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  1. Article: Prevention and management of critical care complications in cardiogenic shock: a narrative review.

    Kirigaya, Jin / Iwahashi, Noriaki / Terasaka, Kengo / Takeuchi, Ichiro

    Journal of intensive care

    2023  Volume 11, Issue 1, Page(s) 31

    Abstract: Background: Cardiogenic shock (CS) is a common cause of morbidity and mortality in cardiac intensive care units (CICUs), even in the contemporary era.: Main text: Although mechanical circulatory supports have recently become widely available and used ...

    Abstract Background: Cardiogenic shock (CS) is a common cause of morbidity and mortality in cardiac intensive care units (CICUs), even in the contemporary era.
    Main text: Although mechanical circulatory supports have recently become widely available and used in transforming the management of CS, their routine use to improve outcomes has not been established. Transportation to a high-volume center, early reperfusion, tailored mechanical circulatory supports, regionalized systems of care with multidisciplinary CS teams, a dedicated CICU, and a systemic approach, including preventing noncardiogenic complications, are the key components of CS treatment strategies.
    Conclusions: This narrative review aimed to discuss the challenges of preventing patients from developing CS-related complications and provide a comprehensive practical approach for its management.
    Language English
    Publishing date 2023-07-06
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2739853-5
    ISSN 2052-0492
    ISSN 2052-0492
    DOI 10.1186/s40560-023-00675-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Coronary protection using a pressure wire during transcatheter aortic valve implantation.

    Kikuchi, Shinnosuke / Terasaka, Kengo / Minamimoto, Yugo / Cho, Tomoki / Okada, Kozo / Matsuzawa, Yasushi / Iwahashi, Noriaki / Uchida, Keiji / Hibi, Kiyoshi

    Journal of cardiology cases

    2023  Volume 29, Issue 2, Page(s) 73–77

    Abstract: Coronary obstruction is a rare but life-threatening complication of transcatheter aortic valve implantation (TAVI). This article describes the case of a patient with severe aortic valve stenosis treated with TAVI, during which preventive coronary wiring ... ...

    Abstract Coronary obstruction is a rare but life-threatening complication of transcatheter aortic valve implantation (TAVI). This article describes the case of a patient with severe aortic valve stenosis treated with TAVI, during which preventive coronary wiring using a pressure wire was performed for coronary protection. After the deployment of the transcatheter heart valve (THV), the values of the fractional flow reserve (FFR) and resting full-cycle ratio (RFR) remarkably decreased, although the findings of transesophageal echocardiography and coronary angiography did not suggest coronary obstruction. Intravascular ultrasound revealed severe stenosis in the left main trunk due to the displacement of the calcified native leaflets. The decrease in the FFR and RFR values after THV deployment led to a diagnosis of partial coronary obstruction, and percutaneous coronary intervention was successfully performed. In patients at a high risk for coronary obstruction, coronary protection with a pressure wire is useful for the diagnosis and prevention of coronary flow deterioration during TAVI. Functional assessment using a pressure wire before and after TAVI may contribute to the accurate diagnosis of coronary obstruction.
    Learning objective: Accurate diagnosis of coronary obstruction during transcatheter aortic valve implantation (TAVI) is important for successful management. In patients at a high risk for coronary obstruction, coronary protection with a pressure wire is useful for the diagnosis and prevention of coronary flow deterioration during TAVI. The remarkable decrease in the fractional flow reserve and resting full-cycle ratio values after the deployment of the transcatheter heart valve may suggest coronary obstruction.
    Language English
    Publishing date 2023-11-10
    Publishing country Japan
    Document type Case Reports
    ISSN 1878-5409
    ISSN (online) 1878-5409
    DOI 10.1016/j.jccase.2023.10.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Impact of New-Onset Right Bundle-Branch Block After Transcatheter Aortic Valve Replacement on Permanent Pacemaker Implantation.

