13 March, 2014

Surgeons perform first totally endoscopic aortic valve replacement

For aortic valve replacement, cardiovascular surgeons usually have to make a large cut in the patient's chest. But this may be a thing of the past; for the first time, surgeons in France have successfully replaced the aortic valve in two patients without opening their chest during surgery.

A study detailing the procedure, carried out using totally endoscopic aortic valve replacement (TEAVR), has been published in the Journal of Thoracic and Cardiovascular Surgery.

The researchers, led by Dr. Marco Vola of the Department of Cardiovascular Surgery at the Centre Hospitalier Universitaire de Saint-Etienne in France, say their findings show that TEAVR has the potential to improve the quality of life for heart patients by reducing chest trauma.

Cardiovascular surgeons already use endoscopic surgery for many heart procedures, including coronary artery bypass grafting and atrial septal defect repair. Compared with other methods, endoscopic surgery leads to faster recovery time for patients and is less painful, meaning their quality of life after the procedure is improved.

How was the TEAVR procedure carried out?

The research team says that until now, using TEAVR had not been feasible as the required stented tissue valves were not available. But the recent introduction of sutureless bioprostheses for aortic valves that are mounted on a compressible self-expanded nitinol (nickel titanium) stent allowed the surgeons to carry out the procedure.

Explaining how the surgeons completed the aortic valve replacement in each patient, Dr. Vola says they began by using the mini-sternotomy technique. This involves a small incision through the sternum (breastbone).

They then carried out a mini-thoractomy, involving a small incision through the throrax. The surgeons did this under direct view before changing to the use of an endoscopic camera. The rest of the procedure, which included the implantation of the stent, was done using a totally endoscopic technique.

"It is important to note that when performing TEAVR, a quick and safe conversion to mini-thoracotomy under direct view can be made if circumstances demand. This would still offer significantly reduced chest trauma," explains Dr. Vola.

The procedure took less than 45 minutes for each patient.

Source: www.medicalnewstoday.com                         13.03.2014

Unmarried women 'more likely to die from heart disease'

It seems unlikely that marital status could influence the risk of death from heart disease, but new research from the University of Oxford in the UK has found that unmarried women are more likely to die from heart disease than women who are married.

This is according to a study recently published in the journalBMC Medicine.

Past research has found that married men have a lower risk of death from heart disease than unmarried men, but the research team, led by Sarah Floud, says that there have not been many large-scale studies that assess this link among women.

With this in mind, the investigators analyzed data from the UK's Million Women Study - a national health study involving more than 1.3 million women aged 50 years and over who were recruited between 1996 and 2001. The women were required to complete a health questionnaire at the baseline of the study and were re-evaluated 3 years later.

Of the women who were surveyed for hospital admissions and deaths as a result of heart disease, 734,626 with a mean age of 60 were included in the University of Oxford's study.

The women had no previous history of heart disease, stroke or cancer, and average follow-up duration was 8.8 years.

Higher risk of heart disease-related death for unmarried women

During the follow-up period, 30,747 women developed heart disease and 2,148 women died from the condition. The researchers found that women who were married or living with a partner had the same risk of developing heart disease as unmarried women.

However, they found that women who were married were 28% less likely to die from heart disease, compared with women who were unmarried. These findings were significant even after the investigators took other influencing factors into account, including age, socioeconomic status and lifestyle.

The researchers say that the reason married women have a lower risk of death from heart disease may be because their spouse encourages them to respond to symptoms of the condition and seek medical treatment.

Furthermore, the investigators say spouses may provide emotional support that helps their partner cope with the distress of having a cardiac event.

Source: www.medicalnewstoday.com  

13.03.2014

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