P3135Tricuspid valve dysfunction caused by transvenous lead extraction. Can we predict this complication?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Polewczyk ◽  
D Nowosielecka ◽  
A Tomaszewski ◽  
W Brzozowski ◽  
D Szczesniak Stanczyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Tricuspid Valve ◽  
Dwell Time ◽  
Lead Extraction ◽  
Function Evaluation ◽  
Main Risk Factor ◽  
Valve Dysfunction ◽  
Valve Function

Abstract Background Accidental damage of tricuspid apparatus is known complication of TLE procedure risk factors of this complication remain unknown. Purpose The goal of this study was to search factors which can predict damage of tricuspid apparatus during TLE. Methods Between 2006 and 2018 we performed 2002 TLE procedures using conventional mechanical sheaths. 3366 leads (mean implant duration 95,2 months) were removed due to non-infective indications in 62,0%. Tricuspid valve function was examined with preoperative and post-operative TTE and during monitoring of procedure. Patients with incomplete TV function evaluation were excluded from the study. Three groups of patients were compared Results TLE procedure brings risk (7%) of different degree damage or tricuspid leflet or even chordae tendinae (2%). The detailed results are presented in the table. Conclusions TLE using conventional mechanical sheaths is effective but brings risk of extraction related tricuspid valve dysfunction. Main risk factor of this complication seems to be implant dwell time, number of leads presence of abandoned leads and lead loop in the heart remaining in conflict with tricuspid valve.

scholarly journals Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis

2021 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Anna Polewczyk ◽  
Wojciech Jacheć ◽  
Dorota Nowosielecka ◽  
Andrzej Tomaszewski ◽  
Wojciech Brzozowski ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tricuspid Valve ◽  
Lead Extraction ◽  
Common Mechanism ◽  
Term Survival ◽  
Long Term Survival ◽  
Valve Dysfunction ◽  
Valve Function ◽  
Long Term Prognosis

Background: Lead-related tricuspid valve dysfunction (LDTVD) has not been studied in a large population and its management remains controversial. Methods: An analysis of the clinical data of 2678 patients undergoing transvenous lead extraction (TLE) in years 2008–2021 was conducted, with a separate group of 119 patients with LDTVD. Potential risk factors for LDTVD, improvement in valve function, and long-term prognosis after TLE were assessed. Results: LDTVD was diagnosed in 4.44% of patients referred for lead extraction due to different reasons. The most common mechanism of LDTVD was propping upward or clamping down the leaflet by the lead (85.71%). The probability of LDTVD was higher in female sex, patients with valvular heart disease, atrial fibrillation, heart failure, large right ventricle and high pulmonary artery systolic pressure, the presence of only pacing lead, and in case of collision of the lead with tricuspid valve and adhesion of the lead to the heart structures. The prognosis of patients with LDTVD was worse, however, patients with improved valve function after TLE showed a significantly better long-term survival. Conclusions: Lead dependent tricuspid valve dysfunction is a potentially serious condition that requires thorough diagnostics and thoughtful management. The risk factors for LDTVD are primarily related to the course of the lead and its adhesion to the heart structures. Improvement of tricuspid valve function after TLE is observed in 35.29% of patients Patients with LDTVD have a worse long-term survival, but the improvement in valve function following TLE contributes to a significant reduction in mortality.

2407Influence of transvenous lead extraction procedure on function of tricuspid apparatus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Polewczyk ◽  
D Nowosielecka ◽  
A Tomaszewski ◽  
W Brzozowski ◽  
D Szczesniak Stanczyk ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Clinical Success ◽  
Extraction Procedure ◽  
Lead Extraction ◽  
Lead Removal ◽  
Separate Analysis ◽  
Valve Dysfunction ◽  
Valve Function ◽  
Procedural Success

