Abstract:
PURPOSE OF REVIEW:A recently published study has alerted the cardiovascular community to the existence of a significant and previously unrecognized risk of subclinical valve thrombosis following implantation of surgical and catheter-based bioprosthetic valves. The purpose of this article is to review our current understanding of this new clinical entity and to identify unanswered questions and areas for future research. RECENT FINDINGS:Subclinical bioprosthetic valve thrombosis (BPVT) is a more common phenomenon than previously appreciated. It appears that the incidence of BPVT is higher following transcatheter aortic valve replacement compared with surgical aortic valve replacement. Four-dimensional computed tomography (CT) is the most sensitive imaging modality for detection of leaflet immobility and subclinical BPVT. Certain echocardiographic findings, such as increasing transaortic gradients, increased cusp thickness and abnormal cusp mobility, predict the presence of BPVT on four-dimensional CT. There is a growing body of evidence linking subclinical BPVT with premature valvular hemodynamic deterioration and structural valve degeneration. Furthermore, subclinical leaflet thrombosis may constitute a nidus for unrecognized subacute cerebral or other thromboembolic events. Oral anticoagulation seems effective in both the prevention and treatment of BPVT. SUMMARY:Subclinical valve thrombosis is an important and underappreciated cause of early bioprosthetic valve failure. Although several recent studies have improved our understanding of this newly recognized clinical entity, a number of questions remain unanswered. Further studies are warranted to elucidate the true incidence of subclinical BPVT, its clinical consequences, as well as the optimal antithrombotic regimen following bioprosthetic valve implantation. The subgroups of patients at highest risk of BPVT will need to be identified for risk stratification purposes. Several ongoing clinical trials will shed some light on these important issues.
journal_name
Curr Opin Cardioljournal_title
Current opinion in cardiologyauthors
Yanagawa B,Mazine A,Bhatt DL,Clavel MA,Côté N,Cheema AN,Pibarot P,Verma Sdoi
10.1097/HCO.0000000000000373subject
Has Abstractpub_date
2017-03-01 00:00:00pages
137-146issue
2eissn
0268-4705issn
1531-7080journal_volume
32pub_type
杂志文章,评审abstract::Stress myocardial perfusion imaging has become a mainstay in the noninvasive assessment of patients with known or suspected coronary artery disease for several compelling reasons. Radionuclide myocardial perfusion imaging can be performed using a variety of stressors, including exercise, pharmacologic stress (includin...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199711000-00012
更新日期:1997-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this article is to review the strengths and weaknesses of systematic reviews and meta-analyses to inform our current understanding of cardiac surgery. RECENT FINDINGS:A systematic review and meta-analysis of a focused topic can provide a quantitative estimate for the effect of a treatm...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,meta分析
doi:10.1097/HCO.0000000000000496
更新日期:2018-03-01 00:00:00
abstract:PURPOSE OF REVIEW:This review describes changes in indications for implantable cardioverter-defibrillator (ICD) implantation made in the American College of Cardiology, American Heart Association, and North American Society of Pacing and Electrophysiology 2002 update of the 1998 guideline for the implantation of cardia...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200401000-00006
更新日期:2004-01-01 00:00:00
abstract::Primary cardiac tumors are rare clinical entities. Benign tumors are often amenable to surgical excision, whereas malignant tumors are seldom resectable. The literature has reported that 28 patients have undergone orthotopic heart transplantation for inoperable primary cardiac tumors. The results of these transplants ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200003000-00010
更新日期:2000-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The goal of this review is to offer an overview of the use of thrombolytic therapy in acute pulmonary embolism. Clinicians including internists, surgeons, pulmonologists, and other specialists continue to face decisions regarding massive and submassive acute pulmonary embolism in their daily routines....
