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Tan MC, Yeo YH, San BJ, Suleiman A, Lee JZ, Chatterjee A, Sell-Dottin KA, Sweeney JP, Fortuin FD, Lee KS. Trends and Disparities in Valvular Heart Disease Mortality in the United States From 1999 to 2020. J Am Heart Assoc 2024; 13:e030895. [PMID: 38587138 DOI: 10.1161/jaha.123.030895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/19/2023] [Indexed: 04/09/2024]
Abstract
BACKGROUND Percutaneous heart valve procedures have been increasingly performed over the past decade, yet real-world mortality data on valvular heart disease (VHD) in the United States remain limited. METHODS AND RESULTS We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database among patients ≥15 years old from 1999 to 2020. VHD and its subtypes were listed as the underlying cause of death. We calculated age-adjusted mortality rate (AAMR) per 100 000 individuals and determined overall trends by estimating the average annual percent change using the Joinpoint regression program. Subgroup analyses were performed based on demographic and geographic factors. In the 22-year study, there were 446 096 VHD deaths, accounting for 0.80% of all-cause mortality (56 014 102 people) and 2.38% of the total cardiovascular mortality (18 759 451 people). Aortic stenosis recorded the highest mortality of VHD-related death in both male (109 529, 61.74%) and female (166 930, 62.13%) populations. The AAMR of VHD has declined from 8.4 (95% CI, 8.2-8.5) to 6.6 (95% CI, 6.5-6.7) per 100 000 population. Similar decreasing AAMR trends were also seen for the VHD subtypes. Men recorded higher AAMR for aortic stenosis and aortic regurgitation, whereas women had higher AAMR for mitral stenosis and mitral regurgitation. Mitral regurgitation had the highest change in average annual percent change in AAMR. CONCLUSIONS The mortality rate of VHD among the US population has declined over the past 2 decades. This highlights the likely efficacy of increasing surveillance and advancement in the management of VHD, resulting in improved outcomes.
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Affiliation(s)
- Min Choon Tan
- Department of Cardiovascular Medicine Mayo Clinic Phoenix AZ USA
- Department of Internal Medicine New York Medical College at Saint Michael's Medical Center Newark NJ USA
| | - Yong Hao Yeo
- Department of Internal Medicine/Pediatrics Beaumont Health Royal Oak MI USA
| | | | - Addi Suleiman
- Department of Cardiovascular Medicine New York Medical College at Saint Michael's Medical Center Newark NJ USA
| | - Justin Z Lee
- Department of Cardiovascular Medicine Cleveland Clinic Cleveland OH USA
| | - Arka Chatterjee
- Department of Cardiovascular Medicine University of Arizona Sarver Heart Center/Banner University Medical Center Tucson AZ USA
| | | | - John P Sweeney
- Department of Cardiovascular Medicine Mayo Clinic Phoenix AZ USA
| | - F David Fortuin
- Department of Cardiovascular Medicine Mayo Clinic Phoenix AZ USA
| | - Kwan S Lee
- Department of Cardiovascular Medicine Mayo Clinic Phoenix AZ USA
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Coronel-Meneses D, Sánchez-Trasviña C, Ratera I, Mayolo-Deloisa K. Strategies for surface coatings of implantable cardiac medical devices. Front Bioeng Biotechnol 2023; 11:1173260. [PMID: 37256118 PMCID: PMC10225971 DOI: 10.3389/fbioe.2023.1173260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Cardiac medical devices (CMDs) are required when the patient's cardiac capacity or activity is compromised. To guarantee its correct functionality, the building materials in the development of CMDs must focus on several fundamental properties such as strength, stiffness, rigidity, corrosion resistance, etc. The challenge is more significant because CMDs are generally built with at least one metallic and one polymeric part. However, not only the properties of the materials need to be taken into consideration. The biocompatibility of the materials represents one of the major causes of the success of CMDs in the short and long term. Otherwise, the material will lead to several problems of hemocompatibility (e.g., protein adsorption, platelet aggregation, thrombus formation, bacterial infection, and finally, the rejection of the CMDs). To enhance the hemocompatibility of selected materials, surface modification represents a suitable solution. The surface modification involves the attachment of chemical compounds or bioactive compounds to the surface of the material. These coatings interact with the blood and avoid hemocompatibility and infection issues. This work reviews two main topics: 1) the materials employed in developing CMDs and their key characteristics, and 2) the surface modifications reported in the literature, clinical trials, and those that have reached the market. With the aim of providing to the research community, considerations regarding the choice of materials for CMDs, together with the advantages and disadvantages of the surface modifications and the limitations of the studies performed.
