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Largest U.S. Cardiac Database Shows Excellent Long-term Survival After Surgical Aortic Valve Replacement

Study in Low-Risk Patients Reveals 5-year Survival Rate of 93%

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Newswise — A study published today in The Annals of Thoracic Surgery demonstrates outstanding long-term survival following low-risk isolated surgical aortic valve replacement (SAVR).

The study reviewed 42,586 patients who underwent low-risk isolated SAVR between 2011 and 2019 at 981 different cardiac surgery programs across the U.S. Conducted by eight leading national investigators, the assessment relied on evidence from The Society of Thoracic Surgeons (STS) National Database, with linkage to the Centers for Disease Control and Prevention’s National Death Index (NDI).

The STS National Database, with nearly 10 million patient records, is the nation’s largest and most comprehensive clinical registry for cardiothoracic disease. The linkage to the NDI has permitted highly accurate survival information to now be available following heart and lung operations performed in the U.S.

All patients in the study were classified as low risk for SAVR mortality as defined by the STS predicted risk of operative mortality (PROM ≤ 4%). Overall, 92.9% survived after five years, and the eight-year survival was close to 90%. The study matched the criterion used in the current low-risk trials evaluating SAVR with transcatheter aortic valve replacement (TAVR). The average age of patients was 74.2 years with a mean PROM of 1.92%

“This study sets a benchmark for outcomes for management of aortic valve stenosis,” said Vinod Thourani, MD, Bernie Marcus Chair of Cardiovascular Surgery and the Marcus Valve Center, Piedmont Heart Institute, Atlanta, Georgia. “This analysis is significant because of the longitudinal follow-up with very large numbers of patients, and it is an important complement to results from randomized clinical trials that are commonly measured over just one year.”

Recent evidence has revealed that SAVR following failed TAVR requiring explant of the TAVR valve, has been the fastest-growing cardiac procedure over the last five years, associated with worse outcomes than those expected following primary SAVR surgeries.

The most recent mid-term results from the PARTNER 3 and Evolut Low-Risk trials comparing risk of death and stroke from SAVR and TAVR are expected to be released in fall 2023. As there have been some concerns raised regarding the representativeness of these trials, the current study was performed to establish real-world long-term results from SAVR to serve as a benchmark for outcomes.

“There remains absolutely no doubt that TAVR is an excellent primary option for patients of higher risk or advanced age. The aim of this study was to specifically evaluate patients of low risk, and this revealed that longitudinal outcomes of SAVR in this specific population are outstanding. As surgeons are consistently performing these surgeries with excellent outcomes, and now in minimally invasive fashion, these data should give providers of valve therapy, including cardiologists and surgeons, a point of reflection when it comes to deciding what the best option is for their patients,” said senior study author Vinay Badhwar, MD, Professor and Chairman of the Department of Cardiovascular and Thoracic Surgery of West Virginia University, and Executive Chair of the WVU Heart and Vascular Institute.

The STS National Database includes 97% of all cardiac operations performed in the U.S. with precise and validated statistical models for patients receiving adult cardiac, general thoracic, and congenital operations.

Study authors also included Robert H. Habib, PhD, Wilson Szeto, MD, Joseph Sabik, MD, Jennifer Romano, MD, MS, and Thomas MacGillivray, MD.

Link to “Survival Following Surgical Aortic Valve Replacement in Low-Risk Patients: A Contemporary Trial Benchmark:” https://www.annalsthoracicsurgery.org/article/S0003-4975(23)01064-0/fulltext

Journal Link: The Annals of Thoracic Surgery, Oct-2023

Source: The Society of Thoracic Surgeons

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Health

Study finds risk factors for severe COVID-19 cases in children

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UT Southwestern researchers show living in the Southern U.S., having preexisting conditions linked to more serious illness

Newswise — DALLAS – Nov. 21, 2023 – Children who had preexisting health problems or who lived in the Southern United States had a higher risk for severe health outcomes from acute COVID-19 infections, according to researchers at UT Southwestern Medical Center. The results, reported in the journal Hospital Pediatrics that is published by the American Academy of Pediatrics, also showed the importance of vaccinations in reducing the severity of illness for those who became infected.

“While receiving the COVID-19 vaccines did not mean that our little patients would not get sick from the virus, vaccines did protect them from more severe outcomes such as death and intensive care admissions. Protecting your children by immunizing them is a good thing, especially if your child has a preexisting condition, such as heart disease or asthma,” said one of the study’s authors, Christoph Lehmann, M.D., Professor of Pediatrics and in the Lyda Hill Department of Bioinformatics, Director of the Clinical Informatics Center, and a member of the Peter O’Donnell Jr. School of Public Health at UT Southwestern.