    Kikuchi, Shinnosuke / Minamimoto, Yugo / Matsushita, Kensuke / Cho, Tomoki / Terasaka, Kengo / Hanajima, Yohei / Nakahashi, Hidefumi / Gohbara, Masaomi / Kimura, Yuichiro / Yasuda, Shota / Okada, Kozo / Matsuzawa, Yasushi / Iwahashi, Noriaki / Kosuge, Masami / Ebina, Toshiaki / Morel, Olivier / Ohlmann, Patrick / Uchida, Keiji / Hibi, Kiyoshi

    Journal of the American Heart Association

    2024  Volume 13, Issue 9, Page(s) e032777

    Abstract: Background: A delayed and recurrent complete atrioventricular block (CAVB) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Post-TAVR evaluation may be important in predicting delayed and recurrent CAVB requiring ... ...

    Abstract Background: A delayed and recurrent complete atrioventricular block (CAVB) is a life-threatening complication of transcatheter aortic valve replacement (TAVR). Post-TAVR evaluation may be important in predicting delayed and recurrent CAVB requiring permanent pacemaker implantation (PPI). The impact of new-onset right bundle-branch block (RBBB) after TAVR on PPI remains unknown.
    Methods and results: In total, 407 patients with aortic stenosis who underwent TAVR were included in this analysis. Intraprocedural CAVB was defined as CAVB that occurred during TAVR. A 12-lead ECG was evaluated at baseline, immediately after TAVR, on postoperative days 1 and 5, and according to the need to identify new-onset bundle-branch block (BBB) and CAVB after TAVR. Forty patients (9.8%) required PPI, 17 patients (4.2%) had persistent intraprocedural CAVB, and 23 (5.7%) had delayed or recurrent CAVB after TAVR. The rates of no new-onset BBB, new-onset left BBB, and new-onset RBBB were 65.1%, 26.8%, and 4.7%, respectively. Compared with patients without new-onset BBB and those with new-onset left BBB, the rate of PPI was higher in patients with new-onset RBBB (3.4% versus 5.6% versus 44.4%,
    Conclusions: Patients with new-onset RBBB after TAVR are at high risk for PPI.
    MeSH term(s) Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Male ; Female ; Bundle-Branch Block/etiology ; Bundle-Branch Block/therapy ; Bundle-Branch Block/physiopathology ; Bundle-Branch Block/diagnosis ; Aortic Valve Stenosis/surgery ; Aged, 80 and over ; Pacemaker, Artificial ; Aged ; Electrocardiography ; Cardiac Pacing, Artificial/adverse effects ; Atrioventricular Block/therapy ; Atrioventricular Block/etiology ; Atrioventricular Block/diagnosis ; Atrioventricular Block/physiopathology ; Risk Factors ; Retrospective Studies ; Treatment Outcome ; Time Factors ; Postoperative Complications/etiology ; Postoperative Complications/therapy ; Postoperative Complications/diagnosis ; Recurrence
    Language English
    Publishing date 2024-04-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.123.032777
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Association between evolocumab use and slow progression of aortic valve stenosis.

    Terasaka, Kengo / Gohbara, Masaomi / Abe, Takeru / Yoshii, Tomohiro / Hanajima, Yohei / Kirigaya, Jin / Horii, Mutsuo / Kikuchi, Shinnosuke / Nakahashi, Hidefumi / Matsushita, Kensuke / Minamimoto, Yugo / Okada, Kozo / Matsuzawa, Yasushi / Iwahashi, Noriaki / Kosuge, Masami / Sugano, Teruyasu / Ebina, Toshiaki / Hibi, Kiyoshi

    Heart and vessels

    2024  

    Abstract: No medications have been reported to inhibit the progression of aortic valve stenosis (AS). The present study aimed to investigate whether evolocumab use is related to the slow progression of AS evaluated by serial echocardiography. This was a ... ...