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328358308c
更新日期:2012-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with mild-to-severe heart failure. However, up to 40% of CRT recipients are nonresponders. This review addresses important aspects with regard to the identification and management of CRT nonresponders. RECENT FINDINGS...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HCO.0000000000000140
更新日期:2015-01-01 00:00:00
abstract::With 550,000 new cases each year, congestive heart failure is a major medical problem. Several medical therapies, including digoxin, angiotensin-converting enzyme inhibitors, and beta-blockers, have reduced the number of re-hospitalizations and slowed the progression of congestive heart failure. Angiotensin-converting...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200201000-00014
更新日期:2002-01-01 00:00:00
abstract:PURPOSE OF REVIEW:There is controversy regarding the optimal choice of prosthetic valves in patients less than 65 years of age requiring mitral valve replacement (MVR). Recently, trends for valve replacement are moving towards biological prosthesis also in younger patients, which is justified by the fact that a later v...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000151
更新日期:2015-03-01 00:00:00
abstract::Acute mesenteric ischemia (AMI) remains a complex and difficult clinical problem. Such acute ischemia is usually either embolic or thrombotic in nature, but other etiologies exist. The diagnosis of AMI is difficult to establish and often delayed, resulting in irreversible bowel injury that requires intestinal resectio...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199909000-00016
更新日期:1999-09-01 00:00:00
abstract::Brugada syndrome is characterized by ST segment elevation in the right precordial leads, V1-V3 (unrelated to ischemia or structural disease), normal QT intervals, apparent right bundle branch block, and sudden cardiac death, particularly in men of Asian origin. An autosomal dominant mode of inheritance with variable e...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199905000-00013
更新日期:1999-05-01 00:00:00
abstract::This review describes to date the experience with combined heart-kidney transplant (HNTx) from a single donor. HNTxs are very uncommon relative to single-organ transplants of the heart and kidney, as well as combined kidney-pancreas and combined kidney-liver transplants. Two groups of patients seem to be candidates fo...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199903000-00008
更新日期:1999-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Coarctation of the aorta is the discrete narrowing of the proximal descending aorta and is the sixth most common lesion in congenital heart disease. Repair of the coarctation can relieve the obstruction, but recurrent coarctation and future aneurysm formation can occur, and a heightened risk of vascul...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328330cc22
更新日期:2009-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Changing demands in healthcare, new leadership structures and physician preferences on work-life balance have made culture, teamwork and engagement vitally important for the long-term success of medical practices. With recent emphasis placed on culture, teamwork and engagement, leaders have had to acq...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000805
更新日期:2021-01-01 00:00:00
abstract::Optimized medical treatment for the non-ST segment elevation acute coronary syndromes (NSTE ACS) should consist of a combined antithrombotic/anti-anginal regimen. Standard antithrombotic treatment is currently unfractionated heparin and aspirin, and in high-risk patients glycoprotein IIb/IIIa inhibitors. However, low-...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200111000-00012
更新日期:2001-11-01 00:00:00
abstract::Ambulatory blood pressure monitoring is becoming increasingly popular in the diagnosis and treatment of patients with hypertensive disorders. Widespread clinical use, however, has been limited by a lack of normative data and prospective, controlled clinical studies of its impact on subsequent cardiovascular morbidity ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199309000-00007
更新日期:1993-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To review trends in practice for mitral valve surgery in the US over the past decade. RECENT FINDINGS:Advances in the understanding of mitral valve pathophysiology and the technology involved with mitral valve surgery have led to significant changes of the current practice for mitral valve surgery, w...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3282f4624f
更新日期:2008-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this article is to provide an overview of investigational work which has demonstrated the ability of MRI to define abnormalities caused by coronary heart disease. There have been numerous recent advances in the MRI assessment of coronary heart disease which warrant review. RECENT FINDI...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283315553
更新日期:2009-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The safety and efficiency of trans catheter aortic valve implantation (TAVI) has been clearly demonstrated. In high-risk patients, the number of procedures is constantly increasing and in western European countries this procedure is employed in more than 30% of isolated aortic valve replacements. The ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283655bb5
