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326 results on '"Fremes, S"'

4. Fractional Flow Reserve–Based Coronary Artery Bypass Surgery: Current Evidence and Future Directions

Author

Spadaccio, C., Glineur, D., Barbato, E., Di Franco, A., Oldroyd, K. G., Biondi-Zoccai, G., Crea, Filippo, Fremes, S. E., Angiolillo, D. J., Gaudino, Mario Fulvio Luigi, Spadaccio, C., Glineur, D., Barbato, E., Di Franco, A., Oldroyd, K. G., Biondi-Zoccai, G., Crea, F., Fremes, S. E., Angiolillo, D. J., and Gaudino, M.

Subjects
Cardiac Catheterization, Coronary Artery Bypa, Predictive Value of Test, Coronary Artery Disease, Coronary Angiography, Fractional Flow Reserve, FFR, Article, Fractional Flow Reserve, Myocardial, surgical procedures, operative, Treatment Outcome, Predictive Value of Tests, myocardial revascularization, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Myocardial, Humans, Coronary Artery Bypass, CABG, Vascular Patency, Human
Abstract

Fractional flow reserve (FFR) provides an objective measurement of the severity of ischemia caused by coronary stenoses in downstream myocardial regions. Data from the interventional cardiology realm have suggested benefits of a FFR-guided percutaneous coronary intervention (PCI) strategy. Limited evidence is available on the use of FFR to guide coronary artery bypass grafting (CABG). The most recent data have shown that FFR might simplify CABG procedures and optimize patency of arterial grafts without any clear impact on clinical outcomes. The aim of this review is to summarize the available data on FFR-based CABG and discuss the rationale and potential consequences of a switch towards FFR-based surgical revascularization strategy.

Published
2020

5. Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery: an adaptive, single-centre, single-blind, randomised, controlled trial

Author

Gaudino, Mario Fulvio Luigi, Sanna, Tommaso, Ballman, K. V., Robinson, N. B., Hameed, I., Audisio, K., Rahouma, M., Di Franco, A., Soletti, G. J., Lau, C., Rong, L. Q., Massetti, Massimo, Gillinov, M., Ad, N., Voisine, P., Dimaio, J. M., Chikwe, J., Fremes, S. E., Crea, Filippo, Puskas, J. D., Girardi, L., Gaudino M. (ORCID:0000-0001-7529-438X), Sanna T. (ORCID:0000-0002-5760-6885), Massetti M. (ORCID:0000-0002-7100-8478), Crea F. (ORCID:0000-0001-9404-8846), Gaudino, Mario Fulvio Luigi, Sanna, Tommaso, Ballman, K. V., Robinson, N. B., Hameed, I., Audisio, K., Rahouma, M., Di Franco, A., Soletti, G. J., Lau, C., Rong, L. Q., Massetti, Massimo, Gillinov, M., Ad, N., Voisine, P., Dimaio, J. M., Chikwe, J., Fremes, S. E., Crea, Filippo, Puskas, J. D., Girardi, L., Gaudino M. (ORCID:0000-0001-7529-438X), Sanna T. (ORCID:0000-0002-5760-6885), Massetti M. (ORCID:0000-0002-7100-8478), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Background: Atrial fibrillation is the most common complication after cardiac surgery and is associated with extended in-hospital stay and increased adverse outcomes, including death and stroke. Pericardial effusion is common after cardiac surgery and can trigger atrial fibrillation. We tested the hypothesis that posterior left pericardiotomy, a surgical manoeuvre that drains the pericardial space into the left pleural cavity, might reduce the incidence of atrial fibrillation after cardiac surgery. Methods: In this adaptive, randomised, controlled trial, we recruited adult patients (aged ≥18 years) undergoing elective interventions on the coronary arteries, aortic valve, or ascending aorta, or a combination of these, performed by members of the Department of Cardiothoracic Surgery from Weill Cornell Medicine at the New York Presbyterian Hospital in New York, NY, USA. Patients were eligible if they had no history of atrial fibrillation or other arrhythmias or contraindications to the experimental intervention. Eligible patients were randomly assigned (1:1), stratified by CHA2DS2-VASc score and using a mixed-block randomisation approach (block sizes of 4, 6, and 8), to posterior left pericardiotomy or no intervention. Patients and assessors were blinded to treatment assignment. Patients were followed up until 30 days after hospital discharge. The primary outcome was the incidence of atrial fibrillation during postoperative in-hospital stay, which was assessed in the intention-to-treat (ITT) population. Safety was assessed in the as-treated population. This study is registered with ClinicalTrials.gov, NCT02875405, and is now complete. Findings: Between Sept 18, 2017, and Aug 2, 2021, 3601 patients were screened and 420 were included and randomly assigned to the posterior left pericardiotomy group (n=212) or the no intervention group (n=208; ITT population). The median age was 61·0 years (IQR 53·0–70·0), 102 (24%) patients were female, and 318 (76%) were male, with a me

