ABSTRACT
The authors present a case of percutaneous closure of an incomplete surgical left atrial appendage (LAA) ligation with a new device LAmbre (Lifetech ScientificCo Ltd).
Subject(s)
Aortic Valve Stenosis , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/methods , Transcatheter Aortic Valve Replacement/adverse effects , Aortic Valve Stenosis/surgery , Aortic Valve Stenosis/diagnostic imaging , Aorta/diagnostic imaging , Dilatation, Pathologic , Male , Aged , Aged, 80 and over , FemaleSubject(s)
Aortic Valve Insufficiency , Aortic Valve Stenosis , Heart Failure , Heart Valve Prosthesis , Heart-Assist Devices , Transcatheter Aortic Valve Replacement , Humans , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/etiology , Aortic Valve Insufficiency/surgery , Heart Failure/etiology , Heart Failure/surgery , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome , Prosthesis DesignSubject(s)
Cardiac Valve Annuloplasty , Tricuspid Valve Insufficiency , Humans , Ventricular Remodeling , Treatment Outcome , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Mitral Valve/surgery , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/surgery , Cardiac Valve Annuloplasty/adverse effectsSubject(s)
Heart Valve Prosthesis Implantation , Tricuspid Valve Insufficiency , Humans , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/surgery , Treatment Outcome , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Mitral Valve/surgery , Heart Valve Prosthesis Implantation/adverse effects , Cardiac CatheterizationSubject(s)
Aneurysm, False , Aortic Valve Stenosis , Heart Aneurysm , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Aneurysm, False/diagnostic imaging , Aneurysm, False/etiology , Aneurysm, False/therapy , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Treatment Outcome , Aortic Valve/diagnostic imaging , Aortic Valve/surgery , Risk FactorsABSTRACT
BACKGROUND: Severe tricuspid regurgitation (TR) is frequently associated with significant morbidity and mortality; such patients are often deemed to be at high surgical risk. Heterotopic bicaval stenting is an emerging, attractive transcatheter solution for these patients. OBJECTIVES: The aim of this study was to evaluate the 30-day safety and 6-month efficacy outcomes of specifically designed bioprosthetic valves for the superior and inferior vena cava. METHODS: TRICUS EURO (Safety and Efficacy of the TricValve® Transcatheter Bicaval Valves System in the Superior and Inferior Vena Cava in Patients With Severe Tricuspid Regurgitation) is a nonblinded, nonrandomized, single-arm, multicenter, prospective trial that enrolled patients from 12 European centers between December 2019 and February 2021. High-risk individuals with severe symptomatic TR despite optimal medical therapy were included. The primary endpoint was quality-of-life (QOL) improvement measured by Kansas City Cardiomyopathy Questionnaire score and New York Heart Association (NYHA) functional class improvement at 6-month follow-up. RESULTS: Thirty-five patients (mean age 76 ± 6.8 years, 83% women) were treated using the TricValve system. All patients at baseline were in NYHA functional class III or IV. At 30 days, procedural success was 94%, with no procedural deaths or conversions to surgery. A significant increase in QOL at 6 months follow-up was observed (baseline and 6-month Kansas City Cardiomyopathy Questionnaire scores 42.01 ± 22.3 and 59.7 ± 23.6, respectively; P = 0.004), correlating with a significant improvement in NYHA functional class, with 79.4% of patients noted to be in functional class I or II at 6 months (P = 0.0006). The rates of 6-month all-cause mortality and heart failure hospitalization were 8.5% and 20%, respectively. CONCLUSIONS: The dedicated bicaval system for treating severe symptomatic TR was associated with a high procedural success rate and significant improvements in both QOL and functional classification at 6 months follow-up.
Subject(s)
Cardiomyopathies , Heart Valve Prosthesis Implantation , Tricuspid Valve Insufficiency , Aged , Aged, 80 and over , Cardiac Catheterization/adverse effects , Female , Heart Valve Prosthesis Implantation/adverse effects , Humans , Male , Prospective Studies , Quality of Life , Severity of Illness Index , Treatment Outcome , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/surgerySubject(s)
Aortic Valve Stenosis , Transcatheter Aortic Valve Replacement , Tricuspid Valve Insufficiency , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , Humans , Treatment Outcome , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/surgeryABSTRACT
INTRODUCTION: In previous studies the risk of stroke recurrence has been associated with the left atrial appendage (LAA) morphology (non-chicken wing (NCW)), knowing those with a greater risk as malignant LAA. Recently, a simpler morphological classification has been suggested with two categories: Low-risk (LAA-L) and High-risk (LAA-H); which could be easier to apply and may correlate better with the risk of embolic stroke. METHODS: Retrospective analysis from a registry of patients with recurrent cardioembolic strokes despite appropriate anticoagulant therapy, in which LAA morphology was studied with cardiac CT scan. LAA morphology was classified according to the four current categories and H-L morphology by the same cardiologist. Other variables associated with a high risk of stroke were also assessed, such as CHA2DS2-VASc score and left atrial (LA) size. RESULTS: Twenty-six cases were included in the analysis. We identified 22 (84.6%) chicken wing (CW), 1 (3.8%) windsock and 3 (11.5%) cactus by the current classification system, while 15 (57.7%) were classified as LAA-H and 11 (42.3%) as LAA-L by the new system. Half of the 22 cases with CW morphology were considered LAA-H, whereas all NCW were also classified as LAA-H. LA diameter and area were significantly higher in cases with LAA-H morphology (p=0.03 and 0.014), and also in those CW and LAA-H, compared to those CW with LAA-L (p=0.035). CONCLUSIONS: With this new classification system more than half of the cases of our malignant LAAs were classified as high-risk morphology. This morphology was also associated with an increased LA size.
