Tricuspid valve replacement: an appraisal of 45 years of experience

2020 ◽  
Vol 30 (6) ◽  
pp. 896-903 ◽  
Author(s):  
Kevin M Veen ◽  
Thijs J M Quanjel ◽  
Mostafa M Mokhles ◽  
Ad J J C Bogers ◽  
Johanna J M Takkenberg
Keyword(s):  
Risk Factors ◽  
Patient Outcome ◽  
Regression Analysis ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Potential Risk ◽  
Carcinoid Heart Disease ◽  
Tricuspid Valve Replacement ◽  
Potential Risk Factors ◽  
Over Time

Abstract OBJECTIVES This study provides an overview of the change over a 45-year time period in the characteristics and outcome of patients with tricuspid valve disease undergoing surgical tricuspid valve replacement (TVR). METHODS The characteristics and outcomes of all consecutive TVRs from November 1972 to November 2017 at Erasmus MC were collected retrospectively. A logistic regression analysis was conducted to identify the significant predictors of 30-day mortality. Multivariable Cox regression analysis was used to identify the potential risk factors of patient outcome and the effect of time on these factors. RESULTS Ninety-eight patients with tricuspid valve dysfunction underwent 114 consecutive TVRs at a mean age of 50.1 ± 17.2 years (68.5% female). Aetiology changed over time from predominantly functional regurgitation (42.9% in 1972-1985) to predominantly carcinoid heart disease (47.7% in 2001-2017). Early mortality declined significantly from 35% in 1972–1985 to 6.7% in 2001–2017 (P < 0.001). Over time, the hazard ratio of late mortality decreased for higher New York Heart Association class, lower preoperative haemoglobin, and high central venous pressure and increased for the presence of preoperative leg oedema, higher creatinine and alkaline phosphatase. The late survival was 43.8% ± 5.89% at 10 years and was comparable among eras (P = 0.44). The cumulative incidence of reoperation at 10 years was 14.1% (2.3–26.0) in biological valves and 4.9% (0.1–10.3) in mechanical valves (P = 0.25). CONCLUSIONS Patient characteristics, potential risk factors and patient outcome changed considerably over time in patients undergoing TVR. Notably, there was a shift in aetiology, completely altering the patient population and their characteristics.

scholarly journals Risk Factors and Prediction of Leptospiral Seropositivity Among Dogs and Dog Handlers in Malaysia

2019 ◽  
Vol 16 (9) ◽  
pp. 1499 ◽  
Author(s):  
Soon Heng Goh ◽  
Rosnah Ismail ◽  
Seng Fong Lau ◽  
Puteri Azaziah Megat Abdul Rani ◽  
Taznim Begam Mohd Mohidin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Small Mammal ◽  
Potential Risk ◽  
Contact Time ◽  
Agglutination Test ◽  
Housing Area ◽  
Common Area ◽  
Potential Risk Factors

This study determined the potential risk factors that may contribute to seropositivity among dogs and dog handlers from working dog and dog shelter institutions. Data was collected from dogs (n = 266) and dog handlers (n = 161) using a standardised guided questionnaire. Serum obtained from the dogs and dog handlers was tested using the microscopic agglutination test (MAT). A logistic regression analysis was used to predict leptospiral seropositivity of dogs and dog handlers based on potential risk factors. A total of 22.2% of dogs and 21.7% of dog handlers were seropositive. The significant predictors for the dogs’ seropositivity were presence of rats (OR = 4.61 (95% CI: 1.05, 20.33), p = 0.043) and shared common area (OR = 5.12 (95% CI: 1.94, 13.46), p = 0.001) within the organisation. Significant predictor for dog handler seropositivity was contact time with the dogs of more than six hours/day (OR = 3.28 (95% CI: 1.28, 8.40), p = 0.013) after controlling for the effect of other risk factors such as small mammal contact, rat infestation at home, flooding at housing area (within three months) and urban locality. The exposure to various disease sources identified poses risk to dogs and dog handlers. Risk could be reduced with adequate application of protection at work while handling dogs and thus limiting contact with these sources and reducing exposure to infection.

scholarly journals Outcomes after Tricuspid Valve Replacement for Carcinoid Heart Disease: A Multicenter Study

2020 ◽  
Vol 4 (2) ◽  
pp. 122-130
Author(s):  
Kevin M. Veen ◽  
Einar A. Hart ◽  
Mostafa M. Mokhles ◽  
Peter L. de Jong ◽  
Frederiek de Heer ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Multicenter Study ◽  
Carcinoid Heart Disease ◽  
Tricuspid Valve Replacement

scholarly journals A comprehensive evaluation of early potential risk factors for disease aggravation in patients with COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qiang Tang ◽  
Yanwei Liu ◽  
Yingfeng Fu ◽  
Ziyang Di ◽  
Kailiang Xu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Serum Ferritin ◽  
Potential Risk ◽  
Comprehensive Evaluation ◽  
Organ Damage ◽  
Kaplan Meier ◽  
Public Crisis ◽  
Potential Risk Factors ◽  
Multivariable Regression

