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Transaortic valve replacement

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https://www.readbyqxmd.com/read/28712578/outcomes-readmissions-and-costs-in-transfemoral-and-alterative-access-transcatheter-aortic-valve-replacement-in-the-us-medicare-population
#1
Fenton H McCarthy, Danielle D Spragan, Danielle Savino, Taylor Dibble, Ashley C Hoedt, Katherine M McDermott, Joseph E Bavaria, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To comprehensively evaluate and compare utilization, outcomes, and especially costs of transfemoral (TF), transapical (TA), and transaortic (TAO) transcatheter aortic valve replacement (TAVR). METHODS: All Medicare fee-for-service patients undergoing TF (n = 4065), TA (n = 691), or TAO (n = 274) TAVR between January 1, 2011, and November 30, 2012, were identified using Health Care Procedure Classification Codes present on Medicare claims. Hospital charges from Medicare claims were converted to costs using hospital-specific Medicare cost-to-charge ratios...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711323/transapical-and-transaortic-transcatheter-aortic-valve-replacement-still-part-of-the-game-and-at-what-cost
#2
EDITORIAL
Jessica Forcillo, Vinod H Thourani
No abstract text is available yet for this article.
June 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28676179/transaortic-edge-to-edge-mitral-valve-repair-for-moderate-secondary-functional-mitral-regurgitation-in-patients-undergoing-aortic-root-valve-intervention
#3
Shiv Kumar Choudhary, Atul Abraham, Amol Bhoje, Parag Gharde, Manoj Sahu, Sachin Talwar, Balram Airan
OBJECTIVE: The present study evaluates the feasibility, safety, and efficacy of edge-to-edge repair for moderate secondary/functional mitral regurgitation in patients undergoing aortic valve/root interventions. METHODS: Sixteen patients underwent transaortic edge-to-edge mitral valve repair. Mitral regurgitation was 2+ in 8 patients and 3+ in 6 patients. Two patients in whom cardiac arrest developed preoperatively had severe (4+) mitral regurgitation. Patients underwent operation for severe aortic regurgitation ± aortic root lesions...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28598875/early-hemodynamic-results-in-patients-with-small-aortic-annulus-after-aortic-valve-replacement
#4
Pierre Olivier Dionne, Frédéric Poulin, Denis Bouchard, Philippe Généreux, Reda Ibrahim, Raymond Cartier, Yoan Lamarche, Philippe Demers
OBJECTIVE: Patients with a small aortic annulus (≤21 mm) have an increased risk of patient-prosthesis mismatch after valve replacement. The aim of this study was to compare the early hemodynamic performance of the balloon-expandable transaortic valve implantation Edwards system (SAPIEN) and the sutureless Perceval prostheses. METHODS: Fifty patients underwent transcatheter aortic valve implantation, and 113 patients underwent sutureless aortic valve replacement...
June 8, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549026/the-use-of-rapid-deployment-valves-in-combined-aortic-and-mitral-valve-surgery-one-year-clinical-and-echocardiographic-outcomes
#5
Markus Schlömicher, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine, Justus Thomas Strauch
OBJECTIVE: Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. METHODS: Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28516313/dynamic-changes-in-aortic-impedance-after-transcatheter-aortic-valve-replacement-and-its-impact-on-exploratory-outcome
#6
Yukari Kobayashi, Juyong B Kim, Kegan J Moneghetti, Yuhei Kobayashi, Ran Zhang, Daniel A Brenner, Ryan O'Malley, Ingela Schnittger, Michael Fischbein, D Craig Miller, Alan C Yeung, David Liang, Francois Haddad, William F Fearon
Valvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure + mean transaortic gradient)/stroke volume index)...
May 17, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28516100/transient-aortic-intramural-hematoma-complicating-transaortic-valve-replacement
#7
Taylor Thomas, Anil K Poulose, Kevin M Harris
Acute aortic intramural hematoma, which is a variant of acute aortic syndromes, most frequently occurs spontaneously and typically is treated similar to classic aortic dissection. Here, we describe a case in which an iatrogenic aortic intramural hematoma occurs shortly after transaortic valve replacement. The patient was managed conservatively, and the hematoma quickly resolved as demonstrated by serial imaging.
