1
|
Dimarakis I, Aldea GS. Commentary: Extreme cardiorespiratory pathophysiology: Critical care evolution in response to a pandemic. J Thorac Cardiovasc Surg 2024; 167:1842-1844. [PMID: 36764913 PMCID: PMC9859641 DOI: 10.1016/j.jtcvs.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Affiliation(s)
- Ioannis Dimarakis
- Division of Cardiothoracic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Wash.
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Wash
| |
Collapse
|
2
|
DeRoo S, Aldea GS. 5-year COMMENCE Data Highlights Excellent Surgical Outcomes in Aortic Valve Replacement. Ann Thorac Surg 2024:S0003-4975(24)00119-X. [PMID: 38369176 DOI: 10.1016/j.athoracsur.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/08/2024] [Accepted: 02/10/2024] [Indexed: 02/20/2024]
Affiliation(s)
- Scott DeRoo
- Division of Cardiothoracic Surgery, University of Washington, Box 356310, 1959 NE Pacific Street, AA115, Seattle, WA 98195-6310
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Box 356310, 1959 NE Pacific Street, AA115, Seattle, WA 98195-6310.
| |
Collapse
|
3
|
DeRoo SC, Aldea GS. Commentary: Mind MELD complete: Can the model for end-stage liver disease (MELD) score predict risk in isolated tricuspid surgery? J Thorac Cardiovasc Surg 2023; 166:1442-1443. [PMID: 34998595 DOI: 10.1016/j.jtcvs.2021.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Scott C DeRoo
- Division of Cardiac Surgery, University of Washington, Seattle, Wash
| | - Gabriel S Aldea
- Division of Cardiac Surgery, University of Washington, Seattle, Wash.
| |
Collapse
|
4
|
Gaudino M, Bakaeen FG, Sandner S, Aldea GS, Arai H, Chikwe J, Firestone S, Fremes SE, Gomes WJ, Bong-Kim K, Kisson K, Kurlansky P, Lawton J, Navia D, Puskas JD, Ruel M, Sabik JF, Schwann TA, Taggart DP, Tatoulis J, Wyler von Ballmoos M. Expert systematic review on the choice of conduits for coronary artery bypass grafting: endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and The Society of Thoracic Surgeons (STS). J Thorac Cardiovasc Surg 2023; 166:1099-1114. [PMID: 37542480 DOI: 10.1016/j.jtcvs.2023.06.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/10/2023] [Accepted: 04/20/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY.
| | - Faisal G Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Wash
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, Calif
| | | | - Stephen E Fremes
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, and the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Walter J Gomes
- Cardiology and Cardiovascular Surgery Disciplines, São Paulo Hospital, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil
| | - Ki Bong-Kim
- Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, Republic of Korea
| | | | - Paul Kurlansky
- Division of Cardiac Surgery, Department of Surgery, Columbia University, New York, NY
| | - Jennifer Lawton
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Md
| | - Daniel Navia
- Department of Cardiac Surgery, ICBA Instituto Cardiovascular, Buenos Aires, Argentina
| | - John D Puskas
- Department of Cardiovascular Surgery, Mount Sinai Saint Luke's, New York, NY
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | | | - David P Taggart
- Department of Cardiac Surgery, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - James Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | | |
Collapse
|
5
|
Gaudino M, Bakaeen FG, Sandner S, Aldea GS, Arai H, Chikwe J, Firestone S, Fremes SE, Gomes WJ, Bong-Kim K, Kisson K, Kurlansky P, Lawton J, Navia D, Puskas JD, Ruel M, Sabik JF, Schwann TA, Taggart DP, Tatoulis J, Wyler von Ballmoos M. Expert Systematic Review on the Choice of Conduits for Coronary Artery Bypass Grafting: Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and The Society of Thoracic Surgeons (STS). Ann Thorac Surg 2023; 116:659-674. [PMID: 37542509 DOI: 10.1016/j.athoracsur.2023.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York.
| | - Faisal G Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Stephen E Fremes
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, and the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Walter J Gomes
- Cardiology and Cardiovascular Surgery Disciplines, São Paulo Hospital, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Ki Bong-Kim
- Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, Republic of Korea
| | - Kalie Kisson
- The Society of Thoracic Surgeons, Chicago, Illinois
| | - Paul Kurlansky
- Division of Cardiac Surgery, Department of Surgery, Columbia University, New York, New York
| | - Jennifer Lawton
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Daniel Navia
- Department of Cardiac Surgery, ICBA Instituto Cardiovascular, Buenos Aires, Argentina
| | - John D Puskas
- Department of Cardiovascular Surgery, Mount Sinai Saint Luke's, New York, New York
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Thomas A Schwann
- Division of Cardiac Surgery, Baystate Health, Springfield, Massachusetts
| | - David P Taggart
- Department of Cardiac Surgery, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - James Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Moritz Wyler von Ballmoos
- Division of Cardiothoracic Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| |
Collapse
|
6
|
Gaudino M, Bakaeen FG, Sandner S, Aldea GS, Arai H, Chikwe J, Firestone S, Fremes SE, Gomes WJ, Bong-Kim K, Kisson K, Kurlansky P, Lawton J, Navia D, Puskas JD, Ruel M, Sabik JF, Schwann TA, Taggart DP, Tatoulis J, Wyler von Ballmoos M. Expert systematic review on the choice of conduits for coronary artery bypass grafting: endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and The Society of Thoracic Surgeons (STS). Eur J Cardiothorac Surg 2023; 64:ezad163. [PMID: 37535847 DOI: 10.1093/ejcts/ezad163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/10/2023] [Accepted: 04/20/2023] [Indexed: 08/05/2023] Open
Abstract
PREAMBLE The finalized document was endorsed by the EACTS Council and STS Executive Committee before being simultaneously published in the European Journal of Cardio-thoracic Surgery (EJCTS) and The Annals of Thoracic Surgery (The Annals) and the Journal of Thoracic and Cardiovascular Surgery (JTCVS).
Collapse
Affiliation(s)
- Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA
| | - Faisal G Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Sigrid Sandner
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, WA, USA
| | - Hirokuni Arai
- Department of Cardiovascular Surgery, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Joanna Chikwe
- Department of Cardiac Surgery, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Stephen E Fremes
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, and the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Walter J Gomes
- Cardiology and Cardiovascular Surgery Disciplines, São Paulo Hospital, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Ki Bong-Kim
- Cardiovascular Center, Myong-ji Hospital, Gyeong-gi-do, Republic of Korea
| | - Kalie Kisson
- The Society of Thoracic Surgeons, Chicago, IL, USA
| | - Paul Kurlansky
- Division of Cardiac Surgery, Department of Surgery, Columbia University, New York, NY, USA
| | - Jennifer Lawton
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Daniel Navia
- Department of Cardiac Surgery, ICBA Instituto Cardiovascular, Buenos Aires, Argentina
| | - John D Puskas
- Department of Cardiovascular Surgery, Mount Sinai Saint Luke's, New York, NY, USA
| | - Marc Ruel
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, ON, Canada
| | - Joseph F Sabik
- Department of Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Thomas A Schwann
- Division of Cardiac Surgery, Baystate Health, Springfield, MA, USA
| | - David P Taggart
- Department of Cardiac Surgery, John Radcliffe Hospital, University of Oxford, Oxford, UK
| | - James Tatoulis
- Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Moritz Wyler von Ballmoos
- Division of Cardiothoracic Surgery, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| |
Collapse
|
7
|
Aldea GS, Burke CR, Fischlein T, Heimansohn DA, Haverich A, Suri RM, Ad N. Does valve size impact hemodynamic, left ventricular mass regression, and prosthetic valve deterioration with a sutureless aortic valve? J Thorac Cardiovasc Surg 2023:S0022-5223(23)00085-5. [PMID: 36858846 DOI: 10.1016/j.jtcvs.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To assess the mid-term clinical outcomes, hemodynamics, left ventricular (LV) mass regression, and structural valve deterioration (SVD) in patients implanted with the Perceval aortic sutureless valve across valve sizes. METHODS Data were obtained from a multicenter European trial and a US Investigational Device Exemption trial. Echocardiography data were analyzed by an echocardiography core lab. A mixed-effects regression model was used to assess relationships between hemodynamic outcomes, time from the procedure, and valve sizes. The Valve Academic Research Consortium (VARC)-3 definition for bioprosthetic valve failure was applied. RESULTS A Perceval sutureless valve was implanted in 970 patients. The median patient age was 77.8 years, 57.2% were female, the median Society of Thoracic Surgeons predicated risk of mortality was 3.3% (range, 2.1%-6.2%), and 33.4% had a concomitant procedure. The median clinical follow-up was 45.7 months (range, 28.2-76.1 months). Small and medium valves were implanted more commonly in women than in men (16.9% vs 1.9% for small and 55.1% vs 19.5% for medium; P < .001). The mean aortic valve gradients decreased significantly postimplantation and remained stable across all valve sizes throughout the follow-up period. All patients were free from severe patient-prosthesis mismatch (with an effective orifice area/m2 of >0.8). Significant LV mass regression was documented regardless valve sizes, plateaued at -9.1% at 5 years. Freedom from SVD and reintervention were 95.2% and 96.3%, respectively, at 5 years and were independent of implanted valve size (P = .22). The VARC-3 stage 3 bioprosthetic valve failure rate was low, 2.8% at 5 years. CONCLUSIONS The Perceval valve demonstrated low and stable mean gradients, significant LV mass regression, and low SVD and reintervention rates across all valve sizes.
