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Guideline-driven earlier mitral valve repair for patients with mitral regurgitation (MR) due to degenerative disease has increased in the last 25 years.
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Many patients need to take long-term oral anticoagulants (OAC) for indications such as atrial fibrillation (AF) or mechanical prosthetic valves.
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The decision to choose a mechanical or a tissue valve for patients undergoing surgical aortic valve replacement (AVR) is a complex one that involves synthesizing clinical factors such as risk of bleeding, likelihood of reoperation, and patient preference. Increasingly, older patients with more comorbidities are being referred for AVR surgery.
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Atrial septal defects (ASD) can lead to exercise intolerance, pulmonary hypertension, right heart failure, and reduced life expectancy if they are not repaired. Surgical closure for ASD transformed the care of these patients and resulted in similar life expectancy to subjects without ASD. In recent years, transcatheter ASD closure has largely replaced surgery, but long-term data comparing the two techniques are limited.
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Elevated troponin levels after non-cardiac surgery have been shown to predict postoperative myocardial infarction (MI) and death. Thus, these investigators from the Netherlands instituted a postoperative troponin monitoring program at one hospital to test the hypothesis that troponin elevations in the first 3 days after surgery would predict 30-day mortality after non-cardiac surgery.
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Young athletes with an inherited arrhythmia syndrome, such as long QT syndrome (LQTS) or hypertrophic cardiomyopathy (HCM), may undergo implantation of an implantable cardioverter defibrillator (ICD) if they are believed to be at high risk of sudden death. American College of Cardiology (ACC) guidelines have typically recommended that such individuals should be prohibited from vigorous sports. Yet for many young athletes, prohibition of participation in any competitive sport may be a life-altering event, followed by poor grades or depression.
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Transient ischemic attacks (TIAs) and minor strokes are often the harbingers of a large, debilitating stroke. Approximately 10% of patients experiencing a TIA will go on to have a large stroke within the next 3 months.
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The Get with the Guidelines-Resuscitation registry is a large, prospective registry of in-hospital cardiac arrests that analyzes data to promote quality improvement. In this paper, Chan and colleagues report the long-term outcomes in Medicare-age patients who suffered an in-hospital cardiac arrest and survived to discharge.
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The incidence and predictive value of abnormal liver function tests (LFTs) in patients with acute decompensated heart failure is poorly understood. Thus, these investigators from the SURVIVE study report their experience in patients with acute decompensated heart failure due to systolic dysfunction treated with positive inotropic infusions
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There is considerable debate concerning the optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Clearly, there is benefit to DAPT early after PCI.
