Clinically significant mitral regurgitation is often found in conjunction with severe aortic valve stenosis. Adding mitral valve surgery to an aortic valve replacement (AVR) increases the operative risk. However, this increased operative risk may be reduced if, during AVR, a standard double-valve surgery is avoided and AVR isperformed instead with a transaortic edge-to-edge repair of the mitral...

I n this issue of JACC: Cardiovascular Interventions, De Backer et al. (1) describe the evolving trends in aortic valve replacement (AVR), both surgical AVR (SAVR) and transcatheter AVR (TAVR), for aortic stenosis over the past decade. They report findings from a regional administrative registry database from eastern Denmark for the period from 2005 to 2015. We briefly discuss the implications ...

Method Between 2006 and 2014, 72 patients met criteria for inclusion. Out of these 72, 59 had previous CAB and 13 had CAB + AVR. The surgical procedures performed in these series included 50 AVR and 22 AVR + CAB. Myocardial protection was delivered using mild systemic hypothermia and continuous cold blood retrograde and intermittent antegrade cardioplegia, avoiding any manipulation of the LIMA ...

Lead aVR, 1 of 12 electrocardiographic leads, is frequently ignored in clinical medicine. In fact, many clinicians refer to the 12-lead electrocardiogram (ECG) as the 11-lead ECG, noting the commonly held belief that lead aVR rarely offers clinically useful information. In this report, we discuss the findings in lead aVR, which are potentially of value, including ST-segment elevation in the pat...

Background/Introduction Aortic valve replacement (AVR) is the current gold standard treatment for aortic stenosis. In the last 15 years popularity for minimally invasive (MI) AVR has grown exponentially. The most common techniques for MI-AVR are a partial sternotomy (PS) or a mini-thoracotomy (MT). Although MI access is technically more challenging and results in longer cross clamp and cardiopu...

Isolated ST-segment elevation only in the aVR lead, reflecting an acute myocardial infarction due to a left main coronary artery occlusion, was ignored as part of physicians' training in emergency medicine for a long time. The recognition of aVR lead elevation is becoming more accepted as a mandatory diagnostic tool, in particular for physicians working at emergency departments. We report a typ...

Plant pathogens display impressive versatility in adapting to host immune systems. Pathogen effector proteins facilitate disease but can become avirulence (Avr) factors when the host acquires discrete recognition capabilities that trigger immunity. The mechanisms that lead to changes to pathogen Avr factors that enable escape from host immunity are diverse, and include epigenetic switches that ...

This paper presents a tuning approach based on Continuous firefly algorithm (CFA) to obtain the proportional-integralderivative (PID) controller parameters in Automatic Voltage Regulator system (AVR). In the tuning processes the CFA is iterated to reach the optimal or the near optimal of PID controller parameters when the main goal is to improve the AVR step response characteristics. Conducted ...

Aortic valve replacement (AVR) is currently the treatment of choice in patients with symptomatic aortic stenosis, but transcatheter off-pump aortic valve implantation is a novel and emerging technique, which might be performed more frequently in the near future and may be a less invasive alternative to conventional AVR in selected high-risk patients. Up to date, the preoperative patient selecti...