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Ben-Avi R, Orlov B, Sternik L, Kogan A, Kuperstien R, Shalabi A, Ram E, Lipey A, Raanani E. Short- and long-term results after prosthetic mitral valve implantation in patients with severe mitral annulus calcification†. Interact Cardiovasc Thorac Surg 2017; 24:876-881. [PMID: 28329271 DOI: 10.1093/icvts/ivx043] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 01/03/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate short- and long-term outcomes of a conservative decalcification approach in mitral valve replacement (MVR) surgery in the presence of mitral annulus calcification (MAC). METHODS Of the 1038 patients who underwent MVR, 133 (13%) had significant MAC with at least 30% of the annular circumference heavily calcified. In most patients, the surgical approach to MAC included conservative decalcification, supra-annular prosthesis implantation and insertion of a pericardial patch between the MV annulus and the prosthesis. These patients were matched by a propensity score to a group of patients who underwent MVR without MAC ( n = 118 in each group) and served as a control group. RESULTS There were 6 early deaths in each group with an overall mortality of 5% ( P = 0.90). Early complications included one major stroke in the non-MAC group and acute renal failure needing dialysis in 2 and 3 patients in the MAC and non-MAC groups, respectively. Mean follow-up was 55 ± 37 months and 99.1% complete. There were 38 (33%) and 33 (29%) late deaths with an estimated survival of 61% and 69% at 6 years in the MAC and non-MAC groups, respectively ( P = 0.55). At follow-up, functional class did not differ between groups ( P = 0.096). Mean echo follow-up time was 40 ± 35 months and was 83% complete. Freedom from moderate or severe mitral regurgitation was 95% and 98%, with an estimated freedom of 95% and 96% at 6 years ( P = 0.20), and mean gradient was 4.9 ± 2.3 mmHg and 5.2 ± 2.0 mmHg for MAC and non-MAC groups, respectively ( P = 0.58). CONCLUSIONS A conservative approach for dealing with MAC is suitable for the majority of patients. Early and late clinical and echocardiographic outcomes did not differ between the MAC and non-MAC patients, including freedom from early and late occurrence of MV prosthesis paravalvular leak.
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Ghanim D, Kachel E, Lavie J, Carasso S, Shalabi A, Kuzniec F, Raanani E, Salman N, Amir O, Kinany W. [SUDDEN CARDIAC DEATH IN A YOUNG ADULT WITH DIFFUSE CORONARY ARTERY DISEASE]. HAREFUAH 2017; 156:635-637. [PMID: 29072381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION We present a very unusual case in which a high-school student was admitted to our cardiac center unconscious and intubated after suffering from out of hospital SCD. There was no history of fever, substance abuse, family history of sudden cardiac death and/or coronary artery disease, arthralgia, hypercoagulable state or familial hyperlipidemia. An emergent coronary angiogram revealed diffuse obstructive coronary artery disease which was treated with several stents. The following days of his admission were characterized by hemodynamic instability, necessitating temporary support via extracorporeal membrane oxygenation (ECMO), from which he was weaned off at a later stage. A full work-up regarding the etiology of the premature coronary artery disease was negative including cardiac magnetic resonance imaging, yet an empirical steroids course trial was given. Eventually, the patient regained full recovery, both cardiac and neurological, and returned to his usual daily activities. BACKGROUND Diffuse coronary artery disease at a young age, manifesting itself as sudden cardiac death (SCD) is a rare event.
