2018年9月30日日曜日

Transcatheter Mitral-Valve Repair in Patients With Heart Failure

Transcatheter Mitral-Valve Repair in Patients With Heart Failure

https://www.ctsnet.org/jans/transcatheter-mitral-valve-repair-patients-heart-failure?utm_source=iContact&utm_medium=email&utm_campaign=ctsnet&utm_content=JANS+9%2F28%2F2018

This multicenter RCT study evaluated the efficacy of medical therapy plus transcatheter valve repair (MitraClip) to medical therapy alone for heart failure accompanied by secondary moderate to severe mitral regurgitation.

The device group experienced significantly fewer hospitalizations and lower mortality at 24 months follow-up.

Neither surgical repair nor surgical replacement of the mitral valve has been shown to lower the rate of hospitalization or death associated with secondary mitral regurgitation, and both procedures confer a substantial risk of complications.

Why are there the difference between surgery and MitraClip?

If surgery is too invasive, the mortality of surgical survivor must be improved.

According to MR improvement, MVR must be better than MVP and Mitraclip. But there were no differences between MVR and MVP.

I doubt some limitations affect the results.
1. Abbot's trial  It might cause COI.
2. F/U doctors know who are MitraClip patients due to XP.

2018年9月26日水曜日

Combined Transaortic and Transapical Approach to Septal Myectomy for Complex Long-Segment Hypertrophy

Combined Transaortic and Transapical Approach to Septal Myectomy for Complex Long-Segment Hypertrophy

https://www.ctsnet.org/article/combined-transaortic-and-transapical-approach-septal-myectomy-complex-long-segment?utm_source=iContact&utm_medium=email&utm_campaign=ctsnet&utm_content=Pulse+9%2F25%2F2018

Standard Morrow's myectomy + myectomy through LV apex 5cm incision

Aortic Valve Replacement With Right Anterior Thoracotomy, Sutureless Valves, and Ultrafast-Track Anesthesia: A Truly Minimally Invasive Approach in Ancona

Aortic Valve Replacement With Right Anterior Thoracotomy, Sutureless Valves, and Ultrafast-Track Anesthesia: A Truly Minimally Invasive Approach in Ancona

https://www.ctsnet.org/article/aortic-valve-replacement-right-anterior-thoracotomy-sutureless-valves-and-ultrafast-track?utm_source=iContact&utm_medium=email&utm_campaign=ctsnet&utm_content=Pulse+9%2F25%2F2018

MICS-AVR
Need the disrtance between Aortomy and aortic valve over 7cm
Standard antegrade CP x1
Sutureless valve Perceval (crimp)
Every Nadia 1 suture