Heart, lung & circulation
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Heart, lung & circulation · Mar 2014
Clinical TrialSurgical aortic valve replacement in very elderly patients aged 80 years and over: evaluation of early clinical outcomes.
An increasing number of very elderly patients aged ≥80 years will require aortic valve replacement (AVR) for severe aortic stenosis (AS). Many are classified as high-risk surgical candidates. Transcatheter aortic valve implantation (TAVI) has been proposed as an alternative to surgical AVR (SAVR) for high-risk patients. We evaluated early clinical outcomes of very elderly patients undergoing SAVR to optimise TAVI candidate selection. ⋯ SAVR can be performed in very elderly patients with acceptable operative morbidity and mortality. The outcomes at our institution are comparable to contemporary SAVR and TAVI outcomes.
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Heart, lung & circulation · Mar 2014
Bacteraemia in ventricular assist devices: a common complication that need not affect clinical outcomes.
Ventricular assist device (VAD) implantation has become an effective option for patients with severe heart failure. However, device-related infections remain a significant problem. The aim of this study was to describe the incidence and microbiological aetiology of bacteraemia in patients with VADs, and to assess the impact of bacteraemia on clinical outcomes. ⋯ Bacteraemia is common in VAD patients. However, the incidence of VAD-associated bacteraemia is independent of device type and with aggressive antimicrobial therapy; clinical outcomes need not be affected by the bacteraemia.