cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.13281492
title: Complicated Bi-Pella Support: Acute Mitral Regurgitation and Bailout MitraClip Repair

description: Complicated Bi-Pella Support: Acute Mitral Regurgitation and Bailout MitraClip Repair
DOI: 10.6084/m9.figshare.13161825
title: Bioprosthetic Valve Fracture to Facilitate Valve-in-Valve Transcatheter Aortic Valve Replacement

description: Degeneration of surgical bioprosthetic heart valves (BPVs) occurs in up to one third of surviving patients within a decade of implantation and is a common cause of cardiovascular morbidity. Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is a safe and effective treatment for patients with failed BPVs who are unsuitable for reoperation. However, there may be patient-prosthesis mismatch (PPM) following VIV TAVR, particularly in patients with small BPVs. This may influence both morbidity and mortality. Bioprosthetic valve fracture (BVF) has emerged as a novel technique to prevent PPM. It involves high-pressure inflation of a non-compliant balloon to fracture the ring of the BPV, allowing for further expansion of the implanted transcatheter heart valve (THV) and thereby reducing residual transvalvular gradients. Early experience with this technique has been promising. This review will describe the procedural technique of BVF, explore the lessons learned from bench testing and early clinical experience, and discuss the limitations of the current literature as well as future directions. <b>Abbreviations:</b> ACn: ACURATE neo; BPV: Bioprosthetic heart valve; BVF: Bioprosthetic valve fracture; BVR: Bioprosthetic valve remodeling; EOA: Effective orifice area; NYHA: New York Heart Association; PPM: Patient-prosthesis mismatch; PWI: Pin-wheeling index; S3: Sapien 3; SAVR: Surgical aortic valve replacement; TAVR: Transcatheter aortic valve replacement; TPVR: Transcatheter pulmonary valve replacement; THV: Transcatheter heart valve; VIV: Valve-in-valve
DOI: 10.6084/m9.figshare.13316107
title: Spatial Modeling of Landscape Values: Discovering the Boundaries of Conflicts and Identifying Mutual Benefits as a Basis for Land Management

description: Conflicting interests amongst different stakeholder groups regarding land use challenge the protection of natural values in socio-ecological systems (SES). In this paper we show, based on a case study of Israel’s Makhteshim Country National Park, how mapping the different interests and analyzing the data with a GIS system allows us to locate significant conflict points between groups. Semi-structured interviews were conducted with 60 individuals from three major stakeholder groups in the region: semi-nomadic Bedouins, nature reserve rangers, and tourist operators. The qualitative findings were then mapped by a GIS platform. The mapping indicated that the stakeholder groups’ land-use is distributed in a manner that makes conflict unavoidable, but relatively limited to only certain specific areas. Moreover, in some areas, the three groups share similar or complementary values, reaping mutual benefits from shared use. We conclude that GIS mapping can serve as a powerful tool for conflict management in complex SES.
DOI: 10.6084/m9.figshare.13161825.v1
title: Bioprosthetic Valve Fracture to Facilitate Valve-in-Valve Transcatheter Aortic Valve Replacement

description: Degeneration of surgical bioprosthetic heart valves (BPVs) occurs in up to one third of surviving patients within a decade of implantation and is a common cause of cardiovascular morbidity. Valve-in-valve transcatheter aortic valve replacement (VIV TAVR) is a safe and effective treatment for patients with failed BPVs who are unsuitable for reoperation. However, there may be patient-prosthesis mismatch (PPM) following VIV TAVR, particularly in patients with small BPVs. This may influence both morbidity and mortality. Bioprosthetic valve fracture (BVF) has emerged as a novel technique to prevent PPM. It involves high-pressure inflation of a non-compliant balloon to fracture the ring of the BPV, allowing for further expansion of the implanted transcatheter heart valve (THV) and thereby reducing residual transvalvular gradients. Early experience with this technique has been promising. This review will describe the procedural technique of BVF, explore the lessons learned from bench testing and early clinical experience, and discuss the limitations of the current literature as well as future directions.
DOI: 10.6084/m9.figshare.13316107.v1
title: Spatial Modeling of Landscape Values: Discovering the Boundaries of Conflicts and Identifying Mutual Benefits as a Basis for Land Management