The national study analyzed records from 165,437 children age 18 and younger who tested positive for COVID-19 between January 2020 and January 2022. About 1.8% were hospitalized without complication, 1.8% were admitted to intensive care or needed intensive respiratory support, and 31 children died.

The researchers found that children in the Southern United States were more than three times as likely to have more severe complications compared with other areas of the country.

“It matters where you live,” Dr. Lehmann noted. “While we do not know what causes children in the South to have worse outcomes, our findings call for an exploration of possible causes – such as weather and climate, immunization rates, public health or government messaging, mandates, and closures.”

The study also found that among children under age 5, those younger than 2 years old were at the highest risk for severe outcomes. This finding contradicts initial anecdotal observations suggesting that infants were not as prone to severe disease with COVID-19 as they were from other respiratory viruses such as respiratory syncytial virus (RSV).

“While this wasn’t surprising to us – smaller airways are disproportionately affected by respiratory illness – it does mean that we have to be more vigilant when the little ones acquire COVID-19,” Dr. Lehmann added.

Finally, the study found that those with multiple chronic medical conditions, such as heart disease and lung disease, were more than twice as likely to have severe complications following COVID-19 infection, and the more chronic conditions they had, the higher the risk.

Other UTSW researchers who contributed to this study include lead author Robert W. Turer, M.D., Assistant Professor of Emergency Medicine; first author and medical student Milan Ho, B.S.; Trish M. Perl, M.D., M.Sc., Professor of Internal Medicine; Zachary M. Most, M.D., M.Sc., Assistant Professor of Pediatrics; Bhaskar Thakur, Ph.D., Assistant Professor of Family and Community Medicine, Emergency Medicine, and Physical Medicine & Rehabilitation and a member of the O’Donnell School of Public Health; John J. Hanna, M.D., Assistant Instructor of Internal Medicine; Marlon I. Diaz, B.S., Sameh Saleh, M.D., Madison Pickering, M.S., and Richard J. Medford, M.D., all with the Clinical Informatics Center; medical student Julia A. Casazza, B.S.; and Postdoctoral Research Fellow Alexander P. Radunsky, Ph.D.

Dr. Lehmann holds the Willis C. Maddrey, M.D. Distinguished Professorship in Clinical Science. Dr. Perl, a member of the O’Donnell School of Public Health, holds the H. Ben and Isabelle T. Decherd Chair in Internal Medicine in Honor of Henry M. Winans, Sr., M.D.

This study was funded by the National Center for Advancing Translational Sciences of the National Institutes of Health (UL1 TR003163).

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Association of Healthcare Access With Intensive Care Unit Utilization and Mortality in Patients of Hispanic Ethnicity Hospitalized With COVID-19

Early Crowdfunding Response to the COVID-19 Pandemic: Cross-Sectional Study

What the Coronavirus Disease 2019 (COVID-19) Pandemic Has Reinforced: The Need for Accurate Data

Evaluating Short-Term Forecasting of COVID-19 Cases Among Different Epidemiological Models Under a Bayesian Framework

An “Infodemic”: Leveraging High-Volume Twitter Data to Understand Early Public Sentiment for the Coronavirus Disease 2019 Outbreak

About UT Southwestern Medical Center 

UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 26 members of the National Academy of Sciences, 20 members of the National Academy of Medicine, and 13 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,100 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 120,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5 million outpatient visits a year.

Journal Link: Hospital Pediatrics

Source: UT Southwestern Medical Center

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Health

Family Caregivers are Filling the Gap

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More than 53 million Americans serve as “informal” caregivers filling critical roles that make independent living possible for people with disabilities.

MIDDLEVILLE, MICHIGAN, UNITED STATES /EINPresswire.com/ — In the wake of a direct care worker shortage, more than 53 million Americans serve as “informal” caregivers filling critical roles that make independent living possible for people with disabilities and chronic health conditions. However, family caregiving can take a financial, emotional, and physical toll on those performing the unpaid work. Below, we explore five opportunities to help family caregivers build sustainable and strong caregiving relationships.


Family caregivers are critical resources in the quest to promote independence and autonomy among people with disabilities, and they deserve all the support our communities can offer.”

— Steve Locke

Determine Whether Payment is Possible

In some cases, family caregivers can receive financial compensation for their caregiving. Medicaid’s Self-Directed Services program, the Department of Veterans’ Affairs Veteran-Directed Care program, certain Home and Community-Based Services programs, many long-term care insurance plans, and even some employers offer stipends to informal caregivers providing necessary care.

Make a Plan for Respite Care
Creating a respite care plan helps caregivers build in time on a regular basis to take a break from caregiving and pass their responsibilities on to a trustworthy provider. The AARP outlines the process for creating a plan, including identifying what you and your loved one need and who could provide support. Professional respite care resources are available through the Senior Corps, local Area Agency on Aging, and Elder Helpers.