Collapse
Affiliation(s)
- Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, Wash.
| | | | - Theodor Fischlein
- Department of Cardiac Surgery, Klinikum Nürnberg, Paracelsus Medical University, Nürnberg, Germany
| | | | - Axel Haverich
- Clinic for Cardiac, Thoracic, Transplantation and Vascular Surgery, Medizinische Hochschule Hannover, Hannover, Germany
| | - Rakesh M Suri
- Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic Abu Dhabi and Cleveland Clinic Foundation, Cleveland, Ohio
| | - Niv Ad
- Cardiothoracic Surgery, Adventist White Oak Medical Center and Johns Hopkins University, Silver Spring, Md
| |
Collapse
|
8
|
Velders BJ, Vriesendorp MD, Sabik JF, Dagenais F, Labrousse L, Bapat V, Aldea GS, Anyanwu AC, Cai Y, Klautz RJ. Pledgeted versus nonpledgeted sutures in aortic valve replacement: Insights from a prospective multicenter trial. JTCVS Tech 2022; 17:23-46. [PMID: 36820352 PMCID: PMC9938379 DOI: 10.1016/j.xjtc.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The objective of this study was to compare short- and midterm clinical and echocardiographic outcomes according to the use of pledgeted sutures during aortic valve replacement. Methods Patients with aortic stenosis or regurgitation requiring aortic valve replacement were enrolled in a prospective cohort study to evaluate the safety of a new stented bioprosthesis. Outcomes were analyzed according to the use of pledgets (pledgeted group) or no pledgets (nonpledgeted group). The primary outcome was a composite of thromboembolism, endocarditis, and major paravalvular leak at 5 years of follow-up. Secondary outcomes included multiple clinical endpoints and hemodynamic outcomes. Propensity score matching was performed to adjust for prognostic factors, and subanalyses with small valve sizes (<23 mm) and suturing techniques were performed. Results The pledgeted group comprised 640 patients (59%), and the nonpledgeted group 442 (41%), with baseline discrepancies in demographic characteristics, comorbidities, and stenosis severity. There were no differences between groups in any outcome. After propensity score matching, the primary outcome occurred in 41 (11.7%) patients in the pledgeted and 36 (9.8%) in the nonpledgeted group (P = .51). The effective orifice area was smaller in the pledgeted group (P = .045), whereas no difference was observed for the mean or peak pressure gradient. Separate subanalyses with small valve sizes and suturing techniques did not show relevant differences. Conclusions In this large propensity score-matched cohort, comprehensive clinical outcomes were comparable between patients who underwent aortic valve replacement with pledgeted and nonpledgeted sutures up to 5 years of follow-up, but pledgets might lead to a slightly smaller effective orifice area in the long run.
Collapse
Key Words
- AVR, aortic valve replacement
- BMI, body mass index
- BSA, body surface area
- EOA, effective orifice area
- EOAi, effective orifice area indexed
- LVOT, left ventricular outflow tract
- PERIGON, PERIcardial SurGical AOrtic Valve ReplacemeNt
- PPM, prosthesis–patient mismatch
- PVL, paravalvular leak
- STS, Society of Thoracic Surgeons
- endocarditis
- paravalvular leak
- pledgets
- surgical aortic valve replacement
- suturing technique
- thromboembolism
Collapse
Affiliation(s)
- Bart J.J. Velders
- Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands,Address for reprints: Bart J. J. Velders, MD, Department of Cardiothoracic Surgery, Leiden University Medical Centre, Albinusdreef 2, Leiden, Zuid-Holland 2333 ZA, The Netherlands.
| | - Michiel D. Vriesendorp
- Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| | - Joseph F. Sabik
- Department of Surgery, University Hospitals, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Francois Dagenais
- Division of Cardiac Surgery, Quebec Heart and Lung Institute, Quebec, Quebec, Canada
| | - Louis Labrousse
- Medico-Surgical Department of Valvulopathies, Bordeaux Heart University Hospital, Bourdeaux-Pessac, France
| | - Vinayak Bapat
- Department of Cardiothoracic Surgery, NHS Foundation Trust–St Thomas' Hospital, London, United Kingdom
| | - Gabriel S. Aldea
- Department of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Wash
| | - Anelechi C. Anyanwu
- Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yaping Cai
- Core Clinical Solutions, Medtronic, Mounds View, Minn
| | - Robert J.M. Klautz
- Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, the Netherlands
| |
Collapse
|
9
|
MacGillivray TE, Gleason TG, Patel HJ, Aldea GS, Bavaria JE, Beaver TM, Chen EP, Czerny M, Estrera AL, Firestone S, Fischbein MP, Hughes GC, Hui DS, Kissoon K, Lawton JS, Pacini D, Reece TB, Roselli EE, Stulak J. The Society of Thoracic Surgeons/American Association for Thoracic Surgery clinical practice guidelines on the management of type B aortic dissection. J Thorac Cardiovasc Surg 2022; 163:1231-1249. [PMID: 35090765 DOI: 10.1016/j.jtcvs.2021.11.091] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 01/16/2023]
Affiliation(s)
| | - Thomas G Gleason
- Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Md
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Wash
| | - Joseph E Bavaria
- Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - Thomas M Beaver
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Fla
| | - Edward P Chen
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, NC
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
| | - Anthony L Estrera
- Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Center at Houston and Memorial Hermann Hospital, Houston, Tex
| | | | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, Calif
| | - G Chad Hughes
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, NC
| | - Dawn S Hui
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Tex
| | | | - Jennifer S Lawton
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Md
| | - Davide Pacini
- Department of Cardiac Surgery, University of Bologna, Bologna, Italy
| | - T Brett Reece
- Department of Cardiothoracic Surgery, University of Colorado School of Medicine, Aurora, Colo
| | - Eric E Roselli
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - John Stulak
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minn
| |
Collapse
|
10
|
MacGillivray TE, Gleason TG, Patel HJ, Aldea GS, Bavaria JE, Beaver TM, Chen EP, Czerny M, Estrera AL, Firestone S, Fischbein MP, Hughes GC, Hui DS, Kissoon K, Lawton JS, Pacini D, Reece TB, Roselli EE, Stulak J. The Society of Thoracic Surgeons/American Association for Thoracic Surgery Clinical Practice Guidelines on the Management of Type B Aortic Dissection. Ann Thorac Surg 2022; 113:1073-1092. [PMID: 35090687 DOI: 10.1016/j.athoracsur.2021.11.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 02/07/2023]
Affiliation(s)
| | - Thomas G Gleason
- Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland
| | - Himanshu J Patel
- Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Joseph E Bavaria
- Division of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Thomas M Beaver
- Division of Thoracic and Cardiovascular Surgery, University of Florida, Gainesville, Florida
| | - Edward P Chen
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Martin Czerny
- Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany
| | - Anthony L Estrera
- Department of Cardiothoracic and Vascular Surgery, The University of Texas Health Science Center at Houston and Memorial Hermann Hospital, Houston, Texas
| | | | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, California
| | - G Chad Hughes
- Division of Cardiovascular and Thoracic Surgery, Duke University School of Medicine, Durham, North Carolina
| | - Dawn S Hui
- Department of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas
| | | | - Jennifer S Lawton
- Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Davide Pacini
- Department of Cardiac Surgery, University of Bologna, Bologna, Italy
| | - T Brett Reece
- Department of Cardiothoracic Surgery, University of Colorado School of Medicine, Aurora, Colorado
| | - Eric E Roselli
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - John Stulak
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
11
|
Keenan JE, Aldea GS. Commentary: For Once, the Right Deserves a Little More Attention. Semin Thorac Cardiovasc Surg 2021; 34:904-905. [PMID: 34433095 DOI: 10.1053/j.semtcvs.2021.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Jeffrey E Keenan
- Department of Surgery, Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
| | - Gabriel S Aldea
- Department of Surgery, Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington
| |
Collapse
|
12
|
Burke CR, Aldea GS. Commentary: The frozen elephant trunk-the "hot" procedure. An important evolutionary step but probably not a final destination. J Thorac Cardiovasc Surg 2021; 164:1693-1694. [PMID: 33994207 DOI: 10.1016/j.jtcvs.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/19/2022]
Affiliation(s)
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, Wash.