description: Conflicting interests amongst different stakeholder groups regarding land use challenge the protection of natural values in socio-ecological systems (SES). In this paper we show, based on a case study of Israel’s Makhteshim Country National Park, how mapping the different interests and analyzing the data with a GIS system allows us to locate significant conflict points between groups. Semi-structured interviews were conducted with 60 individuals from three major stakeholder groups in the region: semi-nomadic Bedouins, nature reserve rangers, and tourist operators. The qualitative findings were then mapped by a GIS platform. The mapping indicated that the stakeholder groups’ land-use is distributed in a manner that makes conflict unavoidable, but relatively limited to only certain specific areas. Moreover, in some areas, the three groups share similar or complementary values, reaping mutual benefits from shared use. We conclude that GIS mapping can serve as a powerful tool for conflict management in complex SES.
DOI: 10.6084/m9.figshare.12382532.v1
title: Climate Change Views, Energy Policy Support, and Personal Action in the Intermountain West: The Anti-Reflexivity Effect

description: Reducing the environmental impacts of energy production and consumption is part of addressing climate change. Prior research finds political-economic factors shape climate change views, perceptions of and policy support for renewable and nonrenewable energy, and pro-environmental behaviors (PEBs). This study contributes to research in these three areas by empirically testing the anti-reflexivity thesis, which posits that forces defending the industrial capitalist system are sources of anti-reflexivity, obstructing critical self-evaluation and societal action to address climate change. Using OLS and logistic regression analysis of survey data from respondents in five states in the US Intermountain West region, we find empirical support for the effect of anti-reflexivity on climate views, energy policy support, and PEBs. We also find that PEBs in the Intermountain West still largely occur in the realm of personal conservation actions rather than being politically focused, collectively organized, or leading toward systemic change.
DOI: 10.6084/m9.figshare.12382532
title: Climate Change Views, Energy Policy Support, and Personal Action in the Intermountain West: The Anti-Reflexivity Effect

description: Reducing the environmental impacts of energy production and consumption is part of addressing climate change. Prior research finds political-economic factors shape climate change views, perceptions of and policy support for renewable and nonrenewable energy, and pro-environmental behaviors (PEBs). This study contributes to research in these three areas by empirically testing the anti-reflexivity thesis, which posits that forces defending the industrial capitalist system are sources of anti-reflexivity, obstructing critical self-evaluation and societal action to address climate change. Using OLS and logistic regression analysis of survey data from respondents in five states in the US Intermountain West region, we find empirical support for the effect of anti-reflexivity on climate views, energy policy support, and PEBs. We also find that PEBs in the Intermountain West still largely occur in the realm of personal conservation actions rather than being politically focused, collectively organized, or leading toward systemic change.
DOI: 10.6084/m9.figshare.11395548.v2
title: Temporal Trends and Outcomes of Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Myocardial Infarction

description: <b>Background</b><b>:</b> There is a paucity of data regarding the comparative safety and effectiveness of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with prior myocardial infarction (MI). <b>Methods</b><b>:</b> We queried the NIS database (2012–2016) to identify patients with a prior history of MI who underwent isolated AVR. We conducted a propensity matching analysis comparing patients with TAVR versus SAVR based on patient demographics, comorbidities and hospital characteristics. The primary outcome was in-hospital mortality. <b>Results</b><b>:</b> Among 24,090 hospitalizations with prior MI undergoing isolated AVR, 58.5% underwent TAVR. Over the study period, there was an increase in the proportion of patients undergoing TAVR and a decrease in patients undergoing SAVR (P<sub>trend</sub>&lt;0.001). After propensity matching, in-hospital mortality was not different between TAVR and SAVR (odds ratio 1.07; 95% confidence interval 0.85–1.33). Compared with SAVR, TAVR was associated with lower rates of cardiac arrest, cardiogenic shock, acute kidney injury, respiratory complications, postoperative bleeding, blood transfusion, acute stroke, vascular complications and shorter length of stay. TAVR was associated with a higher incidence of complete heart block and pacemaker implantation. <b>Conclusion</b><b>:</b> In this nationwide observational study, there has been a steady increase in the number of TAVRs performed in patients with prior MI. Compared with SAVR, TAVR was associated with similar in-hospital mortality and a lower rate of complications and length of stay.
DOI: 10.6084/m9.figshare.11395548
title: Temporal Trends and Outcomes of Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Myocardial Infarction

