Early outcomes of percutaneous pulmonary valve implantation using the Edwards SAPIEN XT transcatheter heart valve system

BACKGROUND: Patients with congenital or acquired heart defects affecting the pulmonary valve and right ventricular outflow tract (RVOT) commonly require multiple surgical interventions, resulting in significant morbidity. A less invasive alternative is percutaneous pulmonary valve implantation (PPVI). Though studies have previously reported the safety and efficacy of the early generation transcatheter heart valves (THVs), data on more recent devices are severely lacking. METHODS AND RESULTS: We performed a multinational, multicentre, retrospective, observational registry analysis of patients who underwent PPVI using the Edwards SAPIEN XT THV. Of the 46 patients that were enrolled, the majority had tetralogy of Fallot as the underlying diagnosis (58.7%), and stentless xenograft as the most common RVOT anatomy (34.8%). Procedural success rate was high (93.5%), with a low frequency of periprocedural complications and adverse events (6.5% and 10.9%, respectively). At 30days post-procedure, NYHA class had improved significantly (90.6% were at NYHA I or II). The rate of moderate/severe pulmonary regurgitation had decreased from 76.1% at baseline to 5.0% at 30days, and the calculated peak systolic gradient had decreased from 45.2 (SD±21.3) mmHg to 16.4 (SD±8.0) mmHg, with these values remaining low up to 2years. CONCLUSIONS: The data suggest the efficacy and safety of the SAPIEN XT THV in PPVI in common anatomies in patients with conduits, as well as those with native pulmonary valves or transannular patches. Continued data collection is necessary to verify long-term findings

Transcatheter valve implantation for right atrium‐to‐right ventricle conduit obstruction or regurgitation after modified Björk–fontan procedure

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/136276/1/ccd26648_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/136276/2/ccd26648.pd

Additions to the Last Millennium Reanalysis Multi-Proxy Database

Progress in paleoclimatology increasingly occurs via data syntheses. We describe additions to a collection prepared for use in paleoclimate state estimation, specifically the Last Millennium Reanalysis (LMR). The 2290 additional series include 2152 tree ring chronologies and 138 other series. They supplement the collection used previously and together form a database titled LMRdb 1.0.0. The additional data draws from lake core, ice core, coral, speleothem, and tree ring archives, using published data primarily from the NOAA Paleoclimatology archive and a set of tree ring width chronologies standardized from raw International Tree Ring Data Bank ring width series. In contrast to many previous paleo compilations, the data were not selected (screened) on the basis of their environmental correlation, multi-century length, or other attributes. The inclusion of proxies sensitive to moisture and other environmental variables expands their use in data assimilation. A preliminary calibration using linear regression with mean annual temperature reveals characteristics of the proxy series and their relationship to temperature, as well as the noise and error characteristics of the records. The additional records are structured as individual files in the NOAA Paleoclimatology format and archived at NOAA Paleoclimatology (Anderson et al. 2018) and will continue to be improved and expanded as part of the LMR Project. The additions represent a four-fold increase in the number of records available for assimilation, provide expanded geographic coverage, and add additional proxy variables. Applications include data assimilation, proxy system model development, and paleoclimate reconstruction using climate field reconstruction and other methods

A Canadian Perspective on Patient Experience using Virtual Care During COVID-19

The COVID-19 pandemic has necessitated a rapid change in the delivery of healthcare around the world. Many facilities have transitioned suitable services to virtual care to reduce the risk of viral transmission and preserve healthcare resources for spikes in COVID-19 cases. Since institutions have rapidly expanded the usage of virtual care beyond its previous confines, investigations are required to ensure that the adapted system is working for patients. While important, clinical and patient-reported outcome data do not provide complete insight into the specific impacts of pandemic-time changes from the patient’s perspective. Therefore, to get a complete picture of these changes, it is also necessary to look at patient experience, which evidence suggests, could be impacted by virtual care in positive ways, but only in specific cases. Thus, it is vital to record pandemic-time patient experiences and analyse how the implementation of virtual visits impacts the delivery of person-centred care. This data should be used to determine how virtual care can be optimally implemented into the Canadian healthcare system after the resolution of the COVID-19 pandemic. Although it is currently unclear how virtual care will be integrated into the post-pandemic landscape, the approach offers benefits to both patients and providers. Canada-wide, longitudinal studies investigating patient experience using virtual care during the COVID-19 pandemic are required in order to ascertain exactly how this novel approach can be leveraged to benefit patients