Texas Heart Institute Journal最新文献

{"title":"Nursing Home Admission and Home Care Initiation After Acute Aortic Dissection: A Nationwide Registry-Based Cohort Study.","authors":"Maria Weinkouff Pedersen, Riina Oksjoki, Jacob Eifer Møller, Anna Gundlund, Emil Fosbøl, Dorte Guldbrand Nielsen, Lars Køber, Mikkel Porsborg Andersen, Christian Torp-Pedersen, Peter Søgaard, Niels Holmark Andersen, Kristian Kragholm","doi":"10.14503/THIJ-23-8366","DOIUrl":"10.14503/THIJ-23-8366","url":null,"abstract":"<p><strong>Background: </strong>Little is known about long-term outcomes beyond survival following acute aortic dissection. The aim of this research was to evaluate rates of home care initiation and nursing home admission during the first year after discharge and to assess factors associated with these needs.</p><p><strong>Methods: </strong>All patients in Denmark with a first-time diagnosis of acute aortic dissection type A or B between 2006 and 2015 were identified using national registries. Patients discharged alive without nursing home or home care use before aortic dissection were included, along with age-matched and sex-matched population controls without aortic dissection (at a ratio of 1:5). Cause-specific multivariable Cox regression was used to derive adjusted hazard ratios.</p><p><strong>Results: </strong>The study population comprised 1093 patients and 5465 control individuals with a median (IQR) age of 64 (55-71) years; 70.6% were men. During their hospital stay, 2.7% of patients were registered with a first-time diagnosis of stroke, 7.1% with heart failure, and 2.2% with acute kidney failure; 5.9% of patients needed first-time dialysis. During the first year after discharge, 0.8% of patients who had had aortic dissection were admitted to a nursing home, 7.8% started home care, and 5.9% died. Among controls, these rates were 0.2%, 1.2%, and 1.2%, respectively. Patients who had had aortic dissection had significantly increased risk of initiating home care (hazard ratio, 7.47 [95% CI, 5.38-18.37]; <i>P</i> < .001) and of being admitted to a nursing home (hazard ratio, 4.28 [95% CI, 1.73-10.59]; <i>P</i> = .001). Initiation of home care and nursing home admission were related to advanced age, female sex, preexisting comorbidities, in-hospital complications, and conservative management of type A aortic dissection.</p><p><strong>Conclusion: </strong>Only a small proportion of patients who survived an aortic dissection needed home care or nursing home admission after hospital discharge.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238366"},"PeriodicalIF":0.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of ACEF-II Score in Predicting Major Adverse Cardiac Events in Patients With Non-ST-Segment Elevation Myocardial Infarction and Unstable Angina.","authors":"Burak Ayça, Yasin Yüksel, Cennet Yildiz","doi":"10.14503/THIJ-23-8310","DOIUrl":"10.14503/THIJ-23-8310","url":null,"abstract":"<p><strong>Background: </strong>A score based on age, creatinine level, and ejection fraction as well as hematocrit value and the presence of emergency surgery (ACEF-II) has been proposed to have predictive value for risk stratification in cardiac surgery. This study aimed to evaluate its utility in patients with non-ST-segment elevation myocardial infarction and unstable angina (NSTEMI-ACS) to predict 1-year major adverse cardiac events (MACE).</p><p><strong>Methods: </strong>In all, 768 patients with NSTEMI-ACS were enrolled in the study. After propensity score matching, the MACE and control groups comprised 168 patients each. Blood samples were drawn from patients during emergency department admission and hospitalization. The Global Registry of Acute Coronary Events, Acute Coronary Treatment and Intervention Outcome Network Intensive Care Unit risk, ACEF, and ACEF-II scores of each patient were evaluated.