Minerva cardioangiologica
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Minerva cardioangiologica · Jun 2020
Multicenter Study Comparative StudyThe attitude towards disease management programs in Austrian heart failure patients: a pilot study comparing rural and urban patients.
Disease Management Programs (DMPs) for heart failure (HF) patients have been developed to better control patients' well-being as well as their daily drug intake. DMPs for HF are not always accepted by the patients, and the reasons for this phenomenon are largely unknown. We hypothesized that patients from rural areas accept a DMP more likely than patients living in a big city. Thus, a pilot study investigated differences in the attitude towards DMPs between HF-patients in one rural and one urban hospital in Austria. ⋯ Structures of the health care system and patients' attitudes must be considered when planning DMPs. Development of DMPs which are accepted by urban patients will be relevant for the future.
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Minerva cardioangiologica · Apr 2018
Multicenter Study Comparative StudyStentless sutureless and transcatheter valves: a comparison of the hemodynamic performance of different prostheses concept.
Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. A new concept of surgical sutureless (SU) bioprosthesis has been developed in the last decade. In this multi-institutional study we sought to compare hemodynamics of different bioprosthesis concept as transcatheter (TAVR), Livanova Perceval S sutureless valve and Freedom Solo Stentless (FS) valve in patients undergoing aortic valve replacement (sAVR). ⋯ SU patients demonstrated post-operative excellent hemodynamic performance with smaller EROA and higher gradients compared to FS and TAVR. TAVR demonstrated higher mortality and pacemaker rates. Further studies are warrented to validate TAVR indications in this subset of patients.
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Minerva cardioangiologica · Oct 2013
Multicenter StudyMechanical circulatory support with the Impella 5.0 device for postcardiotomy cardiogenic shock: a three-center experience.
Postcardiotomy cardiogenic shock (PCCS) is associated with high mortality rates, despite full conventional treatment. Although the results of treatment with surgically implantable ventricular assist devices have been encouraging, the invasiveness of this treatment limits its applicability. Several less invasive devices have been developed, including the Impella system. The objective of this study was to describe our three-center experience with the Impella 5.0 device in the setting of PCCS. ⋯ Thirty-day survival rates for patients with PCCS, refractory to aggressive conventional treatment and treated with the Impella 5.0 device, are comparable to those reported in studies evaluating surgically implantable VADs, whereas the Impella system is much less invasive. Therefore, mechanical circulatory support with the Impella 5.0 device is a suitable treatment modality for patients with severe PCCS.
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Minerva cardioangiologica · Jun 2012
Review Randomized Controlled Trial Multicenter StudyRenalguard system in high-risk patients for contrast-induced acute kidney injury.
Contrast-induced acute kidney injury (CI-AKI) predicts unfavorable outcomes. The use of the RenalGuard™® system, to create high urine output and fluid balancing, may be beneficial in preventing CI-AKI. The REMEDIAL II trial is a randomized, multicenter, investigator-driven trial addressing the prevention of CI-AKI in high risk patients. ⋯ CI-AKI (defined as an increase of ≥0.3 mg/dL in the serum creatinine concentration at 48 hours after the procedure) occurred in 16/146 patients in the RenalGuard group (11%) and in 30/146 patients in the Control group (20.5%) (P=0.025; OR=0.47; 95% CI=0.24-0.92). Absolute changes in CyC at 24 hours (0.02±0.32 versus -0.08±0.26; P=0.002) and at 48 hours (0.12±0.42 versus -0.03±0.31; P=0.001), as well as the rate of in-hospital dialysis (4.1% versus 0.7%; P=0.056) were higher in the Control group. In conclusion, the RenalGuard therapy seems to be a promising new approach in preventing CI-AKI in high risk patients.