Published
2021

6. An optimal control approach to determine resistance-type boundary conditions from in-vivo data for cardiovascular simulations

Author

Fevola, E., Ballarin, Francesco, Jimenez-Juan, L., Fremes, S., Grivet-Talocia, S., Rozza, G., Triverio, P., Ballarin F. (ORCID:0000-0001-6460-3538), Fevola, E., Ballarin, Francesco, Jimenez-Juan, L., Fremes, S., Grivet-Talocia, S., Rozza, G., Triverio, P., and Ballarin F. (ORCID:0000-0001-6460-3538)

Abstract

The choice of appropriate boundary conditions is a fundamental step in computational fluid dynamics (CFD) simulations of the cardiovascular system. Boundary conditions, in fact, highly affect the computed pressure and flow rates, and consequently haemodynamic indicators such as wall shear stress (WSS), which are of clinical interest. Devising automated procedures for the selection of boundary conditions is vital to achieve repeatable simulations. However, the most common techniques do not automatically assimilate patient-specific data, relying instead on expensive and time-consuming manual tuning procedures. In this work, we propose a technique for the automated estimation of outlet boundary conditions based on optimal control. The values of resistive boundary conditions are set as control variables and optimized to match available patient-specific data. Experimental results on four aortic arches demonstrate that the proposed framework can assimilate 4D-Flow MRI data more accurately than two other common techniques based on Murray's law and Ohm's law.

Published
2021

7. The association between coronary graft patency and clinical status in patients with coronary artery disease

Author

Gaudino, Mario Fulvio Luigi, Di Franco, A., Bhatt, D. L., Alexander, J. H., Abbate, A., Azzalini, L., Sandner, S., Sharma, G., Rao, S. V., Crea, Filippo, Fremes, S. E., Bangalore, S., Gaudino M. (ORCID:0000-0001-7529-438X), Crea F. (ORCID:0000-0001-9404-8846), Gaudino, Mario Fulvio Luigi, Di Franco, A., Bhatt, D. L., Alexander, J. H., Abbate, A., Azzalini, L., Sandner, S., Sharma, G., Rao, S. V., Crea, Filippo, Fremes, S. E., Bangalore, S., Gaudino M. (ORCID:0000-0001-7529-438X), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

The concept of a direct association between coronary graft patency and clinical status is generally accepted. However, the relationship is more complex and variable than usually thought. Key issues are the lack of a common definition of graft occlusion and of a standardized imaging protocol for patients undergoing coronary bypass surgery. Factors like the type of graft, the timing of the occlusion, and the amount of myocardium at risk, as well as baseline patients' characteristics, modulate the patency-to-clinical status association. Available evidence suggests that graft occlusion is more often associated with non-fatal events rather than death. Also, graft failure due to competitive flow is generally a benign event, while graft occlusion in a graft-dependent circulation is associated with clinical symptoms. In this systematic review, we summarize the evidence on the association between graft status and clinical outcomes.

