Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Oct 2018
Comparative StudyIn-hospital outcomes of transcatheter versus surgical aortic valve replacement in end stage renal disease.
Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at intermediate and high risk for surgery. Commercial use of TAVR has expanded to patients with end stage renal disease (ESRD). ⋯ Regardless of treatment modality, patients with AS on HD have high in-hospital mortality. TAVR and SAVR have comparable in-hospital mortality in this population. However, TAVR is associated with shorter LOS, lower hospitalization costs, lower in-hospital complications, and higher rates of home discharge.
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Catheter Cardiovasc Interv · Oct 2018
False lumen intervention to promote remodelling and thrombosis-The FLIRT concept in aortic dissection.
Thoracic endovascular aortic repair (TEVAR) has changed the management of aortic dissection by induced remodelling. Beyond reconstructing the true lumen, we describe the concept of False Lumen Intervention to promote Remodelling and Thrombosis (FLIRT) in both type A and B aortic dissection. ⋯ Interventional FL management, using the FLIRT concept, is feasible in selected cases of aortic dissection, promotes FL thrombosis and induces successful remodelling.
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Catheter Cardiovasc Interv · Sep 2018
Multicenter Study Observational StudyChronic total occlusion in non-infarct-related artery is associated with increased short-and long-term mortality in patients with ST-segment elevation acute myocardial infarction complicated by cardiogenic shock (from the CREDO-Kyoto AMI registry).
We aimed to investigate the effect of chronic total occlusion (CTO) in non-infarct-related artery (IRA) on short- and long-term mortality in ST-segment elevation myocardial infarction (STEMI) patients complicated by cardiogenic shock (CS). ⋯ In STEMI patients complicated by CS, CTO in non-IRA was associated with increased 30-day and 5-year mortality.
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Catheter Cardiovasc Interv · Sep 2018
Case ReportsAfterload mismatch after transcatheter mitral valve repair with MitraClip for degenerative mitral regurgitation in acute cardiogenic shock.
Acute afterload mismatch after surgery for mitral regurgitation (MR) with transient left ventricular dysfunction is well known, but not described after transcatheter mitral valve repair with MitraClip, except in functional MR and cardiomyopathy. MitraClip to manage acute severe MR and cardiogenic shock has also been rarely reported. We report here a 77-year-old female who presented with acute severe degenerative MR from a flail posterior leaflet, with cardiogenic shock requiring intra-aortic balloon pump support. ⋯ She subsequently fully recovered with normal ventricular function and was discharged after 14 days. Patient remained asymptomatic in NYHA I functional class 9 months after MitraClip repair, with mild residual MR and normal ventricular function. MitraClip repair in patients with acute severe degenerative MR and cardiogenic shock is a less invasive and potentially safer alternative to open surgery, but acute afterload mismatch may occur and requires prompt diagnosis and management for a successful outcome. © 2017 Wiley Periodicals, Inc.
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Catheter Cardiovasc Interv · Sep 2018
Case ReportsTranscatheter edge-to-edge repair of anterior mitral flail through a dehisced annuloplasty ring.
Recurrent mitral regurgitation (MR) due to mitral annuloplasty ring dehiscence is an uncommon late complication of surgery, and is associated with an increased risk of heart failure and mortality. We report the first application of MitraClip for recurrent primary MR and annuloplasty ring dehiscence in a patient with prohibitive surgical risk.