Find Peer Support
Up to 40% of informal caregivers report that caregiving makes them feel alone, yet there are many others experiencing the same scenarios and connecting can help caregivers cope. Your local Center for Independent Living can connect you with caregiving support groups, the Area Agency on Aging can provide assistance, or even nonprofit or religious groups like Courage to Caregivers that link volunteer peer mentors with caregivers.

Ask for Help!
The digital age has brought a wealth of apps that make it easier for caregivers to communicate their needs and get other friends and family members on board to help. Whether you need alternative transportation to a medical appointment or would love a friend to drop off dinner a few days per month, apps like Carely, Caring Village, and LotsaHands provide tools to help caregivers coordinate caregiving responsibilities among family and friends.

Pay Attention to your Mental Health
Up to 4 in 10 caregivers report that they “never relax,” and one survey revealed that more than half of caregivers polled had experienced suicidal ideation during the COVID pandemic. Caregiving while experiencing this level of mental anguish is dangerous for both the caregiver and the patient. In cases like this, finding an alternate source of care at least part of the time is necessary. Individuals in crisis can call 988 for 24/7 mental health support and the Caregiver Action Network can provide a listening ear, resources, and assistance.

Family caregivers are critical resources in the quest to promote independence and autonomy among people with disabilities, and they deserve all the support our communities can offer. As organizations like MiSILC advocate for formal and informal caregivers at the highest levels, nonprofits and community resources can provide the services necessary for effective, sustainable caregiving. Learn more about our work at MiSILC.org.
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Beverages

Stay Balanced this Holiday Season with Health-Ade Kombucha

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Celebrate the return of a seasonal favorite plus a new limited-edition collab

LOS ANGELES /PRNewswire/ — Health-Ade, makers of delicious, bubbly beverages that support a happy and healthy gut, are celebrating feeling good from the inside out this holiday season. A perfect swap for alcohol or soda, Health-Ade Kombucha’s living probiotics help keep your gut in balance while enjoying the season’s festivities and indulging in your favorite holiday foods. 

To celebrate the season, Health-Ade Kombucha has launched its seasonal holiday flavor, Holiday Cheers, which expertly blends notes of ginger, vanilla, allspice, and cacao for the perfect sip to spread the cheer all season long. This winter staple is a perfect accompaniment for sipping by the fire, enjoying as a festive treat, or even as a delicious probiotic hostess gift for those holiday parties and celebrations. Every bottle of Health-Ade’s Holiday Cheers Kombucha will help you celebrate the seasonal flavors you love, while supporting a happy and healthy gut.

“Health-Ade is a delicious, easy way to support your gut health during the holiday season,” says Claire Chewning, Health-Ade’s Registered Dietitian Advisor. “Good nutrition is all about adding IN, not restricting unnecessarily. Adding in sources of fermented foods and probiotics, like kombucha, can increase the number of good bacteria in your gut. For many, this can help manage symptoms of bloating and other digestive discomforts. For another gut-happy practice, you can also consider swapping alcohol for a few fun Health-Ade Kombucha mocktails. Cheers to a delicious and nourished holiday season!”

Special for this season, Health-Ade has partnered with fellow Los Angeles-based brand Mar Mar to create a limited edition Holiday Minis candle set. The Mar Mar x Health-Ade Kombucha collaboration features three best-selling Mar Mar scents reimagined with a Health-Ade twist. Titled The Bold, The Rebel, and The Optimist these 2oz votives are wrapped in Health-Ade’s beloved and recognizable color schemes to make the perfect gift set for anyone on your list and a great companion to your Health-Ade Kombucha selection.

You can purchase the limited-edition candle set and Holiday Cheers flavor now on health-ade.com for yourself and all of the Health-Ade Kombucha lovers on your holiday gift list. The Mini Candle set retails for $60, or you can bundle with your favorite case of Health-Ade for a $10 discount. Holiday Cheers can also be found at select retailers nationwide, while supplies last.

About Health-Ade Kombucha
Health-Ade creates feel-good, bubbly beverages with gut health benefits so you can follow your gut and show the world what you’re made of. The brand got started in the Brentwood Farmers Market in 2012 selling its flagship kombucha drinks. Instantly gaining a cult following in Southern California, Health-Ade Kombucha rapidly expanded to sell nationwide in over 65,000 stores including Whole Foods Market, Sprouts, Safeway / Albertsons, Kroger, Publix, and Target. All Health-Ade products are naturally fermented with high-quality ingredients and are certified organic, non-GMO, gluten-free and vegan, and each bottle of Health-Ade Kombucha exceeds the World Health Organization’s daily standard for probiotics.

SOURCE Health-Ade

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