67 research outputs found
VizieR Online Data Catalog: Radial velocities of galaxies in A523 field (Girardi+, 2016)
Multi-object spectroscopic observations of A523 were carried out at the TNG in 2012 December and 2014 January. We used the instrument DOLORES in MOS mode with the LR-B Grism. In summary, we observed six MOS masks for a total of 210 slits. The total exposure time was 3600s for three masks, 5400s for two masks and 7200s for the last one. Our photometric observations were carried out with the Wide Field Camera (WFC), mounted at the prime focus of the 2.5-m INT telescope. We observed A523 in g, r and i Sloan-Gunn filters in photometric conditions and a seeing of ~1.4arcsec. (1 data file)
Comparison of Early and Long-Term Outcomes After Transcatheter Aortic Valve Implantation in Patients with New York Heart Association Functional Class IV to those in Class III and Less
Our aim was to investigate the impact of a baseline New York Heart Association (NYHA) class IV on clinical outcomes of a large real-world population who underwent transcatheter aortic valve implantation (TAVI). The primary end points were all-cause mortality, cardiovascular mortality, and re-hospitalization, evaluated at the longest available follow-up and by means of a 3-month landmark analysis. The secondary end points were: change in NYHA class, left ventricular ejection fraction, pulmonary pressure and mitral regurgitation. Out of 2,467 patients, 271 (11%) had a NYHA functional class IV at the admission. The latter had higher Society of Thoracic Surgeons (STS) score (9.2% vs 5.5%; p < 0.001) compared to NYHA ≤ III patients, owing to more comorbidities (prior myocardial infarction, severe long-term kidney disease, atrial fibrillation, left ventricular dysfunction, significant mitral regurgitation, pulmonary hypertension). Device success was similar between the two groups (93.7% vs 94.5%; p = 0.583). At a median follow-up of 15 months (interquartile range 4 to 36 months) a lower freedom from primary end points was observed among NYHA IV versus NYHA ≤ III group (survival from all-cause death: 52% vs 58.4%; p = 0.002; survival from cardiovascular death: 72.5% vs 76.5%; p = 0.091; freedom from re-hospitalization: 81.5% vs 85.4%; p = 0.038). However, after adjustment for baseline imbalance, NYHA IV did not influence the relative risk of long-term primary end points. A 3-month landmark analysis showed that NYHA IV independently predicted 3-month all-cause and cardiovascular mortality (hazard ratio: 1.77; 95% CI [1.10 to 2.83]; p = 0.018 and hazard ratio: 1.64; 95% CI [1.03 to 2.59]; p = 0.036, respectively). Instead, after 3-month follow-up NYHA IV did not affect the risk of primary end points. A significant improvement of the secondary end points was noted in both NYHA IV and NYHA ≤≤ III groups. In conclusion, the presence of NYHA class IV in TAVI candidates was associated to a significant increased risk of mortality within 3 months. Patients with baseline NYHA IV who survived at 3 months had a long-term outcome comparable to that of other subjects. Left ventricular systolic function, pulmonary pressure, and mitral insufficiency significantly improved after TAVI regardless of baseline NYHA class IV
Transcathether aortic valve implantation with the new repositionable self-expandable Evolut R versus CoreValve system: A case-matched comparison
Background: Despite promising results following transcatheter aortic valve implantation (TAVI), several relevant challenges still remain. To overcome these issues, new generation devices have been developed. The purpose of the present study was to determine whether TAVI with the new self-expanding repositionable Evolut R offers potential benefits compared to the preceding CoreValve, using propensity matching. Methods: Between June 2007 and November 2015, 2148 consecutive patients undergoing TAVI either CoreValve (n = 1846) or Evolut R (n = 302) were prospectively included in the Italian TAVI ClinicalService® project. For the purpose of our analysis 211 patients treated with the Evolut R were matched to 211 patients treated with the CoreValve. An independent core laboratory reviewed all angiographic procedural data and an independent clinical events committee adjudicated all events. Results: Patients treated with Evolut R experienced higher 1-year overall survival (log rank test p = 0.045) and a significantly lower incidence of major vascular access complications, bleeding events and acute kidney injury compared to patients treated with the CoreValve. Recapture manoeuvres to optimize valve deployment were performed 44 times, allowing a less implantation depth for the Evolut R. As a consequence, the rate of more than mild paravalvular leak and new permanent pacemaker was lower in patients receiving the Evolut R. Conclusion: In this matched comparison of high surgical risk patients undergoing TAVI, the use of Evolut R was associated with a significant survival benefit at 1. year compared with the CoreValve. This was driven by lower incidence of periprocedural complications and higher rates of correct anatomic positioning
Coronary angiography safety between radial and femoral access
One of the major criticisms of the radial approach is that it takes longer overall procedure and fluoroscopy time, which means not only more staff will be exposed during the procedures, but they will also stand close to the patient where rates of radiation scattered by the patient are higher. The aim of this study was to evaluate the safety of the radial versus femoral artery approach in our institution’s routine coronary angiography practice.
Methods: All cases of diagnostic coronary angiography (CA) over a 23 month period at a tertiary care hospital were reviewed for this analysis. Procedure duration was calculated as a total in laboratory catheter time. Contrast volume and fluoroscopy time were recorded, as it is correlated to catheter manipulation.
Results: Eight hundred patients who underwent a diagnostic CA were included in this study. The radial approach was used in 586 patients (73.25%) and the femoral approach in 214 patients (26.75%). Comparing the radial and femoral approaches, fluoroscopy and procedure times were not significantly different (3.43 ± 1.19 vs 3.86 ± 1.49 min, P = 0.215 and 31.87 ± 9.61 vs 33.24 ± 10.33 min, P = 0.170, respectively). While contrast utilization during the procedure was significantly lower in the radial than the femoral approach (67.63 ± 25.49 vs 81.53 ± 24.80 mL respectively, P = 0.03).