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Affiliation(s)
- David Coronel-Meneses
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Mexico
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Centro de Biotecnología-FEMSA, Monterrey, Mexico
| | - Calef Sánchez-Trasviña
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Mexico
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Centro de Biotecnología-FEMSA, Monterrey, Mexico
| | - Imma Ratera
- Institute of Materials Science of Barcelona (ICMAB-CSIC), Campus UAB, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Instituto de Salud Carlos IIIBellaterra, Spain
| | - Karla Mayolo-Deloisa
- Tecnologico de Monterrey, The Institute for Obesity Research, Monterrey, Mexico
- Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Centro de Biotecnología-FEMSA, Monterrey, Mexico
- Institute of Materials Science of Barcelona (ICMAB-CSIC), Campus UAB, Bellaterra, Spain
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Toma M, Einstein DR, Kohli K, Caroll SL, Bloodworth CH, Cochran RP, Kunzelman KS, Yoganathan AP. Effect of Edge-to-Edge Mitral Valve Repair on Chordal Strain: Fluid-Structure Interaction Simulations. BIOLOGY 2020; 9:biology9070173. [PMID: 32708356 PMCID: PMC7407795 DOI: 10.3390/biology9070173] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 07/13/2020] [Accepted: 07/16/2020] [Indexed: 11/22/2022]
Abstract
Edge-to-edge repair for mitral valve regurgitation is being increasingly performed in high-surgical risk patients using minimally invasive mitral clipping devices. Known procedural complications include chordal rupture and mitral leaflet perforation. Hence, it is important to quantitatively evaluate the effect of edge-to-edge repair on chordal integrity. in this study, we employ a computational mitral valve model to simulate functional mitral regurgitation (FMR) by creating papillary muscle displacement. Edge-to-edge repair is then modeled by simulated coaptation of the mid portion of the mitral leaflets. in the setting of simulated FMR, edge-to-edge repair was shown to sustain low regurgitant orifice area, until a two fold increase in the inter-papillary muscle distance as compared to the normal mitral valve. Strain in the chordae was evaluated near the papillary muscles and the leaflets. Following edge-to-edge repair, strain near the papillary muscles did not significantly change relative to the unrepaired valve, while strain near the leaflets increased significantly relative to the unrepaired valve. These data demonstrate the potential for computational simulations to aid in the pre-procedural evaluation of possible complications such as chordal rupture and leaflet perforation following percutaneous edge-to-edge repair.
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Affiliation(s)
- Milan Toma
- Department of Osteopathic Manipulative Medicine, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury Campus, Northern Boulevard, Old Westbury, NY 11568-8000, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA; (K.K.); (S.L.C.); (C.H.B.IV); (A.P.Y.)