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Grossman Y, Barbash IM, Fefer P, Goldenberg I, Berkovitch A, Regev E, Fink N, Ben-Zekry S, Brodov Y, Kogan A, Guetta V, Raanani E, Segev A. Addition of albumin to Traditional Risk Score Improved Prediction of Mortality in Individuals Undergoing Transcatheter Aortic Valve Replacement. J Am Geriatr Soc 2017; 65:2413-2417. [PMID: 28941287 DOI: 10.1111/jgs.15070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The ability of the Society of Thoracic Surgeons (STS) and European System for Cardiac Operative Risk Evaluation (EuroSCORE)-2 scores to predict outcomes after transcatheter aortic valve replacement (TAVR) is insufficient. Frailty and serum albumin as a frailty marker were shown to correlate with prognosis after TAVR. We sought to evaluate the additive value of serum albumin to STS and EuroSCORE-2 scores to predict mortality in individuals undergoing TAVR. DESIGN Retrospective analysis. SETTING Tertiary-care hospital prospective registry. PARTICIPANTS Individuals who underwent TAVR (N = 426). MEASUREMENTS We compared survival rates according to median baseline albumin levels (4 g/dL), STS score (4.5%), and EuroSCORE-2 (3.45%). Participants were divided into four groups according to median serum albumin and median STS and EuroSCORE-2 scores (high vs low), and 1-year survival rates were compared. A category-free net reclassification index (NRI) was calculated to compare the ability of a model of STS or EuroSCORE-2 alone to classify mortality risk with and without the addition of baseline serum albumin. RESULTS Participants with low albumin levels had higher mortality (hazard ratio (HR) = 3.03, 95% confidence interval (CI) = 1.66-5.26, P < .001). Participants with low serum albumin and a high STS (HR = 4.55, 95% CI = 2.21-9.38, P < .001) or EuroSCORE-2 (HR = 2.72, 95% CI = 1.48-5.06, P = .001) score had higher mortality. Using NRI analysis, a model that included albumin in addition to STS correctly reclassified 42% of events (NRI = 0.58) and a model that included albumin in addition to EuroSCORE-2 correctly reclassified 44% of events (NRI = 0.64). CONCLUSION Serum albumin, as a marker of frailty, can significantly improve the ability of STS and EuroSCORE-2 scores to predict TAVR-related mortality.
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Dechtman ID, Grossman C, Shinar Y, Cohen R, Nachum E, Raanani E, Livneh A, Ben-Zvi I. Carriage of Mediterranean Fever (MEFV) Mutations in Patients with Postpericardiotomy Syndrome (PPS). THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2017; 19:562-565. [PMID: 28971640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Postpericardiotomy syndrome (PPS) is characterized by pleuro-pericardial inflammation, which occurs in patients undergoing surgical procedures involving the pleura, pericardium, or both. The syndrome is considered to be immune mediated. However, its pathogenesis is not fully understood. It has previously been demonstrated that the Mediterranean Fever (MEFV) gene, which is associated with familial Mediterranean fever (FMF), has a role in the activation and expression of several inflammatory diseases. OBJECTIVES To investigate whether carriage of the MEFV mutation may precipitate PPS or affect its phenotype. METHODS The study population included 45 patients who underwent cardiac surgery and developed PPS. The control group was comprised of 41 patients who did not develop PPS. Clinical and demographic data was collected. The severity of PPS was evaluated. Genetic analysis to determine the carriage of one the three most common MEFV gene mutations (M694V, V726A, E148Q) was performed. The carriage rate of MEFV mutations in patients with and without PPS was compared. Association between MEFV mutation carriage and severity of PPS was evaluated. RESULTS The rate of mutation carriage in the MEFV gene was similar in patients with and without PPS (15.6% in the study groups vs. 29.3% in the control group, P = 0.1937). The rate of mutation carriage in the MEFV gene was significantly lower among patients with severe PPS as compared to patients with mild-moderate PPS (4.8% vs. 25%, P < 0.05). CONCLUSIONS Carriage of mutations in the MEFV gene is not associated with development of PPS; however, it may affect PPS severity.