| |
Collapse
|
13
|
Aldea GS. Commentary: Valve Surgery for Bacterial Endocarditis in Patients Who Use Intravenous Drugs a Societal Failure to Rescue. Semin Thorac Cardiovasc Surg 2021; 33:711-712. [PMID: 33607260 DOI: 10.1053/j.semtcvs.2021.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/05/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington.
| |
Collapse
|
14
|
Oyetunji SO, Aldea GS. Commentary: Treating tricuspid regurgitation: Too much too early or too little too late. Can we find the right balance? J Thorac Cardiovasc Surg 2020; 161:1249-1250. [PMID: 33514464 DOI: 10.1016/j.jtcvs.2020.12.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 12/12/2020] [Accepted: 12/14/2020] [Indexed: 11/26/2022]
Affiliation(s)
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, Wash.
| |
Collapse
|
15
|
Komatsu I, Tang GHL, Leipsic J, Webb JG, Blanke P, Mackensen GB, Kitamura M, Wolak A, Don CW, McCabe JM, Rumer C, Tan CW, Levin DB, Ramos M, Aldea GS, Reisman M, Wijeysundera HC, Radhakrishnan S, Sathananthan J, Piazza N, Kornowski R, Abdel-Wahab M, Dvir D. Distribution of C-arm projections in native and bioprosthetic aortic valves cusps: Implication for BASILICA procedures. Catheter Cardiovasc Interv 2020; 97:E580-E587. [PMID: 32894804 DOI: 10.1002/ccd.29224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 07/15/2020] [Accepted: 08/06/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We sought to document aortic cusps fluoroscopic projections and their distributions using leaflet alignment which is a novel concept to optimize visualization of leaflets and for guiding BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent coronary artery obstruction) and determine whether these projections were feasible in catheter laboratory. BACKGROUND Optimal fluoroscopic projections of aortic valve cusps have not been well described. METHODS A total of 128 pre-transcatheter aortic valve replacement (pre-TAVR) computed tomographies (CT) (72 native valves and 56 bioprosthetic surgical valves) were analyzed. Using CT software (3Mensio, Pie medical imaging, the Netherlands), leaflet alignment was performed and the feasibility of these angles, which were defined as rate of obtainable with efforts (within LAO/RAO of 85° and CRA/CAU of 50°) were evaluated. RESULTS High feasibility was seen in right coronary cusp (RCC) front view (100%) and left coronary cusp (LCC) side view (99.2%), followed by noncoronary cusp side view (95.3%). In contrast, low feasibility of RCC side view (7.8%) and LCC front view (47.6%) was observed. No statistical differences were seen between the distribution of native valves and bioprosthetic surgical valves. With patient/table tilt of 20°LAO and 10°CRA, the feasibility of RCC side view and LCC front view increased to 43.7 and 85.2%, respectively. CONCLUSION Distributions of each cusp's leaflet alignment follows "sigmoid curve" which can provide better understanding of aortic valve cusp orientation in TAVR and BASILICA. RCC side view used in right cusp BASILICA is commonly unachievable in catheter laboratory and may improve with patient/table tilt.
Collapse
Affiliation(s)
- Ikki Komatsu
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Gilbert H L Tang
- Department of Cardiovascular Surgery, Mount Sinai Medical Center, New York, New York
| | - Jonathon Leipsic
- Department of Radiology, St Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - John G Webb
- Center for Heart Valve Innovation, St Paul's Hospital, Vancouver, British Colombia, Canada
| | - Philipp Blanke
- Department of Radiology, St Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada
| | - G Burkhard Mackensen
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington
| | | | - Arik Wolak
- Cardiology Department, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Creighton W Don
- Division of Cardiology, University of Washington, Seattle, Washington
| | - James M McCabe
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Christopher Rumer
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Christina W Tan
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Dmitry B Levin
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Mario Ramos
- Division of Cardiology, University of Washington, Seattle, Washington
| | - Gabriel S Aldea
- Division of Cardiovascular surgery, University of Washington, Seattle, Washington
| | - Mark Reisman
- Division of Cardiology, University of Washington, Seattle, Washington
| | | | - Sam Radhakrishnan
- Department of Cardiology, Sunnybrook Health Sciences Center, Toronto, Canada
| | | | - Nicolo Piazza
- Department of Medicine, Division of Cardiology, McGill University, Montreal, Quebec, Canada
| | - Ran Kornowski
- Division of Interventional Cardiology, Rabin Medical Center, Petah Tikva, Israel
| | | | - Danny Dvir
- Division of Cardiology, University of Washington, Seattle, Washington
| |
Collapse
|
16
|
Abstract
Purpose: To evaluate the clinical and anatomical features of patients with arch pathology to better understand the applicability of the Zenith inner branched arch endograft (IBAE). Materials and Methods: A retrospective review was performed of 60 consecutive patients (mean age 62.5 years; 42 men) who presented with nonruptured aortic arch pathology at a single institution between 2009 and 2016. Patients were stratified into standard (no previous cardiac surgery, <80 years old, and no significant medical comorbidity), high (previous cardiac surgery or significant comorbidity), or prohibitive risk (turned down for operative intervention) for operative intervention. Anatomical measurements of the aorta were obtained on computed tomography scans; anatomical suitability was based on the device's instructions for use. Results: Overall, 27 (45%) patients had anatomy amenable to treatment with the existing IBAE. Inadequate proximal seal length and large ascending aortic diameters were the primary reasons for anatomical unsuitability. Shortening the inner curve seal zone from 25 to 15 mm and increasing the proximal seal zone diameter from 38 to 42 mm increased anatomical suitability to include 49 (82%) patients. Of these, 31 were in the high-risk cohort and 7 were deemed prohibitive risk; therefore, IBAE would have been strongly considered in these 38 patients. Conclusion: Based on anatomical criteria alone, nearly half of patients with aortic arch pathology have anatomy suitable to the Zenith IBAE in its current design. Arch branch vessel anatomy was not a limitation of the device. From a clinical standpoint, if endovascular repair were reserved for those at high or prohibitive risk for open repair, approximately 30% of patients would likely benefit from the IBAE in its current form.
Collapse
Affiliation(s)
- Christopher R Burke
- Division of Cardiothoracic Surgery, University of Washington, Seattle, WA, USA
| | | | | | | | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, WA, USA
| | - Matthew P Sweet
- Division of Vascular Surgery, University of Washington, Seattle, WA, USA
| |
Collapse
|
17
|
Aldea GS. Commentary: Tricuspid valve ring characteristics: Physiologically important, clinically relevant, or too little too late? J Thorac Cardiovasc Surg 2019; 161:e209-e210. [PMID: 31703897 DOI: 10.1016/j.jtcvs.2019.09.133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 02/05/2023]
Affiliation(s)
- Gabriel S Aldea
- Department of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Wash.