- Correspondence:
| | - Daniel R. Einstein
- Department of Mechanical Engineering, St. Martin’s University, 5000 Abbey Way SE, Lacey, WA 98503, USA;
| | - Keshav Kohli
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA; (K.K.); (S.L.C.); (C.H.B.IV); (A.P.Y.)
| | - Sheridan L. Caroll
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA; (K.K.); (S.L.C.); (C.H.B.IV); (A.P.Y.)
| | - Charles H. Bloodworth
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA; (K.K.); (S.L.C.); (C.H.B.IV); (A.P.Y.)
| | - Richard P. Cochran
- Department of Mechanical Engineering, University of Maine, 219 Boardman Hall, Orono, ME 04469-5711, USA; (R.P.C.); (K.S.K.)
| | - Karyn S. Kunzelman
- Department of Mechanical Engineering, University of Maine, 219 Boardman Hall, Orono, ME 04469-5711, USA; (R.P.C.); (K.S.K.)
| | - Ajit P. Yoganathan
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Technology Enterprise Park, 387 Technology Circle, Atlanta, GA 30313-2412, USA; (K.K.); (S.L.C.); (C.H.B.IV); (A.P.Y.)
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Elbadawi A, Elgendy IY, Mohamed AH, Almahmoud MF, Omer M, Abuzaid A, Mahmoud K, Ogunbayo GO, Denktas A, Paniagua D, Banerjee S, Jneid H. Temporal Trends and Outcomes of Transcatheter Mitral Valve Repair and Surgical Mitral Valve Intervention. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:1560-1566. [PMID: 32620401 DOI: 10.1016/j.carrev.2020.05.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is a paucity of data regarding the contemporary changes in the uptake and outcomes of transcatheter mitral valve repair (TMVR) and surgical mitral valve repair/replacement (SMVR). METHODS We queried the NIS database (2012-2016) to identify hospitalizations for TMVR and SMVR. We reported the temporal trends for uptake of TMVR and SMVR and their in-hospital outcomes. RESULTS The analysis included 77,645 hospitalizations: 8760 (11.3%) for TMVR and 68,885 (88.7%) for SMVR. Those undergoing TMVR were older and had a higher prevalence of comorbidities, but shorter length of stay (5.5 ± 8.8 vs. 14.3 ± 13.8, p < 0.001) compared with SMVR. There was a marked increase in the number of TMVRs over time (from 420 in 2012 to 3850 in 2016; +917%; Ptrend = 0.008) but a modest increase in the number of SMVRs (+117%; Ptrend = 0.02). Overall, TMVR was associated with low in-hospital mortality (2%) and favorable safety profile. After adjusting for clinical and hospital variables, there were non-significant trends towards lower adjusted mortality among TMVR and SMVR (Ptrend = 0.16 and Ptrend = 0.13, respectively). Notably, among TMVR patients, female sex was associated with lower in-hospital mortality while CKD was associated with increased in-hospital mortality. There was a significant downtrend in the incidences of cardiac arrest, hemodialysis and length of stay in TMVR patients. CONCLUSION Real world data showed a steady increase in the number of TMVR and SMVR procedures. Overall, TMVR was associated with low in-hospital mortality and complications rates. Despite older age and increased comorbidities, TMVR patients had lower in-hospital mortality and shorter length than their SMVR counterparts.
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Affiliation(s)
- Ayman Elbadawi
- Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, United States of America
| | - Islam Y Elgendy
- Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
| | - Ahmed H Mohamed
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, United States of America
| | - Mohamed F Almahmoud
- Division of Cardiovascular Medicine, University of South Carolina, Charleston, SC, United States of America
| | - Mohmed Omer
- Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, MN, United States of America
| | - A Abuzaid
- Division of Cardiovascular Medicine, University of California San Francisco, San Francisco, CA, United States of America
| | - Karim Mahmoud
- Department of Internal Medicine, Houston Medical Center, Warner Robins, GA, United States of America
| | - Gbolahan O Ogunbayo
- Department of Cardiovascular Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Ali Denktas
- Division of Cardiovascular Medicine, Baylor School of Medicine, Houston, TX, United States of America
| | - David Paniagua
- Division of Cardiovascular Medicine, Baylor School of Medicine, Houston, TX, United States of America
| | - Subhash Banerjee
- Division of Cardiovascular Medicine, University of Texas South Western, Dallas, TX, United States of America
| | - Hani Jneid
- Division of Cardiovascular Medicine, Baylor School of Medicine, Houston, TX, United States of America.
