Harbinder Virdi

Italian registry data confirm the so-called "valve-in-valve" technique for repairing malpositioned CoreValve (Medtronic, Minneapolis, MN) transcatheter aortic valves is a good option for patients with significant paraprosthetic leaks without recourse to surgery. Dr Gian Paolo Ussia   (University of Catania, Italy) and colleagues reviewed 663 consecutive patients who underwent transcatheter aortic-valve implantation (TAVI) with the 18-F CoreValve ReValving System at 14 centers across Italy and analyzed the clinical and echocardiographic outcomes of the 24 patients in that group who underwent a valve-in-valve intervention for severe paraprosthetic leaks. Alternatives to the valve-in-valve approach include postdilation with balloons, repositioning the valve with a snare catheter, or just observation. The physician decides which approach to use based on hemodynamic parameters, echo, and the clinical response of the patient, according to Ussia. "We found that a seco...

It's time to acknowledge the pile of evidence that light to moderate alcohol consumption is not only good for cardiovascular health, it could potentially be recommended for CV risk reduction, according to authors of two meta-analyses published online February 22, 2011 in   BMJ . An analysis of prospective cohort studies showing alcohol effects on cardiovascular end points, with first author   Dr Paul E Ronksley   (University of Calgary, AB), suggested that most any level of alcohol intake is protective against CV mortality, incident CHD, and CHD mortality, while intake of up to one drink per day is protective against incident stroke and stroke mortality. The findings are consistent with a vast evidence base linking light to moderate alcohol intake with reduced CV risk. The other report focused on clinical intervention studies of alcohol effects on biomarkers associated with CV disease and concluded that moderate intake raises levels of HDL cholesterol, apolipoprotei...

As Actor and Director Sylvester Stallone has rightly said it in the movie ‘Rocky Balboa’: “The world ain’t all sunshine and rainbows. It’s a very rough, mean place. And no matter how tough you think you are, it will always bring you to your knees and keep you there permanently if you let it. You or nobody ain’t gonna hit as hard as life. But it ain’t about how hard you hit. It’s about how hard you can get hit and keep moving forward. How much you can take and keep moving forward. If you know what you are worth, go out and get what you are worth. But you gotta be willing to take the hit.” The train started moving. It was packed with people of all ages, mostly with workingclass men and women and young collegegoing boys and girls. An old man was sitting near the window with his 30 year old son. As the train moved by, the son was overwhelmed and thrilled by the scenic beauty outside. “See dad, the green trees moving away are so...

Adults receiving a transplant because of congenital heart disease are more likely to die within a month than other transplant patients, suggesting that these patients ought to be listed for transplant earlier, a review of registry data shows. Dr Ryan Davies   (Columbia University, New York, NY) and colleagues analyzed records of 41 849 adult patients listed for primary transplantation between 1995 and 2009 in the   Thoracic Registry of the United Network for Organ Sharing Standard Transplant and Research Dataset . A subset of 1035 (2.5%) of the patients had congenital heart disease. Previous studies have shown reoperation is independently associated with higher posttransplantation mortality, so the researchers separately analyzed the patients who had had a previous sternotomy operation (1.8% of the congenital heart disease patients) and those who had not (1.2% of the congenital heart disease patients). Congenital heart disease patients were more likely than the non-congen...

Both short and long duration of sleep are predictors or markers of cardiovascular outcomes, a new review suggests [ 1 ]. The review, published online February 7, 2011 in the   European Heart Journal , included 15 prospective studies in a total of 474 684 participants and shows an increased risk of developing or dying of CHD and stroke on either end of the distribution of sleep duration. But results for total cardiovascular events showed no detectable effect in short sleepers and a significant increased risk in long sleepers. Relative risk of developing or dying of CHD, stroke, or total CVD in short sleepers   Outcome   RR (95% CI)   p   CHD   1.48 (1.22-1.80) 0.0001 Stroke   1.15 (1.00-1.31) 0.047 Total CVD   1.03 (0.93-1.15)   0.52 Relative risk of developing or dying of CHD, stroke, or total CVD in ...