Abstract Background Accidental damage of tricuspid apparatus remain known complication of TLE procedure but our knowledge is limited due lack of separate analysis in the literature. Purpose The goal of this study was analysis of the appearance of lead extraction related tricuspid valve dysfunction using trans-chest and trans-oesophageal echocardiography. Methods Between March 2006 and December 2018 we performed 2900 TLE procedures using conventional mechanical sheaths in 1760 male and 1140 female patients (mean age 66.6y). 4811 leads (mean implant duration 91.5 months) were removed due to non-infective indications in 65.3%. Full radiological success was obtained in 95.7% procedures, partial in 4.0%, clinical success in 98.0%, full procedural success in 96.1%. Major complications (MC) appeared in 8 (1.8%). Results Results are presented in the table Conclusions TLE using conventional mechanical sheaths is effective. Tricuspid valve dysfunction different degree is frequent finding in candidates for TLE. TLE procedure brings risk (7.2%) of different degree damage of tricuspid leflet (significant in 1.5%) or even chordae tendinae (4%). Patients with severe lead extraction related tricuspid valve dysfunction needs exact follow-up and some of them can be candidates for cardiac surgery. On the other hand in not so rare cases of lead related tricuspid valve dysfunction – lead removal/replacement can to bring improvement of tricuspid valve function (6.1%).

Risk factors for sporadic Shiga toxin-producingEscherichia coliO157 and non-O157 illness in The Netherlands, 2008–2012, using periodically surveyed controls

2014 ◽  
Vol 143 (7) ◽  
pp. 1360-1367 ◽  
Author(s):  
I. H. M. FRIESEMA ◽  
M. SCHOTSBORG ◽  
M. E. O. C. HECK ◽  
W. VAN PELT
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
The Netherlands ◽  
Shiga Toxin ◽  
Age Groups ◽  
Meat Products ◽  
Farm Animals ◽  
Severe Illness ◽  
Main Risk Factor ◽  
Using Data

SUMMARYShiga toxin-producingEscherichia coli(STEC) infections have been associated with severe illness. Ruminants are seen as the main reservoir and the major transmission route is considered to be foodborne. In The Netherlands, a case-control study was conducted, using data collected during 2008–2012. Patients were interviewed and controls completed a self-administered questionnaire. Patients travelling abroad were excluded from the analyses. STEC O157 and non-O157 were examined separately and differentiated into two age groups (<10 years, ⩾10 years). We included 130 O157 cases, 78 non-O157 cases and 1563 controls. In both age groups of O157 patients, raw spreadable sausage was the main risk factor for infection. For STEC non-O157 cases aged <10 years, contact with farm animals was the main risk factor and in non-O157 cases aged ⩾10 years, consumption of beef was the main risk factor. During 2008–2012, risk factors for STEC infections in the Dutch population differed between age groups and serogroup categories, and were related to eating meat and contact with farm animals. Advising the public about the risks of consuming raw or undercooked meat (products) and hygiene habits in case of contact with farm animals, could help in the prevention of STEC infections.

scholarly journals THE RESULTS OF PREVENTIVE MEDICAL EXAMINATION FOR ADULTS IN SHPAKOVSKY DISTRICT OF STAVROPOL REGION IN 2015–2017

2018 ◽  
pp. 16-18
Author(s):  
N.E. Afanasev ◽  
A.K. Shishmanidi ◽  
I.V. Koshel
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Medical Examination ◽  
Endocrine Disorders ◽  
Main Risk Factor ◽  
Genitourinary System ◽  
Stavropol Region ◽  
Unbalanced Diet

The article presents the results analysis of preventive medical examination for adults in the Shpakovsky region of Stavropol region for 2015–2017. In the disease structure cardiovascular diseases ranks first, endocrine disorders has the second highest rate of incidence, genitourinary system diseases ranked third. The main risk factor for the chronic non-communicable diseases is unbalanced diet (35,74 %). Low physical activity ranks second accroding to the results of questionnaire (31,23 %) and high blood pressure ranked third (24,45 %). Frequency rate of chronic non-comminicable risk factors detection had been decreased during the years.

scholarly journals Analysis of Risk Factors for Major Complications of 1500 Transvenous Lead Extraction Procedures with Especial Attention to Tricuspid Valve Damage