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#8
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
July 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28329159/concomitant-therapy-off-pump-coronary-revascularization-and-transcatheter-aortic-valve-implantation
#9
Samir Ahad, Kristina Wachter, Christian Rustenbach, Alina Stan, Stephan Hill, Tim Schäufele, Adrian Ursulescu, Ulrich F W Franke, Hardy Baumbach
OBJECTIVES: Significant coronary artery disease (CAD) is common among patients evaluated for transcatheter aortic valve implantation (TAVI). Only little data exist on outcome of patients undergoing concomitant off-pump coronary revascularization and TAVI. The goal of this study was to analyse the impact of concomitant off-pump revascularization on early clinical outcome and 2-year follow-up of patients undergoing TAVI. METHODS: A total of 70 patients with significant CAD and aortic valve stenosis were included between January 2011 and January 2016...
March 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28246571/avoiding-the-learning-curve-for-transcatheter-aortic-valve-replacement
#10
Sergey Gurevich, Ranjit John, Rosemary F Kelly, Ganesh Raveendran, Gregory Helmer, Demetris Yannopoulos, Timinder Biring, Brett Oestreich, Santiago Garcia
Objectives. To evaluate whether collaboration between existing and new transcatheter aortic valve replacement (TAVR) programs could help reduce the number of cases needed to achieve optimal efficiency. Background. There is a well-documented learning curve for achieving procedural efficiency and safety in TAVR procedures. Methods. A multidisciplinary collaboration was established between the Minneapolis VA Medical Center (new program) and the University of Minnesota (established program since 2012, n = 219) 1 year prior to launching the new program...
2017: Cardiology Research and Practice
https://www.readbyqxmd.com/read/28106026/successful-simultaneous-ipsilateral-stenting-of-common-iliac-artery-stenosis-and-transfemoral-aortic-valve-replacement
#11
Abdullah Nabi Aslan, Hacı Ahmet Kasapkara, Serkan Sivri, Murat Can Güney, Engin Bozkurt
Transcatheter aortic valve replacement (TAVR) was designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is most commonly performed with retrograde approach through femoral arteries. However, in up to 30% of cases, it is either not possible to use this access route or it is considered to have high risk of vascular injury. Alternative approaches have been described for patients with no suitable femoral access: trans-subclavian, transaortic, or direct aortic access; however, since the introduction of new valves deployed with low-profile delivery systems, another alternative transcatheter approach has been discovered...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28073571/early-clinical-outcomes-of-a-novel-self-expanding-transapical-transcatheter-aortic-valve-bioprosthesis
#12
Michael W A Chu, Rodrigo Bagur, Katie L Losenno, Philip M Jones, Pantelis Diamantouros, Patrick Teefy, Jill J Gelinas, Bob Kiaii
OBJECTIVE: Coronary obstruction remains a challenging complication of transcatheter aortic valve replacement; however, a new self-expanding transapical prosthesis may reduce this risk. The purpose of this study was to evaluate the early 1-year outcomes of patients with low coronary heights who received the Acurate TA bioprosthesis (Symetis, Ecublens, Switzerland). METHODS: Between May 2014 and April 2015, 30 consecutive patients (aged 85 ± 6 years, 63% were female, Society of Thoracic Surgeons score 8...
April 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28030440/subclinical-bioprosthetic-aortic-valve-thrombosis-clinical-and-translational-implications
#13
Bobby Yanagawa, Amine Mazine, Deepak L Bhatt, Marie-Annick Clavel, Nancy Côté, Asim N Cheema, Philippe Pibarot, Subodh Verma
PURPOSE OF REVIEW: A recently published study has alerted the cardiovascular community to the existence of a significant and previously unrecognized risk of subclinical valve thrombosis following implantation of surgical and catheter-based bioprosthetic valves. The purpose of this article is to review our current understanding of this new clinical entity and to identify unanswered questions and areas for future research. RECENT FINDINGS: Subclinical bioprosthetic valve thrombosis (BPVT) is a more common phenomenon than previously appreciated...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27989885/transcaval-access-and-closure-for-transcatheter-aortic-valve-replacement-a%C3%A2-prospective-investigation
#14
MULTICENTER STUDY
Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Annette M Stine, Toby Rogers, William W O'Neill, Gaetano Paone, Vinod H Thourani, Kamran I Muhammad, Robert A Leonardi, Stephen Ramee, James F Troendle, Robert J Lederman