| |
Collapse
|
18
|
Komatsu I, Leipsic J, Webb JB, Blanke P, Mackensen GB, Don CW, McCabe JM, Rumer C, Tan CW, Levin DB, Ramos M, Aldea GS, Reisman M, Wijeysundera HC, Radhakrishnan S, Sathananthan J, Piazza N, Kornowski R, Dvir D. Imaging of Aortic Valve Cusps Using Commissural Alignment. JACC Cardiovasc Imaging 2019; 12:2262-2265. [DOI: 10.1016/j.jcmg.2019.04.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 10/26/2022]
|
19
|
Nelson KA, Aldea GS, Warner P, Latchman Y, Gunasekera D, Tamir A, Gernsheimer T, Bolgiano D, Slichter SJ. Transfusion‐related immunomodulation: gamma irradiation alters the effects of leukoreduction on alloimmunization. Transfusion 2019; 59:3396-3404. [DOI: 10.1111/trf.15555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 08/21/2019] [Accepted: 08/21/2019] [Indexed: 12/28/2022]
Affiliation(s)
| | - Gabriel S. Aldea
- Department of Surgery, Division of Cardiothoracic Surgery University of Washington Seattle Washington
| | | | - Yvette Latchman
- Bloodworks Northwest Seattle Washington
- Silverback Therapeutics Seattle Washington
| | - Devi Gunasekera
- Bloodworks Northwest Seattle Washington
- Uniformed Services University of Health Sciences Bethesda Maryland
| | | | - Terry Gernsheimer
- Bloodworks Northwest Seattle Washington
- Division of Hematology University of Washington School of Medicine Seattle Washington
- Seattle Cancer Care Alliance Seattle Washington
| | | | - Sherrill J. Slichter
- Bloodworks Northwest Seattle Washington
- Division of Hematology University of Washington School of Medicine Seattle Washington
- Seattle Cancer Care Alliance Seattle Washington
| |
Collapse
|
20
|
Komatsu I, Mackensen GB, Aldea GS, Reisman M, Dvir D. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction. Part 1: how to evaluate patients for BASILICA. EUROINTERVENTION 2019; 15:47-54. [DOI: 10.4244/eij-d-19-00057] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
21
|
Suri RM, Javadikasgari H, Heimansohn DA, Weissman NJ, Ailawadi G, Ad N, Aldea GS, Thourani VH, Szeto WY, Michler RE, Michelena HI, Dabir R, Fontana GP, Kessler WF, Moront MG, Brunsting LA, Griffith BP, Montoya A, Subramanian S, Mostovych MA, Roselli EE. Prospective US investigational device exemption trial of a sutureless aortic bioprosthesis: One-year outcomes. J Thorac Cardiovasc Surg 2019; 157:1773-1782.e3. [DOI: 10.1016/j.jtcvs.2018.08.121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 08/05/2018] [Accepted: 08/14/2018] [Indexed: 11/26/2022]
|
22
|
Landes U, Dvir D, Schoels W, Tron C, Ensminger S, Simonato M, Schäfer U, Bunc M, Aldea GS, Cerillo A, Windecker S, Marzocchi A, Andreas M, Amabile N, Webb J, Kornowski R. Transcatheter aortic valve-in-valve implantation in degenerative rapid deployment bioprostheses. EUROINTERVENTION 2019; 15:37-43. [DOI: 10.4244/eij-d-18-00752] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
23
|
Komatsu I, Mackensen GB, Aldea GS, Reisman M, Dvir D. Bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction. Part 2: how to perform BASILICA. EUROINTERVENTION 2019; 15:55-66. [DOI: 10.4244/eij-d-19-00056] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
24
|
Aldea GS. Commentary: Reassessing efficacy of treatment strategies for secondary mitral regurgitation-Combining pathoanatomic and pathophysiologic perspectives. J Thorac Cardiovasc Surg 2019; 158:84-85. [PMID: 30853237 DOI: 10.1016/j.jtcvs.2019.01.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Gabriel S Aldea
- Department of Cardiothoracic Surgery, University of Washington Medical School, Seattle, Wash.
| |
Collapse
|
25
|
Bedzra E, Aldea DA, Aldea GS. Last gasp revisited. J Thorac Cardiovasc Surg 2018; 156:2168-2169. [PMID: 30098803 DOI: 10.1016/j.jtcvs.2018.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Edo Bedzra
- Department of Cardiothoracic Surgery, University of Washington, Seattle, Wash
| | | | - Gabriel S Aldea
- Department of Cardiothoracic Surgery, University of Washington, Seattle, Wash.
| |
Collapse
|
26
|
Mankad SV, Aldea GS, Ho NM, Mankad R, Pislaru S, Rodriguez LL, Whisenant B, Zimmerman K. Transcatheter Mitral Valve Implantation in Degenerated Bioprosthetic Valves. J Am Soc Echocardiogr 2018; 31:845-859. [DOI: 10.1016/j.echo.2018.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Indexed: 02/07/2023]
|
27
|
Atkins BZ, Aldea GS. “Drilling Down” on Structural Valve Deterioration. J Am Coll Cardiol 2018; 72:586. [DOI: 10.1016/j.jacc.2018.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 04/25/2018] [Indexed: 10/28/2022]
|
28
|
Aldea GS, Dvir D. Exuberance meets harsh realities in the bioprosthetic tissue valve era. J Thorac Cardiovasc Surg 2018; 155:e145-e146. [PMID: 29482848 DOI: 10.1016/j.jtcvs.2018.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Affiliation(s)
- Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington, Seattle, Wash.
| | - Danny Dvir
- Division of Cardiology, University of Washington, Seattle, Wash
| |
Collapse
|
29
|
Dvir D, Bourguignon T, Otto CM, Hahn RT, Rosenhek R, Webb JG, Treede H, Sarano ME, Feldman T, Wijeysundera HC, Topilsky Y, Aupart M, Reardon MJ, Mackensen GB, Szeto WY, Kornowski R, Gammie JS, Yoganathan AP, Arbel Y, Borger MA, Simonato M, Reisman M, Makkar RR, Abizaid A, McCabe JM, Dahle G, Aldea GS, Leipsic J, Pibarot P, Moat NE, Mack MJ, Kappetein AP, Leon MB. Standardized Definition of Structural Valve Degeneration for Surgical and Transcatheter Bioprosthetic Aortic Valves. Circulation 2018; 137:388-399. [DOI: 10.1161/circulationaha.117.030729] [Citation(s) in RCA: 260] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bioprostheses are prone to structural valve degeneration, resulting in limited long-term durability. A significant challenge when comparing the durability of different types of bioprostheses is the lack of a standardized terminology for the definition of a degenerated valve. This issue becomes especially important when we try to compare the degeneration rate of surgically inserted and transcatheter bioprosthetic valves. This document, by the VIVID (Valve-in-Valve International Data), proposes practical and standardized definitions of valve degeneration and provides recommendations for the timing of clinical and imaging follow-up assessments accordingly. Its goal is to improve the quality of research and clinical care for patients with deteriorated bioprostheses by providing objective and strict criteria that can be utilized in future clinical trials. We hope that the adoption of these criteria by both the cardiological and surgical communities will lead to improved comparability and interpretation of durability analyses.
Collapse
Affiliation(s)
- Danny Dvir
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | | | - Catherine M. Otto
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | - Rebecca T. Hahn
- Columbia University Medical Center, New York (R.T.H., M.A.B., M.B.L.)
| | | | - John G. Webb
- St Paul’s Hospital, Vancouver, British Columbia, Canada (J.G.W., M.S., J.L.)
| | | | | | - Ted Feldman
- NorthShore University HealthSystem, Evanston, IL (T.F.)
| | | | - Yan Topilsky
- Tel Aviv Sourasky Medical Center, Israel (Y.T., Y.A.)
| | | | | | - G. Burkhard Mackensen
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | | | - Ran Kornowski
- Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Israel (R.K.)
| | - James S. Gammie
- University of Maryland School of Medicine, Baltimore (J.S.G.)
| | - Ajit P. Yoganathan
- Georgia Institute of Technology and Emory University, Atlanta, GA (A.P.Y.)
| | - Yaron Arbel
- Tel Aviv Sourasky Medical Center, Israel (Y.T., Y.A.)
| | - Michael A. Borger
- Columbia University Medical Center, New York (R.T.H., M.A.B., M.B.L.)
| | - Matheus Simonato
- St Paul’s Hospital, Vancouver, British Columbia, Canada (J.G.W., M.S., J.L.)
| | - Mark Reisman
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | - Raj R. Makkar
- Cedars-Sinai Medical Center, Los Angeles, CA (R.R.M.)
| | | | - James M. McCabe
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | - Gry Dahle
- Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway (G.D.)
| | - Gabriel S. Aldea
- University of Washington Medical Center, Seattle (D.D., C.M.O., G.B.M., M.R., J.M.M., G.S.A.)
| | - Jonathon Leipsic
- St Paul’s Hospital, Vancouver, British Columbia, Canada (J.G.W., M.S., J.L.)
| | | | - Neil E. Moat
- Royal Brompton Hospital, London, United Kingdom (N.E.M.)
| | | | | | - Martin B. Leon
- Columbia University Medical Center, New York (R.T.H., M.A.B., M.B.L.)
| |
Collapse
|
30
|
Bedzra E, Don CW, Reisman M, Aldea GS. Transapical Mitral Valve Replacement for Mixed Native Mitral Stenosis and Regurgitation. Ann Thorac Surg 2017; 102:e97-9. [PMID: 27449468 DOI: 10.1016/j.athoracsur.2015.12.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 12/14/2015] [Accepted: 12/16/2015] [Indexed: 11/26/2022]
Abstract
A 71-year-old man presented with New York Heart Association (NYHA) class IV heart failure. He had undergone transapical mitral valve replacement for mixed mitral stenosis and mitral regurgitation. At the 1 month follow-up, the patient reported symptom resolution. An echocardiogram revealed a low gradient and no regurgitation. Our case shows that with careful multidisciplinary evaluation, preoperative planning, and patient selection, percutaneous mitral intervention can become an alternative therapy for high-risk patients who cannot undergo conventional surgical therapy.
