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Category: Valve

Valve Suction

Development of Endocavitary Suction Device for MiECC on Minimally Invasive Mitral Valve Surgery

This paper introduces a new endocavitary suction device designed to enhance minimally invasive extracorporeal circulation (MiECC) systems during mitral valve surgeries. By reducing blood contact with air and foreign surfaces, it aims to diminish the inflammatory response and improve biocompatibility. The device, coupled with the MiECC technique in minimally invasive mitral valve surgery (MIMVS), addresses limitations in endo-cavitary aspiration, aiming to eliminate gaseous micro-embolic activity and hemolysis while adjusting CO2 levels. This innovation could revolutionize cardiac chamber surgery by facilitating safer, less invasive procedures, ultimately improving patient outcomes and reducing healthcare costs.

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Valve Knot

Efficacy of Automated Fasteners Versus Hand-Tied Knots in Cardiac Surgery: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis compares the efficacy of COR-KNOT® automated fasteners to hand-tied knots in cardiac valve surgery. Analyzing data from 1,411 participants across eight observational studies and two randomized controlled trials, the findings indicate that COR-KNOT significantly reduces aortic cross-clamp (AXT) and cardiopulmonary bypass (CPB) times, as well as the incidences of valvular regurgitation and need for prolonged ventilatory support, without negatively impacting mortality, atrial fibrillation, left ventricular ejection fraction, or renal failure rates. These results support the use of COR-KNOT devices in cardiac surgery to enhance surgical efficiency and patient outcomes.

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Redo AVR

Recent Outcomes of Surgical Redo Aortic Valve Replacement in Prosthetic Valve Failure

This study analyzed the clinical outcomes of redo surgical aortic valve replacement (AVR) for prosthetic valve failure from 2010 to 2021 across four tertiary centers, involving 324 patients. The primary focus was on operative mortality, with secondary outcomes including overall survival, cardiac death, and aortic valve-related events. The findings revealed that redo AVR poses a relatively high risk, particularly in patients with endocarditis, resulting in a 4.6% overall operative mortality. However, for patients without endocarditis, the operative mortality decreased significantly to 2.5%. Risk factors identified for operative mortality included endocarditis, longer cardiopulmonary bypass time, and lower left ventricular ejection fraction. The study concludes that redo AVR offers excellent outcomes for patients without endocarditis, especially those with acceptable left ventricular ejection fraction.

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Valve AVR

Outcomes of Minimally Invasive Aortic Valve Replacement in Obese Patients: A Propensity-Matched Study

This study compared minimally invasive aortic valve replacement (MIAVR) to conventional approaches (CAVR) in 203 obese patients, using propensity-matched analysis to ensure comparability. Results indicated no significant difference in 30-day mortality rates, with MIAVR patients benefiting from faster extubation times, reduced need for continuous positive airway pressure therapy, and shorter ICU stays, though hospital stays were comparable. This suggests that MIAVR is a safe, effective option for obese patients, offering notable postoperative respiratory and recovery advantages.

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TAVR Valve

Right Anterior versus Right Transaxillary Access for Minimally Invasive Aortic Valve Replacement: A Propensity Matched Competitive Analysis

This study compares the procedural and clinical outcomes of two minimally invasive techniques for aortic valve replacement: right anterior thoracotomy (RAT-AVR) and transaxillary access (MICLATS-AVR). With a cohort of 918 patients, after propensity score matching, both methods showed comparable major adverse cardio-cerebral events, cardiopulmonary bypass, and aortic cross-clamp times. However, MICLATS-AVR patients had a significantly shorter hospital stay and lower rates of postoperative wound issues, suggesting MICLATS-AVR as a safe, efficient, and feasible alternative for aortic valve replacement.

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Happy Heart Image

Early Outcome of Endoscopic Mitral Valve Surgery in Elderly Patients: A High-Volume Single Center Experience

This study analyzes the outcomes of endoscopic mitral valve surgery (MVS) in 756 patients, focusing on those aged ≥75. Despite the elderly patients’ increased surgical risk and prevalence of comorbidities like hypertension and diabetes, the perioperative outcomes were favorable. The use of minimally invasive techniques, including 3D-camera visualization, resulted in low rates of postoperative complications and a 2.2% acute mortality rate at 30 days for elderly patients. Thus, endoscopic MVS is deemed a viable option for elderly patients, underlining the importance of including it in heart-team discussions.

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Aorta

Artificial Intelligence in Transcatheter Aortic Valve Replacement: Its Current Role and Ongoing Challenges

The integration of Artificial Intelligence (AI) into Transcatheter Aortic Valve Replacement (TAVR) is revolutionizing cardiology, offering enhanced patient selection, procedural planning, and post-implantation monitoring. As TAVR becomes a viable option for a broader range of patients with severe aortic stenosis, AI’s role in interpreting medical imaging and developing risk models is increasingly critical. This article delves into AI’s current contributions to TAVR and examines the challenges and future directions of its implementation in ensuring optimized patient outcomes.

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AVR

The Northern New England Rapid Deployment Valve Experience: Survival and Procedural Outcomes From 2015 to 2021

This study examines the outcomes of rapid deployment aortic valve replacement (rdAVR) compared to stented aortic valve replacement (sAVR) in patients undergoing isolated aortic valve replacement or combined procedures with coronary artery bypass grafting from 2015 to 2021. Utilizing data from the Northern New England Cardiovascular Database, the research found that rdAVR offers significant advantages in terms of shorter cross-clamp and cardiopulmonary bypass times without compromising immediate postoperative gradients or long-term survival. However, rdAVR is associated with higher pacemaker rates, especially in larger valve sizes. The study concludes that rdAVR is a viable and safe alternative to sAVR, necessitating further long-term follow-up.

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Aortic Aneruysm

Midterm Clinical Outcomes of Reimplantation Versus Remodeling Valve-Sparing Aortic Root Replacement in Patients With Connective Tissue Disorders: A Meta-Analysis

This meta-analysis compared the midterm clinical outcomes of reimplantation versus remodeling techniques for valve-sparing aortic root replacement in patients with connective tissue disorders, finding no significant difference in mortality, reoperation rates, or postoperative aortic regurgitation. However, a sensitivity analysis excluding annuloplasty suggested that reimplantation may be superior to remodeling alone, indicating that further research is needed to fully evaluate these surgical techniques in this patient demographic.

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Chip Heart

Meta-Analysis of the Performance of AI-Driven ECG Interpretation in the Diagnosis of Valvular Heart Diseases

Artificial intelligence (AI) applied to electrocardiogram (ECG) interpretation shows high accuracy for early detection of valvular heart diseases (VHDs), based on a meta-analysis of data from 713,537 patients, with pooled accuracy and sensitivity of 81% and 83%, respectively. However, the low positive predictive value (PPV) of 13% suggests that AI should be used in conjunction with clinical judgment for VHD screening in primary care settings.

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