BACKGROUND: Transcaval access may enable fully percutaneous transcatheter aortic valve replacement (TAVR) without the hazards and discomfort of transthoracic (transapical or transaortic) access. OBJECTIVES: The authors performed a prospective, independently adjudicated, multicenter, single-arm trial of transcaval access for TAVR in patients who were ineligible for femoral artery access and had high or prohibitive risk of complications from transthoracic access...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#15
RANDOMIZED CONTROLLED TRIAL
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27884356/direct-comparison-of-feasibility-and-safety-of-transfemoral-versus-transaortic%C3%A2-versus-transapical-transcatheter-aortic%C3%A2-valve-replacement
#16
Takahide Arai, Mauro Romano, Thierry Lefèvre, Thomas Hovasse, Arnaud Farge, Daniel Le Houerou, Kentaro Hayashida, Yusuke Watanabe, Philippe Garot, Hakim Benamer, Thierry Unterseeh, Erik Bouvier, Marie-Claude Morice, Bernard Chevalier
OBJECTIVES: The aim of this study was to compare outcomes among transfemoral (TF), transaortic (TAo), and transapical (TA) transcatheter aortic valve replacement (TAVR). BACKGROUND: Very few studies have investigated the differences among TF, TAo, and TA TAVR in terms of safety and feasibility. METHODS: Between January 2011 and December 2014, 467 consecutive cases of TF TAVR, 289 cases of TAo TAVR, and 42 cases of TA TAVR were analyzed. Baseline characteristics, procedural characteristics, and outcomes were compared between TF and TAo and between TAo and TA approaches...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27879530/transaortic-edge-to-edge-repair-for-functional-mitral-regurgitation-during-aortic-valve-replacement-a-13-year-experience
#17
Christos G Mihos, Maiteder Larrauri-Reyes, Judy Hung, Orlando Santana
OBJECTIVE: The study evaluated the feasibility of a transaortic edge-to-edge mitral valve repair (Alfieri stitch) for moderate or greater (≥2+) functional mitral regurgitation (MR) in high-risk patients undergoing aortic valve replacement. METHODS: We retrospectively evaluated 40 consecutive patients who underwent aortic valve replacement combined with a transaortic edge-to-edge mitral valve repair for 2+ or greater functional MR, between February 2002 and April 2015...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27765175/learning-alternative-access-approaches-for-transcatheter-aortic-valve-replacement-implications-for-new-transcatheter-aortic-valve%C3%A2-replacement-centers
#18
Matthew C Henn, Thomas Percival, Alan Zajarias, Spencer J Melby, Brian R Lindman, Nishath Quader, Ralph J Damiano, Marc R Moon, John M Lasala, Ravinder S Rao, Jennifer Bell, Marci S Damiano, Hersh S Maniar
BACKGROUND: Smaller transcatheter aortic valve replacement (TAVR) delivery systems have increased the number of patients eligible for transfemoral procedures while decreasing the need for transaortic (TAo) or transapical (TA) access. As a result, newer TAVR centers are likely to have less exposure to these alternative access techniques, making it harder to achieve proficiency. The purpose of this study was to evaluate the learning curve for TAVR approaches and compare perioperative outcomes...
October 17, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27753861/br-02-1-management-of-hypertension-in-severe-aortic-stenosis
#19
Yong-Jin Kim
Aortic stenosis (AS) is a common valve disease, affecting nearly 5% of elderly individuals. Because most common etiology of AS is degenerative valve disease, hypertension (HT) is not rare in patients with AS. It was reported that more than 30% of patients with AS had systemic hypertension. Therefore, management of hypertension is an important issue for these patients. There are several effects of combined AS and HT. First, HT increases hemodynamic load of left ventricle and peak systolic left ventricular wall stress...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27712776/late-outcomes-of-transcatheter-aortic-valve-replacement-in-high-risk-patients-the-france-2-registry
#20
MULTICENTER STUDY
Martine Gilard, Hélène Eltchaninoff, Patrick Donzeau-Gouge, Karine Chevreul, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lievre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Didier Tchetche, Didier Carrié, Dominique Himbert, Bernard Albat, Alain Cribier, Arnaud Sudre, Didier Blanchard, Gilles Rioufol, Frederic Collet, Remi Houel, Pierre Dos Santos, Nicolas Meneveau, Said Ghostine, Thibaut Manigold, Philippe Guyon, Dominique Grisoli, Herve Le Breton, Stephane Delpine, Romain Didier, Xavier Favereau, Geraud Souteyrand, Patrick Ohlmann, Vincent Doisy, Gilles Grollier, Antoine Gommeaux, Jean-Philippe Claudel, Francois Bourlon, Bernard Bertrand, Marc Laskar, Bernard Iung
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up. OBJECTIVES: This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. METHODS: The FRANCE-2 registry prospectively included all TAVRs performed in France...
October 11, 2016: Journal of the American College of Cardiology
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