Collapse
Affiliation(s)
- Edo Bedzra
- Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington.
| | - Creighton W Don
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington
| | - Mark Reisman
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington
| | - Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle, Washington
| |
Collapse
|
31
|
Nevidomskyte D, Shalhub S, Aldea GS, Byers PH, Schwarze U, Murray ML, Starnes B. Endovascular Repair of Internal Mammary Artery Aneurysms in 2 Sisters with SMAD3 Mutation. Ann Vasc Surg 2017; 41:283.e5-283.e9. [PMID: 28286188 DOI: 10.1016/j.avsg.2016.10.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022]
Abstract
True aneurysms of the internal mammary artery are rare and have been described in association with vasculitis or connective tissue disorders. Herein, we describe 2 cases of familial internal mammary artery aneurysms (IMAs) in 2 sisters with SMAD3 mutation. The older sister presented at the age of 54 years with an incidental diagnosis of a multilobed right IMA and the younger sister presented several years earlier with a ruptured left IMA aneurysm at the age of 49 years. Both sisters had Debakey type I aortic dissections prior to the IMA aneurysm presentation. To our knowledge, this is the first time IMA aneurysms have been described in siblings with SMAD3 mutation. In our experience, endovascular repair is a feasible and safe treatment option. An assessment of the entire arterial tree is recommended in patients diagnosed with SMAD3 mutations.
Collapse
Affiliation(s)
- Daiva Nevidomskyte
- Department of Surgery, Division of Vascular Surgery, University of Washington, Seattle, WA.
| | - Sherene Shalhub
- Department of Surgery, Division of Vascular Surgery, University of Washington, Seattle, WA
| | - Gabriel S Aldea
- Department of Surgery, Division of Cardiothoracic Surgery, University of Washington, Seattle, WA
| | - Peter H Byers
- Department of Pathology, University of Washington, Seattle, WA; Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
| | - Ulrike Schwarze
- Department of Pathology, University of Washington, Seattle, WA
| | - Mitzi L Murray
- Department of Pathology, University of Washington, Seattle, WA; Department of Medicine (Medical Genetics), University of Washington, Seattle, WA
| | - Benjamin Starnes
- Department of Surgery, Division of Vascular Surgery, University of Washington, Seattle, WA
| |
Collapse
|
32
|
Pal JD, McCabe JM, Dardas T, Aldea GS, Mokadam NA. Transcatheter aortic valve repair for management of aortic insufficiency in patients supported with left ventricular assist devices. J Card Surg 2016; 31:654-657. [DOI: 10.1111/jocs.12814] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jay D. Pal
- Division of Cardiothoracic Surgery; University of Washington; Seattle Washington
| | - James M. McCabe
- Division of Cardiology, Department of Surgery; University of Washington; Seattle Washington
| | - Todd Dardas
- Division of Cardiology, Department of Surgery; University of Washington; Seattle Washington
| | - Gabriel S. Aldea
- Division of Cardiothoracic Surgery; University of Washington; Seattle Washington
| | - Nahush A. Mokadam
- Division of Cardiothoracic Surgery; University of Washington; Seattle Washington
| |
Collapse
|
33
|
Aldea GS, Bakaeen FG, Pal J, Fremes S, Head SJ, Sabik J, Rosengart T, Kappetein AP, Thourani VH, Firestone S, Mitchell JD. The Society of Thoracic Surgeons Clinical Practice Guidelines on Arterial Conduits for Coronary Artery Bypass Grafting. Ann Thorac Surg 2015; 101:801-9. [PMID: 26680310 DOI: 10.1016/j.athoracsur.2015.09.100] [Citation(s) in RCA: 245] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 09/22/2015] [Accepted: 09/24/2015] [Indexed: 12/16/2022]
Abstract
Internal thoracic arteries (ITAs) should be used to bypass the left anterior descending (LAD) artery when bypass of the LAD is indicated (class of recommendation [COR] I, level of evidence [LOE] B). As an adjunct to left internal thoracic artery (LITA), a second arterial graft (right ITA or radial artery [RA]) should be considered in appropriate patients (COR IIa, LOE B). Use of bilateral ITAs (BITAs) should be considered in patients who do not have an excessive risk of sternal complications (COR IIa, LOE B). To reduce the risk of sternal infection with BITA, skeletonized grafts should be considered (COR IIa, LOE B), smoking cessation is recommended (COR I, LOE C), glycemic control should be considered (COR IIa, LOE B), and enhanced sternal stabilization may be considered (COR IIb, LOE C). As an adjunct to LITA to LAD (or in patients with inadequate LITA grafts), use of a RA graft is reasonable when grafting coronary targets with severe stenoses (COR IIa, LOE: B). When RA grafts are used, it is reasonable to use pharmacologic agents to reduce acute intraoperative and perioperative spasm (COR IIa, LOE C). The right gastroepiploic artery may be considered in patients with poor conduit options or as an adjunct to more complete arterial revascularization (COR IIb, LOE B). Use of arterial grafts (specific targets, number, and type) should be a part of the discussion of the heart team in determining the optimal approach for each patient (COR I, LOE C).
Collapse
Affiliation(s)
- Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Washington.
| | - Faisal G Bakaeen
- Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - Jay Pal
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Washington
| | - Stephen Fremes
- Schulich Heart Centre, Sunnybrook Health Sciences Centre, and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Stuart J Head
- Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, Netherlands
| | - Joseph Sabik
- Center of Heart Valve Disease, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Todd Rosengart
- Department of Cardiovascular Surgery, Texas Heart Institute, Houston, Texas
| | - A Pieter Kappetein
- Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, Netherlands
| | - Vinod H Thourani
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | | | - John D Mitchell
- Department of Surgery, Division of Cardiothoracic Surgery, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | | |
Collapse
|
34
|
Affiliation(s)
- Gabriel S Aldea
- Division of Cardiothoracic Surgery, University of Washington School of Medicine, Box 356310, 1959 NE Pacific St, AA115, Seattle, WA 98195.
| |
Collapse
|
35
|
Hijazi ZM, Ruiz CE, Zahn E, Ringel R, Aldea GS, Bacha EA, Bavaria J, Bolman RM, Cameron DE, Dean LS, Feldman T, Fullerton D, Horlick E, Mack MJ, Miller DC, Moon MR, Mukherjee D, Trento A, Tommaso CL. SCAI/AATS/ACC/STS Operator and Institutional Requirements for Transcatheter Valve Repair and Replacement, Part III: Pulmonic Valve. J Am Coll Cardiol 2015; 65:2556-63. [DOI: 10.1016/j.jacc.2015.02.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
36
|
Nathan DP, Shalhub S, Tang GL, Sweet MP, Verrier ED, Tran NT, Aldea GS, Starnes BW. Outcomes after stent graft therapy for dissection-related aneurysmal degeneration in the descending thoracic aorta. J Vasc Surg 2015; 61:1200-6. [DOI: 10.1016/j.jvs.2014.12.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 12/08/2014] [Indexed: 10/23/2022]
|
37
|
Hijazi ZM, Ruiz CE, Zahn E, Ringel R, Aldea GS, Bacha EA, Bavaria J, Bolman RM, Cameron DE, Dean LS, Feldman T, Fullerton D, Horlick E, Mack MJ, Miller DC, Moon MR, Mukherjee D, Trento A, Tommaso CL. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement, part III: Pulmonic valve. J Thorac Cardiovasc Surg 2015; 149:e71-8. [PMID: 25816957 DOI: 10.1016/j.jtcvs.2015.02.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Ziyad M Hijazi
- Sidra Cardiovascular Center of Excellence, Department of Pediatrics, Sidra Medical & Research Center, Doha, Qatar.