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Raanani E. Break the vicious cycle: Time for mentorship. J Thorac Cardiovasc Surg 2017; 154:1686. [PMID: 28781087 DOI: 10.1016/j.jtcvs.2017.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022]
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Barbash IM, Raanani E. A journey to the "sweet spot". J Thorac Cardiovasc Surg 2017; 153:1316-1317. [PMID: 28526100 DOI: 10.1016/j.jtcvs.2017.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 01/28/2017] [Indexed: 11/28/2022]
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Kogan A, Segel M, Levin S, Sternik L, Raanani E. Incidence of ARDS following cardiac surgery: comparison between American-European Consensus Conference Definition and Berlin Definition. J Cardiothorac Vasc Anesth 2017. [DOI: 10.1053/j.jvca.2017.02.167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Leitman M, Tyomkin V, Raanani E, Sharony R, Tzatskin L, Peleg E, Blatt A, Vered Z. Assessment and Management of Acute Severe Mitral Regurgitation in the Intensive Care Unit. THE JOURNAL OF HEART VALVE DISEASE 2017; 26:161-168. [PMID: 28820545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND AIM OF THE STUDY Acute severe mitral regurgitation (MR) is a serious medical condition. Whilst clear guidelines exist regarding the management of chronic MR, acute severe MR is usually treated on an individual basis. Currently, few data exist regarding acute MR in the era of primary coronary interventions (PCI). The present study included patients admitted to the Department of Cardiology during recent years with acute severe MR of different etiologies, and an analysis of these data in the light of previous investigations. METHODS The digital database of the present authors' hospital was searched for patients diagnosed with severe MR between 2008 and 2015. From a total of 228 patients identified, 19 with primary MR and 17 with secondary (functional) MR were admitted to the Department of Cardiology. The clinical data and outcome of these patients were analyzed. RESULTS Among patients with MR due to acute myocardial infarction (MI), 13 had functional MR and six had MR due to mechanical complications, namely rupture of the papillary muscle or chordae tendineae. Among patients with MR not in the setting of MI, 13 had primary MR and four had functional MR. Patients with MR due to acute MI were more often in cardiogenic shock or had pulmonary edema and had a higher mortality. The strongest predictor of mortality was the presence of shock, followed by female gender, hypertension, age ≥68 years; previous MI and pulmonary edema were also predictors of mortality. In patients with acute MI and secondary MR, PCI to the culprit coronary artery was associated with a lesser degree of MR on follow up. CONCLUSIONS Patients with severe MR are at high risk of in-hospital death. Patients with functional MR are likely to benefit from prompt PCI to the culprit artery, and for those with primary MR urgent surgery is life-saving.
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Barbash IM, Bogdan A, Fefer P, Spiegelstein D, Raanani E, Beinart R, Guetta V, Segev A, Eggebrecht H, Zierer A, Dworakowski R, MacCarthy P. How should I treat a left ventricular outflow tract-migrated balloon-expandable transcatheter heart valve? EUROINTERVENTION 2016; 11:1442-5. [PMID: 26999684 DOI: 10.4244/eijv11i12a278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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El-Dosouky I, Polte CL, Okubo T, Gonzalez Gomez A, Liu B, Generati G, Drakopoulou M, Olmos C, Trifunovic D, Ilhao Moreira R, Ilhao Moreira R, Morgan HP, Bosseau C, Romano G, Argiolas A, Kuperstein R, Koyuncu A, Sahara E, Spinelli L, Yaneva-Sirakova T, Ben Said R, Nowakowska MA, Ruivo C, Neves Pestana G, Wiligorska N, Gao SA, Lagerstrand KM, Johnsson ÅA, Bech-Hanssen O, Mahara K, Yamamoto H, Shitan H, Abe K, Terada M, Saito M, Nagatomo Y, Takanashi S, Del Val D, Monteagudo JM, Fernandez-Golfin C, Hinojar R, Garcia A, Marco A, Casas E, Jimenez-Nacher JJ, Zamorano JL, Baig S, Hayer M, Edwards N, Steeds R, Bandera F, Alfonzetti E, Guazzi M, Toutouzas K, Stathogiannis K, Michelongona A, Latsios G, Synetos A, Lazaros G, Brili S, Tsiamis E, Tousoulis D, Islas F, Ferrera C, Sanchez-Enrique C, Freitas-Ferraz A, Mahia P, Marcos-Alberca P, Tirado G, Perez De Isla L, Vilacosta I, Marinkovic J, Obrenovic- Kircanski B, Ivanovic B, Kalimanovska-Ostric D, Stevanovic G, Petrovic M, Boricic-Kostic M, Petrovic O, Tutos V, Petrovic I, Petrovic J, Draganic G, Stepanovic J, Vujisic-Tesic B, Coutinho Cruz M, Moura Branco L, Galrinho A, Coutinho Miranda L, Almeida Morais L, Modas Daniel P, Rodrigues I, Fragata J, Cruz Ferreira R, Coutinho