Journal of Yeungnam Medical Science

Original article

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study: Ji Eun Im, Eun Yeung Jung, Seok Soo Lee, Ho-Ki Min; J Yeungnam Med Sci. 2024;41(2):96-102. Published online February 26, 2024; DOI: https://doi.org/10.12701/jyms.2023.01228

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Background
The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease.
Methods
In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed.
Results
There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001).
Conclusion
In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

Citations

Citations to this article as recorded by

Aortic valve replacement through right anterior mini-thoracotomy in patients with chronic severe aortic regurgitation: a retrospective single-center study
Eun Yeung Jung, Ji Eun Im, Ho-Ki Min, Seok Soo Lee
Journal of Yeungnam Medical Science.2024; 41(3): 213. CrossRef
Sutureless Aortic Prosthesis Valves versus Transcatheter Aortic Valve Implantation in Intermediate Risk Patients with Severe Aortic Stenosis: A Literature Review
Laura Asta, Adriana Sbrigata, Calogera Pisano
Journal of Clinical Medicine.2024; 13(18): 5592. CrossRef

Review Article

Recent updates in transcatheter aortic valve implantation: Jeonghwan Cho, Ung Kim; Yeungnam Univ J Med. 2018;35(1):17-26. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.17

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Abstract PDF

Transcatheter aortic valve implantation (TAVI) has evolved from a challenging intervention to a standardized, simple, and streamlined procedure with over 350,000 procedures performed in over 70 countries. It is now a novel alternative to surgical aortic valve replacement in patients with intermediate surgical risk and its indications have been expanded to cohorts with bicuspid aortic valves, low surgical risk, and younger age and fewer comorbidities. Attention should be paid to further reducing remaining complications, such as paravalvular aortic regurgitation, conduction abnormalities, cardiac tamponade, and stroke. The aim of this review is to provide an overview on the rapidly changing field of TAVI treatment and to explore past achievements, current issues, and future perspectives of this treatment modality.

Citations

Citations to this article as recorded by

Surgical Repair of Ventricular Septal Defect Following Transcatheter Aortic Valve Implantation: A Case Report
Satoru Fujii, Mohammed Tarabzoni, Pantelis Diamantouros, Rodrigo Bagur, Michael W. A. Chu
A&A Practice.2024; 18(6): e01790. CrossRef
Might simplification of transcatheter aortic valve implantation reduce the burden on hospital resources?
Lenka Kratochvílová, Petr Mašek, Marek Neuberg, Markéta Nováčková, Petr Toušek, Jakub Sulženko, Tomáš Buděšínský, , and Viktor Kočka
European Heart Journal Supplements.2022; 24(Supplement): B28. CrossRef

Case Reports

Pulmonary artery sarcoma manifesting as a main pulmonary artery stenosis diagnosed by 18F-FDG PET/CT: Hoonhee Lee, Han Bit Park, Yun Kyung Cho, Jung Min Ahn, Sang Min Lee, Jae Seung Lee, Dae Hee Kim; Yeungnam Univ J Med. 2017;34(2):279-284. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.279

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Abstract PDF: Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

Successful emergency transcatheter aortic valve implantation.: Jung Hee Lee, Ah Young Ji, Young Ju Kim, Changho Song, Moo Nyun Jin, Sun Wook Kim, Myeong Ki Hong, Geu Ru Hong; Yeungnam Univ J Med. 2014;31(2):144-147. Published online December 31, 2014; DOI: https://doi.org/10.12701/yujm.2014.31.2.144

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Abstract PDF: Despite the necessity of surgical aortic valve replacement, many patients with symptomatic severe aortic stenosis (AS) cannot undergo surgery because of their severe comorbidities. In these high-risk patients, percutaneous transcatheter aortic valve implantation (TAVI) can be safely accomplished. However, no study has shown that TAVI can be performed for patients with severe AS accompanied by acute decompensated heart failure. In this case report, 1 patient presented a case of severe pulmonary hypertension with decompensated heart failure after diagnosis with severe AS, and was successfully treated via emergency TAVI. Without any invasive treatment, acute decompensated heart failure with severe pulmonary hypertension is common in patients with severe AS, and it can increase mortality rates. In conclusion, TAVI can be considered one of the treatment options for severe as presented as acute decompensated heart failure patients with pulmonary hypertension.

