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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28211605/end-stage-renal-disease-and-severe-aortic-stenosis-does-valve-replacement-improve-one-year-outcomes
#1
Jose F Condado, Aneel Maini, Bradley Leshnower, Vinod Thourani, Jessica Forcillo, Chandan Devireddy, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Amy Simone, Patricia Keegan, Stamatios Lerakis, Peter C Block, Vasilis Babaliaros
BACKGROUND: Treatment for patients with end-stage renal disease (ESRD) and severe aortic stenosis (AS) includes balloon aortic valvuloplasty (BAV), surgical (SAVR), or transcatheter (TAVR) aortic valve replacement. We compared outcomes among these strategies. METHODS: A retrospective review of patients with ESRD undergoing treatment for severe AS between 07/2007 and 06/2015 was performed at our center. Patients were classified based on treatment: BAV-only, TAVR, or SAVR...
February 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28146260/quality-of-life-outcomes-after-transcatheter-aortic-valve-replacement-in-an-unselected-population-a-report-from-the-sts-acc-transcatheter-valve-therapy-registry
#2
Suzanne V Arnold, John A Spertus, Sreekanth Vemulapalli, Zhuokai Li, Roland A Matsouaka, Suzanne J Baron, Amit N Vora, Michael J Mack, Matthew R Reynolds, John S Rumsfeld, David J Cohen
Importance: In clinical trials, transcatheter aortic valve replacement (TAVR) has been shown to improve symptoms and quality of life. As this technology moves into general clinical practice, evaluation of the health status outcomes among unselected patients treated with TAVR is of critical importance. Objective: To examine the short- and long-term health status outcomes of surviving patients after TAVR in the context of an unselected population. Design, Setting, and Participants: This observational cohort study included patients with severe aortic stenosis who underwent TAVR in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy (TVT) Registry from November 1, 2011, to March 31, 2016, at more than 450 clinical sites...
February 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28145039/procedural-and-30-day-clinical-outcomes-following-transcatheter-aortic-valve-replacement-with-lotus-valve-results-of-the-relevant-study
#3
Rocco A Montone, Luca Testa, Chiara Fraccaro, Matteo Montorfano, Fausto Castriota, Roberto Nerla, Marco Angelillis, Maurizio Tusa, Francesco Giannini, Andrea Garatti, Giuseppe Tarantini, Anna Sonia Petronio, Nedy Brambilla, Francesco Bedogni
OBJECTIVES: We report procedural and 30-day clinical outcomes following transcatheter aortic valve replacement (TAVR) with Lotus Valve system in a high-risk population. BACKGROUND: Lotus valve is a second-generation TAVR fully repositionable and retrievable device. RELEVANT (REgistry of Lotus valvE for treatment of aortic VAlve steNosis with Tavr) study is an Italian prospective multicentre registry. METHODS: Five major centers performing TAVR using Lotus participated...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28106026/successful-simultaneous-ipsilateral-stenting-of-common-iliac-artery-stenosis-and-transfemoral-aortic-valve-replacement
#4
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/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#5
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#6
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#7
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088437/safety-and-feasibility-of-pci-in-patients-undergoing-tavr-a-systematic-review-and-meta-analysis
#8
REVIEW
Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28077468/integrated-imaging-of-echocardiography-and-computed-tomography-to-grade-mitral-regurgitation-severity-in-patients-undergoing-transcatheter-aortic-valve-implantation
#9
Philippe J van Rosendael, Suzanne E van Wijngaarden, Vasileios Kamperidis, William K F Kong, Melissa Leung, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. METHODS AND RESULTS: Systolic MDCT data of 73 patients, referred for transcatheter aortic valve implantation (TAVI) who also had MR, were evaluated...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28075036/double-trouble-a-case-of-periprocedural-detection-of-intracardiac-thrombus-and-aortic-root-dissection-during-emergent-transfemoral-tavr
#10
Carlos Corredor, Eric Horlick, Wendy Tsang, Massimiliano Meineri
We report a case of emergency transcatheter aortic valve replacement (TAVR) in a 65-year-old patient presenting with decompensated severe aortic stenosis. Transesophageal echocardiography (TEE) was used effectively to obtain measurements of the aortic annulus and for intra-procedural guidance. At baseline, we detected a left atrial appendage thrombus and a localized aortic root dissection after balloon valvuloplasty. The case highlights the important role that TEE may play during TAVR procedures.