description: <b>Background</b><b>:</b> There is a paucity of data regarding the comparative safety and effectiveness of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with prior myocardial infarction (MI). <b>Methods</b><b>:</b> We queried the NIS database (2012–2016) to identify patients with a prior history of MI who underwent isolated AVR. We conducted a propensity matching analysis comparing patients with TAVR versus SAVR based on patient demographics, comorbidities and hospital characteristics. The primary outcome was in-hospital mortality. <b>Results</b><b>:</b> Among 24,090 hospitalizations with prior MI undergoing isolated AVR, 58.5% underwent TAVR. Over the study period, there was an increase in the proportion of patients undergoing TAVR and a decrease in patients undergoing SAVR (P<sub>trend</sub>&lt;0.001). After propensity matching, in-hospital mortality was not different between TAVR and SAVR (odds ratio 1.07; 95% confidence interval 0.85–1.33). Compared with SAVR, TAVR was associated with lower rates of cardiac arrest, cardiogenic shock, acute kidney injury, respiratory complications, postoperative bleeding, blood transfusion, acute stroke, vascular complications and shorter length of stay. TAVR was associated with a higher incidence of complete heart block and pacemaker implantation. <b>Conclusion</b><b>:</b> In this nationwide observational study, there has been a steady increase in the number of TAVRs performed in patients with prior MI. Compared with SAVR, TAVR was associated with similar in-hospital mortality and a lower rate of complications and length of stay.
DOI: 10.6084/m9.figshare.11505708
title: Outcomes after Tricuspid Valve Replacement for Carcinoid Heart Disease: A Multicenter Study

description: <b>Background:</b> This study evaluates clinical and echocardiographic outcomes in patients who underwent tricuspid valve replacement (TVR) for carcinoid heart disease (CaHD) stratified to prosthesis type (biological vs mechanical). <b>Methods:</b> All patients undergoing TVR for CaHD between 1991 and 2017 were analyzed retrospectively in four tertiary centers. Cox-proportional hazard models were used to analyze survival data and mixed-models for repeated measurements of echo and laboratory data. <b>Results:</b> In total, 49 patients (median age: 59 [51–66], 45% male) underwent biological (n = 20, 41%) or mechanical (n = 29, 59%) TVR. Three (6%) patients died in-hospital and 3-year actuarial survival was 73.3 ± 8.7% (biological) and 56.1 ± 10.0% (mechanical) (<i>P</i> = 0.69). During a median follow-up of 17 months, two patients with a biological prosthesis required reoperation for structural valve deterioration, while one patient with mechanical prostheses had a reoperation due to valve thrombosis. No significant differences in bleeding, thrombosis, thromboembolism and heart failure admissions were noted between prosthesis types. Postoperative valve regurgitation increased more in patients with a biological prosthesis (<i>p</i> = 0.022). Maximum tricuspid inflow gradient was higher in patients with biological prostheses (<i>p</i> = 0.02); however, course over time was comparable between prosthesis types (<i>p</i> = 0.136). <b>Conclusion:</b> Tricuspid valve surgery for CaHD can be performed with acceptable hospital mortality risk. This data shows no apparent benefit of biological valves over mechanical prosthesis or vice versa. Valve choice should be made in a multi-disciplinary team taking into account expected lifespan, planned treatment for the carcinoid syndrome and neuroendocrine tumor and patient preferences.
DOI: 10.6084/m9.figshare.11505708.v2
title: Outcomes after Tricuspid Valve Replacement for Carcinoid Heart Disease: A Multicenter Study