</p><p><strong>Results: </strong>Mean (SD) age of the study population was 63.07 (12.39) years; 547 (71.2%) patients were male. After propensity score matching for 7 variables, a comparison of the matched groups revealed that patients with MACE had higher heart rates and rates of ST-segment deviation, cardiac arrest, and creatinine levels and lower left ventricular ejection fraction and albumin, hemoglobin, hematocrit, systolic blood pressure, and oxygen saturation values. Multivariate logistic regression analysis revealed that ACEF-II score had the highest odds ratio of the evaluated scores, at 1.41 (95% CI, 1.12-1.81; <i>P</i> = .005). The ACEF score did not reach statistical significance for the prediction of 1-year MACE according to multivariate analysis. In addition to type of risk score, left ventricular ejection fraction and heart rate had predictive value for 1-year MACE. An ACEF-II score cutoff of 1.82 predicted 1-year MACE, with a sensitivity of 61.2% and a specificity of 76.2%.</p><p><strong>Conclusion: </strong>ACEF-II score, which is easy to calculate, could be used to predict 1-year MACE in patients with NSTEMI-ACS.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238310"},"PeriodicalIF":0.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Tamponade Secondary to Esophagopericardial Fistula.","authors":"Caitlin T Perez-Stable, Lauren T Callaghan, Christopher K Wong, Jorge M Escobar, Mahboob Alam","doi":"10.14503/THIJ-24-8443","DOIUrl":"10.14503/THIJ-24-8443","url":null,"abstract":"<p><p>Esophagopericardial fistulas are an extremely rare structural defect that may arise from malignant or iatrogenic etiologies. This article reports the case of a patient with cardiac tamponade secondary to hydropneumopericardium from esophagopericardial fistula. Given the high morbidity and mortality of this condition, this article describes challenges in diagnosis and clinical decision-making to improve early identification and interdisciplinary management.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e248443"},"PeriodicalIF":0.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Treatment of Brachiocephalic Artery Aneurysm With Impending Rupture and Tracheal Communication.","authors":"Soon Jin Kim, Kyung Hwa Kim, Jong Hun Kim, Tae Yun Kim","doi":"10.14503/THIJ-24-8453","DOIUrl":"10.14503/THIJ-24-8453","url":null,"abstract":"<p><p>Brachiocephalic artery aneurysm is uncommon but may require surgery because it tends to enlarge, rupture, or cause symptoms related to thrombosis or compression. This case report describes a brachiocephalic artery aneurysm in a 72-year-old man who presented at the hospital with dyspnea and hemoptysis resulting from impending rupture and tracheal communication.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e248453"},"PeriodicalIF":0.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Aortic Valve Implantation Bailout for Severe Aortic Insufficiency due to Aortic Root Dissection Following Ascending Aortic Aneurysm Repair.","authors":"Alejandro Sanchez-Nadales, Mileydis Alonso, David Lopez, Craig R Asher, Emad U Hakemi","doi":"10.14503/THIJ-23-8368","DOIUrl":"10.14503/THIJ-23-8368","url":null,"abstract":"<p><p>This novel case documents the successful use of transcatheter aortic valve implantation to treat severe aortic insufficiency arising from aortic root dissection following the repair of an ascending aortic aneurysm in a 75-year-old female patient. After she presented with symptoms of congestive heart failure, investigation revealed new severe aortic insufficiency and an acute aortic dissection. Given the prohibitive risks of reoperation, a self-expanding 27-mm Portico (St Jude Medical) prosthetic aortic valve was deployed, resulting in substantial clinical improvement without procedural complications. This case highlights the versatility of transcatheter aortic valve implantation in managing complex aortic disease and emphasizes the critical role of multidisciplinary evaluation and careful prosthesis selection.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238368"},"PeriodicalIF":0.