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Journal and News Scan
Bauters C, et al. – There are limited data on the prognosis of patients with stable coronary artery disease (CAD) in modern clinical practice. The mortality rate of patients with stable CAD in modern clinical practice is similar to that of the general population and is mostly due to noncardiovascular causes.
The purpose of this study was to assess the outcome of SA over 5 years and determine predictors for success over that period. This study demonstrated stable results of SA for AF over time with somewhat different predictors for 2– and 5–year NSR in a group of patients with complete follow–up at both time points. Accurate models to determine predictors for success of SA more than 2 years after surgery are essential to better understand long–term outcome for patients with AF.
Authors compared transcatheter aortic–valve replacement (TAVR), using a self–expanding transcatheter aortic–valve bioprosthesis, with surgical aortic–valve replacement in patients with severe aortic stenosis and an increased risk of death during surgery. In patients with severe aortic stenosis who are at increased surgical risk, TAVR with a self–expanding transcatheter aortic–valve bioprosthesis was associated with a significantly higher rate of survival at 1 year than surgical aortic–valve replacement.
- Authors recruited patients with severe aortic stenosis who were at increased surgical risk as determined by the heart team at each study center.
- Risk assessment included the Society of Thoracic Surgeons Predictor Risk of Mortality estimate and consideration of other key risk factors.
- Eligible patients were randomly assigned in a 1:1 ratio to TAVR with the self–expanding transcatheter valve (TAVR group) or to surgical aortic–valve replacement (surgical group).
- The primary end point was the rate of death from any cause at 1 year, evaluated with the use of both noninferiority and superiority testing.
- A total of 795 patients underwent randomization at 45 centers in the United States.
- In the as–treated analysis, the rate of death from any cause at 1 year was significantly lower in the TAVR group than in the surgical group (14.2% vs. 19.1%), with an absolute reduction in risk of 4.9 percentage points (upper boundary of the 95% confidence interval, -0.4; P<0.001 for noninferiority; P = 0.04 for superiority).
- The results were similar in the intention–to–treat analysis.
- In a hierarchical testing procedure, TAVR was noninferior with respect to echocardiographic indexes of valve stenosis, functional status, and quality of life.
- Exploratory analyses suggested a reduction in the rate of major adverse cardiovascular and cerebrovascular events and no increase in the risk of stroke.
In this study the authors looked at the impact of coronary artery disease (CAD) in a single series of 445 patients undergoing TAVI for aortic valve stenosis. The pre-established primary endpoint of the study was a composite of cardiovascular death, stroke, or myocardial infarction (MI)—at 1 year. Patients were divided into three groups according to the severity of CAD as determined by the SYNTAX score (SS): no CAD, CAD with SS ≤ 22 and CAD with SS >22. At 1-year, increased CAD severity was associated with higher rates of the primary endpoint. This was mainly driven by a difference in cardiovascular death. The risk of stroke and MI was similar in all three groups.
The Flex System is a flexible endoscopic system that enables surgeons to access and visualize hard-to-reach anatomical locations. The system thus promises to extend the benefits of minimally invasive surgery – shorter hospital stays and recovery times – to a broader population of patients. The company initially has targeted the system for use in head and neck surgery, operating through the mouth.
This is a free app that collates thousands of new stories and abstracts from peer reviewed journal and news organisations. It also has a forum area and has cardiology and surgery sections.
Nothing to do with CTSNet, but it is free so might be worth a look
This is an interesting article on the provision of pediatric cardiac surgery in the developing world.
Dr. Gabriel Aldea outlines the latest in surgical techniques to repair the irregular rhythms, rapid heart beats, blood clots and ineffective heart muscle contractions associated with atrial fibrillation. He also discusses the restoration of normal cardiac function using catheters, pacemakers and gives insight on the surgical MAZE technique and innovations in ultrasound, laser and cryothermal tools.
In this observational study, the utility of decellularized allogeneic pulmonary artery patches for pulmonary arterioplasty was evaluated in 108 patients. No device failures or adverse events were detected. An historical comparison cohort in whom conventional materials were used experienced a 14% failure rate.