description: <b>Background:</b> This study evaluates clinical and echocardiographic outcomes in patients who underwent tricuspid valve replacement (TVR) for carcinoid heart disease (CaHD) stratified to prosthesis type (biological vs mechanical). <b>Methods:</b> All patients undergoing TVR for CaHD between 1991 and 2017 were analyzed retrospectively in four tertiary centers. Cox-proportional hazard models were used to analyze survival data and mixed-models for repeated measurements of echo and laboratory data. <b>Results:</b> In total, 49 patients (median age: 59 [51–66], 45% male) underwent biological (n = 20, 41%) or mechanical (n = 29, 59%) TVR. Three (6%) patients died in-hospital and 3-year actuarial survival was 73.3 ± 8.7% (biological) and 56.1 ± 10.0% (mechanical) (<i>P</i> = 0.69). During a median follow-up of 17 months, two patients with a biological prosthesis required reoperation for structural valve deterioration, while one patient with mechanical prostheses had a reoperation due to valve thrombosis. No significant differences in bleeding, thrombosis, thromboembolism and heart failure admissions were noted between prosthesis types. Postoperative valve regurgitation increased more in patients with a biological prosthesis (<i>p</i> = 0.022). Maximum tricuspid inflow gradient was higher in patients with biological prostheses (<i>p</i> = 0.02); however, course over time was comparable between prosthesis types (<i>p</i> = 0.136). <b>Conclusion:</b> Tricuspid valve surgery for CaHD can be performed with acceptable hospital mortality risk. This data shows no apparent benefit of biological valves over mechanical prosthesis or vice versa. Valve choice should be made in a multi-disciplinary team taking into account expected lifespan, planned treatment for the carcinoid syndrome and neuroendocrine tumor and patient preferences.
DOI: 10.6084/m9.figshare.11899926
title: Transcatheter Aortic Valve Replacement in Left Ventricular Assist Device Patients with Aortic Regurgitation

description: <b>Backgro</b><b>und:</b> Development of aortic regurgitation (AR) following left ventricular assist device (LVAD) implantation is common, and it is associated with a poor prognosis. Transcatheter aortic valve replacement (TAVR) has become a mainstay therapy for patients with severe aortic stenosis, with an off-label use for severe AR. The aim of this study was to assess the feasibility and durability of TAVR in LVAD patients with significant AR. <b>Methods:</b> We evaluated all LVAD patients within our database that underwent TAVR for AR. Clinical and echocardiographic data were collected before and after TAVR procedure. Aortic regurgitant fraction (RF) was calculated using outflow graft Doppler echocardiography. <b>Results:</b> Seven patients underwent nine attempted TAVR procedures. Median age was 69 (IQR 63–73) and 43% were female. Median time from LVAD to TAVR was 23 (IQR 17–52) months. One procedure was aborted due to vascular complications, and one patient underwent two separate procedures 22 months apart. Five patients (71%) survived over median follow-up of 9 (IQR 6–23) months. Two patients died of paravalvular complications following device deployment. Procedural success was achieved in 67% of attempts, with significant improvement in RF from 44.8% (IQR 37.6–63.6) pre-procedurally to 28.1% (IQR 0.30–29.6) at six-month follow-up. Qualitatively, mild or moderate paravalvular leak was noted on all surviving patients at one- and six-month follow-up. There was significant improvement in right ventricular function at 6-month follow-up. <b>Conclusion:</b> TAVR is a reasonable option for treating LVAD-induced AR. Longer follow-up and larger cohorts are needed to assess the durability and long-term efficacy of this procedure. <b>Abbreviations:</b> AR: Aortic regurgitation; AV: Aortic valve; LV: Left ventricle; LVAD: Left ventricular assist device; LVIDd: Left ventricular internal dimension at end-diastole; LVIDs: Left ventricular internal dimension at end-systole; PAPi: Pulmonary artery pulsatility index; RA: Right atrial; RF: Regurgitant fraction; RV: Right ventricle; RVEDA: Right ventricular end-diastolic area; RVFAC: Right ventricular fractional area change; RVSP: Right ventricular systolic pressure; TAPSE: tricuspid annular plane systolic excursion; TAVR: Transcatheter aortic valve replacement; TV: Tricuspid valve
DOI: 10.6084/m9.figshare.11395548.v1
title: Temporal Trends and Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Prior Myocardial Infarction