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Extracorporeal Membrane Oxygenation-Facilitated Large-Bore Catheter Embolectomy in the Treatment of Acute Pulmonary Embolism Complicated by Shock.","authors":"Hugh A Glazier, Amir Kaki","doi":"10.14503/THIJ-24-8425","DOIUrl":"10.14503/THIJ-24-8425","url":null,"abstract":"<p><p>This article reports the case of a 42-year-old man who presented with a saddle pulmonary embolus complicated by normotensive cardiogenic shock. The patient was first stabilized with venoarterial extracorporeal membrane oxygenation. Then, while the patient was still on extracorporeal membrane oxygenation, thrombectomy with a large-bore catheter device was performed that resulted in a large decrease in pulmonary artery pressures and a clinically significant increase in cardiac index, with rapid clinical improvement. Complete recovery of the patient's cardiopulmonary status has been maintained at intermediate-term follow-up. This treatment strategy should be considered favorably in the treatment of patients presenting with pulmonary embolism complicated by cardiogenic shock.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e248425"},"PeriodicalIF":0.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Bioprosthetic Valve Fracturing on Valve-in-Valve Transcatheter Aortic Valve Implantation Transvalvular Gradients.","authors":"Osama Hallak, Karley Fischer, Shaina Ailawadi, Damian Valencia, Yan Yatsynovich, Raja Nazir, Brian Schwartz","doi":"10.14503/THIJ-23-8304","DOIUrl":"10.14503/THIJ-23-8304","url":null,"abstract":"<p><strong>Background: </strong>Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) is quickly becoming a routine and effective means by which to treat degenerated bioprosthetic valves. A known complication of ViV-TAVI is patient-prosthesis mismatch, which substantially affects survival. Bioprosthetic valve fracture is a method by which to reduce the risk of patient-prosthesis mismatch and post-ViV-TAVI transvalvular gradients. This study sought to determine the safety and efficacy of post-ViV-TAVI bioprosthetic valve fracture.</p><p><strong>Methods: </strong>Patients with a history of surgical aortic valve replacement undergoing ViV-TAVI bioprosthetic valve fracture (N = 25) at the corresponding institution from 2015 to 2022 were cataloged for a retrospective analysis. The implanted transcatheter valves were Medtronic Evolut R, Evolut PRO, and Evolut PRO+. Gradients were assessed before and after implantation and after fracturing using transthoracic echocardiogram.</p><p><strong>Results: </strong>The mean left ventricular ejection fraction of patients who underwent fracturing was 55.04%. The average (SD) peak and mean (SD) transvalvular gradients before the intervention were 68.17 (19.09) mm Hg and 38.98 (14.37) mm Hg, respectively. After ViV-TAVI, the same gradients were reduced to 27.25 (12.27) mm Hg and 15.63 (6.47) mm Hg, respectively. After bioprosthetic valve fracture, the gradients further decreased to 17.59 (7.93) mm Hg and 8.860 (3.334) mm Hg, respectively. The average reduction in peak gradient associated with fracturing was 12.07 mm Hg (95% CI, 5.73-18.41 mm Hg; <i>P</i> = .001). The average reduction in mean gradient associated with valve fracturing was 6.97 mm Hg (95% CI, 3.99-9.74 mm Hg; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Bioprosthetic valve fracture is a viable option for reducing residual transvalvular gradients after ViV-TAVI and should be considered in patients with elevated gradients (>20 mm Hg) or with concern for patient-prosthesis mismatch in patients who have an unacceptable risk for a redo sternotomy and surgical aortic valve replacement.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238304"},"PeriodicalIF":0.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Review of Atrial Infarction.","authors":"Domenic Grosso, Jacob Dickman, Damian Valencia","doi":"10.14503/THIJ-23-8334","DOIUrl":"10.14503/THIJ-23-8334","url":null,"abstract":"<p><p>Atrial infarction is often undiagnosed in patients with underlying ischemic heart disease and is identified only later, upon autopsy. One of the main challenges in diagnosing the condition is its localization within the affected atria. Treatment of atrial infarction focuses on acute reperfusion therapy, long-term management of cardiovascular disease risk factors, consideration of antiarrhythmia medications, and anticoagulation therapy. This review covers the anatomy of the atrial vasculature, complications associated with atrial infarction, diagnostic criteria for use of electrocardiography and other imaging modalities, and overall prognosis and management.