2021 ◽  
Vol 18 (17) ◽  
pp. 9100
Author(s):  
Łukasz Tułecki ◽  
Anna Polewczyk ◽  
Wojciech Jacheć ◽  
Dorota Nowosielecka ◽  
Konrad Tomków ◽  
...  
Keyword(s):  
Risk Factors ◽  
Tricuspid Valve ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lead Extraction ◽  
Safe Procedure ◽  
Term Survival ◽  
Technical Problems ◽  
Extraction Procedures ◽  
Major Complications

Background: Transvenous lead extraction (TLE) is a relatively safe procedure, but it may cause severe complications such as cardiac/vascular wall tear (CVWT) and tricuspid valve damage (TVD). Methods: The risk factors for CVWT and TVD were examined based on an analysis of data of 1500 extraction procedures performed in two high-volume centers. Results: The total number of major complications was 33 (2.2%) and included 22 (1.5%) CVWT and 12 (0.8%) TVD (with one case of combined complication). Patients with hemorrhagic complications were younger, more often women, less often presenting low left ventricular ejection fraction (LVEF) and those who received their first cardiac implantable electronic device (CIED) earlier than the control group. A typical patient with CVWT was a pacemaker carrier, having more leads (including abandoned leads and excessive loops) with long implant duration and a history of multiple CIED-related procedures. The risk factors for TVD were similar to those for CVWT, but the patients were older and received their CIED about nine years earlier. Any form of tissue scar and technical problems were much more common in the two groups of patients with major complications. Conclusions: The risk factors for CVWT and TVD are similar, and the most important ones are related to long lead dwell time and its consequences for the heart (various forms of fibrotic scarring). The occurrence of procedural complications does not affect long-term survival in patients undergoing lead extraction.

scholarly journals Gender Differences in Risk Factors for Stice’s Bulimia in a Non-Clinical Sample

2015 ◽  
Vol 18 ◽  
Author(s):  
Pablo Ruisoto ◽  
Raúl Cacho ◽  
José J. López-Goñi ◽  
Eulogio Real Deus ◽  
Silvia Vaca ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gender Differences ◽  
Eating Disorders ◽  
Risk Factor ◽  
Body Dissatisfaction ◽  
Dietary Restraint ◽  
Social Pressure ◽  
Equation Modeling ◽  
Main Risk Factor ◽  
Increased Risk

AbstractSome females are at an increased risk of developing bulimia. However, etiological factors and their interplay remain controversial. The present study analyzed Sticefe Model for eating disorders in a non-clinical population by examining gender differences with respect to the following risk factors: body mass index (BMI), body dissatisfaction, perceived social pressure to be thin, body-thin internalization, and dieting behavior. A sample of 162 American college students (64 males and 91 females) was surveyed, and validated scales were used. The Sticey model was tested using Structural Equation Modeling. Our results supported Stice r Dual Pathway Model of bulimic pathology for females but not for males. Females reported significantly higher body dissatisfaction, perceived pressure to be thin and weight-loss oriented behaviors than males (p < .05), but no gender differences were found in their degree of body thin internalization (p > .05), a key predictor of body dissatisfaction (r = .33; p < .01). Participants with higher BMI reported greater social pressure to be thin than those with lower BMI (p < .05). However, females engaged in dietary restraint, the main risk factor for eating disorders, regardless of their BMI (p > .05) although their BMI was significantly lower than males (d = 0,51). The results of this study fail to support the role of BMI as a predictor of dietary restraint in females, the main risk factor of eating disorders. Males may abstain from dietary restraint to gain muscular volume and in turn increase their BMI. Implications are discussed.

scholarly journals How Can Diet Influence the Risk of Stroke?

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Fernanda Medeiros ◽  
Marcela de Abreu Casanova ◽  
Julio Cesar Fraulob ◽  
Michelle Trindade
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Stroke Risk ◽  
Cerebrovascular Diseases ◽  
Dietary Interventions ◽  
Main Risk Factor ◽  
The World ◽  
Polyunsaturated Fats ◽  
High Glycemic Index

Cerebrovascular diseases are the second cause of mortality in the world, and hypertension is considered a main risk factor for occurrence of stroke. The mechanisms responsible for the increased stroke risk remain unclear. However, dietary interventions have been applied in the management and treatment of their risk factors, which include increased blood pressure levels, obesity, diabetes, and dyslipidemia. Further studies should be conducted to assess the effects of carotenoids, flavonoids, n-3 polyunsaturated fats, and lower salt and high glycemic index intake in risk of stroke.