Subject(s)
Atrial Appendage/diagnostic imaging , Embolic Stroke/etiology , Heart Diseases/diagnostic imaging , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Embolic Stroke/diagnostic imaging , Female , Heart Diseases/complications , Humans , Male , Middle Aged , Predictive Value of Tests , Registries , Retrospective Studies , Risk Assessment , Risk Factors , Terminology as TopicABSTRACT
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to a paradigm shift in healthcare worldwide. Little is known about the impact on the cardiovascular system, and the incidence and consequences of new onset of atrial fibrillation (AF) in infected patients remain unclear. The aim of this study was to analyze the cardiovascular outcomes of patients with newonset AF and coronavirus disease 2019 (COVID-19) infection. METHODS: This observational study analyzed a sample of 160 consecutive patients hospitalized due to COVID-19. A group with new-onset AF (n = 12) was compared with a control group (total: n = 148, sinus rhythm: n = 118, previous AF: n = 30). New-onset AF patients were significantly older and hypertensive, as well as presenting more frequently with a history of acute coronary syndrome and renal dysfunction. This group showed a higher incidence of thromboembolic events (41.7% vs. 4.1%; p < 0.001), bleeding (33.3% vs. 4.7%, p = 0.005), a combined endpoint of thrombosis and death (58.3% vs. 19.6%, p = 0.006) and longer hospital stays (16.4 vs. 8.6 days, p < 0.001), with no differences in all-cause mortality. RESULTS: In multivariate analysis, adjusted by potential confounding factors, new-onset AF demonstrated a 14.26 odds ratio for thromboembolism (95% confidence interval 2.86-71.10, p < 0.001). CONCLUSIONS: New-onset AF in COVID-19 patients presumably has a notable impact on prognosis. The appearance of new-onset AF is related to worse cardiovascular outcomes, considering it as an independent predictor of embolic events. Further studies are needed to identify patients with COVID-19 at high risk of developing "de novo" AF, provide early anticoagulation and minimize the embolic risk of both entities.
Subject(s)
Atrial Fibrillation/epidemiology , COVID-19/epidemiology , Pandemics , Registries , SARS-CoV-2 , Aged , Hospital Mortality/trends , Humans , Incidence , Middle Aged , Prognosis , Risk Factors , Spain/epidemiology , Survival Rate/trendsABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Aged, 80 and over , Serum Albumin/analysis , Risk Assessment/methods , Aortic Valve Stenosis/surgery , Transcatheter Aortic Valve Replacement/methods , Aortic Valve Stenosis/mortality , Albumins/metabolism , Biomarkers , Retrospective Studies , Serum Albumin/administration & dosage , Serum Albumin/classificationABSTRACT
No disponible
Subject(s)
Humans , Tricuspid Valve Insufficiency/surgery , Mitral Valve Insufficiency/surgery , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Treatment OutcomeSubject(s)
Heart Valve Prosthesis Implantation , Heart Valve Prosthesis , Tricuspid Valve Insufficiency , Cardiac Catheterization , Fluoroscopy , Humans , Treatment Outcome , Tricuspid Valve/diagnostic imaging , Tricuspid Valve/surgery , Tricuspid Valve Insufficiency/diagnostic imaging , Tricuspid Valve Insufficiency/surgeryABSTRACT
BACKGROUND: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip® between two groups according to LVEF. METHODS: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%. The primary endpoint was the combined one-year all-cause mortality and unplanned hospital readmissions due to HF. The secondary end-points were New York Heart Association (NYHA) functional class and mitral regurgitation (MR) severity. Propensity-score matching was used to create two groups with the same baseline characteristics, except for baseline LVEF. RESULTS: Among 535 FMR eligible patients, 144 patients with LVEF <30% (group 1) and 144 with LVEF >30% (group 2) had similar propensity scores and were included in the analyses. The primary study endpoint was significantlly higher in group 1 (33.3% vs. 9.4%, p = 0.002). There was a maintained improvement in secondary endpoints without significant differences among groups. CONCLUSION: FMR patients with LVEF <30% treated with MitraClip® had higher mortality and readmissions than patients with LVEF ≥30% treated with the same device. However, both groups improved the NYHA functional class and MR severity.
ABSTRACT
No disponible