Published
2021

8. Committee Recommendations for Resuming Cardiac Surgery Activity in the SARS-CoV-2 Era: Guidance From an International Cardiac Surgery Consortium

Author

Chikwe, J, Gaudino, M, Hameed, I, Robinson, NB, Bakaeen, FG, Menicanti, L, Doenst, T, Zheng, Z, Lemma, M, Falk, V, Tatoulis, J, Girardi, LN, Fremes, S, Ruel, M, Chikwe, J, Gaudino, M, Hameed, I, Robinson, NB, Bakaeen, FG, Menicanti, L, Doenst, T, Zheng, Z, Lemma, M, Falk, V, Tatoulis, J, Girardi, LN, Fremes, S, and Ruel, M

Abstract

Recommendations for the safe and optimized resumption of cardiac surgery care, research, and education during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) era were developed by a cardiovascular research consortium, based in 19 countries and representing a wide spectrum of experience with COVID-19. This guidance document provides a framework for restarting cardiac surgery in the outpatient and inpatient settings, in accordance with the current understanding of SARS-CoV-2, the risks posed by interrupted cardiovascular care, and the available recommendations from major societies.

Published
2020

9. Characteristics of Contemporary Randomized Clinical Trials and Their Association with the Trial Funding Source in Invasive Cardiovascular Interventions

Author

Gaudino, Mario Fulvio Luigi, Hameed, I., Rahouma, M., Khan, F. M., Tam, D. Y., Biondi-Zoccai, G., Demetres, M., Charlson, M. E., Ruel, M., Crea, Filippo, Falk, V., Girardi, L. N., Fremes, S., Chikwe, J., Gaudino M. (ORCID:0000-0001-7529-438X), Crea F. (ORCID:0000-0001-9404-8846), Gaudino, Mario Fulvio Luigi, Hameed, I., Rahouma, M., Khan, F. M., Tam, D. Y., Biondi-Zoccai, G., Demetres, M., Charlson, M. E., Ruel, M., Crea, Filippo, Falk, V., Girardi, L. N., Fremes, S., Chikwe, J., Gaudino M. (ORCID:0000-0001-7529-438X), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Importance: Changes in evidence-based practice and guideline recommendations depend on high-quality randomized clinical trials (RCTs). Commercial device and pharmaceutical manufacturers are frequently involved in the funding, design, conduct, and reporting of trials, the implications of which have not been recently analyzed. Objective: To evaluate the design, outcomes, and reporting of contemporary randomized clinical trials of invasive cardiovascular interventions and their association with the funding source. Design, Setting, and Participants: This cross-sectional study analyzed published RCTs between January 1, 2008, to May 31, 2019. The trials included those involving coronary, vascular and structural interventional cardiology, and vascular and cardiac surgical procedures. Main Outcomes and Measures: We assessed (1) trial characteristics, (2) finding of a statistically significant difference in the primary end point favoring the experimental intervention, (3) reporting of implied treatment advantage in trials without significant differences in primary end point, (4) existence of major discrepancies between registered and published primary outcomes, (5) number of patients whose outcomes would need to switch from a nonevent to an event to convert a significant difference in primary end point to nonsignificant, and (6) association with funding source. Results: Of the 216 RCTs analyzed, 115 (53.2%) reported having commercial sponsorship. Most trials had 80% power to detect an estimated treatment effect of 30%, and 128 trials (59.3%) used composite primary end points. The median (interquartile range [IQR]) sample size was 502 (204-1702) patients, and the median (IQR) follow-up duration was 12 (1.0-14.4) months. Overall, 123 trials (57.0%) reported a statistically significant difference in the primary outcome favoring the experimental intervention; reporting strategies that implied an advantage were identified in 55 (65.5%) of 84 trials that reported nonsignificant di

Published
2020

12. Safety of a Restrictive versus Liberal Approach to Red Blood Cell Transfusion on the Outcome of AKI in Patients Undergoing Cardiac Surgery: A Randomized Clinical Trial

