Aortic valve surgery: Marked increases in volume and significant decreases in mechanical valve use—an analysis of 41,227 patients over 5 years from the Society for Cardiothoracic Surgery in Great Britain and Ireland National database

Dunning, Joel; H, Gao; Chambers, John; Moat, Neil; Murphy, Gavin J.; Pagano, Domenic; Ray, Simon; Roxburgh, James; Bridgewater, Ben

doi:10.1016/j.jtcvs.2011.04.048

Cited by 199 publications

(146 citation statements)

References 24 publications

Supporting

Mentioning

127

Contrasting

Unclassified

Order By: Relevance

“…by guest on May 11, 2018 http://circinterventions.ahajournals.org/ Downloaded from Renal Dysfunction Impacts on TAVI Outcomes was set at P≤0.05 (2-tailed). Heterogeneity was assessed by Qstatistic and I 2 tests.…”

Section: What the Study Addsmentioning

confidence: 99%

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Gargiulo

Capodanno

Sannino

et al. 2015

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

T ranscatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery therapy for severe aortic stenosis.1,2 The detrimental impact of baseline chronic kidney disease (CKD) on worsening the prognosis of patients undergoing surgical aortic valve replacement is well established. 3,4 Conversely, this remains a debated issue in patients undergoing TAVI.Mixed evidences are available regarding the relationship between baseline CKD and clinical outcomes in TAVI, and patients with CKD were typically under-represented in TAVI trials. On the other hand, CKD showed to be an independent predictor of mortality at 1-year after TAVI in some registries, [5][6][7][8] but not in others. 9 The degree of CKD, which exposes to the highest risk is also a matter of debate: recent data suggest that CKD stage 4 and 5, but not stage 3, are predictors of 30-day and late mortality after TAVI.10,11 Finally, cross-sectional studies failed to show a significant impact of CKD on mortality. 12,13 On this background, given the contrasting evidence and the latest literature in this field, there is a clinical and scientific rationale to investigate the impact of preoperative CKD on the clinical outcomes of patients undergoing TAVI. Methods Study SelectionThe study was designed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses requirements. MEDLINE, Cochrane, ISI Web of Science, and SCOPUS databases were searched Background-There is a conflicting evidence on safety and efficacy of transcatheter aortic valve implantation in patients with preoperative chronic kidney disease (CKD). Therefore, we conducted a meta-analysis on the impact of CKD on outcomes after transcatheter aortic valve implantation. Methods and Results-Nine

show abstract

Section: What the Study Addsmentioning

confidence: 99%

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Gargiulo

Capodanno

Sannino

et al. 2015

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

show abstract

“…Approximately 280.000 heart valve replacements are performed each year (Pibarot and Dumesnil, 2009) and this number still increases (Takkenberg et al, 2008;Dunning et al, 2011). Currently, diseased valves are replaced by either mechanical or bioprosthetic valves.…”

Section: Introductionmentioning

confidence: 99%

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Loerakker

Argento

Oomens

et al. 2013

Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotran

View full text Add to dashboard Cite

Tissue engineering represents a promising technique to overcome the limitations of the current valve replacements, since it allows for creating living autologous heart valves that have the potential to grow and remodel. However, also this approach still faces a number of challenges. One particular problem is regurgitation, caused by cell-mediated tissue retraction or the mismatch in geometrical and material properties between tissue-engineered heart valves (TEHVs) and their native counterparts. The goal of the present study was to assess the influence of valve geometry and tissue anisotropy on the deformation profile and closed configuration of TEHVs. To achieve this aim, a range of finite element models incorporating different valve shapes was developed, and the constitutive behavior of the tissue was modeled using an established computational framework, where the degree of anisotropy was varied between values representative of TEHVs and native valves. The results of this study suggest that valve geometry and tissue anisotropy are both important to maximize the radial strains and thereby the coaptation area. Additionally, the minimum degree of anisotropy that is required to obtain positive radial strains was shown to depend on the valve shape and the pressure to which the valves are exposed. Exposure to pulmonary diastolic pressure only yielded positive radial strains if the anisotropy was comparable to the native situation, whereas considerably less anisotropy was required if the valves were exposed to aortic diastolic pressure. AbstractTissue engineering represents a promising technique to overcome the limitations of the current valve replacements, since it allows for creating living autologous heart valves that have the potential to grow and remodel. However, also this approach still faces a number of challenges. One particular problem is regurgitation, caused by cell-mediated tissue retraction or the mismatch in geometrical and material properties between tissue-engineered heart valves (TEHVs) and their native counterparts. The goal of the present study was to assess the influence of valve geometry and tissue anisotropy on the deformation profile and closed configuration of TEHVs. To achieve this aim, a range of finite element models incorporating different valve shapes was developed, and the constitutive behavior of the tissue was modeled using an established computational framework, where the degree of anisotropy was varied between values representative of TEHVs and native valves. The results of this study suggest that valve geometry and tissue anisotropy are both important to maximize the radial strains and thereby the coaptation area. Additionally, the minimum degree of anisotropy that is required to obtain positive radial strains was shown to depend on the valve shape and the pressure to which the valves are exposed. Exposure to pulmonary diastolic pressure only yielded positive radial strains if the anisotropy was comparable to the native situation, whereas considerably less anisotropy was ...

show abstract

“…The annual number increased by 20%, with significant increases in the mean age of patients with aortic stenosis, octogenarians, the proportion of high-risk patients and again those receiving biological valves (which is almost certainly influenced by surgeons' views of better longevity of modern biological valves and the promise of a transcatheter valve solution for subsequent valve failure) (47). Over this time, in-hospital mortality decreased from 4.4% to 3.7% (48). While transcatheter valve insertion (TAVI) (see below) is having an impact on valve surgery, in contract to just eroding the numbers of conventional valve operations, it has been reported that starting a TAVI service may increase overall aortic valve interventions, including those for conventional surgery (49).…”

Section: Aortic Valve Surgerymentioning

confidence: 99%

Almanac 2012 adult cardiac surgery

Bridgewater¹

2013

Anadolu Kardiyol Derg

Self Cite

View full text Add to dashboard Cite

This review covers the important publications in adult cardiac surgery in the last few years, including the current evidence base for surgical revascularisation and the use of off-pump surgery, bilateral internal mammary arteries and endoscopic vein harvesting. The changes in conventional aortic valve surgery are described alongside the outcomes of clinical trials and registries for transcatheter aortic valve implantation, and the introduction of less invasive and novel approaches of conventional aortic valve replacement surgery. Surgery for mitral valve disease is also considered, with particular reference to surgery for asymptomatic degenerative mitral regurgitation. (Anadolu Kardiyol Derg 2013; 13: 414-21) ALMANAC series ALMANAC serileri 414

show abstract

Aortic valve surgery: Marked increases in volume and significant decreases in mechanical valve use—an analysis of 41,227 patients over 5 years from the Society for Cardiothoracic Surgery in Great Britain and Ireland National database

Abstract: We have seen a large increase in annual volume of aortic valve replacements, with more patients undergoing surgery for aortic stenosis and an increase in surgery in the elderly and high-risk patients.

Cited by 199 publications

References 24 publications

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Moderate and Severe Preoperative Chronic Kidney Disease Worsen Clinical Outcomes After Transcatheter Aortic Valve Implantation

Effects of Valve Geometry and Tissue Anisotropy on the Radial Stretch and Coaptation Area of Tissue-Engineered Heart Valves

Almanac 2012 adult cardiac surgery

Contact Info

Product

Resources

About