Cruz M, Moura Branco L, Galrinho A, Timoteo AT, Viveiros Monteiro S, Aguiar Rosa S, Rodrigues I, Fragata J, Cruz Ferreira R, Nana M, Constantin C, Tarando F, Galli E, Rousseau C, Hubert A, Leclercq C, Donal E, Vitale G, Agnese V, Mina' C, Magro S, Falletta C, Di Gesaro G, Bellavia D, Clemenza F, Elena Reffo ER, Ornella Milanesi OM, Klempfner R, Ben-Zekry S, Maor E, Raanani E, Ofek E, Freimark D, Arad M, Oflar E, Ciftci S, Ungan I, Caglar FM, Ocal L, Kilicgedik A, Toprak C, Kahveci G, Atmadikoesoemah C, Kasim M, Pellegrino T, Pisani A, Giudice CA, Riccio E, Imbriaco M, Cuocolo A, Trimarco B, Tarnovska-Kadreva R, Traykov L, Vassilev D, Vladimirova L, Shumkova M, Gruev I, Zairi I, Mzoughi K, Ben Moussa F, Kammoun S, Fennira S, Kraiem S, Chrzanowski L, Frynas-Jonczyk K, Wdowiak-Okrojek K, Wejner-Mik P, Lipiec P, Krakowska M, Potemski P, Plonska-Gosciniak E, Kasprzak JD, Marques N, Domingues K, Lourenco C, Santos R, Gomes C, Abreu L, Reis L, Moz M, Azevedo O, Tavares-Silva M, Sousa C, Pinto R, Ribeiro V, Vasconcelos M, Bernardo-Almeida P, Macedo F, Maciel MJ, Wiligorska D, Talarowska P, Segiet A, Mozenska O, Kosior DA. P1088Match and mismatch between opening area and resistance in mild and moderate rheumatic mitral stenosisP1089When should cardiovascular magnetic resonance imaging be considered in patients with chronic aortic or mitral regurgitation?P1090Echocardiographic characteristics of aortic valve fenestration with aortic regurgitation for aortic valve repairP1091Aortic regurgitation assessment by 3D transesophageal echocardiography vena contracta area: usefulness and comparison with 2D methods.P1092Characterising cardiomyopathy in mitral regurgitation due to barlow disease: role of CMRP1093Compensatory peripheral increase in artero-venous o2 difference to severe functional mitral regurgitation in heart failureP1094Prognostic impact of concomitant atrioventricular valve regurgitation in patients undergoing transcatheter aortic valve implantationP1095Morphological characterization of vegetations by real-time three-dimensional transesophageal echocardiography in infective endocarditis: prognostic impactP1096Relation between causative pathogen and echocardiographic findings in patients with infective endocarditis: is there an association and is it clinically relevant?P1097Aortic and mitral valve infective endocarditis: different clinical and echocardiographic features and peculiar complication ratesP1098Vegetation size relevance and impact on prognosis in patients with infective endocarditisP1099Causes of death on the valvular heart disease surveillance list- a 5 year auditP1100Left ventricular non-compaction and idiopathic dilated cardiomyopathy: the significant diagnostic value of longitudinal strainP1101The role of echocardiography in the management of diuretics withdrawal in patients with chronic heart failure and severely reduced ejection fraction: a prospective cohort studyP1102Outcomes in paediatric new onset left ventricle dysfunction and dilatation: differences between post-myocarditis and DCMP1103De novo mitral regurgitation as a cause of heart failure exacerbation in hypertrophic cardiomyopathyP1104Correlation of conventional and new echocardiograhic parameters with sudden cardiac death risk score in patients with hypertrophic cardiomyopathyP1105Inverse correlation between myocardial fibrosis and left ventricular function in rheumatic mitral stenosis: a preliminary study with cardiac magnetic resonanceP1106Left ventricular diastolic dysfunction and cardiac sympathetic derangement in patients with Anderson-Fabry disease: a 2D speckle tracking echocardiography and cardiac 123I-MIBG studyP1107Left ventricular hypertrophy and mild cognitive impairment as markers for target organ damage in hypertensive patients with multiple risk factorsP1108Subclinical left ventricular dysfunction in asymptomatic type 1 diabetic childrenP1109Minimal differences shown by echocardiography and NT-proBNP level distinguishing cardiotoxic effect related to breast cancer therapy in patients with or without HER2 expression.P1110Speed of recovery of left ventricular function is not related to the prognosis of takotsubo cardiomyopathy - a portuguese multicenter studyP1111Myocardial dysfunction in Takotsubo cardiomyopathy - more than meets the eye?P1112Obstructive sleep apnea and echocardiographic parameters. Eur Heart J Cardiovasc Imaging 2016; 17:ii227-ii234. [DOI: 10.1093/ehjci/jew262.