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  1. Article ; Online: Ruptured sinus of Valsalva aneurysm with dynamic aortic regurgitation.

    Pollak, Angela L / Vega, Eleanor / Whitacre, Meredith / Nicoara, Alina

    Echocardiography (Mount Kisco, N.Y.)

    2022  Volume 40, Issue 1, Page(s) 74–81

    Abstract: The ruptured sinus of Valsalva aneurysm (SVA) can present with dynamic aortic regurgitation (AR). Hemodynamic changes elicited by induction of general anesthesia can lead to dynamic AR in setting of ruptured SVA. Perioperative echocardiography is ... ...

    Abstract The ruptured sinus of Valsalva aneurysm (SVA) can present with dynamic aortic regurgitation (AR). Hemodynamic changes elicited by induction of general anesthesia can lead to dynamic AR in setting of ruptured SVA. Perioperative echocardiography is critical in understanding the etiology of AR and in guiding surgical decision-making. If the aortic valve is structurally normal, AR may resolve following patch repair of the SVA rupture defect. Conventional measures of assessing AR severity are not accurate with continuous left-to-right flow across a ruptured SVA.
    MeSH term(s) Humans ; Aortic Valve Insufficiency/complications ; Aortic Valve Insufficiency/diagnostic imaging ; Aortic Valve Insufficiency/surgery ; Sinus of Valsalva/diagnostic imaging ; Sinus of Valsalva/surgery ; Echocardiography ; Aortic Valve ; Aneurysm/complications ; Aortic Rupture/complications ; Aortic Rupture/diagnostic imaging ; Aortic Rupture/surgery
    Language English
    Publishing date 2022-12-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 843645-9
    ISSN 1540-8175 ; 0742-2822
    ISSN (online) 1540-8175
    ISSN 0742-2822
    DOI 10.1111/echo.15502
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Predictive capabilities of the European registry for patients with mechanical circulatory support right-sided heart failure risk score after left ventricular assist device implantation.

    Nicoara, Alina / Wright, Mary Cooter / Rosenkrans, Daniel / Patel, Chetan B / Schroder, Jacob N / Cherry, Anne D / Hashmi, Nazish K / Pollak, Angela L / McCartney, Sharon L / Katz, Jason / Milano, Carmelo A / Podgoreanu, Mihai V

    Journal of cardiothoracic and vascular anesthesia

    2022  Volume 36, Issue 10, Page(s) 3740–3746

    Abstract: Objectives: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory ... ...

    Abstract Objectives: The prediction of right heart failure (RHF) after left ventricular assist device (LVAD) implantation remains a challenge. Recently, risk scores were derived from analysis of the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) data, the EUROMACS-RHF, and the modified postoperative EUROMACS-RHF. The authors assessed the performance characteristics of these 2 risk score formulations in a continuous-flow LVAD cohort at their institution.
    Design: A retrospective, observational study.
    Setting: At a tertiary-care academic medical center.
    Participants: Adult patients who underwent durable LVAD implantation between 2015 and 2018.
    Interventions: None MEASUREMENTS AND MAIN RESULTS: Early post-LVAD RHF was defined as follows: (1) need for right ventricular assist device, or (2) inotropic or inhaled pulmonary vasodilator support for ≥14 postoperative days. The authors used logistic regression and examined receiver operating characteristic (ROC) curves to evaluate the ability of the 2 risk scores to distinguish between outcome groups. A total of 207 patients met the inclusion criteria. Of the patients, 16% developed RHF (33/207). The EUROMACS-RHF score was not predictive of RHF in the authors' cohort (odds ratio [OR] 1.25; 95% CI [0.99-1.60]; p = 0.06), but the postoperative EUROMACS-RHF CPB score was significantly associated (OR 1.38; 95% CI [1.03-1.89]; p = 0.03). The scores had similar ROC curves, with weak discriminatory performance: 0.601 (95% CI [0.509-0.692]) and 0.599 (95% CI [0.505-0.693]) for EUROMACS-RHF and postoperative EUROMACS-RHF, respectively.
    Conclusions: In the authors' single-center retrospective analysis, the EUROMACS-RHF risk score did not predict early RHF. An optimized risk score for the prediction of RHF after LVAD implantation remains an urgent unmet need.
    MeSH term(s) Adult ; Heart Failure/diagnosis ; Heart Failure/etiology ; Heart Failure/surgery ; Heart-Assist Devices/adverse effects ; Humans ; Registries ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Right
    Language English
    Publishing date 2022-06-23
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2022.06.022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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