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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28808772/longitudinal-strain-assessed-by-cardiac-magnetic-resonance-correlates-to-hemodynamic-findings-in-patients-with-severe-aortic-stenosis-and-predicts-positive-remodeling-after-transcatheter-aortic-valve-replacement
#1
Dominik Buckert, Maciej Cieslik, Raid Tibi, Michael Radermacher, Volker Rasche, Peter Bernhardt, Vinzenz Hombach, Wolfgang Rottbauer, Jochen Wöhrle
AIMS: To assess left-ventricular strain parameters before and after transcatheter aortic valve replacement (TAVR) by feature tracking cardiac magnetic resonance imaging (FT CMR) and to correlate the findings to hemodynamic state and left-ventricular remodeling. METHODS AND RESULTS: Patients with symptomatic AS underwent FT CMR before and after TAVR. Patients were carefully evaluated by a comprehensive work-up including CMR, echocardiography and left and right heart catheterization...
August 14, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28797353/clinical-outcomes-with-a-repositionable-self-expanding-transcatheter-aortic%C3%A2-valve%C3%A2-prosthesis-the-international-forward-study
#2
Eberhard Grube, Nicolas M Van Mieghem, Sabine Bleiziffer, Thomas Modine, Johan Bosmans, Ganesh Manoharan, Axel Linke, Werner Scholtz, Didier Tchétché, Ariel Finkelstein, Ramiro Trillo, Claudia Fiorina, Antony Walton, Christopher J Malkin, Jae K Oh, Hongyan Qiao, Stephan Windecker
BACKGROUND: Clinical outcomes in large patient populations from real-world clinical practice with a next-generation self-expanding transcatheter aortic valve are lacking. OBJECTIVES: This study sought to document the clinical and device performance outcomes of transcatheter aortic valve replacement (TAVR) with a next-generation, self-expanding transcatheter heart valve (THV) system in patients with severe symptomatic aortic stenosis (AS) in routine clinical practice...
August 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28794053/low-flow-severe-aortic-stenosis-evolving-role-of-transcatheter-aortic-valve-replacement
#3
REVIEW
Matthew D Saybolt, Paul N Fiorilli, Zachary M Gertz, Howard C Herrmann
The definition of severe aortic stenosis has classically and retrospectively been based on the natural history of patients with medically managed aortic stenosis and preserved left ventricular function in an era where surgical aortic valve replacement was the sole therapy. We now recognize that this disease is more heterogeneous and includes important subsets of patients with low stroke volume index (low flow) and low-gradient with reduced (classical) or preserved (paradoxical) ejection fraction. These patients pose diagnostic and treatment dilemmas, requiring a comprehensive assessment with integration of multimodality imaging, testing, and clinical assessment...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28774836/transcatheter-aortic-valve-replacement-through-transcaval-aortic-access-in-a-patient-with-duplicated-inferior-vena-cava-and-poor-iliofemoral-anatomy
#4
Zaher Fanari, Mohammad Al-Akchar, Hadi Mahmaljy, Sachin Goel, Nilesh J Goswami
Transthoracic (transapical and transaortic) access is inferior compared with femoral artery access. Percutaneous transcaval aortic access is a reasonable alternative approach that is being used in transcatheter aortic valve replacement (TAVR) in patients with poor iliofemoral anatomy. Duplicated Inferior vena cava (DIVC) is an uncommon abnormality. We report the case of 76-year-old lady with history of severe peripheral vascular disease, morbid obesity, diabetes, hypertension, hyperlipidemia and duplicated IVC that had severe symptomatic aortic stenosis...
July 1, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28756420/safety-and-feasibility-of-rotational-atherectomy-in-elderly-patients-with-severe-aortic-stenosis
#5
Matthew Lippmann, Jigar Patel, Jared Kvapil, David Westover, Michael Pierpoline, Peter Tadros, Mark Wiley, George Zorn, Greg Muehlebach, Ashwani Mehta, Eric Hockstad, Matthew Earnest, Kamal Gupta
BACKGROUND: Percutaneous coronary intervention (PCI) followed by transcatheter aortic valve replacement (TAVR) is an alternative to surgery in patients with severe aortic stenosis (AS) and coronary artery disease (CAD). In many, the coronary arteries are severely calcified and best treated with rotational atherectomy (RA). However, RA is not routinely performed in severe AS patients due to safety concerns. There is a paucity of data on the safety of RA in severe AS patients with calcific CAD...