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bogdan A, Barbash IM, Segev A, Fefer P, Bogdan SN, Asher E, Fink N, Hamdan A, Spiegelstein D, Raanani E, Guetta V. Albumin correlates with all-cause mortality in elderly patients undergoing transcatheter aortic valve implantation. EUROINTERVENTION 2016; 12:e1057-e1064. [PMID: 27159658 DOI: 10.4244/eijy15m10_09] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Albumin is a marker of frailty. Scarce data are available on correlations between frailty-related parameters and outcomes in patients undergoing TAVI. This study sought to evaluate the relation between albumin and mortality in TAVI candidates. METHODS AND RESULTS A total of 150 patients (mean age 81±6 years) undergoing TAVI were included in the study. Patients with pre-procedural albumin >4 g/dl (>40 g/L) (n=71) were compared to those ≤4 g/dl (≤40 g/L) (n=79). The cut-off value of 4 g/dl (40 g/L) was based on the mean value of albumin in the patients included in the study. During a mean follow-up of 2.1 years the survival rate was 72%. Patients in both groups had similar baseline characteristics. The 2.1-year mortality was higher in the low albumin group compared with the normal albumin group (35% vs. 19%, p=0.01). Multivariate analysis indicated that low pre-procedural albumin was independently associated with a more than twofold increase in 2.1-year all-cause mortality (p=0.01, HR=2.28; 95% CI: 1.17-4.44). Low post-procedural serum albumin remained a strong parameter correlated with all-cause mortality (HR=2.47; 95% CI: 1.28-4.78; p<0.01). CONCLUSIONS Baseline albumin can be used as a simple tool that correlates with survival after TAVI. Low albumin is an important parameter associated with all-cause mortality after the procedure.
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Shalabi A, Spiegelstein D, Sternik L, Feinberg MS, Kogan A, Levin S, Orlov B, Nachum E, Lipey A, Raanani E. Sutureless Versus Stented Valve in Aortic Valve Replacement in Patients With Small Annulus. Ann Thorac Surg 2016; 102:118-22. [DOI: 10.1016/j.athoracsur.2016.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/04/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
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Shapira OM, Sahar G, Raanani E. Cardiothoracic surgery training in Israel: A critical look at the past, aiming for a better future. J Thorac Cardiovasc Surg 2016; 151:1508-15. [DOI: 10.1016/j.jtcvs.2016.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 11/21/2015] [Accepted: 01/03/2016] [Indexed: 11/30/2022]
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Ben-Zvi D, Savion N, Kolodgie F, Simon A, Fisch S, Schäfer K, Bachner-Hinenzon N, Cao X, Gertler A, Solomon G, Kachel E, Raanani E, Lavee J, Kotev Emeth S, Virmani R, Schoen FJ, Schneiderman J. Local Application of Leptin Antagonist Attenuates Angiotensin II-Induced Ascending Aortic Aneurysm and Cardiac Remodeling. J Am Heart Assoc 2016; 5:JAHA.116.003474. [PMID: 27143353 PMCID: PMC4889208 DOI: 10.1161/jaha.116.003474] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Ascending thoracic aortic aneurysm (ATAA) is driven by angiotensin II (AngII) and contributes to the development of left ventricular (LV) remodeling through aortoventricular coupling. We previously showed that locally available leptin augments AngII‐induced abdominal aortic aneurysms in apolipoprotein E–deficient mice. We hypothesized that locally synthesized leptin mediates AngII‐induced ATAA. Methods and Results Following demonstration of leptin synthesis in samples of human ATAA associated with different etiologies, we modeled in situ leptin expression in apolipoprotein E–deficient mice by applying exogenous leptin on the surface of the ascending aorta. This treatment resulted in local aortic stiffening and dilation, LV hypertrophy, and thickening of aortic/mitral valve leaflets. Similar results were obtained in an AngII‐infusion ATAA mouse model. To test the dependence of AngII‐induced aortic and LV remodeling on leptin activity, a leptin antagonist was applied to the ascending aorta in AngII‐infused mice. Locally applied single low‐dose leptin antagonist moderated AngII‐induced ascending aortic dilation and protected mice from ATAA rupture. Furthermore, LV hypertrophy was attenuated and thickening of aortic valve leaflets was moderated. Last, analysis of human aortic valve stenosis leaflets revealed de novo leptin synthesis, whereas exogenous leptin stimulated proliferation and promoted mineralization of human valve interstitial cells in culture. Conclusions AngII‐induced ATAA is mediated by locally synthesized leptin. Aortoventricular hemodynamic coupling drives LV hypertrophy and promotes early aortic valve lesions, possibly mediated by valvular in situ leptin synthesis. Clinical implementation of local leptin antagonist therapy may attenuate AngII‐induced ATAA and moderate related LV hypertrophy and pre–aortic valve stenosis lesions. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00449306.
