26 research outputs found
Left Atrial Appendage Closure: Initial Experience with the Watchman Device
We herein present the first left atrial appendage (LAA) percutaneous closure procedure performed in our Institution with use of the Watchman device in an 82-year old woman with atrial fibrillation, unable to continue receiving anticoagulation therapy due to bleeding complications. A propos with this case, we discuss the data related to this therapeutic approach geared to prevent thromboembolism in patients with atrial fibrillation and contraindications to treatment with anticoagulants
Multi-slice CT (MSCT) imaging in pretrans-catheter aortic valve implantation (TAVI) screening. How to perform and how to interpret
Aortic valve stenosis (AS) is the most common valvular heart disease among elderly. Trans-catheter aortic valve implantation (TAVI) has become an established and effective alternative therapeutical procedure for inoperable and high-risk patients with symptomatic AS. The procedural success is greatly dependent on a thorough pre-TAVI imaging screening. This requires a comprehensive and multi-modality approach, in which multi-slice computed tomography (MSCT) is the cornerstone in the selection of eligible patients, in choosing the appropriate prosthesis and size, and in mapping the safest access route for the intervention. From our experience of more than 400 TAVI procedures and many more MSCTs for screening purposes, we provide clinical and technical details on the use of MSCT pre-TAVI and brief review of the knowledge so far. Keywords: Transcatheter aortic valve implantation, Multi-slice computed tomograph
Therapeutic Applications of Calcium Metabolism Modulation in Heart Disease
Cardiovascular disease is the leading cause of death worldwide and there
is extensive research on the pathophysiology of all its clinical
entities. Despite the big array of possible therapeutic modalities for
cardiovascular disease, there is still a big necessity to develop novel
treatments that will augment our strategies for tackling the burden of
cardiovascular disease and decrease morbidity and mortality. A major
player in both the physiology and pathophysiology of the cardiovascular
system is calcium. Extracellular calcium is required in order to
initiate cardiac muscle contraction and promote the calcium-induced
calcium release mechanism from the sarcoplasmic reticulum. A lot of
molecules and structures that in a direct or indirect way interact with
calcium are being studied and there is a constant flow of new
information that is emerging. In this review we focus on some of these
calcium metabolism modulators representatives such as SERCA2a, RyR2,
S100A1, phosholamban and calcineurin. We emphasize on their mechanism of
action, their role in cardiovascular disease and potential therapeutic
implications. We also focus on the effect the bisphosphonates might have
in regression of the calcium deposition in the human arteries as well as
the usage of novel biomarkers such as mircoRNAs in calcium metabolism
modulation in heart disease
The requirement of extracorporeal circulation system for transluminal aortic valve replacement: Do we really need it in the catheterization laboratory?
Transcatheter aortic valve replacement (TAVR) is the mainstay for
treating high-risk patients with aortic stenosis. As the TAVR procedures
worldwide keep increasing, it is inevitable that more issues and
complications will arise. Such a complication that merits attention is
the conversion of TAVR into open-heart surgery and the necessity this
complication creates to have an extracorporeal circulation system in the
catheterization laboratory. This review contains an analysis of all
major randomized trials and registries on the number and cause of TAVR
procedures that ended up in open-heart surgery and presents data to
challenge the prerequisite of extracorporeal circulation system in the
cath laboratory. (c) 2015 Wiley Periodicals, Inc