Author

Garg A, Badner N, Bagshaw S, Cuerden M, Fergusson D, Gregory A, Hall J, Hare G, Khanykin B, McGuinness S, Parikh C, Roshanov P, Shehata N, Sontrop J, Syed S, Tagarakis G, Thorpe K, Verma S, Wald R, Whitlock R, Mazer C, de Medicis E, Masse M, Marchand J, MacAdams C, Seal D, Ferland A, Ali I, Maier K, Creary T, Tittley L, Spence J, Jaffer I, Brodutch S, Lellouche F, Bussieres J, Dagenais F, Lizotte P, Gagne N, Tremblay H, Breton C, Bouchard P, Bainbridge D, Bentall T, Beique F, Ramachandran S, Rochon A, Vervais M, Grenier S, Grocott H, Kashani H, Ambrose E, McVagh J, Mazer, Hare, Verma, Crescini C, Yagnik S, Slabiak A, Han K, Fremes S, Karkhanis R, Baig N, Sidhu S, MacArthur R, Reid K, Boehnke S, Hudson C, Rubens F, Winch D, Klein R, Grey R, Teoh K, Wiley W, Darby C, Ho A, Saha T, Shore D, Shelley J, Lamarche Y, Sirois C, Brown C, Dube C, Holden K, Roy L, Rolfe B, Brown S, Saczkowski R, Senner W, Carrier F, Noiseux N, Hebert P, Benettaib F, Ghamraoui A, Lebrasseur M, Beattie W, Carroll J, Poonawala H, Zbitnew G, Howells S, Mawhinney R, Sampson S, Yegappan C, Schroeder R, Perfect S, Jones M, Leff J, Nair S, Moncada K, Joco C, Harrison M, Greilich P, Landgraf K, Kramer R, Gallant B, Fontes M, Stavris K, Rosengart T, Debakey M, Omer S, Coffey K, Broussard E, Tseng E, London M, Stanley K, Casson L, Julien M, Myles P, Wallace S, Galagher W, Ditoro A, Royse A, Royse C, Williams Z, Tivendale L, Dong N, Judelman S, Leyden J, Yarad E, Doane M, Player C, Scott D, Slater B, Corcoran P, Hu R, Sidiropoulos S, Baulch S, Brewster D, Simpson S, Smith J, Hulley A, Painter T, de Prinse L, Bannon P, Turner L, Beattie L, Eslick A, Cope L, Sanderson B, Baker R, Pesudovs B, Bennetts J, Dimovski D, Duggan N, Ives K, Yap C, Byrne K, Mans G, Termaat J, Young P, Ridgeon E, Reddy S, Hurford S, Mackle D, Baker T, Hunt A, Cruz R, Henderson S, Mehrtens J, Parke R, Gilder E, Cowdrey K, Dalton J, Butler M, Long S, Lammert A, Blakemore A, Walker C, France D, Hutchison R, Xue S, Gu J, Chen X, Fan A, Suraya S, Raja N, Yusnida I, Azura T, Saibon T, Bing M, Hwang N, Tan R, Ang F, Chin T, Mehta C, Jain A, Sharma P, Shah R, Shaikh P, Kanchi M, Sigamani A, Anusha K, Johansson P, Anderson T, Olesen L, Lilleor N, Rasmussen S, Fenger A, Treskatsch S, Mezger V, Falk E, Habicher M, Sander M, Edinger F, Koch C, Boening A, Oswald I, Bulat-Genc S, Seeberger D, Fassl J, Seeberger E, Eberle B, Takala J, Stucki M, Mateo E, Moreno J, Gabaldon T, Cobo I, Pena J, Ferrer C, Carmona P, Lopez Cantero M, Pajares A, Zarragoikoetxea I, Galan J, Urrutia G, Martinez-Zapata M, Rivilla M, Cegarra V, Acosta-Isaac R, Gajate-Martin L, Candela-Toha A, Simopoulos V, Karangelis D, Filipescu D, Paunescu A, Fawzy H, Mawlana W, Preisman S, Raanani E, Kogan D, Matot I, Cattan A, Artsi H, Galhardo C, Olival S, Toledo R, Villar J, Hernandez E, Montes F, Vaquiro E, Garavito C, Abello M, Manrique E, Vasquez S, Aguilar L, Coral M, Rodriguez H, Tellez J, Martinez C, Biccard B, Alphonsus C, Spiess B, Hall R, Kent B, Denault A, Deschamps A, TRICS Investigators, and Perioperative Anesthesia Clinical

Abstract

Background Safely reducing red blood cell transfusions can prevent transfusion-related adverse effects, conserve the blood supply, and reduce health care costs. Both anemia and red blood cell transfusion are independently associated with AKI, but observational data are insufficient to determine whether a restrictive approach to transfusion can be used without increasing AKI risk. Methods In a prespecified kidney substudy of a randomized noninferiority trial, we compared a restrictive threshold for red blood cell transfusion (transfuse if hemoglobin= 0.3 mg/dl within 48 hours of surgery, or >= 50% within 7 days of surgery. Results Patients in the restrictive-threshold group received significantly fewer transfusions than patients in the liberal-threshold group (1.8 versus 2.9 on average, or 38% fewer transfusions in the restricted threshold group compared with the liberal-threshold group; P