AbstractThe 2019 Coronavirus Disease (COVID-19) has become an unprecedented public crisis. We retrospectively investigated the clinical data of 197 COVID-19 patients and identified 88 patients as disease aggravation cases. Compared with patients without disease aggravation, the aggravation cases had more comorbidities, including hypertension (25.9%) and diabetes (20.8%), and presented with dyspnoea (23.4%), neutrophilia (31.5%), and lymphocytopenia (46.7%). These patients were more prone to develop organ damage in liver, kidney, and heart (P < 0.05). A multivariable regression analysis showed that advanced age, comorbidities, dyspnea, lymphopenia, and elevated levels of Fbg, CTnI, IL-6, and serum ferritin were significant predictors of disease aggravation. Further, we performed a Kaplan–Meier analysis to evaluate the prognosis of COVID-19 patients, which suggested that 64.9% of the patients had not experienced ICU transfers and survival from the hospital.

scholarly journals 1650. Clinical Features and Risk Factors of Active Tuberculosis in Patients with Behçet’s Disease

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S812-S813
Author(s):  
Yaxu Liu ◽  
Lifan Zhang ◽  
Ziyue Zhou ◽  
Luxi Sun ◽  
Baotong Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Weight Loss ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Potential Risk ◽  
Behcet’S Disease ◽  
Active Tuberculosis ◽  
Unexplained Weight Loss ◽  
Potential Risk Factors

Abstract Background Understanding the clinical characteristics and risk factors of active tuberculosis (ATB) in Behçet’s disease (BD) is of great significance to improve the treatment efficacy and guide the preventive treatment. However, the relevant studies are very limited. Methods We retrospectively reviewed medical records of BD patients admitted to our institute from 2010 to 2019. BD patients with ATB were enrolled as the case group, and the control group was selected by random number sampling from the remaining BD patients. Multivariate logistic regression analysis was performed to explore the potential risk factors of ATB in BD patients. Figure 1. Flowchart of the study Results Twenty-one ATB cases were identified from 386 BD patients, including four (19.0%) microbiologically confirmed and 17 (81.0%) clinically diagnosed. ATB patients can present with systemic symptoms (fever, night sweating, unexplained weight loss) and/or symptoms related to the infection site. Logistic regression analysis revealed that ESR&gt;60mm/h (OR=13.710, 95%CI (1.101, 170.702)), increased IgG (OR=1.226, 95%CI (1.001, 1.502)), and positive T-SPOT.TB (OR=7.793, 95%CI (1.312, 48.464), for 24-200 SFC/106PBMC; OR=17.705 (2.503, 125.260), for &gt;200 SFC/106PBMC) were potential risk factors for ATB in BD patients. Table 1. Past medical history and medication of BD patients with and without ATB Table 2. Clinical presentation and laboratory results of BD patients with and without ATB Table 3. Potential risk factors for ATB in BD patients Conclusion When BD patients have fever, night sweating, unexplained weight loss, or manifestations rarely occurred in BD, the diagnosis of ATB should be considered. Significantly elevated T-SPOT.TB indicates a high risk of ATB in BD patients. Disclosures All Authors: No reported disclosures

scholarly journals Bioprosthetic Pulmonary and Tricuspid Valve Replacement in Carcinoid Heart Disease From Ovarian Primary Cancer

2009 ◽  
Vol 73 (8) ◽  
pp. 1554-1556 ◽  
Author(s):  
Hiroaki Takahashi ◽  
Kenji Okada ◽  
Mitsuru Asano ◽  
Masamichi Matsumori ◽  
Yoshihisa Morimoto ◽  
...  
Keyword(s):  
Heart Disease ◽  
Valve Replacement ◽  
Tricuspid Valve ◽  
Carcinoid Heart Disease ◽  
Primary Cancer ◽  
Tricuspid Valve Replacement

Clinical features of and risk factors for intracranial aneurysms associated with moyamoya disease

2020 ◽  
pp. 174749302096722
Author(s):  
Hecheng Yang ◽  
Limin Zhang ◽  
Menghan Wang ◽  
Jingtao Wang ◽  
Lijie Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Logistic Regression Analysis ◽  
Potential Risk ◽  
Intracranial Aneurysms ◽  
Age Of Onset ◽  
Potential Risk Factors

Background The clinical features of aneurysms associated with moyamoya disease (MMD) and risk factors for the formation and rupture of aneurysms are not well defined. Aims In this study, we retrospectively analyzed clinical data of MMD patients and examined the potential risk factors for the formation and rupture of aneurysms in these patients. Methods The medical records of all MMD patients in our hospital from April 2012 to May 2019 were reviewed. The logistic regression analysis was used to determine the independent association between various potential risk factors and the presence or rupture of intracranial aneurysms in MMD patients. Results Of 2230 MMD patients, 182 (8.2%) cases had intracranial aneurysms. The mean age of onset in patients with aneurysms was 47.2 years, which was significantly higher when compared with those without aneurysms ( p < 0.001). In logistic regression analysis, age of onset remained significantly associated with the presence of intracranial aneurysms, while female gender, hypertension, diabetes mellitus, and coronary artery disease were not. Besides, intracranial aneurysms were significantly associated with intracranial hemorrhage in MMD patients (odds ratio [OR] = 5.19; 95% confidence interval [CI], 3.80–7.09). About 60% aneurysms >5 mm in size, and 62.1% aneurysms with irregularly shaped morphology were ruptured. Aneurysms located in basilar tip, collateral or moyamoya vessels were more likely to present with rupture. Conclusions Age was an important risk factor for intracranial aneurysms formation in MMD patients. Aneurysms increased the risk of intracerebral hemorrhage in MMD patients, and their ruptures were correlated with aneurysms size, location, and morphology.

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