TAVI improves QoL in perioperative and 12 months observation in comparison with mini-thoracotomy, mini-sternotomy and SAVR. Improvement in QoL was obtained in both generic and disease specific questionnaires. © 2016 Wiley Periodicals, Inc.
BackgroundThe oblique vein of the left atrium is of interest for electrophysiologists working in the field of both basic science and clinical practice. aims We aimed to examine the topographic anatomy of the oblique vein and to assess the vein's location and relationships with surrounding cardiac structures. methods A total of 200 autopsied adult human hearts were examined. results The oblique vein was observed in 71% of the hearts. Its mean (SD) total length was 30.8 (13.6) mm. In hearts with the oblique vein, a larger distance was observed between the left inferior pulmonary vein (LIPV) and great cardiac vein (mean [SD], 18.6 [5.1] mm vs 16.3 [4.8] mm; P = 0.004), between the left atrial appendage (LAA) and LIPV (mean [SD], 17.8 [6.8] mm vs 15.1 [5.2] mm; P = 0.007), and between the LAA and left superior pulmonary vein (LSPV; mean [SD], 28.5 [7.2] mm vs 21.3 [6.4] mm; P <0.001). Hearts with a classic pattern of left -sided pulmonary veins were categorized into 4 types based on the length of oblique vein extension. In type I, the vein extended below the level of the LIPV (21.9%); in type II, to the level of the LIPV (47.7%); in type III, to the level of the interpulmonary area (17.2%); and in type IV, to the level of the LSPV (13.3%). In each type, the distance between the oblique vein and LIPV was shorter than that between the oblique vein and LAA. conclusions The oblique vein had a variable course and differing lengths of extension. The presence of the oblique vein was connected with a greater distance between the left -sided pulmonary veins and LAA.
Introduction: To deliver accurate morphological descriptions of the Vieussens valve (VV) and to investigate whether this structure could be visualized using standard contrastenhanced electrocardiogram-gated multislice computed tomography (MSCT).Methods: A total of 145 human autopsied hearts and 114 cardiac MSCT scans were examined. Results:The VV was observed in both study groups, however, the detection rate was significantly worse in the MSCT examination (18.4% in MSCT vs 62.1% in cadavers, P < .0001). The VV height was larger in MSCT patients (2.8 ± 1.2 vs 5.4 ± 1.7 mm; P < .0001). No significant difference was found in the measured distance between the VV and the coronary sinus ostium between the two separate subgroups (27.3 ± 9.5 vs 24.4 ± 5.8 mm; P = .18). In autopsied material the most frequent valve location was the anterior wall of the coronary sinus (43.3%); the same was observed in MSCT scans (71.4%). Conclusion:The VV is a common heart structure, present in over 60% of humans, located mainly on the anterior and superior circuit of the coronary sinus, with relatively high morphological variability. Large VVs, which pose a significant obstacle in catheterization procedures, may be visualized using standard-protocol contrastenhanced cardiac MSCT. K E Y W O R D S catheterization, coronary sinus, great cardiac vein, MSCT
IntroductionThe extent of peripheral artery disease (PAD) measured by the ankle-brachial index (ABI) and intima-media thickness (IMT) is correlated with the complexity of coronary artery disease (CAD) in stable angina patients. However, data regarding patients with acute coronary syndromes are still lacking.AimTo compare coronary complexity measured by the SYNTAX score in patients with and without PAD presenting with myocardial infarction (MI).Material and methodsBoth ABI and IMT were measured in 101 consecutive patients who underwent primary diagnostic due to MI. Patients were divided into three tertile groups depending on the SYNTAX score (0–4; 5–11; 12 and more points).ResultsMean ABI in the general population was 0.9 ±0.26, mean IMT was 0.8 ±0.3 mm and mean SYNTAX score was 7.8 ±5.4 points. We found significant correlations between ABI and SYNTAX score (p = 0.01), IMT and SYNTAX score (p < 0.001), and IMT and ABI (p < 0.001). The highest mean values of IMT (p < 0.001) and lowest mean values of ABI (p = 0.015) were found in patients in the highest SYNTAX score group. When analyzing receiver operating characteristics (ROC) curves, IMT had greater specificity and sensitivity than ABI.ConclusionsBoth IMT and ABI are correlated with SYNTAX score (positively for IMT and negatively for ABI values). In our study, IMT was a better predictor of SYNTAX score than ABI. Our study suggests that the higher rate of cardiovascular events in patients with PAD presenting with MI may be partially explained by greater coronary lesion complexity.
A b s t r a c tBackground: Radial access during coronary angiography has become an increasingly popular alternative to femoral access. The procedural outcomes and complications of these two approaches have been thoroughly evaluated; however, no studies have focused exclusively on the postprocedural quality of life of patients. Aim:To determine and compare both methods from the patient's point of view.Methods: Data were gathered from 165 consecutive patients scheduled for elective coronary angiography (from October 2011 to June 2012). The choice of the access site was left at operator's discretion. Femoral and radial groups consisted of 91 and 74 patients, respectively. Quality of life was assessed by the Short Form of the McGill Questionnaire and a self-designed questionnaire (Questionnaire II) consisting of eight questions evaluating the procedure-specific aspects of recovery time. After three months from index hospitalisation post-discharge interviews were conducted using a modified version of Questionnaire II with an additional two questions. Conclusions: The quality of life of patients who underwent coronary angiography from radial access was remarkably better in terms of pain characteristic and overall discomfort.
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