scholarly journals 1032-132 An analysis of patients with hypertrophic obstructive cardiomyopathy and persisting New York heart association class III symptoms during long-term follow-up after septal ablation

2004 ◽  
Vol 43 (5) ◽  
pp. A167
Author(s):  
Dirk Welge ◽  
Lothar Faber ◽  
Hubert Seggewiss ◽  
Dieter Fassbender ◽  
Dieter Horstkotte
Keyword(s):  
New York ◽  
Heart Association ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
York Heart Association Class ◽  
Class Iii ◽  
Association Class ◽  
Long Term Follow Up ◽  
New York Heart Association

scholarly journals Minimally Invasive versus Full-Sternotomy Septal Myectomy for Hypertrophic Cardiomyopathy

2018 ◽  
Vol 13 (4) ◽  
pp. 261-266
Author(s):  
Farah N. Musharbash ◽  
Matthew R. Schill ◽  
Vivek H. Hansalia ◽  
Richard B. Schuessler ◽  
Jeremy E. Leidenfrost ◽  
...  
Keyword(s):  
New York ◽  
Minimally Invasive ◽  
Heart Association ◽  
Hypertrophic Obstructive Cardiomyopathy ◽  
Left Ventricular ◽  
York Heart Association Class ◽  
Septal Myectomy ◽  
Association Class ◽  
New York Heart Association

Objective Septal myectomy remains the criterion standard for the treatment of patients with hypertrophic obstructive cardiomyopathy refractory to medical therapy. There have been few reports of minimally invasive approaches. This study compared a minimally invasive septal myectomy performed at our institution with the traditional full-sternotomy approach. Methods Patients receiving a stand-alone septal myectomy were retrospectively reviewed from November 1999 to December 2016 (N = 120). Patients were stratified by surgical approach: traditional full sternotomy (n = 34) and ministernotomy (n = 86). Preoperative and perioperative variables were compared as well as follow-up symptomatic and echocardiographic outcomes. Results Both groups had a significant decrease in New York Heart Association class heart failure symptoms ( P < 0.001). At a mean ± SD follow-up time of 2.0 ± 3.4 years, postoperative New York Heart Association class distribution was similar between ministernotomy and full sternotomy ( P = 0.684). Follow-up resting left ventricular outflow tract gradient was also similar between ministernotomy and full sternotomy (11 mm Hg ± 15 vs 9 mm Hg ± 13, P = 0.381). Perioperatively, ministernotomy was not significantly different from full sternotomy in median cardiopulmonary bypass time (81 minutes vs 78 minutes, P = 0.101) but had a slightly longer median cross-clamp time (39 minutes vs 35 minutes, P = 0.017). Major complications were similar in the two groups. There was one 30-day mortality in the full-sternotomy group, but no in-hospital deaths. Conclusions Septal myectomy performed using a minimally invasive approach has similar outcomes to the criterion standard operation done through a full sternotomy. It represents a feasible option for patients with hypertrophic obstructive cardiomyopathy unresponsive to medications.

Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project

2021 ◽  
Author(s):  
Luca Testa ◽  
Mauro Agnifili ◽  
Nicolas M. Van Mieghem ◽  
Didier Tchétché ◽  
Anita W. Asgar ◽  
...  
Keyword(s):  
New York ◽  
Transcatheter Aortic Valve Replacement ◽  
Heart Association ◽  
York Heart Association Class ◽  
Class Iii ◽  
Transcatheter Aortic Valve ◽  
Significant Difference ◽  
Association Class ◽  
New York Heart Association ◽  
Overall Mortality

Background: Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR. Methods: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%. Results: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded. Conclusions: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04500964.

scholarly journals CardioMEMS Implantation Using Gadolinium-based Contrast Agent: A Case Report

2021 ◽  
Vol 7 ◽  
Author(s):  
Aniket S Rali ◽  
Lynne W Stevenson ◽  
Sandip K Zalawadiya
Keyword(s):  
Heart Failure ◽  
New York ◽  
Contrast Agent ◽  
Heart Association ◽  
York Heart Association Class ◽  
Class Iii ◽  
Device Implantation ◽  
Association Class ◽  
New York Heart Association ◽  
History Of

A 57-year-old woman with New York Heart Association Class III heart failure requiring multiple hospitalisations over the previous year presented for CardioMEMS implantation. Because of the patient’s allergy history of anaphylaxis to iodine-based contrast agent she underwent the device implantation with gadolinium-based contrast agent (Magnevist), which was successful.

