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77 [95% CI, 1.04-3.01], p=0.03). Although in multivariate analysis neither aortography nor TEE were shown to be significant predictors of survival, hemodynamic assessment using the exact RI result was a significant predictor of survival and its effect was found to be linear (adjusted HR 0.72 [95% CI, 0.52-0.98] for 10% point increase in RI, p=0.03595).

Among the three modalities that are frequently used to evaluate the outcome, post-TAVI RI showed the highest added predictive value for survival.

Among the three modalities that are frequently used to evaluate the outcome, post-TAVI RI showed the highest added predictive value for survival.

Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is frequent and associated with adverse outcomes and mortality; to date, in such setting of patients there is no consistent evidence that either low-osmolar contrast media (LOCM) or iso-osmolar contrast medium (IOCM) are superior to the other in terms of renal safety.

697 consecutive patients not in hemodialysis treatment who underwent TAVI (327 males, mean age 81.01±5.75years, mean european system for cardiac operative risk evaluation II 6.17±0.23%) were enrolled. selleckchem According to osmolality of the different iodinated CM, the population was divided in 2 groups IOCM (n=370) and LOCM group (n=327). Preoperatively, 40.54% of patients in IOCM vs 39.14% in LOCM group (p=0.765) suffered from chronic kidney disease (CKD).

The incidence of AKI was significantly lower with IOCM (9.73%) than with LOCM (15.90%; p=0.02), and such significant difference (p<0.001) in postprocedural change of renal function parameters persisted at discharge too. The incidence of AKI was also significantly lower with IOCM in younger patients, without diabetes, anemia, coronary artery disease history, CKD, chronic or persistent atrial fibrillation, left ventricular ejection fraction ≤35%, and in patients with low operative mortality risk scores, receiving lower amounts of dye (p<0.05 for all). Importantly, multivariate analysis identified LOCM administration as an independent risk factor for both AKI (p=0.006) and 1-year mortality (p=0.001).

The use of IOCM have a favorable impact on renal function with respect to LOCM, but it should be considered especially for TAVI patients at lower AKI risk.

The use of IOCM have a favorable impact on renal function with respect to LOCM, but it should be considered especially for TAVI patients at lower AKI risk.

Cardiac Magnetic Resonance (CMR) data regarding myocarditis presentation and disease course is still lacking in pediatric patients. link2 We evaluate baseline CMR and evolution of functional and tissue abnormalities in children with acute myocarditis.

CMR was performed in 125 patients with clinical diagnosis of acute myocarditis. Clinical follow-up was performed for a median of 498 (214-923) days.

LVEF was depressed (<55%) in 56 cases (45%) upon baseline CMR. LGE was found in 93 patients (77%) of cases. LGE was exclusively subepicardial in 29 patients (23%), while other LGE patterns (midwall/mixed) were present in 64 (51%). CMR was repeated in 92 (74%) patients. 67% presented recover of function at a median of 170 (70-746) days after onset of symptoms. Midwall/mixed LGE pattern had a statistically significant correlation with absent recover of function (OR 0.20 p 0.036). Thirteen patients (16%) had recovery from LV dysfunction but with persistence of LGE. Sub-epicardial pattern of LGE (OR 3.33, 95% CI 1.08-10.2, p=0.036) and the presence of fever at admission (OR 4.67, 95% CI 1.16-18.7, p=0.03) were associated with a significantly higher likelihood of complete normalization while midwall/mixed LGE pattern was associated with non-recovery.

In pediatric myocarditis, midwall/mixed LGE pattern is associated with absent recover of function. Patients with recover of function may still have persistence of LGE, while a complete recovery from functional and tissue abnormalities is found only in a third of patients. Midwall/mixed pattern of LGE at first MRI was associated to worse outcome.

In pediatric myocarditis, midwall/mixed LGE pattern is associated with absent recover of function. Patients with recover of function may still have persistence of LGE, while a complete recovery from functional and tissue abnormalities is found only in a third of patients. Midwall/mixed pattern of LGE at first MRI was associated to worse outcome.

To assess the feasibility of using comprehensive serial cardiovascular MR (CMR) to evaluate bilateral ventricle mechanical changes and myocardial tissue characteristics, as well as correlations between the serial CMR and histology in a beagle model of anthracycline-induced cardiotoxicity.

This animal study was approved by the institutional review board. Serial CMR imaging was performed in a total of fifteen beagles at baseline (n=15), at week 16 (n=10) and week 24 (n=7) post-anthracycline. Feature-tracking CMR (FT-CMR) was applied to measure bilateral ventricular (left ventricle (LV) and right ventricle (RV)) global peak strain including radial (GRS), circumferential (GCS) and longitudinal (GLS) strain. The changes in strain, LV/RV functional parameters, native T1, extracellular volume fraction (ECV) and collagen volume fraction (CVF) were calculated.

Compared to baseline at weeks 16 and 24, significantly decreases to LV-GLS and native T1 were observed, while ECV significantly increased (all P<0.05). LVEF significantly decreased and LV-EDV/ESV significantly increased at week 16 compared to baseline (all P<0.05), but no further progression was seen at week 24. RV-GLS significantly decreased at week 16, but no further progression was seen at week 24, while RVEF was different until week 24. CVF increased significantly during modeling. Native T1 and ECV showed positive correlation with CVF (r=0.645, P<0.001), while LV-GLS showed negative correlation with CVF (r=-0.736, P<0.05).