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Maggiore P, Anastasius M, Huang AL, Blanke P, Leipsic J. Transcatheter Mitral Valve Repair and Replacement: Current Evidence for Intervention and the Role of CT in Preprocedural Planning-A Review for Radiologists and Cardiologists Alike. Radiol Cardiothorac Imaging 2020; 2:e190106. [PMID: 33778537 DOI: 10.1148/ryct.2020190106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/05/2019] [Accepted: 09/26/2019] [Indexed: 01/21/2023]
Abstract
The mitral valve is a complex structure with a three-dimensional saddle shape annulus. Mitral regurgitation occurs from leaflet coaptation failure that is either primary (a problem with the leaflets) or secondary (chamber dilatation in the setting of cardiomyopathy). There has been an increase in focus on transcatheter mitral valve interventions, for both mitral repair and replacement. These technologies have rapidly developed to provide treatment for a substantial number of patients with severe symptomatic mitral regurgitation who are at too high of a risk to undergo open heart surgery. CT assessment of the mitral valve has developed with equal rapidity, with regard to preprocedural planning for transcatheter therapies. This review will provide an overview of mitral valve anatomy, an update on the current transcatheter repair and replacement therapies, as well as a focused overview of the role of multislice CT in mitral assessment prior to intervention. © RSNA, 2020.
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Affiliation(s)
- Paul Maggiore
- Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6
| | - Malcolm Anastasius
- Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6
| | - Alex L Huang
- Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6
| | - Philipp Blanke
- Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6
| | - Jonathon Leipsic
- Centre for Heart Valve Innovation, St Paul's Hospital, University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6
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Eichler S, Hadzic M, Völler H, Salzwedel A. Octogenarians in interventional cardiology: Feasibility and safety of functional and nutritional assessments for a new patient group in cardiac rehabilitation. Eur J Prev Cardiol 2020; 27:2345-2347. [PMID: 32013605 DOI: 10.1177/2047487319899194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Sarah Eichler
- Department of Rehabilitation Research, Faculty of Human Science, University of Potsdam and faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, The Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany
| | - Miralem Hadzic
- Department of Rehabilitation Research, Faculty of Human Science, University of Potsdam and faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, The Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany
| | - Heinz Völler
- Department of Rehabilitation Research, Faculty of Human Science, University of Potsdam and faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, The Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany.,Klinik am See, Rehabilitation Center for Internal Medicine, Rüdersdorf, Germany
| | - Annett Salzwedel
- Department of Rehabilitation Research, Faculty of Human Science, University of Potsdam and faculty of Health Sciences, Joint Faculty of the Brandenburg University of Technology Cottbus-Senftenberg, The Brandenburg Medical School Theodor Fontane and the University of Potsdam, Germany
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Ninios V, Tourmousoglou C, Mezilis N, Ninios I, Dardas P, Tsikaderis D, Theophylogiannakos S, Pitsis A. Simultaneous implantation of MitraClip devices in a patient with severe mitral and tricuspid valve regurgitation. Hellenic J Cardiol 2018; 60:207-208. [PMID: 30292473 DOI: 10.1016/j.hjc.2018.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/13/2018] [Accepted: 09/24/2018] [Indexed: 10/28/2022] Open
Abstract
We present a case of an 84-year old patient with severe mitral and tricuspid regurgitation with a lot of cormobidities who underwent a simultaneous transfemoral (one approach) mitral and tricuspid valve repair using the MitraClip system.
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Affiliation(s)
- Vlasis Ninios
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | | | - Nikolaos Mezilis
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | - Ilias Ninios
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | - Petros Dardas
- Department of Cardiology, St Luke's Hospital, Thessaloniki, Greece
| | | | | | - Antonios Pitsis
- Thessaloniki Heart Institute, St Luke's Hospital, Thessaloniki, Greece
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