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Kogan A, Sternik L, Lavee J, Lipey A, Shalabi A, Levin S, Raanani E. Improved long-term survival in the patients with prolonged intensive care unit stay after cardiac surgery: influence of quality improvement program. J Cardiothorac Vasc Anesth 2016. [DOI: 10.1053/j.jvca.2016.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Kogan A, Segel M, Preisman S, Schäfers HJ, Raanani E. Safety and efficacy of sidenafil for the treatment of residual pulmonary hypertension in the perioperative period after pulmonary endarterectomy. J Cardiothorac Vasc Anesth 2016. [DOI: 10.1053/j.jvca.2016.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Raanani E. Can the art of mitral valve repair become completely standardized? J Thorac Cardiovasc Surg 2016; 151:1671-2. [PMID: 26971381 DOI: 10.1016/j.jtcvs.2016.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 02/02/2016] [Indexed: 10/22/2022]
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Raanani E. Which is the "lord" of the aortic rings? J Thorac Cardiovasc Surg 2016; 151:1286-7. [PMID: 26831925 DOI: 10.1016/j.jtcvs.2015.12.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Accepted: 12/30/2015] [Indexed: 10/22/2022]
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Shalabi A, Raanani E, Shinfeld A, Kuperstein R, Kogan A, Lipey A, Nachum E, Spiegelstein D. Sutureless Aortic Valve: Early and Mid-Term Results at a Single Center. THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2016; 18:119-123. [PMID: 26979006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED Background: Prolonged life expectancy has increased the number of elderly high risk patients referred for surgical aortic valve replacement (AVR). These referred high risk patients may benefit from sutureless bioprosthesis procedures which reduce mortality and morbidity. OBJECTIVES To present our initial experience with sutureless aortic bioprotheses, including clinical and echocardiographic results, in elderly high risk patients referred for AVR. METHODS Forty patients (15 males, mean age 78 ± 7 years) with symptomatic severe aortic stenosis underwent AVR with the 3F Enable or Perceval sutureless bioprosthesis during the period December 2012 to May 2014. Mean logistic EuroScore was 10 ± 3%. Echocardiography was performed preoperatively, intraoperatively, at discharge and at follow-up. RESULTS There was no in-hospital mortality. Nine patients (22%) underwent minimally invasive AVR via a right anterior mini-thoracotomy and one patient via a J-incision. Four patients underwent concomitant coronary aortic bypass graft, two needed intraoperative repositioning of the valve, one underwent valve exchange due to inappropriate sizing, three (7.5%) had a perioperative stroke with complete resolution of neurologic symptoms, and one patient (2.5%) required permanent pacemaker implantation due to complete atrioventricular block. Mean preoperative and postoperative gradients were 44 ± 14 and 13 ± 5 mmHg, respectively. At follow-up, 82% of patients were in New York Heart Association functional class I and II. CONCLUSIONS Sutureless AVR can be used safely in elderly high risk patients with relatively low morbidity and mortality. The device can be safely implanted via a minimally invasive incision. Mid-term hemodynamic results are satisfactory, demonstrating significant clinical improvement.