Published
2019

13. Stroke After Coronary Artery Bypass Grafting and Percutaneous Coronary Intervention: Incidence, Pathogenesis, and Outcomes

Author

Gaudino, M. (Mario), Angiolillo, D.J. (Dominick), Di Franco, A. (Antonino), Capodanno, D. (Davide), Bakaeen, F. (Faisal), Farkouh, M.E. (Michael E.), Fremes, S. (Stephen), Holmes, D.R. (David), Girardi, L.N. (Leonard N.), Nakamura, S. (Sunao), Head, S.J. (Stuart), Park, S.-J. (Seung-Jung), Mack, M.J. (Michael), Serruys, P.W.J.C. (Patrick), Ruel, M. (Marc), Stone, G.W. (Gregg), Tam, D.Y. (Derrick Y.), Vallely, M. (Michael), Taggart, D.P. (David), Gaudino, M. (Mario), Angiolillo, D.J. (Dominick), Di Franco, A. (Antonino), Capodanno, D. (Davide), Bakaeen, F. (Faisal), Farkouh, M.E. (Michael E.), Fremes, S. (Stephen), Holmes, D.R. (David), Girardi, L.N. (Leonard N.), Nakamura, S. (Sunao), Head, S.J. (Stuart), Park, S.-J. (Seung-Jung), Mack, M.J. (Michael), Serruys, P.W.J.C. (Patrick), Ruel, M. (Marc), Stone, G.W. (Gregg), Tam, D.Y. (Derrick Y.), Vallely, M. (Michael), and Taggart, D.P. (David)

Published
2019
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16. Everolimus-eluting stents or bypass surgery for left main coronary artery disease