Patients with New York Heart Association class III heart failure may benefit with high flow nasal cannula supportive therapy

2013 ◽  
Vol 28 (5) ◽  
pp. 741-746 ◽  
Author(s):  
Oriol Roca ◽  
Purificación Pérez-Terán ◽  
Joan R. Masclans ◽  
Lourdes Pérez ◽  
Enrique Galve ◽  
...  
Keyword(s):  
Heart Failure ◽  
New York ◽  
Supportive Therapy ◽  
Heart Association ◽  
High Flow ◽  
York Heart Association Class ◽  
Class Iii ◽  
High Flow Nasal Cannula ◽  
Association Class ◽  
New York Heart Association

scholarly journals Levels of Trimethylamine N-Oxide Remain Elevated Long Term After Left Ventricular Assist Device and Heart Transplantation and Are Independent From Measures of Inflammation and Gut Dysbiosis

2021 ◽  
Vol 14 (6) ◽  
Author(s):  
Melana Yuzefpolskaya ◽  
Bruno Bohn ◽  
Azka Javaid ◽  
Giulio M. Mondellini ◽  
Lorenzo Braghieri ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
New York ◽  
Heart Association ◽  
Left Ventricular ◽  
York Heart Association Class ◽  
Ventricular Assist ◽  
Gut Dysbiosis ◽  
Association Class ◽  
New York Heart Association

Background: Trimethylamine N-oxide (TMAO)—a gut-derived metabolite—is elevated in heart failure (HF) and linked to poor prognosis. We investigated variations in TMAO in HF, left ventricular assist device (LVAD), and heart transplant (HT) and assessed its relation with inflammation, endotoxemia, oxidative stress, and gut dysbiosis. Methods: We enrolled 341 patients. TMAO, CRP (C-reactive protein), IL (interleukin)-6, TNF-α (tumor necrosis factor alpha), ET-1 (endothelin-1), adiponectin, lipopolysaccharide, soluble CD14, and isoprostane were measured in 611 blood samples in HF (New York Heart Association class I–IV) and at multiple time points post-LVAD and post-HT. Gut microbiota were assessed via 16S rRNA sequencing among 327 stool samples. Multivariable regression models were used to assess the relationship between TMAO and (1) New York Heart Association class; (2) pre- versus post-LVAD or post-HT; (3) biomarkers of inflammation, endotoxemia, oxidative stress, and microbial diversity. Results: ln-TMAO was lower among HF New York Heart Association class I (1.23 [95% CI, 0.52–1.94] µM) versus either class II, III, or IV (1.99 [95% CI, 1.68–2.30], 1.97 [95% CI, 1.71–2.24], and 2.09 [95% CI, 1.83–2.34] µM, respectively; all P <0.05). In comparison to class II–IV, ln-TMAO was lower 1 month post-LVAD (1.58 [95% CI, 1.32–1.83] µM) and 1 week and 1 month post-HT (0.97 [95% CI, 0.60–1.35] and 1.36 [95% CI, 1.01–1.70] µM). ln-TMAO levels in long-term LVAD (>6 months: 1.99 [95% CI, 1.76–2.22] µM) and HT (>6 months: 1.86 [95% CI, 1.66–2.05] µM) were not different from symptomatic HF. After multivariable adjustments, TMAO was not associated with biomarkers of inflammation, endotoxemia, oxidative stress, or microbial diversity. Conclusions: TMAO levels are increased in symptomatic HF patients and remain elevated long term after LVAD and HT. TMAO levels were independent from measures of inflammation, endotoxemia, oxidative stress, and gut dysbiosis.

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