Conclusion: Transradial coronary angiography can be safely performed for the patient and the professional staff members as the transfemoral approach
Door-to-balloon time in radial versus femoral approach for primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction
Primary percutaneous coronary intervention (pPCI) is considered the preferred reperfusion strategy for patients presenting with ST-segment elevation myocardial infarction (STEMI). This study compares the door-to-balloon (D2B) time between transradial vs. the transfemoral approach in patients presenting with STEMI.
Methods: A retrospectively collected catheterization laboratory database was reviewed for the consecutive patients presenting with a STEMI. Specific time parameters were recorded, and our composite end points were time to revascularization, angiographic success, short term clinical success, and procedural vascular complications.
Results: Radial PCI (r-PCI) was performed in 33 patients (67.3%) and in 16 patients (32.7%) PCI was done through femoral artery (f-PCI). No significant difference was observed in the pre-catheter and catheter laboratory times. Mean times from emergency room door-to-catheter laboratory time for r-PCI vs. f-PCI were 82.48 ± 37.42 and 76.29 ± 34.32 min, respectively (P = 0.636). The mean time from patient arrival to the cardiac catheter laboratory-to-balloon inflation was 34.56 ± 14.2 in the r-PCI group vs. 33.12 ± 12.56 min with the f-PCI group (P = 0.215). The total D2B time was not significantly different between r-PCI vs. f-PCI groups (100.32 ± 36.3 vs. 97.31 ± 30.37 min, respectively, P = 0.522). Angiographic success rates were observed in 92.1% of the patients for r-PCI, and in 87.5% for f-PCI (P = 0.712). There were no vascular complications in both groups.
Conclusions: Patients presenting with STEMI can undergo successful pPCI via radial artery without compromising patient care
Vascular access and angiographic lesion morphology in elective percutaneous coronary intervention
Many coronary interventionists have a perception that the radial route may not facilitate complex PCI. This study evaluates the association between target lesion morphology, vessel characteristics and angiographic outcome in elective PCI cases carried out through radial versus femoral artery approach.
Methods: Elective PCI cases over a 23 month period at a tertiary care hospital were reviewed for this analysis. Modified ACC/AHA classification was used to ascertain the impact of different arterial accesses in elective PCI on the angiographic outcome with the complex angiographic lesion morphologies.
Results: 343 Patients and 407 lesions were analyzed. Radial access was the final route in 253 procedures treating a total of 300 lesions, while femoral access was the final route in 90 PCI procedures for treating 107 lesions. Lesion complexity incidence in radial PCI group by using modified ACC/AHA classifications A, B1, B2, and C were 4.67%, 15%, 60.33% and 20%, respectively. While in the femoral PCI, the incidence of lesion types was 6.54%, 15.89%, 42.99%, and 34.58%, respectively. By summation of the complex end of the spectrum for ACC/AHA lesion types B2 plus C, the incidence was 241 lesions (80.33%) in radial PCI vs. 83 lesions (77.57%) in femoral PCI, P = 0.25. Angiographic successful outcome according to the combined end point was achieved in 283 lesions (94.33%) for radial PCI vs. 92 lesions (85.99%) in femoral PCI, P = 0.004.
Conclusion: This study confirms that a default radial PCI is an effective strategy for the majority of complex lesions in elective PCI
First-in-Man, Mitral Valve-in-Valve Transcatheter Implantation Through an Innovative Minimally Invasive Surgical Approach
Outcome clinico dei pazienti affetti da stenosi aortica severa e ridotta funzione sistolica ventricolare sinistra trattati non chirurgicamente.
Effects of transcatheter aortic valve implantation on ascending aorta wall elastic properties: Tissue Doppler imaging and strain Doppler echocardiography study
AbstractBackgroundAortic elastic properties are determinants of left ventricular function by means of ventriculo-arterial coupling and indicators of cardiovascular risk. Aortic valve stenosis surgical replacement temporary reduces aortic function damaging vasa vasorum, while transcatheter aortic valve implantation (TAVI) does not influence it in the short term. We studied aortic distensibility, stiffness, M-mode strain and tissue strain after 6 and 12 months from TAVI.MethodsWe enrolled 15 patients with symptomatic severe aortic stenosis who underwent CoreValve prosthesis (Medtronic, Minneapolis, MN) implantation. Everyone had blood pressure measurement and echocardiography registration before TAVI and after 6 and 12 months.ResultsAfter TAVI NYHA class (p = 0.016), peak and mean aortic valve gradients (p < 0.001 for both) improved. Aortic distensibility increased (p = 0.032 in the first 6 months, p = 0.005 in the second 6 months, and p = 0.003 from baseline to 12 months), as well as stiffness decreased (p = 0.034; 0.090; 0.001), M-mode strain and tissue strain ameliorated (p = 0.041; 0.004; 0.004; and p = 0.013; 0.002; 0.001, respectively), tissue Doppler imaging improved (S′ wave: p = 0.289; 0.347; 0.018. E′ wave: p = 0.018; 0.113; 0.007. A′ wave: p = 0.002; 0.532; 0.001). Moreover, some left ventricular parameters improved at 6 months, such as ejection fraction (from 49 ± 16 to 57 ± 11%; p = 0.044) and diastolic interventricular septum thickness (from 14 ± 2 to 12 ± 2 mm; p = 0.010). Even systolic pulmonary artery pressure (p = 0.019) and left diastolic dysfunction grade ameliorated (p = 0.042).ConclusionsFor the first time we demonstrated that aortic elastic properties improve at 6 and 12 months after TAVI, thus influencing ventriculo-arterial coupling and ameliorating left ventricular function
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