Author

Stone, Gw, Sabik, Jf, Serruys, Pw, Simonton, Ca, Généreux, P, Puskas, J, Kandzari, De, Morice, Mc, Lembo, N, Brown WM 3rd, Taggart, Dp, Banning, A, Merkely, B, Horkay, F, Boonstra, Pw, van Boven AJ, Ungi, I, Bogáts, G, Mansour, S, Noiseux, N, Sabaté, M, Pomar, J, Hickey, M, Gershlick, A, Buszman, P, Bochenek, A, Schampaert, E, Pagé, P, Dressler, O, Kosmidou, I, Mehran, R, Pocock, Sj, Kappetein, Ap, van Es GA, Leon, Mb, Gersh, B, Chaturvedi, S, Kint, Pp, Valgimigli, M, Colombo, A, Costa, M, Di Mario, C, Ellis, S, Fajadet, J, Fearon, W, Kereiakes, D, Makkar, R, Mintz, Gs, Moses, Jw, Teirstein, P, Ruel, M, Sergeant, P, Mack, M, Fontana, G, Mohr, Fw, Nataf, P, Smith, C, Boden, B, Fox, K, Maron, D, Steg, G, Blackstone, E, Juni, P, Parise, H, Wallentin, L, Bertrand, M, Krucoff, M, Turina, M, Ståhle, E, Tijssen, J, Brill, D, Atkins, C, Applegate, B, Argenziano, M, Faly, Rc, Dauerman, H, Davidson, C, Griffith, B, Reisman, M, Rizik, D, Sakwa, M, Shemin, R, Romano, M, Hamm, C, Gummert, J, Tamburino, C, Alfieri, O, Savina, C, de Bruyne, B, Machado, Fp, Uva, S, Moccetti, T, Siclari, F, Hildick Smith, D, Szekely, L, Erglis, A, Stradins, P, Abizaid, A, Bento Sousa LC, Belardi, J, Navia, D, Park, Sj, Lee, Jw, Meredith, I, Smith, J, Yehuda, Ob, Schneijdenberg, R, Ronden, J, Jonk, J, Jonkman, A, van Remortel, E, de Zwart, I, Elshout, L, de Vries, T, Andreae, R, Tol van, J, Teurlings, E, Balachandran, S, Breazna, A, Jenkins, P, Mcandrew, T, Marx, So, Connolly, Mw, Hong, Mk, Weinberger, J, Wong, Sc, Dizon, J, Biviano, A, Morrow, J, Wang, D, Corral, M, Alfonso, M, Sanchez, R, Wright, D, Djurkovic, C, Lustre, M, Jankovic, I, Sanidas, E, Lasalle, L, Maehara, A, Matsumura, M, Sun, E, Iacono, S, Greenberg, T, Jacobson, J, Pullano, A, Gacki, M, Liu, S, Cohen, Dj, Magnuson, E, Baron, Sj, Wang, K, Traylor, K, Worthley, S, Stuklis, R, Barbato, E, Stockman, B, Dubois, C, Meuris, B, Vrolix, M, Dion, R, Bento de Souza LC, Costantini, C, Woitowicz, V, Hueb, W, Stolf, N, Beydoun, H, Baskett, R, Curtis, M, Kieser, T, Doucet, S, Pellerin, M, Hamburger, J, Cook, R, Kutryk, M, Peterson, M, Madan, M, Fremes, S, Mehta, S, Cybulsky, I, Prabhakar, M, Peniston, C, Welsh, R, Macarthur, R, Berland, J, Bessou, Jp, Carrié, D, Glock, Y, Darremont, O, Deville, C, Grimaud, Jp, Soula, P, Lefèvre, T, Maupas, E, Durrleman, N, Silvestri, M, Houel, R, Pratt, A, Francis, J, Van Belle, E, Vicentelli, A, Luchner, A, Hilker, M, Endemann, Dh, Felix, S, Wollert, Hg, Walther, T, Erbel, R, Jacob, H, Kahlert, P, Kupatt, C, Näbauer, M, Schmitz, C, Scholtz, W, Börgermann, J, Schuler, G, Borger, M, Davierwala, P, Fontos, G, Székely, L, Bedogni, F, Panisi, P, Berti, S, Glauber, M, Marzocchi, A, Di Bartolomeo, R, Merlo, M, Guagliumi, G, Fenili, F, Napodano, M, Gerosa, G, Ribichini, F, Faggian, Giuseppe, Saccà, S, Giacomin, A, Mignosa, C, Tumscitz, C, Savini, C, Van Mieghem, N, von Birgelen, C, Grandjean, J, Kubica, J, Anisimowicz, L, Zmudka, K, Sadowski, J, Hernández García, J, Such, M, Macaya, C, Rodríguez Hernández JE, Maroto, L, Serra, A, Padro, J, Tenas, Ms, De Souza, A, Egred, M, Clark, S, Trivedi, U, Jain, A, Uppal, R, Redwood, S, Young, C, Stables, Rh, Pullan, M, Uren, N, Pessotto, R, Abu Fadel, M, Peyton, M, Allaqaband, S, O’Hair, D, Bachinsky, W, Mumtaz, M, Blankenship, J, Casale, A, Brott, B, Davies, J, Brown, D, Cannon, L, Talbott, J, Chang, G, Macheers, S, Choi, J, Henry, C, Cutlip, D, Khabbaz, K, Das, G, Liao, K, Diver, D, Thayer, J, Dobies, D, Fliegner, K, Fischbein, M, Feldman, T, Pearson, P, Foster, M, Briggs, R, Giugliano, G, Engelman, D, Gordon, P, Ehsan, A, Grantham, J, Allen, K, Grodin, J, Jessen, M, Gruberg, L, Taylor JR Jr, Gupta, S, Hermiller J., Jr, Heimansohn, D, Iwaoka, R, Chan, B, Kander, Nh, Duff, S, Brown, W, Karmpaliotis, D, Kini, A, Filsoufi, F, Kong, D, Lin, S, Kutcher, M, Kincaid, E, Leya, F, Bakhos, M, Liberman, H, Halkos, M, Lips, D, Eales, F, Mahoney, P, Rich, J, Barreiro, C, Cheng, W, Metzger, C, Greenfield, T, Moses, J, Palacios, I, Macgillivray, T, Perin, E, Del Prete, J, Pompili, V, Kilic, A, Ragosta, M, Kron, I, Rashid, J, Mueller, D, Riley, R, Reimers, C, Patel, N, Resar, J, Shah, A, Schneider, J, Landvater, L, Reardon, M, Shavelle, D, Baker, C, Singh, J, Maniar, H, Wei, L, Strain, J, Zapolanski, A, Taheri, H, Ad, N, Tannenbaum, M, Prabhakar, G, Waksman, R, Corso, P, Wang, J, Fiocco, M, Wilson, Bh, Steigel, Rm, Chadwick, S, Zidar, F, Oswalt, J., Stone, Gregg W., Sabik, Joseph F., Serruys, Patrick W., Simonton, Charles A., Généreux, Philippe, Puskas, John, Kandzari, David E., Morice, Marie Claude, Lembo, Nichola, Brown, W. Morri, Taggart, David P., Banning, Adrian, Merkely, Béla, Horkay, Ferenc, Boonstra, Piet W., Van Boven, Ad J., Ungi, Imre, Bogáts, Gabor, Mansour, Samer, Noiseux, Nicola, Sabaté, Manel, Pomar, José, Hickey, Mark, Gershlick, Anthony, Buszman, Pawel, Bochenek, Andrzej, Schampaert, Erick, Pagé, Pierre, Dressler, Ovidiu, Kosmidou, Ioanna, Mehran, Roxana, Pocock, Stuart J., Kappetein, A. Pieter, for the EXCEL Trial Investigators:, [. . ., Antonio, Marzocchi, DI BARTOLOMEO, Roberto, ], . ., and Cardiothoracic Surgery

