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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28533099/surgical-aortic-valve-replacement-following-early-sapien-xt-valve-failure-a-first
#1
Tanveer Ahmad, Prakash Ludhani, Ronen Gurvitch, John Goldblatt, James Tatoulis
BACKGROUND: Early degeneration of prosthetic aortic valve in transcatheter aortic valve replacement (TAVR) is a rare complication. METHOD: We report the case of a 75-year-old woman who presented with severe calcific stenosis of Edwards SAPIEN-XT valve implanted only four years previously. She is a Jehovah's Witness and has background of Sjogren's syndrome with secondary cryoglobulinaemic vasculitis. She was not a suitable candidate for valve-in-valve TAVR in view of early prosthetic valve failure by calcification...
May 9, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28528156/prognostic-impact-of-low-flow-severe-aortic-stenosis-in-small-body-patients-undergoing-tavr-the-ocean-tavi-registry
#2
Akihisa Kataoka, Yusuke Watanabe, Ken Kozuma, Yugo Nara, Fukuko Nagura, Hideyuki Kawashima, Hirofumi Hioki, Makoto Nakashima, Masanori Yamamoto, Kensuke Takagi, Motoharu Araki, Norio Tada, Shinichi Shirai, Futoshi Yamanaka, Kentaro Hayashida
OBJECTIVES: This study aimed to analyze the prognostic impact of low-flow (LF) severe aortic stenosis in small-body patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Western literature demonstrates a poor prognosis with paradoxical LF and low-flow low-gradient (LF-LG) severe aortic stenosis (AS), as defined by stroke volume index (SVi) <35 ml/m(2) and mean pressure gradient <40 mm Hg with preserved left ventricular ejection fraction (LVEF)...
May 11, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#3
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28516313/dynamic-changes-in-aortic-impedance-after-transcatheter-aortic-valve-replacement-and-its-impact-on-exploratory-outcome
#4
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/28500739/feasibility-and-safety-of-transfemoral-sheathless-portico-aortic-valve-implantation-preliminary-results-in-a-single-center-experience
#5
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28494061/association-between-hospital-volume-and-30-day-readmissions-following-transcatheter-aortic-valve-replacement
#6
Sahil Khera, Dhaval Kolte, Tanush Gupta, Andrew Goldsweig, Poonam Velagapudi, Ankur Kalra, Gilbert H L Tang, Wilbert S Aronow, Gregg C Fonarow, Deepak L Bhatt, Herbert D Aronow, Neal S Kleiman, Michael Reardon, Paul C Gordon, Barry Sharaf, J Dawn Abbott
Importance: With the approval of transcatheter aortic valve replacement (TAVR) for patients with severe symptomatic aortic stenosis at intermediate surgical risk, TAVR volume is projected to increase exponentially in the United States. The 30-day readmission rate for TAVR was recently reported at 17.9%. The association between institutional TAVR volume and the 30-day readmission metric has not been examined. Objective: To assess the association between hospital TAVR volume and 30-day readmission...
May 11, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28488404/low-gradient-dismal-outcome-tavr-should-we
#7
EDITORIAL
Samuel M Butman
Low gradient (<40 mm) aortic valve stenosis (AVA < 1.0 cm(2) ) outcomes with TAVR are worse than when gradients are > 40 mm Hg. Concomitant coronary disease, older age, presence of diabetes, and lower ejection fraction in patients with low gradient aortic valve stenosis account for the poorer outcome after TAVR. Historically, similar results have been seen with surgical AVR.
May 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28484830/insights-on-mid-term-tavr-performance-3-year-clinical-and-echocardiographic-results-from-the-corevalve-advance-study
#8
Sabine Bleiziffer, Johan Bosmans, Stephen Brecker, Ulrich Gerckens, Peter Wenaweser, Corrado Tamburino, Axel Linke
BACKGROUND: Extensive evidence relating to transcatheter aortic valve replacement (TAVR) has accumulated in recent years, but mid-term outcomes are less reported. We investigated 996 patients after implantation of the CoreValve prosthesis for severe aortic stenosis in a real-world setting. OBJECTIVE: To report clinical and echocardiographic 3-year results from the ADVANCE study. METHODS: ADVANCE is a prospective, multicenter, fully monitored, nonrandomized clinical study...
May 8, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28473129/valve-in-valve-tavr-insights-into-the-pathophysiology-of-aortic-stenosis
#9
EDITORIAL
Blase A Carabello
No abstract text is available yet for this article.
May 9, 2017: Journal of the American College of Cardiology
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
#10
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...