| | - Carlos E Ruiz
- Lenox Hill Heart & Vascular Institute of New York, New York, NY
| | - Evan Zahn
- Guerin Family Congenital Heart Program, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Richard Ringel
- Pediatric Cardiac Catheterization Laboratory, The Johns Hopkins Hospital, Baltimore, Md
| | - Gabriel S Aldea
- Regional Heart Center, University of Washington Medical Center, Seattle, Wash
| | - Emile A Bacha
- Pediatric Cardiac Surgery, New York-Presbyterian/Columbia University Medical Center, Morgan Stanley Children's Hospital, New York, NY
| | - Joseph Bavaria
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pa
| | - R Morton Bolman
- Division of Cardiac Surgery, Harvard Medical School, Boston, Mass
| | - Duke E Cameron
- The Dana and Albert "Cubby" Broccoli Center for Aortic Diseases, The Johns Hopkins Hospital, Baltimore, Md
| | - Larry S Dean
- University of Washington, School of Medicine, Seattle, Washington
| | - Ted Feldman
- Cardiac Catheterization Laboratory, Evanston Hospital, Evanston, Ill
| | - David Fullerton
- Cardiothoracic Surgery, University of Colorado Denver, Aurora, Colo
| | - Eric Horlick
- Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada
| | - Michael J Mack
- Cardiovascular Council Dallas, Heart Hospital Baylor, Plano, Tex
| | - D Craig Miller
- Department of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, Calif
| | - Marc R Moon
- Division of Cardiothoracic Surgery, Washington University, St. Louis, Mo
| | - Debabrata Mukherjee
- Department of Internal Medicine, Cardiovascular Medicine, Texas Tech University, El Paso, Tex
| | - Alfredo Trento
- Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif
| | - Carl L Tommaso
- Cardiac Catheterization Laboratory, Skokie Hospital, North Shore University Health System, Skokie, Ill
| | | | | | | | | |
Collapse
|
38
|
Hijazi ZM, Ruiz CE, Zahn E, Ringel R, Aldea GS, Bacha EA, Bavaria J, Bolman RM, Cameron DE, Dean LS, Feldman T, Fullerton D, Horlick E, Mack MJ, Miller DC, Moon MR, Mukherjee D, Trento A, Tommaso CL. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement, Part III: Pulmonic valve. Catheter Cardiovasc Interv 2015; 86:85-93. [PMID: 25809590 DOI: 10.1002/ccd.25710] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 11/10/2022]
Abstract
With the evolution of transcatheter valve replacement, an important opportunity has arisen for cardiologists and surgeons to collaborate in identifying the criteria for performing these procedures. Therefore, The Society for Cardiovascular Angiography and Interventions (SCAI), American Association for Thoracic Surgery (AATS), American College of Cardiology (ACC), and The Society of Thoracic Surgeons (STS) have partnered to provide recommendations for institutions to assess their potential for instituting and/or maintaining a transcatheter valve program. This article concerns transcatheter pulmonic valve replacement (tPVR). tPVR procedures are in their infancy with few reports available on which to base an expert consensus statement. Therefore, many of these recommendations are based on expert consensus and the few reports available. As the procedures evolve, technology advances, experience grows, and more data accumulate, there will certainly be a need to update this consensus statement. The writing committee and participating societies believe that the recommendations in this report serve as appropriate requisites. In some ways, these recommendations apply to institutions more than to individuals. There is a strong consensus that these new valve therapies are best performed using a Heart Team approach; thus, these credentialing criteria should be applied at the institutional level. Partnering societies used the ACC's policy on relationships with industry (RWI) and other entities to author this document (http://www.acc.org/guidelines/about-guidelines-and-clinical-documents). To avoid actual, potential, or perceived conflicts of interest due to industry relationships or personal interests, all members of the writing committee, as well as peer reviewers of the document, were asked to disclose all current healthcare-related relationships including those existing 12 months before the initiation of the writing effort. A committee of interventional cardiologists and surgeons was formed to include a majority of members with no relevant RWI and to be led by an interventional cardiology cochair and a surgical cochair with no relevant RWI. Authors with relevant RWI were not permitted to draft or vote on text or recommendations pertaining to their RWI. RWI were reviewed on all conference calls and updated as changes occurred. Author and peer reviewer RWI pertinent to this document are disclosed in the Appendices. In addition, to ensure complete transparency, authors' comprehensive disclosure information (including RWI not pertinent to this document) is available in Appendix AII. The work of the writing committee was supported exclusively by the partnering societies without commercial support. SCAI, AATS, ACC, and STS believe that adherence to these recommendations will maximize the chances that these therapies will become a successful part of the armamentarium for treating valvular heart disease in the United States. In addition, these recommendations will hopefully facilitate optimum quality during the delivery of this therapy, which will be important to the development and successful implementation of future, less invasive approaches to structural heart disease.
Collapse
Affiliation(s)
- Ziyad M Hijazi
- Sidra Cardiovascular Center of Excellence, Department of Pediatrics, Sidra Medical & Research Center, Doha, Qatar
| | - Carlos E Ruiz
- Lenox Hill Heart & Vascular Institute of New York, New York, New York
| | - Evan Zahn
- Guerin Family Congenital Heart Program, Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Richard Ringel
- Pediatric Cardiac Catheterization Laboratory, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Gabriel S Aldea
- Regional Heart Center, University of Washington Medical Center, Seattle, Washington
| | - Emile A Bacha
- Pediatric Cardiac Surgery, New York-Presbyterian/Columbia University Medical Center, Morgan Stanley Children's Hospital, New York, New York
| | - Joseph Bavaria
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - R Morton Bolman
- Division of Cardiac Surgery, Harvard Medical School, Boston, Massachusetts
| | - Duke E Cameron
- The Dana and Albert "Cubby" Broccoli Center for Aortic Diseases, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Larry S Dean
- University of Washington, School of Medicine, Seattle, Washington
| | - Ted Feldman
- Cardiac Catheterization Laboratory, Evanston Hospital, Evanston, Illinois
| | - David Fullerton
- Cardiothoracic Surgery, University of Colorado Denver, Aurora, Colorado
| | - Eric Horlick
- Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada
| | - Michael J Mack
- Cardiovascular Council Dallas, Heart Hospital Baylor, Plano, Texas
| | - D Craig Miller
- Department of Cardiovascular Surgery, Stanford University School of Medicine, Stanford, California
| | - Marc R Moon
- Division of Cardiothoracic Surgery, Washington University, St. Louis, Missouri
| | - Debabrata Mukherjee
- Department of Internal Medicine, Cardiovascular Medicine, Texas Tech University, El Paso, Texas
| | - Alfredo Trento
- Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Carl L Tommaso
- Cardiac Catheterization Laboratory, Skokie Hospital, North Shore University Health System, Skokie, Illinois
| |
Collapse
|
39
|
Tommaso CL, Fullerton DA, Feldman T, Dean LS, Hijazi ZM, Horlick E, Weiner BH, Zahn E, Cigarroa JE, Ruiz CE, Bavaria J, Mack MJ, Cameron DE, Bolman RM, Craig Miller D, Moon MR, Mukherjee D, Trento A, Aldea GS, Bacha EA. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement. Part II. Mitral valve. Catheter Cardiovasc Interv 2014; 84:567-80. [PMID: 24828236 DOI: 10.1002/ccd.25540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Carl L Tommaso
- Cardiac Cath Lab, North Shore Cardiologists, North Shore University Health System, 9669 North Kenton, Skokie, Illinois
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Nathan DP, Shalhub S, Tang GL, Sweet MP, Verrier ED, Tran NT, Aldea GS, Starnes BW. Outcomes Following Stent Graft Therapy of Dissection-Related Aneurysmal Degeneration in the Descending Thoracic Aorta. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.05.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
41
|
Don CW, Kim MS, Verrier ED, Aldea GS, Dean LS, Reisman M, Mokadam NA. Novel use of an apical-femoral wire rail to assist with transfemoral transcatheter aortic valve replacement. J Invasive Cardiol 2014; 26:E63-E65. [PMID: 24907088 PMCID: PMC4337783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The inability to reposition or retrieve balloon-expandable transcatheter aortic valves once they have been deployed requires implantation of the valve in the descending aorta or open surgical procedures to extract the valve. We describe the challenging transfemoral delivery of an Edwards Lifesciences Sapien valve wherein we had difficulty crossing the aortic valve and the guidewire position was compromised. We performed a transapical puncture to snare the guidewire and create a left ventricular to femoral wire rail, allowing us to deliver the transfemoral transcatheter valve, salvaging a situation where we would have been required to implant the valve in the descending aorta. We believe this is the first time this technique has been reported and represents an important method to facilitate delivery of transcatheter valves where guidewire support is insufficient or lost.