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Disease, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, law.invention, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Percutaneous Coronary Intervention, Randomized controlled trial, law, Internal medicine, medicine, Clinical endpoint, Drug-Eluting Stent, Humans, Everolimus, 030212 general & internal medicine, cardiovascular diseases, Coronary Artery Bypass, Aged, Female, Middle Aged, Drug-Eluting Stents, business.industry, Coronary Artery Bypa, Medicine (all), Percutaneous coronary intervention, General Medicine, medicine.disease, Surgery, Cardiac surgery, Everolimu, surgical procedures, operative, Bypass surgery, Conventional PCI, Cardiology, business, medicine.drug, Human
Abstract

BACKGROUND: Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. METHODS: We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients). Anatomic complexity was assessed at the sites and defined by a Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score of 32 or lower (the SYNTAX score reflects a comprehensive angiographic assessment of the coronary vasculature, with 0 as the lowest score and higher scores [no upper limit] indicating more complex coronary anatomy). The primary end point was the rate of a composite of death from any cause, stroke, or myocardial infarction at 3 years, and the trial was powered for noninferiority testing of the primary end point (noninferiority margin, 4.2 percentage points). Major secondary end points included the rate of a composite of death from any cause, stroke, or myocardial infarction at 30 days and the rate of a composite of death, stroke, myocardial infarction, or ischemia-driven revascularization at 3 years. Event rates were based on Kaplan-Meier estimates in time-to-first-event analyses. RESULTS: At 3 years, a primary end-point event had occurred in 15.4% of the patients in the PCI group and in 14.7% of the patients in the CABG group (difference, 0.7 percentage points; upper 97.5% confidence limit, 4.0 percentage points; P=0.02 for noninferiority; hazard ratio, 1.00; 95% confidence interval, 0.79 to 1.26; P=0.98 for superiority). The secondary end-point event of death, stroke, or myocardial infarction at 30 days occurred in 4.9% of the patients in the PCI group and in 7.9% in the CABG group (P

Published
2017

20. Mechanisms, consequences, and prevention of coronary graft failure

Author

Gaudino, Mario Fulvio Luigi, Antoniades, C., Benedetto, U., Deb, S., Di Franco, A., Di Giammarco, G., Fremes, S., Glineur, D., Grau, J., He, G. -W., Marinelli, D., Ohmes, L. B., Patrono, Carlo, Puskas, J., Tranbaugh, R., Girardi, L. N., Taggart, D. P., Gaudino M. (ORCID:0000-0001-7529-438X), Patrono C., Gaudino, Mario Fulvio Luigi, Antoniades, C., Benedetto, U., Deb, S., Di Franco, A., Di Giammarco, G., Fremes, S., Glineur, D., Grau, J., He, G. -W., Marinelli, D., Ohmes, L. B., Patrono, Carlo, Puskas, J., Tranbaugh, R., Girardi, L. N., Taggart, D. P., Gaudino M. (ORCID:0000-0001-7529-438X), and Patrono C.