Risk Factors and Outcomes of Delirium in Older Patients Admitted to Postacute Care with and without Dementia

2018 ◽  
Vol 45 (1-2) ◽  
pp. 121-129 ◽  
Author(s):  
Neus Gual ◽  
Alessandro Morandi ◽  
Laura Monica Pérez ◽  
Laura Brítez ◽  
Pamela Burbano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Functional Recovery ◽  
Older Patients ◽  
Functional Decline ◽  
Main Risk Factor ◽  
Living Situation ◽  
Functional Loss ◽  
Postacute Care ◽  
Tract Infections

Background: Delirium research is poorly studied in postacute care, a growing setting due to aging populations, as well as in dementia, a critical risk factor for delirium and particularly prevalent in postacute care. We investigated risk factors for delirium and its outcomes in older adults with and without dementia admitted to a subacute care unit (SCU) after exacerbated chronic conditions. Methods: This is a prospective cohort study including patients ≥65 years old admitted to an SCU for 12 months. We collected demographics, comprehensive geriatric assessments, and presence of dementia and delirium at admission. Outcomes included discharge to previous living situation, mortality, and functional evolution. Due to the high prevalence of dementia, a subgroup analysis was performed to investigate specific risk factors for delirium and related outcomes. Results: Of 909 patients (mean age [±SD] 85.8 ± 6.7; 60% women, 47.5% with dementia), 352 (38.7%) developed delirium. The main risk factor for delirium was dementia (HR [95% CI] 5.2 [3.5–7.7]); age, functional status, and urinary tract infections were also independently associated with delirium. In dementia patients, only age (HR [95% CI] 1.0 [1.004–1.1]) and being male (HR [95% CI] 1.7 [1.04–2.6]) were associated with delirium. Delirium was associated with greater mortality (10.8 vs. 3.9%; p < 0.001) and greater functional decline in the entire sample (–12.3 vs. –6.4 Barthel index points; p < 0.001). In the dementia subgroup, patients with delirium experienced greater functional loss (p = 0.013) and less functional recovery (p = 0.025). Conclusions: In older patients admitted to postacute care, dementia is the main risk factor for delirium, and delirium carries worse clinical and functional outcomes. In patients with dementia, delirium is also relevant, since it entails a functional loss at admission and lower functional recovery.

The Impact of Transvenous Lead Extraction on Tricuspid Valve Function

2013 ◽  
Vol 37 (1) ◽  
pp. 19-24 ◽  
Author(s):  
JAMES O. COFFEY ◽  
SOLOMON J. SAGER ◽  
SANDEEP GANGIREDDY ◽  
AVI LEVINE ◽  
JUAN F. VILES-GONZALEZ ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Lead Extraction ◽  
Valve Function ◽  
The Impact

scholarly journals Disseminated superficial actinic porokeratosis in a patient with generalized vitiligo: A case report

2021 ◽  
Vol 12 (1) ◽  
pp. 69-71
Author(s):  
Mancy Abdullah
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Case Report ◽  
Sun Exposure ◽  
Common Type ◽  
Published Data ◽  
Main Risk Factor ◽  
Exposed Skin ◽  
Disseminated Superficial Actinic Porokeratosis ◽  
The Relationship

Disseminated superficial actinic porokeratosis (DSAP) is the most common type of porokeratosis, occurring mainly on sun-exposed skin. Chronic sun exposure is one of the main risk factors, in addition to genetic susceptibility. Most published data concerning the relationship between vitiligo and its predisposition to nonmelanoma skin cancer suggests that patients with vitiligo show the same or even a lower incidence than other populations. Herein, we report a case of disseminated superficial actinic porokeratosis occurring in vitiligo in which chronic sun exposure was the main risk factor

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