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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#1
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28630980/in-severe-aortic-stenosis-with-intermediate-surgical-risk-tavr-was-noninferior-to-savr-for-death-or-disabling-stroke
#2
Frederick A Spencer, Gordon H Guyatt
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28625366/feasibility-of-transcatheter-aortic-valve-replacement-in-low-risk-patients-with-symptomatic-severe-aortic-stenosis-rationale-and-design-of-the-low-risk-tavr-lrt-study
#3
Toby Rogers, Rebecca Torguson, Roshni Bastian, Paul Corso, Ron Waksman
BACKGROUND: Safety and effectiveness of transcatheter aortic valve replacement (TAVR) in low-risk patients with symptomatic severe aortic stenosis have not yet been established. HYPOTHESIS: Transcatheter aortic valve replacement is feasible in patients with symptomatic severe aortic stenosis and low risk for surgical aortic valve replacement. DESIGN: The LRT study is the first US Food and Drug Administration-approved Investigational Device Exemption prospective multicenter feasibility trial of TAVR in low-risk patients...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28623173/outcomes-of-transcatheter-and-surgical-aortic-valve-replacement-in-patients-on-maintenance-dialysis
#4
Fahad Alqahtani, Sami Aljohani, Khaled Boobes, Elad Maor, Assem Sherieh, Charanjit S Rihal, David R Holmes, Mohamad Alkhouli
BACKGROUND: the introduction of transcatheter aortic valve replacement (TAVR) expanded definitive therapy of aortic stenosis to many high-risk patients, but it has not been fully evaluated in the dialysis population. OBJECTIVES: We aimed to evaluate the current trend and in-hospital outcome of Surgical aortic valve replacement (SAVR) and TAVR in the dialysis population. METHODS: Severe aortic stenosis patients on maintenance dialysis who underwent SAVR or TAVR in the Nationwide Inpatient Sample database (NIS) from January 1, 2005, through December 31, 2014, were included in our comparative analysis...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28597767/increased-mortality-from-complications-of-pulmonary-hypertension-in-patients-undergoing-transcatheter-aortic-valve-replacement
#5
Raj Parikh, Benson Varghese, Huma N Khatoon, Julie A Kovach, Clifford J Kavinsky, Rajive Tandon
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28593421/interventional-treatment-of-the-aortic-valve-current-evidence
#6
F Jansen, N Werner
Transcatheter aortic valve replacement (TAVR) has become a standard treatment for patients with severe, symptomatic aortic stenosis. Whereas its use was first limited to inoperable high-risk patients, recent studies demonstrated that TAVR was not inferior to standard surgical aortic valve replacement (SAVR) for intermediate-risk patients. Besides equivalent outcomes, the type and rates of complications differ between the two procedures. Here, we provide an overview of the latest randomized study results comparing TAVR with SAVR and describe possible future directions in transcatheter aortic valve treatment...
June 7, 2017: Herz
https://www.readbyqxmd.com/read/28589708/modified-continuity-equation-using-left-ventricular-outflow-tract-three-dimensional-imaging-for-aortic-valve-area-estimation
#7
Pedro Pinto Teixeira, Ruben Ramos, Pedro Rio, Luísa Moura Branco, Guilherme Portugal, Ana Abreu, Ana Galrinho, Hugo Marques, Luísa Figueiredo, Rui Cruz Ferreira
PURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT...
June 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28583682/outcome-of-stent-graft-implantation-for-treatment-of-access-site-bleeding-after-transfemoral-transcatheter-aortic-valve-replacement
#8
Adi Segal, Moshe Y Flugelman, Nader Khader, Ronen Rubinshtein, Idit Lavi, Ron Karmeli, Ayman Jubran, Avinoam Shiran, Ronen Jaffe
Vascular complications are common after transcatheter aortic valve replacement (TAVR) and are associated with increased morbidity and mortality. Stent graft implantation enables percutaneous treatment of access site bleeding; however, the efficacy and durability and of this approach are unknown. We studied the immediate outcome of stent graft implantation for control of access site bleeding and the need for repeat vascular interventions after stenting, in a cohort of consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28583399/acute-aortic-arch-perforation-during-transcatheter-aortic-valve-replacement-in-bicuspid-aortic-stenosis-and-a-gothic-aortic-arch
#9
Oscar Millan-Iturbe, Fadi J Sawaya, Gintautas Bieliauskas, Danny H F Chow, Ole De Backer, Lars Søndergaard
Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for high/intermediate-risk patients with severe symptomatic aortic stenosis (AS). Although TAVR is used to treat bicuspid severe AS, the large randomized trials typically excluded bicuspid AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a "gothic aortic arch"; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled a sharply angulated aortic arch...
