Robert A. Guyton
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View article: Tricuspid Valve Replacement With a Sewing Ring Extender to Address Conduction Abnormalities
Tricuspid Valve Replacement With a Sewing Ring Extender to Address Conduction Abnormalities Open
Tricuspid valve surgery is associated with a high risk of new permanent pacemaker implantation. Tension on annular tissue by placement of a circular valve in a very noncircular annulus may cause conduction abnormalities. To address this, a…
View article: Impact of aortic root surgery during transcatheter aortic valve explant
Impact of aortic root surgery during transcatheter aortic valve explant Open
Background: Transcatheter aortic valve replacement (TAVR) explantation is currently the fastest-growing cardiac surgery procedure. Issues surrounding TAVR explantation and subsequent surgical aortic valve replacement (SAVR), specifically a…
View article: Mitral regurgitation increases systolic strains in remote zone and worsens left ventricular dyssynchrony in a swine model of ischemic cardiomyopathy
Mitral regurgitation increases systolic strains in remote zone and worsens left ventricular dyssynchrony in a swine model of ischemic cardiomyopathy Open
Background Ischemic mitral regurgitation (IMR) imposes volume overload on the left ventricle (LV), accelerating adverse LV remodeling. In this study, we sought to investigate the impact of volume overload due to IMR on regional myocardial …
View article: Hybrid Closure of Postinfarction Apical Ventricular Septal Defect Using Septal Occluder Device and Right Ventricular Free Wall: The Apical BASSINET Concept
Hybrid Closure of Postinfarction Apical Ventricular Septal Defect Using Septal Occluder Device and Right Ventricular Free Wall: The Apical BASSINET Concept Open
BACKGROUND: Postinfarction ventricular septal defect (VSD) is a catastrophic complication of myocardial infarction. Surgical repair still has poor outcomes. This report describes clinical outcomes after a novel hybrid transcatheter/surgica…
View article: Trends in surgical aortic valve replacement in pre- and post-transcatheter aortic valve replacement eras at a structural heart center
Trends in surgical aortic valve replacement in pre- and post-transcatheter aortic valve replacement eras at a structural heart center Open
Background The advent of transcatheter aortic valve replacement (TAVR) has directly impacted the lifelong management of patients with aortic valve disease. The U.S. Food and Drug Administration has approved TAVR for all surgical risk: proh…
View article: B-38 | Impact of Antithrombotic Strategies on Prosthetic Valve Gradients Following Valve-in-Valve Transcatheter Aortic Valve Replacement
B-38 | Impact of Antithrombotic Strategies on Prosthetic Valve Gradients Following Valve-in-Valve Transcatheter Aortic Valve Replacement Open
Valve-in-valve (ViV) transcatheter aortic valve replacements (TAVRs) are being performed more frequently in patients with degenerated bioprosthetic AVRs at high-risk for redo surgery. Antiplatelet (AP) and anticoagulation (AC) strategies a…
View article: Neutrophil‐to‐Lymphocyte Ratios in Patients Undergoing Aortic Valve Replacement: The PARTNER Trials and Registries
Neutrophil‐to‐Lymphocyte Ratios in Patients Undergoing Aortic Valve Replacement: The PARTNER Trials and Registries Open
Background The neutrophil‐to‐lymphocyte ratio (NLR) as a marker of systemic inflammation has been associated with worse prognosis in several chronic disease states, including heart failure. However, few data exist on the prognostic impact …
View article: Transcatheter Myotomy to Relieve Left Ventricular Outflow Tract Obstruction: The Septal Scoring Along the Midline Endocardium Procedure in Animals
Transcatheter Myotomy to Relieve Left Ventricular Outflow Tract Obstruction: The Septal Scoring Along the Midline Endocardium Procedure in Animals Open
Background: Left ventricular outflow tract obstruction complicates hypertrophic cardiomyopathy and transcatheter mitral valve replacement. Septal reduction therapies including surgical myectomy and alcohol septal ablation are limited by su…
View article: Transcatheter Myotomy to Treat Hypertrophic Cardiomyopathy and Enable Transcatheter Mitral Valve Replacement: First-in-Human Report of Septal Scoring Along the Midline Endocardium
Transcatheter Myotomy to Treat Hypertrophic Cardiomyopathy and Enable Transcatheter Mitral Valve Replacement: First-in-Human Report of Septal Scoring Along the Midline Endocardium Open
ventricular remodeling
View article: Early outcomes of transcatheter mitral valve replacement with the Tendyne system in severe mitral annular calcification
Early outcomes of transcatheter mitral valve replacement with the Tendyne system in severe mitral annular calcification Open
In patients with MR and severe MAC, TMVR with the Tendyne valve was associated with encouraging acute outcomes, midterm durability, and clinical improvement. Dedicated TMVR therapy may have a future role in these anatomically challenging, …
View article: Postoperative Atrial Fibrillation or Flutter Following Transcatheter or Surgical Aortic Valve Replacement
Postoperative Atrial Fibrillation or Flutter Following Transcatheter or Surgical Aortic Valve Replacement Open
In the PARTNER 3 trial, early POAF was more frequent following SAVR compared with TAVR. Late POAF, but not early POAF, was significantly associated with worse outcomes at 2 years, irrespective of treatment modality.
