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Download truespace 4.3Aortic annulus sizing with transesophageal echocardiography predicts prosthetic valve function in valves implanted with the CoreValve aortic prosthesis.
Transesophageal echocardiography (TEE) plays a central role in the preoperative assessment of patients with aortic stenosis who are candidates for transcatheter aortic valve replacement. However, the correlation between TEE-derived measurements of the aortic annulus and periprocedural annular sizing of the valve is currently unknown. In this study, the precision of TEE-based measurements of the aortic annulus was assessed, and the correlation between TEE-derived dimensions of the aortic annulus and implant function was assessed in patients who had undergone transcatheter aortic valve implantation with the CoreValve aortic prosthesis. Fifty-two patients were included in this study. The effective orifice area of the valve was calculated at baseline and follow-up TEE studies (3 and 12 months). The changes in annulus diameter before and after the procedure and annular dimensions by TEE were compared with measures taken before valve implantation and at 3- and 12-month follow-up. The mean aortic annulus diameter by TEE was 23.2 ± 3.2 mm at baseline and 23.6 ± 3.1 mm at follow-up. There was no significant difference in the mean diameter of the aortic annulus before and after the procedure (p = 0.11). The mean preprocedure diameter was 29.8 ± 3.5 mm and that of the postprocedure diameter was 30.4 ± 3.7 mm. The mean diameter of the aortic annulus was 26.6 ± 3.5 mm on the TEE study at 12 months. There was a strong correlation between the diameter of the aortic annulus by TEE
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Download truespace 4.3WASHINGTON — The White House on Friday said President Obama supports Secretary of State Hillary Clinton and her announcement that she is stepping down from her post in the wake of the latest release of the Justice Department’s investigation into her use of a private email server while secretary of state.
“I support Secretary Clinton in terms of her decision to recuse herself from any matters relating to the email issue,” the White House said.
The statement from the White House’s Office of the Press Secretary came after a day of confusion in Washington about how close to President Obama the top diplomat and the president really were. It was unclear whether Mr. Obama knew of Mrs. Clinton’s plan to step down in advance.
The White House official said the statement was sent directly to the press corps Friday afternoon.
“This has been their plan for a while, but I think they wanted to do it in the right way,” a former senior administration official said about Mrs. Clinton and Mr. Obama. “I would say that this is a very good move on her part.”
Mrs. Clinton’s recusal was announced Thursday afternoon, after the latest round of emails from the independent investigation of her use of the private server were released and showed a direct communication between Mrs. Clinton and the White House on the subject.
“I have sent word to my successor at the State Department and as I do on all matters, have directed my senior staff to cooperate with the intergovernmental, independent inquiry led by former federal judge and Secretary of State for President Clinton’s husband,” Mrs. Clinton said in a statement from her lawyer.
But Mr. Obama said he was “saddened and disappointed” that Mrs. Clinton had decided to step down.
“Her service to the nation will not be complete until she has safely left office,” he said in a statement.
Mrs. Clinton’s decision is the culmination of a political scandal in which emails