August 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#6
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28728688/transcatheter-versus-surgical-aortic%C3%A2-valve%C3%A2-replacement-propensity-matched-comparison
#7
J Matthew Brennan, Laine Thomas, David J Cohen, David Shahian, Alice Wang, Michael J Mack, David R Holmes, Fred H Edwards, Naftali Z Frankel, Suzanne J Baron, John Carroll, Vinod Thourani, E Murat Tuzcu, Suzanne V Arnold, Roberta Cohn, Todd Maser, Brenda Schawe, Susan Strong, Allen Stickfort, Elizabeth Patrick-Lake, Felicia L Graham, Dadi Dai, Fan Li, Roland A Matsouaka, Sean O'Brien, Fan Li, Michael J Pencina, Eric D Peterson
BACKGROUND: Randomized trials support the use of transcatheter aortic valve replacement (TAVR) for the treatment of aortic stenosis in high- and intermediate-risk patients, but the generalizability of those results in clinical practice has been challenged. OBJECTIVES: The aim of this study was to determine the safety and effectiveness of TAVR versus surgical aortic valve replacement (SAVR), particularly in intermediate- and high-risk patients, in a nationally representative real-world cohort...
July 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28728657/frequency-timing-and-impact-of-access-site-and-non-access-site-bleeding%C3%A2-on-mortality-among-patients%C3%A2-undergoing-transcatheter-aortic%C3%A2-valve%C3%A2-replacement
#8
Raffaele Piccolo, Thomas Pilgrim, Anna Franzone, Marco Valgimigli, Alan Haynes, Masahiko Asami, Jonas Lanz, Lorenz Räber, Fabien Praz, Bettina Langhammer, Eva Roost, Stephan Windecker, Stefan Stortecky
OBJECTIVES: The aim of this study was to examine the frequency, timing, and association of access-site and non-access-site bleeding with mortality in the setting of transcatheter aortic valve replacement (TAVR) during long-term follow-up. BACKGROUND: Bleeding is frequent and associated with impaired prognosis in patients undergoing TAVR. It is currently unknown whether the site of bleeding differentially influences the outcomes of TAVR patients. METHODS: In total, 926 consecutive patients undergoing TAVR from 2007 through 2014 were evaluated...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28728656/the-prognostic-effects-of-coronary-disease-severity-and-completeness-of-revascularization-on-mortality-in-patients-undergoing-transcatheter-aortic-valve-replacement
#9
Guy Witberg, Ehud Regev, Shmuel Chen, Abbid Assali, Israel M Barbash, David Planer, Hana Vaknin-Assa, Victor Guetta, Vojislav Vukasinovic, Katia Orvin, Haim D Danenberg, Amit Segev, Ran Kornowski
OBJECTIVES: The study sought to examine the effect of coronary artery disease (CAD) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: CAD is common in the TAVR population. However, there are conflicting data on the prognostic significance of CAD and its treatment in this population. METHODS: The authors analyzed 1,270 consecutive patients with severe aortic stenosis (AS) undergoing TAVR at 3 Israeli centers...
July 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28701528/blood-pressure-and-arterial-load-after-transcatheter-aortic-valve-replacement-for-aortic-stenosis
#10
MULTICENTER STUDY
Brian R Lindman, Catherine M Otto, Pamela S Douglas, Rebecca T Hahn, Sammy Elmariah, Neil J Weissman, William J Stewart, Girma M Ayele, Feifan Zhang, Alan Zajarias, Hersh S Maniar, Hasan Jilaihawi, Eugene Blackstone, Khaja M Chinnakondepalli, E Murat Tuzcu, Martin B Leon, Philippe Pibarot
BACKGROUND: After aortic valve replacement, left ventricular afterload is often characterized by the residual valve obstruction. Our objective was to determine whether higher systemic arterial afterload-as reflected in blood pressure, pulsatile and resistive load-is associated with adverse clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS AND RESULTS: Total, pulsatile, and resistive arterial load were measured in 2141 patients with severe aortic stenosis treated with TAVR in the PARTNER I trial (Placement of Aortic Transcatheter Valve) who had systolic blood pressure (SBP) and an echocardiogram obtained 30 days after TAVR...
July 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28698259/reversibility-of-cardiac-function-predicts-outcome-after-transcatheter-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis
#11
Kimi Sato, Arnav Kumar, Brandon M Jones, Stephanie L Mick, Amar Krishnaswamy, Richard A Grimm, Milind Y Desai, Brian P Griffin, L Leonardo Rodriguez, Samir R Kapadia, Nancy A Obuchowski, Zoran B Popović
BACKGROUND: Reversibility of left ventricular (LV) dysfunction in high-risk aortic stenosis patient and its impact on survival after transcatheter aortic valve replacement (TAVR) are unclear. We aimed to evaluate longitudinal changes of LV structure and function after TAVR and their impact on survival. METHODS AND RESULTS: We studied 209 patients with aortic stenosis who underwent TAVR from May 2006 to December 2012. Echocardiograms were used to calculate LV end-diastolic volume index (LVEDVi), LV ejection fraction, LV mass index (LVMi), and global longitudinal strain before, immediately (<10 days), late (1-3 months), and yearly after TAVR...