description: <b>Background</b>: There are paucity of data regarding the comparative safety and effectiveness of transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR) in patients with prior myocardial infarction (MI). <b>Methods</b>: We queried the NIS database (2012-2016) to identify patients with a prior history of MI who underwent isolated AVR. We conducted a propensity matching analysis comparing patients with TAVR versus SAVR based on patient demographics, comorbidities and hospital characteristics. The primary outcome was in-hospital mortality. <b>Results</b>: Among 24,090 hospitalizations with prior MI undergoing isolated AVR, 58.5% underwent TAVR. Over the study period, there was an increase in the proportion of patients undergoing TAVR and a decrease in patients undergoing SAVR (P<sub>trend</sub>&lt;0.001). After propensity matching, in-hospital mortality was not different between TAVR and SAVR (odds ratio 1.07; 95% confidence interval 0.85-1.33). Compared with SAVR, TAVR was associated with lower rates of cardiac arrest, cardiogenic shock, acute kidney injury, respiratory complications, postoperative bleeding, blood transfusion, acute stroke, vascular complications and shorter length of stay. TAVR was associated with a higher incidence of complete heart block and pacemaker implantation. <b>Conclusion</b>: In this nationwide observational study, there has been a steady increase in the number of TAVRs performed in patients with prior MI. Compared with SAVR, TAVR was associated with similar in-hospital mortality and a lower rate of complications and length of stay.
DOI: 10.6084/m9.figshare.11899926.v1
title: Transcatheter Aortic Valve Replacement in Left Ventricular Assist Device Patients with Aortic Regurgitation

description: <b>Backgro</b><b>und:</b> Development of aortic regurgitation (AR) following left ventricular assist device (LVAD) implantation is common, and it is associated with a poor prognosis. Transcatheter aortic valve replacement (TAVR) has become a mainstay therapy for patients with severe aortic stenosis, with an off-label use for severe AR. The aim of this study was to assess the feasibility and durability of TAVR in LVAD patients with significant AR. <b>Methods:</b> We evaluated all LVAD patients within our database that underwent TAVR for AR. Clinical and echocardiographic data were collected before and after TAVR procedure. Aortic regurgitant fraction (RF) was calculated using outflow graft Doppler echocardiography. <b>Results:</b> Seven patients underwent nine attempted TAVR procedures. Median age was 69 (IQR 63–73) and 43% were female. Median time from LVAD to TAVR was 23 (IQR 17–52) months. One procedure was aborted due to vascular complications, and one patient underwent two separate procedures 22 months apart. Five patients (71%) survived over median follow-up of 9 (IQR 6–23) months. Two patients died of paravalvular complications following device deployment. Procedural success was achieved in 67% of attempts, with significant improvement in RF from 44.8% (IQR 37.6–63.6) pre-procedurally to 28.1% (IQR 0.30–29.6) at six-month follow-up. Qualitatively, mild or moderate paravalvular leak was noted on all surviving patients at one- and six-month follow-up. There was significant improvement in right ventricular function at 6-month follow-up. <b>Conclusion:</b> TAVR is a reasonable option for treating LVAD-induced AR. Longer follow-up and larger cohorts are needed to assess the durability and long-term efficacy of this procedure. <b>Abbreviations:</b> AR: Aortic regurgitation; AV: Aortic valve; LV: Left ventricle; LVAD: Left ventricular assist device; LVIDd: Left ventricular internal dimension at end-diastole; LVIDs: Left ventricular internal dimension at end-systole; PAPi: Pulmonary artery pulsatility index; RA: Right atrial; RF: Regurgitant fraction; RV: Right ventricle; RVEDA: Right ventricular end-diastolic area; RVFAC: Right ventricular fractional area change; RVSP: Right ventricular systolic pressure; TAPSE: tricuspid annular plane systolic excursion; TAVR: Transcatheter aortic valve replacement; TV: Tricuspid valve