Review Article

Natural Course of Lumbar Spinal Stenosis: Myun Whan Ahn; Yeungnam Univ J Med. 2007;24(2 Suppl):S49-56. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2S.S49

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Abstract PDF: The purpose of this paper is to review the natural course of spinal stenosis in order to establish an optimal therapeutic plan. As the population becomes older, this condition is encountered more frequently. The numbers of detected cases were increased internationally with the diagnositc tools improved. Good knowledge of natural evolution and of the predictive factors influencing the course of the disease is crucial for the selection of methods of treatment. Unfortunately, in contrast with numerous reports of the results of surgical series, few studies have been reported on the natural evolution. However, results of the studies analyzed in this review suggest that a substantial proportion of patients do not automatically deteriorate and will remain unchanged or even improved by medical means. They also suggest that patients with severe baseline symptoms, block stenosis and degenerative spondylolisthesis tend to require surgical decompression.

Case Report

Treatment of Coronary Artery Perforation and Tamponade Complicating Balloon Angioplasty by PTFE-Covered Stent. A Case Report.: Jong Seon Park, Gu Ru Hong, Jun Ho Bae, Ihn Ho Cho, Bong Sup Shim, Young Jo Kim, Dong Gu Shin; Yeungnam Univ J Med. 2005;22(1):90-95. Published online June 30, 2005; DOI: https://doi.org/10.12701/yujm.2005.22.1.90

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Abstract PDF: A coronary artery perforation is a rare but often fatal complication of angioplasty. We experienced a coronary artery perforation and cardiac tamponade during balloon angioplasty. A polytetrafluorethylene (PTFE) -covered stent was used to successfully close the perforation.

Original Articles

The Predictors of Cerebral infarction in Mitral Stenosis.: Hyung Jun Kim, Woong Kim, Jong suk Lee, Gue Ru Hong, Jong Seon Park, Dong Gu Sin, Young Jo Kim, Bong Sup Shim; Yeungnam Univ J Med. 2000;17(1):75-81. Published online June 30, 2000; DOI: https://doi.org/10.12701/yujm.2000.17.1.75

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Abstract PDF: BACKGROUND
Systemic embolism especially, cerebral infarction is one of the most important complications in patients with mitral stenosis. The authors analyse the some that could predict the development of cerebral infarction in cases of mitral stenosis and propose preventive therapeutic measures. METHODS: Retrospective study of 127 patients with rheumatic mitral stenosis was performed by analysis their medical records for transthoracic(TTE) or transesophageal echocardiography(TEE) over a 12months period. The patients were divided into two groups according to the presence (Group I: n=26, age: 55+/-13 years) or absence (Group II: n=101, age: 48.5+/-13 years) of cerebral infarction. No significant difference was observed between the two groups with respect to sex and functional class. RESULTS: Patients of group I were older (55.0+/-13 vs 48.5+/-13;p<0.05), had more dilated left atrial size(5.10+/-0.48 vs 4.81+/-0.70;p<0.05) and smaller mitral surface area(1.01+/-0.39 vs 1.21+/-0.45;p<0.05). In Group I, the incidence of atrial fibrillation(22 out of 26 vs 57 out of 101;p<0.05) and spontaneous left intra-atrial contrast phenomenon(22 out of 26 vs 44 out of 101;p<0.05) was more frequently observed. On multivariate analysis, atrial fibrillation and anticoagulant therapy were the independent predictive factors. CONCLUSION: Age, left atrial dilatation, the severity of mitral stenosis, the presence of spontaneous contrast and especially the presence of atrial fibrillation are the main predictive factors of the development of cerebral infarction in mitral stenosis. Patients presenting one or several of these factors may benefit from prophylactic anticoagulant treatment.

Infantile Hypertrophic Pyloric Stenosis.: Young Soo Huh, Gyu Rag Kim, Son Moon Shin; Yeungnam Univ J Med. 1996;13(2):199-210. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.199

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Abstract PDF: Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of 1 nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.

Case Report

A case of free-floating left atrial ball thrombus in mitral stenosis.: Young Jin Kim, Tea Il Lee, Kyo Won Choi, Seung Ho Kang, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Eun Pyo Hong; Yeungnam Univ J Med. 1993;10(1):237-244. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.237

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Abstract PDF: A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.

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