March 28, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28571486/repositionable-self-expanding-aortic-bioprosthesis
#10
Bruna Gomes, Hugo A Katus, Raffi Bekeredjian
Transcatheter aortic valve implantation/replacement (TAVI or TAVR) has been established as a first line therapy in patients with symptomatic severe aortic stenosis (AS) at high or prohibitive surgical risk and as an alternative in elderly patients with intermediate surgical risk. Since its first-in-human procedure in 2002, the past 15-years have shown rapid developments in TAVI technology with the introduction and further improvement of new transcatheter heart valves (THV). Areas covered: There are currently several THV systems available, based on balloon-expandable, self-expandable or other technologies...
June 14, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28570260/comparison-of-non-contrast-cardiovascular-magnetic-resonance-imaging-to-computed-tomography-angiography-for-aortic-annular-sizing-before-transcatheter-aortic-valve-replacement
#11
Jing Wang, Dinesh H Jagasia, Yamuna R Kondapally, Howard C Herrmann, Yuchi Han
BACKGROUND: Accurate measurement of aortic annulus is crucial before transcatheter aortic valve replacement (TAVR). Computed tomography (CT) angiography is the most commonly utilized method, but requires contrast administration. Cardiovascular magnetic resonance (CMR) imaging is a promising alternative modality to provide aortic annulus measurements. Few studies have compared the clinical feasibility and accuracy of non-contrast CMR to contrast-enhanced computed tomography (CT) angiography in order to provide a non-contrast alternative to CT annular sizing...
May 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28570236/transcatheter-aortic-valve-replacement-versus-surgical-valve-replacement-in-low-intermediate-surgical-risk-patients-a-systematic-review-and-meta-analysis
#12
Aakash Garg, Sunil V Rao, Gautam Visveswaran, Sahil Agrawal, Abhishek Sharma, Lohit Garg, Indrajeet Mahata, Jalaj Garg, Dinesh Singal, Marc Cohen, John B Kostis
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a viable alternative to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (SAS) who are at high risk for surgery. We sought to evaluate the outcomes of TAVR vs SAVR in low-intermediate risk patients with SAS. METHODS AND RESULTS: We performed random-effects meta-analysis of randomized controlled trials (RCTs) and propensity-matched observational studies comparing TAVR vs SAVR for low-intermediate risk patients...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28549023/technical-feasibility-of-a-combined-noncontrast-magnetic-resonance-protocol-for-preoperative-transcatheter-aortic-valve-replacement-evaluation
#13
Paola M Cannaò, Giuseppe Muscogiuri, U Joseph Schoepf, Carlo N De Cecco, Pal Suranyi, Virginia W Lesslie, Davide Piccini, Shivraman Giri, Akos Varga-Szemes
PURPOSE: The aim of this study was to prospectively evaluate the technical feasibility of a noncontrast magnetic resonance angiography (MRA) protocol using investigational prototype self-navigated 3D (SN3D) radial whole-heart and quiescent-interval single-shot (QISS) pulse sequences regarding their potential in planning transcatheter aortic valve replacement (TAVR). MATERIALS AND METHODS: Five patients (76±7 y) with severe aortic valve stenosis and prior computed tomographic angiography (CTA) for TAVR planning and 10 healthy volunteers (28±6 y) underwent noncontrast MRA on a 1...
May 25, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28545632/a-cautionary-tale-of-2-leaflets-tavr-in-bicuspid-aortic-valve-stenosis
#14
EDITORIAL
Itsik Ben-Dor, Allan Stewart
No abstract text is available yet for this article.
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28545062/association-of-frailty-status-with-acute-kidney-injury-and-mortality-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#15
Charat Thongprayoon, Wisit Cheungpasitporn, Natanong Thamcharoen, Patompong Ungprasert, Wonngarm Kittanamongkolchai, Michael A Mao, Ankit Sakhuja, Kevin L Greason, Kianoush Kashani
OBJECTIVE: Frailty is a common condition in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). The aim of this systematic review was to assess the impact of frailty status on acute kidney injury (AKI) and mortality after TAVR. METHODS: A systematic literature search was conducted using MEDLINE, EMBASE, and Cochrane databases from the inception through November 2016. The protocol for this study is registered with PROSPERO (International Prospective Register of Systematic Reviews; no...