Abstract

Graft failure occurs in a sizeable proportion of coronary artery bypass conduits. We herein review relevant current evidence to give an overview of the incidence, pathophysiology, and clinical consequences of this multifactorial phenomenon. Thrombosis, endothelial dysfunction, vasospasm, and oxidative stress are different mechanisms associated with graft failure. Intrinsic morphological and functional features of the bypass conduits play a role in determining failure. Similarly, characteristics of the target coronary vessel, such as the severity of stenosis, the diameter, the extent of atherosclerotic burden, and previous endovascular interventions, are important determinants of graft outcome and must be taken into consideration at the time of surgery. Technical factors, such as the method used to harvest the conduits, the vasodilatory protocol, the storage solution, and the anastomotic technique, also play a major role in determining graft success. Furthermore, systemic atherosclerotic risk factors, such as age, sex, diabetes mellitus, hypertension, and dyslipidemia, have been variably associated with graft failure. The failure of a coronary graft is not always correlated with adverse clinical events, which vary according to the type, location, and reason for failed graft. Intraoperative flow verification and secondary prevention using antiplatelet and lipid-lowering agents can help reducing the incidence of graft failure.

Published
2017

23. SURGICAL AND PHARMACOLOGICAL NOVEL INTERVENTIONS TO IMPROVE SAPHENOUS VEIN GRAFT PATENCY IN CORONARY ARTERY BYPASS GRAFTING SURGERY: AN INTERNATIONAL MULTI-CENTRE RANDOMIZED CONTROLLED CLINICAL TRIAL (SUPERIOR SVG STUDY)

Author

Deb, S., primary, Singh, S., additional, Chu, M., additional, Souza, D., additional, Whitlock, R., additional, Meyer, S., additional, Verma, S., additional, Raabe, M., additional, Jeppsson, A., additional, Zavodni, A., additional, Jimenez-Juan, L., additional, Brady, K., additional, Rao-Melacini, P., additional, Belley-Cote, E., additional, Novick, R., additional, and Fremes, S., additional

Published
2017
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26. TAVI FOR LEAN PATIENTS

Author

Mitsuhashi, H., primary, Komatsu, I., additional, Abe, K., additional, Ko, D.T., additional, Radhakrishnan, S., additional, and Fremes, S., additional

Published
2016
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28. TAVI FOR EXTREME HIGH RISK PATIENTS

Author

Mitsuhashi, H., primary, Komatsu, I., additional, Abe, K., additional, Ito, J., additional, Okada, O., additional, Radhakrishnan, S., additional, Ko, D.T., additional, and Fremes, S., additional

Published
2015
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29. TAVI FOR VERY SMALL PATIENTS

Author

Mitsuhashi, H., primary, Komatsu, I., additional, Abe, K., additional, Ito, J., additional, Okada, O., additional, Radhakrishnan, S., additional, Ko, D.T., additional, and Fremes, S., additional

Published
2015
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31. CLINICAL OUTCOMES OF TREATMENT BY PERCUTANEOUS CORONARY INTERVENTION VERSUS CORONARY ARTERY BYPASS GRAFT SURGERY IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING INDEX REVASCULARIZATION IN ONTARIO

Author

Chan, W., primary, Ivanov, J., additional, Ko, D., additional, Fremes, S., additional, Rao, V., additional, Jolly, S.S., additional, Cantor, W.J., additional, Lavi, S., additional, Overgaard, C.B., additional, Ruel, M., additional, Tu, J.V., additional, and Dzavik, V., additional

Published
2014
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35. Efficacy and Safety of Different Bridging Regimens of Parenteral Anticoagulation After Mechanical Valve Replacement

Author

Mathew, J., primary, Yusuf, A., additional, Vincent, J., additional, Eikelboom, J., additional, Shestakovska, O., additional, Fremes, S., additional, Noora, J., additional, Guo, L., additional, Peterson, M., additional, Spyropoulos, A., additional, Patel, A., additional, Schulman, S., additional, Pai, M., additional, and Whitlock, R., additional

Published
2013
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