Collapse
Affiliation(s)
- Creighton W Don
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA.
| | | | | | | | | | | | | |
Collapse
|
42
|
Tommaso CL, Fullerton DA, Feldman T, Dean LS, Hijazi ZM, Horlick E, Weiner BH, Zahn E, Cigarroa JE, Ruiz CE, Bavaria J, Mack MJ, Cameron DE, Bolman RM, Miller DC, Moon MR, Mukherjee D, Trento A, Aldea GS, Bacha EA. SCAI/AATS/ACC/STS operator and institutional requirements for transcatheter valve repair and replacement: Part II. Mitral valve. Ann Thorac Surg 2014; 98:765-77. [PMID: 24835557 DOI: 10.1016/j.athoracsur.2014.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/07/2014] [Accepted: 05/08/2014] [Indexed: 01/22/2023]
Affiliation(s)
- Carl L Tommaso
- Cardiac Cath Lab, North Shore Cardiologists, North Shore University Health System, Skokie, Illinois.
| | - David A Fullerton
- Cardiothoracic Surgery, University of Colorado Denver, Aurora, Colorado
| | - Ted Feldman
- Cardiac Catheterization Laboratory, Evanston Hospital, Evanston, Illinois; Cardiology Division, Evanston Hospital, Evanston, Illinois
| | - Larry S Dean
- University of Washington School of Medicine, Seattle, Washington; UW Medicine Regional Heart Center, Seattle, Washington
| | - Ziyad M Hijazi
- Rush Center for Congenital & Structural Heart Disease, Chicago, Illinois; Pediatric Cardiology, Rush University Medical Center, Chicago, Illinois
| | - Eric Horlick
- Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Ontario, Canada
| | - Bonnie H Weiner
- Saint Vincent Hospital at Worcester Medical Center/Fallon Clinic, Worcester, Massachusetts; Boston Biomedical Associates, Northborough, Massachusetts
| | - Evan Zahn
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Joaquin E Cigarroa
- Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Carlos E Ruiz
- Lenox Hill Heart and Vascular Institute of New York, New York, New York
| | - Joseph Bavaria
- Division of Cardiothoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michael J Mack
- Cardiovascular Council Dallas, Heart Hospital Baylor Plano, Plano, Texas
| | - Duke E Cameron
- The Dana and Albert "Cubby" Broccoli Center for Aortic Diseases, The Johns Hopkins Hospital, Baltimore, Maryland
| | - R Morton Bolman
- Division of Cardiac Surgery, Harvard Medical School, Boston, Massachusetts
| | - D Craig Miller
- Cardiovascular Surgical Physiology Research Laboratories, Stanford University Medical Center, Stanford, California; Cardiovascular Surgery, Falk CV Research Center, Stanford, California
| | - Marc R Moon
- Division of Cardiothoracic Surgery, Washington University, St. Louis, Missouri
| | | | - Alfredo Trento
- Division of Cardiothoracic Surgery, Cedar Sinai Medical Center, Los Angeles, California
| | - Gabriel S Aldea
- Regional Heart Center, University of Washington Medical Center, Seattle, Washington
| | - Emile A Bacha
- Division of Cardiac, Thoracic, and Vascular Surgery, New York Presbyterian/Columbia University Medical Center, New York, New York; Pediatric Cardiac Surgery, Morgan Stanley Children's Hospital of New York, New York, New York
| |
Collapse
|
43
|
Riley RF, Don CW, Aldea GS, Mokadam NA, Probstfield J, Maynard C, Goss JR. Recent Trends in Adherence to Secondary Prevention Guidelines for Patients Undergoing Coronary Revascularization in Washington State: An Analysis of the Clinical Outcomes Assessment Program (COAP) Registry. J Am Heart Assoc 2012; 1:e002733. [PMID: 26600570 PMCID: PMC4942980 DOI: 10.1161/jaha.112.002733] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Previous studies indicated that patients undergoing coronary artery bypass graft (CABG) surgery are less likely to receive guideline‐based secondary prevention therapy than are those undergoing percutaneous coronary intervention (PCI) after an acute myocardial infarction. We aimed to evaluate whether these differences have persisted after the implementation of public reporting of hospital metrics. Methods and Results The Clinical Outcomes Assessment Program (COAP) database was analyzed retrospectively to evaluate adherence to secondary prevention guidelines at discharge in patients who underwent coronary revascularization after an acute ST‐elevation myocardial infarction in Washington State. From 2004 to 2007, 9260 patients received PCI and 692 underwent CABG for this indication. Measures evaluated included prescription of aspirin, β‐blockers, angiotensin‐converting enzyme inhibitors or angiotensin II receptor blockers, or lipid‐lowering medications; cardiac rehabilitation referral; and smoking‐cessation counseling. Composite adherence was lower for CABG than for PCI patients during the period studied (79.6% versus 89.7%, P<0.01). Compared to patients who underwent CABG, patients who underwent PCI were more likely to receive each of the pharmacological therapies. There was no statistical difference in smoking‐cessation counseling (91.7% versus 90.3%, P=0.63), and CABG patients were more likely to receive referral for cardiac rehabilitation (70.9% versus 48.3%, P<0.01). Adherence rates improved over time among both groups, with no significant difference in composite adherence in 2006 (85.6% versus 87.6%, P=0.36). Conclusions Rates of guideline‐based secondary prevention adherence in patients with ST‐elevation myocardial infarction who underwent CABG surgery have been improving steadily in Washington State. The improvement possibly is associated with the implementation of public reporting of quality measures.
Collapse
Affiliation(s)
- Robert F Riley
- Section on Cardiology, Wake Forest University Health SciencesWinston-Salem, USA
| | - Creighton W Don
- Section on Cardiology, Wake Forest University Health SciencesWinston-Salem, NC (R.F.R.) Division of Cardiology, University of Washington, Seattle, WA (C.W.D., J.P.)
| | - Gabriel S Aldea
- Cardiothoracic Surgery, University of Washington, Seattle, WA (G.S.A., N.A.M.)
| | - Nahush A Mokadam
- Cardiothoracic Surgery, University of Washington, Seattle, WA (G.S.A., N.A.M.)
| | - Jeffrey Probstfield
- Division of Cardiology, University of Washington, Seattle, WA (C.W.D., J.P.)
| | - Charles Maynard
- School of Public Health, University of Washington, Seattle, WA (C.M.)
| | - J Richard Goss
- Division of General Internal Medicine, Harborview Medical Center, Seattle, WA (J.R.G.)
| |
Collapse
|
44
|
Rabkin DG, Mokadam NA, Miller DW, Goetz RR, Verrier ED, Aldea GS. Long-term outcome for the surgical treatment of infective endocarditis with a focus on intravenous drug users. Ann Thorac Surg 2011; 93:51-7. [PMID: 22054655 DOI: 10.1016/j.athoracsur.2011.08.016] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2011] [Revised: 08/03/2011] [Accepted: 08/08/2011] [Indexed: 12/19/2022]
Abstract
BACKGROUND We reviewed our experience with surgical procedures for infective endocarditis (IE) in order to evaluate modern outcomes and objectively examine our institutional preferences, including the use of bioprostheses in intravenous drug users (IVDUs) regardless of age and prompt surgical intervention in patients with either septic cerebral emboli or active infection. METHODS Review of medical records was conducted from February 1999 to November 2010. The Social Security Death Index was used to determine death from any cause in the postoperative period. Hospital records were used to identify infectious complications, recurrent endocarditis, and reoperation. RESULTS Sixty-four patients were identified as IVDUs and 133 patients as non-IVDUs. Survival at 30 days, 1 year, 5 years, and 10 years for IVDUs and non-IVDUs was 91.2% versus 93.6%, 77.5% versus 83.0%, 46.7% versus 71.1%, and 41.1% versus 52.0%, respectively. Cox regression analysis identified intravenous drug use as an independent risk factor for diminished survival (p=0.03), although not for reoperation (p=0.95) despite 95.3% of IVDUs receiving bioprostheses versus 73.7% of non-IVDUs (p=0.0002, Fisher's exact test). Forty-three patients were identified as having preoperative septic cerebral emboli; none had a perioperative hemorrhagic event. Active infection approached significance as an independent risk factor for the composite end point of recurrent IE and perioperative infection (odds ratio 2.8; 95% confidence interval, 0.777 to 10.9; p=0.12, Fisher's exact test). CONCLUSIONS Bioprostheses are reasonable for IVDUs undergoing valve replacement for IE regardless of age. Prompt surgical intervention in the setting of septic cerebral emboli is justified; in the setting of active infection it is less clear.