更新日期:2013-11-01 00:00:00
abstract:PURPOSE OF REVIEW:With wider indications for implantable cardioverter defibrillator therapy, more patients at lower risk for ventricular tachyarrhythmia receive this treatment. To maintain the ratio of benefit versus side-effects at an acceptable level, the risk of inappropriate implantable cardioverter defibrillator t...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3282f30436
更新日期:2008-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Valvular heart disease is often associated with significant morbidity and mortality. Surgical treatment of stenotic or regurgitant valvular lesions can alter the natural history of the disease process, yielding excellent short and long-term results, meaning that this has been accepted as the gold stan...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0b013e3282a14dc8
更新日期:2007-09-01 00:00:00
abstract::Intravenous thrombolysis has become a primary mode of reperfusion therapy for selected patients with acute myocardial infarction. The timing and potential benefits of cardiac angiography and coronary revascularization after thrombolysis in patients experiencing an uncomplicated myocardial infarction have been extensiv...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199507000-00007
更新日期:1995-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Troponins are a cornerstone for the diagnosis of myocardial infarction, assessment of risk and prognosis, and determination of antithrombotic and a revascularization strategy in patients with acute coronary syndromes. Newer assays with higher precision for detection of troponin levels are about to ent...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283050808
更新日期:2008-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The review is designed to outline the major developments in genetic testing in the cardiovascular arena in the past year or so. This is an exciting time in genetic testing as whole exome and whole genome approaches finally reach the clinic. These new approaches offer insight into disease causation in ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000055
更新日期:2014-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Ablation for atrial fibrillation has become a widely accepted and practiced treatment for this arrhythmia. While this treatment has traditionally been reserved for second-line therapy in patients who have failed drug therapy, ablation is now being contemplated for first-line treatment. This review out...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3282f2e27c
更新日期:2008-01-01 00:00:00
abstract::Several investigators have identified the pulmonary vein as the most common initiator of atrial fibrillation, and isolation of the pulmonary vein from atrial tissue can cure approximately 70% of patients with paroxysmal atrial fibrillation. Ongoing trials of a new device may increase the success rate and decrease the ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200301000-00006
更新日期:2003-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Transseptal endocardial left-ventricular pacing has a number of potential advantages over left-ventricular epicardial pacing from the coronary sinus, for implantation of cardiac resynchronization therapy (CRT) devices. In this study we review the risks and potential benefits. RECENT FINDINGS:Permanen...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32834dc3d4
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Device therapy for atrial fibrillation remains contentious despite the recognized benefit of atrial pacing in sinus node dysfunction. There are various new specialized pacing algorithms that aim to provide rhythm or rate control in atrial fibrillation. We review the various options for device therapy ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000210302.56736.60
更新日期:2006-03-01 00:00:00
abstract::The publications of 2000 and 2001 stress how interventional pediatric cardiology has moved from angioplasty to device placement. This review summarizes the important articles during the past year that evaluated the safety and efficacy of atrial septal defect devices, patent ductus occluders, and stents to treat coarct...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200205000-00013
更新日期:2002-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Natriuretic peptides, high-sensitivity cardiac troponins, and suppression of tumorigenicity 2 are novel biomarkers that reflect the intricate pathophysiology of heart failure and can thus be used for the diagnosis, management, and prognosis of heart failure. RECENT FINDINGS:This review article descri...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000254
更新日期:2016-03-01 00:00:00
abstract::The authors analyzed the early outcomes in two groups of patients undergoing coronary artery bypass grafting (CABG) with single versus bilateral internal thoracic arteries (ITA) in their institution. One thousand sixty-nine patients underwent CABG with single or bilateral ITAs from 1990 to 2000. Of these patients, 911...
journal_title:Current opinion in cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00001573-200211000-00003
更新日期:2002-11-01 00:00:00