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Sündermann S, Czesla M, Jacobs S, Kempfert J, Walther T, Nataf P, Raanani E, Alfieri O, Maisano F, Falk V. Durable Mitral Valve Repair with an Adjustable Annuloplasty Ring Two Years after Implantation. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Nachum ER, Raanani E, Segev A, Guetta V, Hai I, Shinfeld A, Fefer P, Ashraf H, Barabash I, Shalabi A, Spiegelstein D. Transapical Transcatheter Valve-in-Valve Implantation for Failed Mitral Valve Bioprosthesis. THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2016; 18:13-17. [PMID: 26964273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED Background: The rate of mitral bioprosthesis implantation in clinical practice is increasing. Transcatheter valve-in- valve implantation has been described for high risk patients requiring redo valve surgery. OBJECTIVES To report our experience with transapical valve-in-valve implantation for failed mitral bioprosthesis. METHODS Since 2010, 10 patients have undergone transapical valve-in-valve implantation for failed bioprosthesis in our center. Aortic valve-in-valve implantation was performed in one of them and mitral valve-in-valve implantation in nine. Mean age was 82 ± 4 years and 6 were female (67%). Mean time from original mitral valve (MV) replacement to valve-in-valve procedure was 10.5 ± 3.7 years. Follow-up was completed by all patients with a mean duration of 13 ± 12 months. RESULTS Preoperatively, all patients presented with significant mitral regurgitation, two with mitral stenosis due to structural valve failure. All nine patients underwent successful transapical valve-in-valve implantation with an Edwards Sapien balloon expandable valve. There was no in-hospital mortality. Mean and median hospital duration was 15 ± 18 and 7 days respectively. Valve implantation was successful in all patients and there were no major complications, except for major femoral access bleeding in one patient. At last follow-up, all patients were alive and in NYHA functional class I or II. Echocardiography follow-up demonstrated that mitral regurgitation was absent or trivial in seven patients and mild in two. At follow-up, peak and mean gradients changed from 26 ± 4 and 8 ± 2 at baseline to 16.7 ± 3 and 7.3 ± 1.5, respectively. CONCLUSIONS Transcatheter transapical mitral valve-in-valve implantation for failed bioprosthesis is feasible in selected high risk patients. Our early experience with this strategy is encouraging. Larger randomized trials with long-term clinical and echocardiographic follow-up are recommended.
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97
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Maor Y, Sternik L, Orlov B, Rahav G, Keller N, Raanani E, Kogan A. Coxiella burnetii Endocarditis and Aortic Vascular Graft Infection: An Underrecognized Disease. Ann Thorac Surg 2016; 101:141-5. [DOI: 10.1016/j.athoracsur.2015.06.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 06/05/2015] [Accepted: 06/22/2015] [Indexed: 11/26/2022]
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98
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Goitein O, Di Segni E, Eshet Y, Guetta V, Segev A, Nahum E, Raanani E, Konen E, Hamdan A. Non-Valvular Findings before Trans-Catheter Aortic Valve Implantation and their Impact on the Procedure. THE ISRAEL MEDICAL ASSOCIATION JOURNAL : IMAJ 2015; 17:764-767. [PMID: 26897979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED Background: Trans-cathetervalve implantation (TAVI) is a non- surgical alternative for patients with severe aortic stenosis (AS). Pre-procedural computed tomography angiography (CTA) allows accurate "road mapping," aortic annulus sizing and the detection of incidental findings. OBJECTIVES To document the prevalence of non-valvular extracardiac findings on CTA prior to TAVI and the impact of these findings on the procedure. METHODS Ninety AS patients underwent CTA as part of pre-TAVI planning. Scans extended from the clavicles to the groin. Non-vascular non-valvular findings were documented and graded as follows: (A) significant findings causing TAVI cancellation or postponement, (B) significant findings leading to a change in the TAVI procedure approach, (C) non-significant findings not affecting the TAVI procedure. RESULTS TAVI was planned for 90 patients; their average age was 80.2 ± 7.5 years, 53% were females. Overall, non-valvular cardiac, extracardiac and extravascular significant and non-significant incidental findings were documented in 97% of scans (87/90). Significant pathologies causing TAVI cancellation or postponement (category A) were documented in 8%. Significant findings affecting the TAVI procedure (category B) were found in 16% of patients. CONCLUSIONS Pre-TAVI CTA detected non-valvular extravascular pathologies leading to procedure cancellation/postponement or procedure modification in 8% and 16%, respectively. Comprehensive CTA evaluation that acknowledges the importance of such findings is of major importance since it might alter the TAVI procedure or even render it inappropriate.
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Dechtman ID, Ben-Zvi I, Yael S, Cohen R, Nachum E, Lipey A, Sternik L, Kachel E, Kassif Y, Shinfeld A, Spigelstein D, Lavee J, Raanani E, Livneh A. MEFV mutation carriage as possible predisposition factor for the development of Post Pericardiotomy Syndrome (PPS). Pediatr Rheumatol Online J 2015. [PMCID: PMC4599978 DOI: 10.1186/1546-0096-13-s1-p76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ben Zekry S, Spiegelstein D, Sternik L, Lev I, Kogan A, Kuperstein R, Raanani E. Simple repair approach for mitral regurgitation in Barlow disease. J Thorac Cardiovasc Surg 2015; 150:1071-7.e1. [DOI: 10.1016/j.jtcvs.2015.08.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 07/27/2015] [Accepted: 08/09/2015] [Indexed: 11/25/2022]
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