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238334"},"PeriodicalIF":0.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11584634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow-Up Report of Patients With Moderate Aortic Valve Regurgitation After Cardiac Surgery.","authors":"Arezou Zoroufian, Arya Afrooghe, Manouchehr Ziafat, Arash Jalali, Mohammadreza Babaei, Pooria Ahmadi, Hakimeh Sadeghian","doi":"10.14503/THIJ-23-8273","DOIUrl":"10.14503/THIJ-23-8273","url":null,"abstract":"<p><strong>Background: </strong>The appropriateness of aortic valve surgery for patients with moderate aortic valve regurgitation undergoing coronary artery bypass graft (CABG), mitral valve replacement (MVR), or both is uncertain. This study aimed to investigate the outcomes of moderate aortic valve regurgitation following these procedures.</p><p><strong>Methods: </strong>This retrospective cohort study included 113 eligible participants with moderate aortic valve regurgitation who underwent CABG, MVR, or both procedures between January 2014 and January 2015 at Tehran Heart Center. Echocardiographic index data were extracted from the Tehran Heart Center data center after a 2-year follow-up to examine changes in the patients' conditions.</p><p><strong>Results: </strong>A total of 113 patients (mean [SD] age, 64.7 [9.9] years; 78 [69.0%] female patients) were included in the study and followed up for a mean (SD) of 24 (6) months. Among those patients, 38 (33.6%) experienced improvement, with their aortic valve regurgitation downgraded to mild, while the remaining 75 (66.4%) patients maintained a moderate aortic valve regurgitation level. Notably, combined CABG and MVR procedures were associated with statistically significant improvement, with all cases downgraded to mild aortic valve regurgitation. Baseline characteristics, including diabetes, hypertension, dyslipidemia, smoking, family history of aortic valve regurgitation, and a history of drug use, did not differ statistically significantly between patients with improved aortic valve regurgitation and patients with no changes. Echocardiographic indices related to the aorta, such as aortic valve pressure gradient, showed improvement (<i>P</i> < .001), and ejection fractions before and after surgery remained comparable. Changes in aortic valve regurgitation severity were found to differ statistically significantly between the various procedures (<i>P</i> = .001).</p><p><strong>Conclusion: </strong>These findings suggest that it is not likely that moderate aortic valve regurgitation will progress after CABG or MVR. Hence, no support was found for concurrent aortic valve replacement during these procedures.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":"e238273"},"PeriodicalIF":0.9,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Management of Myval Transcatheter Heart Valve Embolization Into Abdominal Aortic Aneurysm During Transcatheter Aortic Valve Replacement.","authors":"Artemio García-Escobar, Guillermo Galeote, Alfonso Jurado-Román, Santiago Jiménez-Valero, José Ángel Cabrera, Raúl Moreno","doi":"10.14503/THIJ-22-7997","DOIUrl":"10.14503/THIJ-22-7997","url":null,"abstract":"<p><p>Transcatheter heart valve embolization is a serious and rare complication of transcatheter aortic valve replacement. Having a strategy for promptly managing transcatheter heart valve embolization is crucial to avoid emergency conversion from transcatheter aortic valve replacement to open-heart surgery. Many cases of transcatheter heart valve embolization occurring with balloon-expandable prostheses such as the SAPIEN 3 (Edwards LifeSciences Corporation) valve and self-expandable prostheses such as the ACURATE neo (Boston Scientific Corporation) valve have been reported in the literature. Here, for the first time (to the authors' knowledge), the case of a Myval (Meril Life Sciences Pvt Ltd) transcatheter heart valve embolization during transcatheter aortic valve replacement, which was treated percutaneously with favorable outcomes, is reported.</p>","PeriodicalId":48680,"journal":{"name":"Texas Heart Institute Journal","volume":"51 2","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}