Collapse
Affiliation(s)
- David G Rabkin
- Division of Cardiac Surgery, Department of Surgery, University of Washington Medical Center, Seattle, Washington 98195, USA.
| | | | | | | | | | | |
Collapse
|
45
|
Woo JS, Rabkin DG, Mokadam NA, Rendi MH, Aldea GS. Gonococcal ascending aortitis with penetrating ulcers and intraluminal thrombus. Ann Thorac Surg 2011; 91:910-2. [PMID: 21353028 DOI: 10.1016/j.athoracsur.2010.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 08/09/2010] [Accepted: 08/11/2010] [Indexed: 11/15/2022]
Abstract
Neisseria gonorrhoeae is an uncommon pathogen causing bacterial aortitis. We describe a patient with a bicuspid aortic valve and known ascending aortic aneurysm who presented with fever and chest pain. Imaging demonstrated complex penetrating ulcers in the proximal ascending aorta. The patient underwent a modified Bentall procedure, resection of the ulcers, and ascending aortic reconstruction. Pathologic examination and culture of the aortic specimens revealed the infectious cause.
Collapse
Affiliation(s)
- J Susie Woo
- Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA
| | | | | | | | | |
Collapse
|
46
|
Mokadam NA, Melford Jr. RE, Maynard C, Goss JR, Stewart D, Reisman M, Aldea GS. Prevalence and Procedural Outcomes of Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in Patients with Diabetes and Multivessel Coronary Artery Disease. J Card Surg 2010; 26:1-8. [DOI: 10.1111/j.1540-8191.2010.01072.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
47
|
Abstract
BACKGROUND Heart transplant candidates carry many of risk factors for vascular disease, and in addition, recipients continue to accumulate them following heart transplantation (HTx). However, very limited information is available on this entity. This study was designed to address characteristics of extracoronary vascular disease in heart transplant recipients. METHODS This is a nonconcurrent cohort study of 402 patients who received HTx at the University of Washington between 1985 and 2004. Pretransplant arterial evaluation included carotid, lower extremity, and renal artery duplex studies. CT angiogram was obtained when indicated. Patients with severe arterial disease were excluded from the transplant list. Posttransplant vascular evaluation was done with the patient's history and physical examination. RESULTS Median follow-up was 5.5 years. Seventy vascular diseases were detected in 49 patients (12% of study population). Patients with pretransplant vascular disease, compared to those without, were older at the HTx, carried the diagnosis of ischemic cardiomyopathy more commonly, and had more comorbidities including history of smoking, alcohol drinking, chronic obstructive pulmonary disease, and prior heart operations. The prevalence of vascular disease was 6% prior to HTx and it cumulatively increased up to 17% at 17 years after HTx. Nineteen percent of these diseases were the result of arterial traumas mostly caused by medical interventions. Fourteen patients developed abdominal aortic aneurysm (AAA) with two deaths. CONCLUSIONS It is important for care providers to be aware of the high probability of vascular disease, to be familiar with vascular disease, and to provide appropriate prophylactic and therapeutic measures when evaluating this patient population.
Collapse
Affiliation(s)
- Hiroo Takayama
- Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan.
| | | | | | | |
Collapse
|
48
|
Abstract
The clinical presentation, treatment, and outcomes of six consecutive patients presenting with acute aortic dissection secondary to hypertensive crises from methamphetamine use is described. Data were obtained prospectively from the expanded STS clinical database of the division of cardiothoracic surgery at the University of Washington, but reviewed in a retrospective fashion. These patients represent 5.5% of all patients diagnosed and treated for aortic dissection in the same time period (6/109) and 20% of all patients with aortic dissection under the age of 50 years (6/30). We conclude that young patients (<age 50 years old) presenting with acute aortic dissections should be routinely tested for methamphetamine. Positive urine tests should be confirmed with chromatography-mass spectrometry (GC-MS). Beta and alpha blockers should be used instead of the more typical beta blockade alone. We recommend the addition and documentation of intense, long-term drug rehabilitation program along with routine periodic clinical and radiographic follow-up to prevent secondary aneurysmal dilation of remaining pathological aorta.
Collapse
Affiliation(s)
- Elizabeth Wako
- Division of Cardiothoracic Surgery, University of Washington, AA-115 Health Sciences Building, 1959 NE Pacific Street, Seattle, Washington 98195-6310, USA
| | | | | | | |
Collapse
|
49
|
Takayama H, Soltow LO, Aldea GS. Differential Expression in Markers for Thrombin, Platelet Activation, and Inflammation in Cell Saver Versus Systemic Blood in Patients Undergoing On-Pump Coronary Artery Bypass Graft Surgery. J Cardiothorac Vasc Anesth 2007; 21:519-23. [PMID: 17678777 DOI: 10.1053/j.jvca.2007.01.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Elimination of cardiotomy suction increases reliance on cell-saver blood-conservation techniques. Reinfusion of processed cell-saver blood (PCSB) even without using cardiotomy field suction may contribute to thrombin, cytokines, platelet activators, and hemolytic factors measured systemically. DESIGN This study was designed as a prospective, unblinded observational study of patients undergoing first-time, nonemergent on-pump coronary artery bypass graft surgery. SETTING A university medical center. PARTICIPANTS Fourteen patients were enrolled after informed consent. INTERVENTIONS Arterial blood was sampled (1) before cardiopulmonary bypass, (2) immediately after bypass, and (3) 4 hours after bypass. PCSB, using the AutoLog (Medtronic, Inc, Minneapolis, MN), was sampled after bypass. MEASUREMENTS AND MAIN RESULTS Blood and PCSB levels of prothrombin fragments 1.2, beta-thromboglobulin, interleukin-6, interleukin-8, polymorphonuclear leukocyte-elastase, neuron-specific enolase, and S-100beta were assayed by using enzyme-linked immunosorbent assay. Paired comparisons were performed by using paired t tests. Compared with postbypass blood, processed cell-saver blood (prepatient infusion) had higher levels of polymorphonuclear leukocyte-elastase, interleukin-8, neuron-specific enolase, and S-100beta (p <or= 0.05). CONCLUSIONS Reinfusion of PCSB directly and independently contributes to systemic elevations in interleukin-8, polymorphonuclear elastase, neuron-specific enolase, and S-100beta, augmenting and perhaps accentuating the postoperative inflammatory response. Further evaluation and improvement in cell-salvaging technology and processing techniques are warranted.
Collapse
Affiliation(s)
- Hiroo Takayama
- Department of Surgery, Cardiothoracic Division, University of Washington School of Medicine, Seattle, WA 98195-3166, USA
| | | | | |
Collapse
|
50
|
Abstract
BACKGROUND Clinical studies conducted to elucidate the systemic response to cardiopulmonary bypass (CPB) did not differentiate possible effect of different types of cardiac surgical pathologies and operations on outcomes and have typically combined different procedures. We hypothesized that valve surgery induces more prominent systemic reaction compared to isolated on-pump CABG. METHODS Twenty-seven patients undergoing primary on-pump CABG (Group 1, n = 14) or valve surgery with or without CABG (Group 2, n = 13) were prospectively enrolled. Heparin-bonded circuits were used in all patients. Cardiotomy suction was only used in Group 2. Clinical and laboratory markers were evaluated. RESULTS Clinical measurements, including chest tube output, blood transfusion requirement, inotropic support requirement, and duration of ICU stay were not significantly different. Thrombin generation (PF-1.2) was significantly higher in Group 2 (p = 0.001). tPA was also significantly higher in Group 2 at 15 and 60 minutes on CPB (p < 0.01). Group 2 had significantly higher inflammatory response shown by elevation of IL6 (p = 0.005). Neuronal injury markers, S100beta and NSE, were significantly higher at the termination of CPB in Group 2 (p < 0.01). At no point of time course for any marker, Group 1 had significantly higher response compared to Group 2. CONCLUSIONS Valve surgery induced more prominent systemic response than CABG. The possible explanations include the difference in baseline disease pathophysiology, and/or difference associated with the procedures such as open systems and use of cardiotomy suction. Future clinical studies assessing systemic response to CPB and therapies to blunt these need consider and account for these observed differences.
Collapse
Affiliation(s)
- Hiroo Takayama
- Department of Surgery, Division of Cardiothoracic Surgery, University of Washington School of Medicine, Seattle, Washington 98195, USA
| | | | | | | | | |
Collapse
|