May 3, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28463403/the-impact-of-frailty-status-on-clinical-and-functional-outcomes-after-transcatheter-aortic-valve-replacement-in-nonagenarians-with-severe-aortic-stenosis
#11
Alexis K Okoh, Dhaval Chauhan, Nathan Kang, Nicky Haik, Aurelie Merlo, Mark Cohen, Bruce Haik, Chunguang Chen, Mark J Russo
BACKGROUND: The impact of frailty status on TAVR outcomes in nonagenarians is unknown. The present study aims to investigate the impact of frailty status on procedural outcomes and overall survival in nonagenarians after TAVR. METHODS: A frailty score (FS) was derived by using preoperative grip strength, gait speed, serum albumin, and daily activities. Patients were divided into two groups: Frail (FS ≥ 3/4) and Non-Frail (FS <3/4). Health status was assessed using the 12-item Kansas City Cardiomyopathy Questionnaire (KCCQ)...
May 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28462224/the-impact-of-frailty-on-mortality-after-transcatheter-aortic-valve-replacement
#12
EDITORIAL
Charat Thongprayoon, Wisit Cheungpasitporn, Kianoush Kashani
Frailty is a notably common problem in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) evaluation. Studies have demonstrated significant associations between frailty and worse outcomes in patients undergoing TAVR including higher risks of disability and mortality and admissions to long-term care facility. While there are multiple methods to identify and measure frailty, there is a critical need for a precise definition of frailty and its standardized assessment protocol based on well-established tests covering all aspects of the frailty, as a syndrome...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28461798/transcatheter-aortic-valve-implantation-in-a-patient-with-unicuspid-aortic-valve
#13
Angelo Nascimbene, Pranav Loyalka, Igor D Gregoric, Ricardo Bellera, Maan Malahfji, Marija Petrovic, Biswajit Kar
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient. A 31-year-old woman with Turner syndrome-who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks-presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28451702/transcatheter-vs-surgical-aortic-valve-replacement-and-medical-treatment-systematic-review-and-meta-analysis-of-randomized-and-non-randomized-trials
#14
A Ak, I Porokhovnikov, F Kuethe, P C Schulze, M Noutsias, P Schlattmann
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as the procedure of choice for patients with severe aortic stenosis (AS) and high perioperative risk. We performed a meta-analysis to compare the mortality related to TAVR with medical therapy (MT) and surgical aortic valve replacement (SAVR). METHODS: A systematic literature search was conducted by two independent investigators from the database inception to 30 December 2014. Relative risk (RR) and odds ratio (OR) were calculated and graphically displayed in forest plots...
April 27, 2017: Herz
https://www.readbyqxmd.com/read/28441641/low-volume-contrast-ct-angiography-via-pulmonary-artery-injection-for-measurement-of-aortic-annulus-in-patients-undergoing-transcatheter-aortic-valve-replacement
#15
Vien T Truong, Joseph Choo, Luke McCoy, Adam Mussman, Stephanie Ambach, Dean Kereiakes, Ian Sarembock, Wojciech Mazur
OBJECTIVES: To investigate the feasibility and image quality of low-dose contrast computed tomography (CT) angiography with pulmonary artery (PA) protocol. BACKGROUND: Aortic stenosis is the most common valvular heart disease and transcatheter aortic valve replacement (TAVR) has evolved as an alternative method for surgical valve replacement in intermediate-risk and high-risk surgical patients. CT is essential for measurement of aortic annulus prior to TAVR. METHODS: Twenty patients underwent a low-dose contrast study with PA protocol and 20 patients underwent a traditional-dose study (traditional protocol)...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28437243/impact-of-pulmonary-hypertension-on-in-hospital-outcome-after-surgical-or-transcatheter-aortic-valve-replacement
#16
Anja Gutmann, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Wolfgang Bothe, Constantin von Zur Mühlen, Manfred Zehender, Jochen Reinöhl, Christoph Bode, Peter Stachon
AIMS: The impact of pulmonary hypertension (PH) on in-hospital outcome of either surgical (SAVR) or transcatheter aortic valve replacement (TAVR) was analyzed. METHODS AND RESULTS: Data from all 107,057 patients undergoing isolated SAVR or TAVR in Germany between 2007 and 2014 was provided by the German Federal Bureau of Statistics. About 18% of patients with aortic valve stenosis suffered from PH. Patients with PH had more co- morbidities with consequently increased EuroSCORE (TAVR without PH: 12...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28433492/is-tavr-ready-for-the-global-aging-population
#17
REVIEW
Travis Bergmann, Partho P Sengupta, Jagat Narula
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR)...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#18
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#19
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#20
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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