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“Purpose of review

Transcatheter mitral valve-in-valve (MVIV) implantation is an emerging technique for reoperative mitral valve replacement in high-risk patients. Clear guidelines on the use of transcatheter MVIV implantation are yet to be determined. In this review, we report our own experience as well as the recent available literature on this procedure.

Recent findings

Since 2010, four case series of three or more patients have been reported with a total number of 23 patients. We also include unpublished data of 13

additional patients, who recently had MVIV implantation at our institution. Mean age was 78.45 +/- 9.2 years with a median follow-up ranging from 70 to 357 days. Mean The Society of Thoracic Surgeons HSP990 research buy (STS) score was 14.1 +/- 7.1%. All patients were in New York Heart Association (NYHA) class III or IV. Thirty days mortality was 7.5% (n = 3) and late mortality was 10% (n = 4). All patients had improvement in postoperative NYHA class to I/II following MVIV implantation. The mitral regurgitation grade was reduced from 3+ or 4- preoperatively to a grade of 0 or 1 postoperatively. There was no structural valve deterioration reported in the follow-up period in any of the Selleckchem ZD1839 studies.

Summary

The available literature supports the use of transcatheter MVIV implantation in selected high-risk

patients with favorable results. Although there are no available long-term data on the procedure, the early and midterm outcomes are excellent with no evidence of structural EPZ5676 order valve deterioration in the available follow-up period.”
“Laparoscopic greater curvature plication (LGCP) is a new metabolic/bariatric surgical procedure that requires no resection, bypass, or implantable device. We report LGCP outcomes in 244 morbidly obese patients.

Between 2010 and 2011, patients underwent LGCP. Body mass index (BMI, kilogram per square meter) evolution, excess BMI loss (%EBMIL), excess weight loss (%EWL), complications, and type 2 diabetes mellitus (T2DM) changes were recorded. Repeated-measures

analysis of variance (ANOVA) was used to assess weight change at 6, 12, and 18 months. Subgroup analyses were conducted to provide benchmark outcomes at 6 months. Logistic regression was used to identify characteristics predictive of suboptimal weight loss.

Mean baseline BMI (+/- SD) was 41.4 +/- 5.5 (80.7 % women, mean age 46.1 +/- 11.0 years, 68 [27.9 %] patients had T2DM). Mean operative time was 70.6 min; mean hospitalization, 36 h (24-72). Sixty-eight patients (27.9 %) experienced postoperative nausea and/or vomiting that was controlled within 36 h. There was no mortality. Major complication rate was 1.2 % (n = 3). Repeated-measures ANOVA indicated significant weight loss across time points (p < 0.001). At 6 months (n = 105), BMI, %EBMIL, and %EWL were 36.1 +/- 4.7, 34.8 +/- 17.3, and 31.8 +/- 15.9. Preoperative BMI was the only predictor of weight loss.