular contraction (PVC) originating from the left ventricular septum without including fascicular PVCs. Jia et al. BMC Cardiovascular Disorders 2011, 11:27 http://www.biomedcentral.com/1471-2261/11/27. Copyright © 2011 Jia et al; licensee BioMed Central Ltd.
Data on clinical outcomes among patients treated with the zotarolimus-eluting Endeavor™ stent versus the sirolimus-eluting Cypher™ stent favor the sirolimus-eluting stent. However, a separate comparison of clinical outcome among patients treated for multiple lesions with these stents is lacking. We performed this comparison within the SORT OUT III trial data set. Thim et al. BMC Cardiovascular Disorders 2012, 12:18 http://www.biomedcentral.com/1471-2261/12/18. Copyright © 2012 Thim et al; licensee BioMed Central Ltd.
The long-term safety and effectiveness of drug-eluting stents (DES) versus bare metal stents (BMS) in non-ST-segment elevation myocardial infarction (NSTEMI) beyond 2 years after percutaneous coronary intervention (PCI) is unknown. Journal of Interventional Cardiology. Vol. 25, No. 1, 2012. Copyright 2011, Wiley Periodicals, Inc.
The risk of excessive bleeding prompts physicians to stop multiple antiplatelet agents before minor surgery, which puts coronary stenting patients at risk for adverse thrombotic events. Hypothesis: We hypothesized that most dental extractions can be carried out safely without stopping multiple antiplatelet agents. Clin. Cardiol. 35, 4, 225–230 (2012) 225 Published online in Wiley Online Library. Copyright © 2012 Wiley Periodicals, Inc.
Background—The NEVO sirolimus-eluting stent (NEVO SES) is a novel cobalt-chromium stent combining sirolimus release from reservoirs with bioabsorbable polymer to reduce spatial and temporal polymer exposure. The aim of this study was to assess the arterial response to the NEVO SES in a randomized, blinded comparison versus the surface-coated TAXUS Liberte paclitaxel-eluting stent (TAXUS Liberte´ PES) in human native coronary lesions using intravascular ultrasound (IVUS). Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632
Spontaneous coronary artery dissection (SCAD) is an infrequent cause of acute coronary syndromes but is represented disproportionately in young female patients. No specific guidelines exist concerning the appropriate treatment (medical therapy, intracoronary stents, coronary bypass surgery) or the optimal type of stents in otherwise atheroma-free vessels. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.
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