    Abstract No medications have been reported to inhibit the progression of aortic valve stenosis (AS). The present study aimed to investigate whether evolocumab use is related to the slow progression of AS evaluated by serial echocardiography. This was a retrospective observational study from 2017 to 2022 at Yokohama City University Medical Center. Patients aged ≥ 18 with moderate AS were included. Exclusion criteria were (1) mild AS; (2) severe AS defined by maximum aortic valve (AV) velocity ≥ 4.0 m/s; and/or (3) no data of annual follow-up echocardiography. The primary endpoint was the association between evolocumab use and annual changes in the maximum AV-velocity or peak AV-pressure gradient (PG). A total of 57 patients were enrolled: 9 patients treated with evolocumab (evolocumab group), and the other 48 patients assigned to a control group. During a median follow-up of 33 months, the cumulative incidence of AS events (a composite of all-cause death, AV intervention, or unplanned hospitalization for heart failure) was 11% in the evolocumab group and 58% in the control group (P = 0.012). Annual change of maximum AV-velocity or peak AV-PG from the baseline to the next year was 0.02 (- 0.18 to 0.22) m/s per year or 0.60 (- 4.20 to 6.44) mmHg per year in the evolocumab group, whereas it was 0.29 (0.04-0.59) m/s per year or 7.61 (1.46-16.48) mmHg per year in the control group (both P < 0.05). Evolocumab use was associated with slow progression of AS and a low incidence of AS events in patients with moderate AS.
    Language English
    Publishing date 2024-03-19
    Publishing country Japan
    Document type Journal Article
    ZDB-ID 89678-0
    ISSN 1615-2573 ; 0910-8327 ; 0935-736X
    ISSN (online) 1615-2573
    ISSN 0910-8327 ; 0935-736X
    DOI 10.1007/s00380-024-02386-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2049: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Ratio of left ventricular outflow tract area to aortic annulus area and complete atrioventricular block after transcatheter aortic valve replacement for aortic stenosis.

    Kikuchi, Shinnosuke / Minamimoto, Yugo / Matsushita, Kensuke / Cho, Tomoki / Terasaka, Kengo / Hanajima, Yohei / Nakahashi, Hidefumi / Gohbara, Masaomi / Kimura, Yuichiro / Yasuda, Shota / Okada, Kozo / Matsuzawa, Yasushi / Iwahashi, Noriaki / Kosuge, Masami / Ebina, Toshiaki / Morel, Olivier / Ohlmann, Patrick / Uchida, Keiji / Hibi, Kiyoshi

    International journal of cardiology

    2023  Volume 397, Page(s) 131608

    Abstract: Background: Mechanical compression of cardiac conduction system by transcatheter heart valves leads to complete atrioventricular block (CAVB) after transcatheter aortic valve replacement (TAVR). Bulging of ventricular septum in the left ventricular ... ...

    Abstract Background: Mechanical compression of cardiac conduction system by transcatheter heart valves leads to complete atrioventricular block (CAVB) after transcatheter aortic valve replacement (TAVR). Bulging of ventricular septum in the left ventricular outflow tract (LVOT) may be associated with greater compression of conduction system, leading to irreversible CAVB.
    Objective: This study aimed to investigate the association of ventricular septal bulging with TAVR-related CAVB and permanent pacemaker implantation (PPI).
    Methods: Among 294 consecutive patients with severe aortic stenosis who underwent TAVR between July 2017 and February 2023, 271 were included in the analysis. As a quantitative evaluation of bulging of the ventricular septum, the ratio of LVOT area to aortic annulus area (L/A ratio) was measured at the systolic phase of computed tomography images.
    Results: TAVR-related CAVB occurred in 64 patients (23.6%). Twenty-eight patients (10.3%) required PPI. The optimal thresholds of L/A ratio for predicting TAVR-related CAVB and PPI were 1.0181 and 0.985, respectively. Patients with less than the cut-off values had higher rate of TAVR-related CAVB and PPI than those above (28.3% vs 13.1%, p = 0.0063; 14.7% vs 4.4%, p = 0.0077, respectively). A multivariate analysis showed that L/A ratio < 1.0181 was an independent predictor of TAVR-related CAVB (odds ratio [OR] 2.65, p = 0.011), in addition to prior right bundle branch block (OR 3.76, p = 0.0005), use of a self-expanding valve (OR 1.99, p = 0.030), and short membranous septum length (OR 0.96, p = 0.037). Only L/A ratio < 0.985 was independently associated with PPI (OR 3.70, p = 0.011).
    Conclusion: Low L/A ratio is a predictor of TAVR-related CAVB and PPI.
    MeSH term(s) Humans ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods ; Atrioventricular Block/diagnostic imaging ; Atrioventricular Block/etiology ; Cardiac Pacing, Artificial/methods ; Pacemaker, Artificial/adverse effects ; Risk Factors ; Treatment Outcome ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Aortic Valve/surgery ; Heart Valve Prosthesis
    Language English
    Publishing date 2023-11-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2023.131608
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1673: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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