Cardiotoxicity affects the RV slightly and less progressively than the LV. FT-CMR-based GLS, native T1 and ECV may potentially be used as imaging biomarkers for early monitoring of anthracycline-induced myocardial Injury.

Cardiotoxicity affects the RV slightly and less progressively than the LV. FT-CMR-based GLS, native T1 and ECV may potentially be used as imaging biomarkers for early monitoring of anthracycline-induced myocardial Injury.

Concern exists about durability of stent grafts used to bridge aortic grafts to visceral and renal arteries during fenestrated and branched endovascular aneurysm repair (F/B-EVAR). There are no guidelines regarding the ideal technique for joining target vessels (TVs).

We systematically reviewed data published from 2014 to 2019 using PRISMA guidelines and PICO models. Keywords were searched in MEDLINE, EMBASE, and Cochrane Library. All articles were screened by two authors (a third author in case of discrepancies). Only original articles regarding F/B-EVAR in complex aortic aneurysm, reporting the number and type of TVs mated, the onset of bridging stent complications, and reinterventions on TVs were included. Analysis included quality assessment scoring, types of stent grafts, and complications related to bridging stents.

19 studies were included with 2,796 patients and 9556TV; 4,797 renal arteries (50.2%), 4,174 visceral arteries (43.6%), and undefined TV (n=585; 6.1%) were bridged. Balloon-expandable ng detailed data of bridging stents in F/B-EVAR. link3 Renal TVs were more prone to complications, with an equivalent reintervention rate to visceral TVs. As to B-EVAR, the choice of B-EXP over S-EXP is still uncertain.

We aimed to evaluate the results of the combined use of rotational atherectomy (RA) followed by drug-coated balloon (DCB) treatment against DCB angioplasty alone in patients who had significantly calcified and symptomatic femoropopliteal peripheral arterial disease.

Patients presented to the clinic with symptoms of chronic limb ischemia of femoropopliteal segment such as moderate or severe claudication and rest pain, who received endovascular therapy between January 2016 and January 2018 in our hospital comprised the study cohort and investigated, retrospectively. Patients with minor or major tissue loss were excluded from the study. We evaluated the effect of RA system followed by DCB with DCB alone in 121 patients and a total of 226 significantly calcified and symptomatic femoropopliteal lesions. Fifty-eight patients and 112 (49.5%) lesions were treated with RA+DCB, whereas 63 patients and 114 (50.5%) lesions were treated with DCB only. The mean age was 61.2±9.7years. Primary patency is evaluated with dions. Combination of RA and DCB angioplasty reveals increased technical success, fewer flow-limiting dissections, significantly reduced TLR, and bailout stenting rates compared with sole DCB angioplasty.

The risk of stent fracture caused by the movements of the hip joint is one of the limitations of the endovascular treatment of the common femoral artery (CFA). The aim of this study was to describe and analyze the deformations of the iliofemoral axis during flexion and extension of the hip, and to evaluate the impact of stents implanted in the CFA on the deformations observed.

This monocentric descriptive study was carried out on the pelvis obtained from three fresh cadavers (two men aged 72 and 71years, respectively, and one 94-year-old woman). Arteriography was carried out to appreciate the deformations of the external iliac and common femoral arteries, and to analyze the femoral junctions. A first arteriography was carried out on native arteries, and a second one was carried out after the implantation of a stent in the CFA (Zilver PTX, Cook Medical, Bloomington, IN, USA). In all the cases, anterior and lateral images were obtained, with the hip maintained in extension (0°) or flexion (45°, 90°).

In aion nor the modifications of angles previously observed on the frontal and the sagittal sections.

As seen from the front and side, the CFA is a fixed segment during the movements of extension and flexion of the hip. The implantation of a stent does not modify this observation.

As seen from the front and side, the CFA is a fixed segment during the movements of extension and flexion of the hip. The implantation of a stent does not modify this observation.

The objectives of the study were to quantitatively evaluate leg edema in patients undergoing endovenous radiofrequency ablation (RFA) for saphenous varicose veins using bioelectrical impedance analysis (BIA) and to elucidate the time course of leg edema after RFA.

The data of 87 patients with 128 limbs undergoing RFA for saphenous varicose veins in Eniwa Midorino Clinic from April 2018 to November 2019 were retrospectively analyzed. Saphenous vein reflux was evaluated by duplex scan. Extracellular water/total body water ratio (ECW/TBW) of the leg was measured by BIA. Moderate to severe leg edema (ECW/TBW ≥ 0.400) was defined as significant leg edema. Venous reflux was evaluated as a venous filling index (VFI) using air plethysmography.

BIA revealed that 26 legs (20.3%) had significant edema and 102 legs (79.7%) did not before RFA. The proportion of patients with significant leg edema increased significantly from preoperative to 1week after RFA (P<0.05) and decreased 1month after RFA (P<0.01). The ECW/TBW increased significantly from preoperative (0.