2017: PloS One
https://www.readbyqxmd.com/read/28544828/acute-aortic-regurgitation-in-the-current-era-of-percutaneous-treatment-pathophysiology-and-hemodynamics
#16
Baris Bugan, Erkan Yildirim, Murat Celik, Uygar Cagdas Yuksel
Aortic regurgitation (AR) is characterized by the backflow of blood from the aorta to the left ventricle. Acute AR typically causes severe pulmonary edema and hypotension, and is a surgical emergency. In chronic AR, however, compensatory mechanisms can clinically compensate for years, with normal left ventricular function and no symptoms. While the hemodynamic mechanisms of chronic AR on the left ventricle are well described, the hemodynamic mechanisms of acute AR are not clear. Most of the literature on acute AR includes either small series or case reports...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544120/prognostic-significance-of-aortic-valve-gradient-in-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#17
Guy Witberg, Arik Finkelstein, Issi Barbash, Abid Assali, Yaron Shapira, Amit Segev, Amir Halkin, Paul Fefer, Jeremy Ben-Shoshan, Maayan Konigstein, Alexander Sagie, Victor Guetta, Ran Kornowski, Alon Barsheshet
OBJECTIVE: To evaluate the effect of baseline aortic valve gradient (AVG) both as a continuous and a categorical variable on mortality in patients undergoing transcatheter aortic valve replacement (TAVR), focusing on the high-gradient severe aortic stenosis (AS) patients. BACKGROUND: Identifying new predictors of mortality in the TAVR population can help refine risk stratification and improve the patient selection process for this procedure. So far, AVG has mainly been studied as a categorical variable and there is a paucity of data on its prognostic value as a continuous variable, especially in patients with high AVG AS, who constitute the majority of patients referred for TAVR...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#18
REVIEW
Arash Salemi, Berhane M Worku
Transcatheter aortic valve replacement (TAVR) has become a widely accepted therapeutic option for patients with severe, symptomatic aortic stenosis at intermediate, high, or extreme risk for conventional surgery as determined through a heart team approach. Two valve prostheses are currently available and the Food and Drug Administration (FDA) approved in the United States for TAVR: the self-expandable Medtronic CoreValve (Medtronic, Inc., Minneapolis, MN, USA) and the balloon-expandable Edwards Sapien Valve (Edwards Lifesciences, Irvine CA, USA)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28536415/late-obstructive-transcatheter-heart-valve-thrombosis-resolved-by-rivaroxaban
#19
Ole Norling Mathiassen, Erik Lerkevang Grove, Nicolaj Christoffer Hansson, Bjarne Linde Norgaard
BACKGROUND Although transcatheter aortic valve replacement (TAVR) has become a worldwide and generally accepted treatment of patients with aortic stenosis at high surgical risk, there is a rising concern and debate about the occurrence of transcatheter heart valve (THV) thrombosis and its impact on TAVR outcome. It seems that the incidence of THV thrombosis is higher than first anticipated, but uncertainty remains regarding how to prevent and how to treat it. Hence, there is an urgent need for understanding THV thrombosis and to communicate experiences within the field...
May 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28536003/impact-of-transcatheter-aortic-valve-implantation-on-surgical-aortic-valve
#20
Beatriz Vaquerizo, Sabine Bleiziffer, Michael Wottke, Marco Spaziano, Lena Eschenbach, Rüdiger Lange, Nicolo Piazza
INTRODUCTION AND OBJECTIVES: TAVR is thought to change the volumes, characteristics, and outcomes of patients with aortic stenosis undergoing SAVR. We sought to investigate the impact of increasing transcatheter aortic valve replacement (TAVR) volumes on surgical aortic valve replacement (SAVR) volumes and to assess the evolution in baseline demographics and its impact on 30-day clinical outcomes across TAVR and SAVR patients. METHODS: From June 2007 through September 2015, 3543 consecutive patients with severe aortic stenosis who underwent TAVR (n=1407) or SAVR (n=2136) in a single center were subcategorized into nine cohorts defined by procedure year...
May 19, 2017: International Journal of Cardiology
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