View article: Papillary muscle approximation reduces systolic tethering forces and improves mitral valve closure in the repair of functional mitral regurgitation
Papillary muscle approximation reduces systolic tethering forces and improves mitral valve closure in the repair of functional mitral regurgitation Open
This biomechanical study, demonstrates that papillary muscle approximation relieves tethering forces and when added to annuloplasty, and mobilizes the leaflets to achieve a good valve closure. Such a result could be achieved without the ne…
View article: Postinfarction Ventricular Septal Rupture and Hemopericardium with Tamponade Physiology
Postinfarction Ventricular Septal Rupture and Hemopericardium with Tamponade Physiology Open
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View article: Sitagliptin for the prevention and treatment of perioperative hyperglycaemia in patients with type 2 diabetes undergoing cardiac surgery: A randomized controlled trial
Sitagliptin for the prevention and treatment of perioperative hyperglycaemia in patients with type 2 diabetes undergoing cardiac surgery: A randomized controlled trial Open
Aim To assess whether treatment with sitagliptin, starting before surgery and continued during the hospital stay, can prevent and reduce the severity of perioperative hyperglycaemia in patients with type 2 diabetes undergoing coronary arte…
View article: Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Valves
Subclinical Leaflet Thrombosis in Transcatheter and Surgical Bioprosthetic Valves Open
Subclinical leaflet thrombosis was more frequent in transcatheter compared with surgical valves at 30 days, but not at 1 year. The impact of HALT on thromboembolic complications and structural valve degeneration needs further assessment.
View article: Left Ventricular Thinning and Distension in Pig Hearts as a Reproducible Ex Vivo Model of Functional Mitral Regurgitation
Left Ventricular Thinning and Distension in Pig Hearts as a Reproducible Ex Vivo Model of Functional Mitral Regurgitation Open
Functional mitral regurgitation in the setting of an enlarged heart is challenging to repair surgically with an annular approach, and the need to develop subannular and ventricular approaches is recognized yet unrealized because of the lac…
View article: Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery
Sitagliptin for the prevention of stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery Open
Aims To determine if treatment with sitagliptin, a dipeptidyl peptidase-4 inhibitor, can prevent stress hyperglycemia in patients without diabetes undergoing coronary artery bypass graft (CABG) surgery. Methods We conducted a pilot, double…
View article: Pathological Remodeling of Mitral Valve Leaflets from Unphysiologic Leaflet Mechanics after Undersized Mitral Annuloplasty to Repair Ischemic Mitral Regurgitation
Pathological Remodeling of Mitral Valve Leaflets from Unphysiologic Leaflet Mechanics after Undersized Mitral Annuloplasty to Repair Ischemic Mitral Regurgitation Open
Background Undersized ring annuloplasty is a commonly used surgical repair for ischemic mitral regurgitation, in which annular downsizing corrects regurgitation, but alters valve geometry and elevates tissue stresses. In this study, we inv…