July 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28666614/multimodality-imaging-for-planning-and-follow-up-of-transcatheter-aortic-valve-replacement
#12
REVIEW
Jeanette Soon, Philippe Pibarot, Philipp Blanke, Mickael Ohana, Jonathon Leipsic
The complementary modalities of Doppler echocardiography and multidetector computed tomography are most frequently used for the planning and follow-up of transcatheter aortic valve replacement (TAVR). TAVR is now a well-established modality in the treatment of high-risk and inoperable patients with symptomatic severe aortic stenosis. Furthermore, recent studies have shown that TAVR is equivalent or superior to surgical aortic valve replacement in patients at intermediate surgical risk. We review the most commonly used imaging modalities and discuss their respective strengths and contributions to optimal patient selection, procedure planning, implementation, and follow-up in TAVR...
April 4, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28662835/ct-angiography-to-evaluate-coronary-artery-disease-and-revascularization-requirement-before-trans-catheter-aortic-valve-replacement
#13
Alexia Rossi, Carlo N De Cecco, Simon R O Kennon, Lu Zou, Felix G Meinel, William Toscano, Sabrina Segreto, Stephan Achenbach, Jörg Hausleiter, U Joseph Schoepf, Francesca Pugliese
BACKGROUND: Coronary artery disease (CAD) and aortic stenosis share pathophysiological mechanisms and risk factors. We evaluated the clinical utility of coronary computed tomography angiography (CTA) to identify CAD and revascularization requirement in patients with severe aortic stenosis considered for transcatheter aortic valve replacement (TAVR). METHODS: Consecutive patients without known CAD underwent calcium scoring, CTA and invasive coronary angiography (ICA)...
June 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28662806/temporal-trends-in-transcatheter-aortic%C3%A2-valve-replacement-in-france-france-2-to-france-tavi
#14
MULTICENTER STUDY
Vincent Auffret, Thierry Lefevre, Eric Van Belle, Hélène Eltchaninoff, Bernard Iung, René Koning, Pascal Motreff, Pascal Leprince, Jean Philippe Verhoye, Thibaut Manigold, Geraud Souteyrand, Dominique Boulmier, Patrick Joly, Frédéric Pinaud, Dominique Himbert, Jean Philippe Collet, Gilles Rioufol, Said Ghostine, Olivier Bar, Alain Dibie, Didier Champagnac, Lionel Leroux, Frédéric Collet, Emmanuel Teiger, Olivier Darremont, Thierry Folliguet, Florence Leclercq, Thibault Lhermusier, Patrick Olhmann, Bruno Huret, Luc Lorgis, Laurent Drogoul, Bernard Bertrand, Christian Spaulding, Laurent Quilliet, Thomas Cuisset, Maxence Delomez, Farzin Beygui, Jean-Philippe Claudel, Alain Hepp, Arnaud Jegou, Antoine Gommeaux, Anfani Mirode, Luc Christiaens, Charles Christophe, Claude Cassat, Damien Metz, Lionel Mangin, Karl Isaaz, Laurent Jacquemin, Philippe Guyon, Christophe Pouillot, Serge Makowski, Vincent Bataille, Josep Rodés-Cabau, Martine Gilard, Hervé Le Breton
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is standard therapy for patients with severe aortic stenosis who are at high surgical risk. However, national data regarding procedural characteristics and clinical outcomes over time are limited. OBJECTIVES: The aim of this study was to assess nationwide performance trends and clinical outcomes of TAVR during a 6-year period. METHODS: TAVRs performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (French Transcatheter Aortic Valve Implantation) registry...
July 4, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28658491/health-status-benefits-of-transcatheter-vs-surgical-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis-at-intermediate-surgical-risk-results-from-the-partner-2-randomized-clinical-trial
#15
Suzanne J Baron, Suzanne V Arnold, Kaijun Wang, Elizabeth A Magnuson, Khaja Chinnakondepali, Raj Makkar, Howard C Herrmann, Susheel Kodali, Vinod H Thourani, Samir Kapadia, Lars Svensson, David L Brown, Michael J Mack, Craig R Smith, Martin B Leon, David J Cohen
Importance: In patients with severe aortic stenosis (AS) at intermediate surgical risk, treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in similar 2-year survival. The effect of TAVR vs SAVR on health status in patients at intermediate surgical risk is unknown. Objective: To compare health-related quality of life among intermediate-risk patients with severe AS treated with either TAVR or SAVR. Design, Setting, and Participants: Between December 2011 and November 2013, 2032 intermediate-risk patients with severe AS were randomized to TAVR with the Sapien XT valve or SAVR in the Placement of Aortic Transcatheter Valve 2 Trial and were followed up for 2 years...
August 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#16
S Chava, G Gentchos, A Abernethy, B Leavitt, E Terrien, H L Dauerman
Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...
August 2017: Journal of Thrombosis and Thrombolysis
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
#17
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...
August 1, 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
#18
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
#19
RANDOMIZED CONTROLLED TRIAL
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
#20
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. 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 from January 1, 2005, through December 31, 2014, were included in our comparative analysis...
June 14, 2017: American Journal of Medicine
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