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28064153/comparison-of-valve-performance-of-the-mechanically-expanding-lotus-and-the-balloon-expanded-sapien3-transcatheter-heart-valves-an-observational-study-with-independent-core-laboratory-analysis
#11
Osama I I Soliman, Nahid El Faquir, Ben Ren, Ernest Spitzer, Lennart van Gils, Hans Jonker, Marcel L Geleijnse, Gerrit-Anne van Es, Jan G Tijssen, Nicolas M van Mieghem, Peter P T de Jaegere
AIMS: The Lotus and SAPIEN3 are second-generation transcatheter heart valves, which are designed to minimize paravalvular aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR). We sought to compare both devices for valve performance and with emphasis on PAR by independent core laboratory analysis. METHODS AND RESULTS: A total of 162 (79 Lotus and 83 SAPIEN3) consecutive patients (51% female, 80 ± 8 years, Logistic EuroSCORE 14.8 ± 9...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28061996/comparative-outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-for-aortic-stenosis-in-nonagenarians
#12
Chad J Zack, Fahad Al-Qahtani, Akram Kawsara, Mohammed Al-Hijji, Ali Hama Amin, Mohamad Alkhouli
Transcatheter aortic valve replacement (TAVR) emerged as a promising alternative to surgical aortic valve replacement (SAVR) in extreme-aged patients with severe aortic stenosis (AS). Data on the outcomes of TAVR or SAVR in nonagenarians are limited. The Nationwide Inpatient Sample was used to identify patients aged 90 years or older who underwent TAVR or SAVR from 2004 to 2013. In-hospital morbidity and mortality were assessed. From 2004 to 2013, 9,066 (national estimate) nonagenarians underwent aortic valve replacement...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28052455/echocardiographic-follow-up-after-transcatheter-aortic-valve-replacement
#13
REVIEW
Vladislavs Sokalskis, Denisa Muraru, Chiara Fraccaro, Massimo Napodano, Augusto D'Onofrio, Giuseppe Tarantini, Luigi Paolo Badano
The use of transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis has rapidly increased during the past years. Accordingly, more and more patients are referred for a follow-up echocardiographic study after TAVR. However, the echocardiographic evaluation of patients who underwent TAVR places specific demands on echocardiographers. Furthermore, TAVR may be associated with new types of complications, which are frequently unrecognized or underestimated due to lack of familiarity with the normal and pathological appearance of TAVR...
January 3, 2017: Echocardiography
https://www.readbyqxmd.com/read/28043443/the-effect-of-initiation-of-a-transcatheter-aortic-valve-replacement-program-in-the-treatment-of-severe-aortic-stenosis
#14
Niv Ad, Sari D Holmes, Deborah J Shuman, Anthony J Rongione, Paul S Massimiano, Alan M Speir, Graciela Pritchard, Shahram Yazdani, Bryan D Raybuck
We assessed the effect of a transcatheter aortic valve replacement (TAVR) program and Heart Team concept on our approach to severe isolated symptomatic aortic stenosis (AS) with regard to surgical practice, patient selection, perioperative outcomes, 1-year survival, and AVR volume. TAVR program began in August 2011. Patients having isolated surgical AVR between January 2008 and August 2011, when the program began (n = 282, 42 months), were compared with those after the program began until February 2015 (n = 344, surgical AVR and n = 126, TAVR, 42 months)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041860/transcatheter-aortic-valve-replacement-for-bicuspid-aortic-stenosis-13years-post-heart-transplant
#15
Maureen B Julien, Nimesh Desai, Susan Brozena, Howard C Herrmann
Despite the widespread use of transcatheter aortic valve replacement (TAVR) for moderate and high-risk patients with severe aortic stenosis, it is utilized less frequently in patients with bicuspid aortic valves (BAV). Orthotopic heart transplant (OHT) donors tend to be younger and may have undiagnosed BAV. We present a case of successful TAVR in a patient with BAV thirteen years after OHT.
December 16, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28039604/socioeconomic-and-racial-disparities-a-case-control-study-of-patients-receiving-transcatheter-aortic-valve-replacement-for-severe-aortic-stenosis
#16
Anna Sleder, Shiloh Tackett, Matthew Cerasale, Chetan Mittal, Iyad Isseh, Ryhm Radjef, Andrew Taylor, Rashad Farha, Oleksandra Lupak, Dana Larkin, Lois Lamerato, George Divine, Kimberlydawn Wisdom, Kimberly Baker-Genaw, William O'Neill
BACKGROUND: We sought to quantify socioeconomic disparities in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) at an urban, tertiary referral center. METHODS: This retrospective case-control study identified 67 patients with severe AS (aortic valve [AV] area ≤1 cm(2) or AV area index ≤0.60 cm(2)/m(2) or AV velocity ≥40 mmHg) who underwent TAVR from November 5, 2013 to June 10, 2014. Study subjects were matched to controls with severe AS without TAVR in a 4:1 age-frequency match...
December 30, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28039339/concomitant-mitral-annular-calcification-and-severe-aortic-stenosis-prevalence-characteristics-and-outcome-following-transcatheter-aortic-valve-replacement
#17
Yigal Abramowitz, Yoshio Kazuno, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, David Anderson, Zev Allison, Geeteshwar Mangat, Wen Cheng, Ambarish Gopal, Hasan Jilaihawi, Michael J Mack, Raj R Makkar
AIMS: Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have certain similar etiology and pathophysiological mechanisms. MAC is frequently encountered in pre-procedural computed tomography (CT) imaging of patients that undergo transcatheter aortic valve replacement (TAVR), but its prognostic implications for these patients have not been thoroughly investigated. This study sought to evaluate the prevalence of MAC among patients with severe AS and to assess the clinical implications of MAC on these patients during and following TAVR...
December 30, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28029207/prospective-comparison-between-three-tavr-devices-acurate-neo-vs-corevalve-vs-sapien-xt-a-single-heart-team-experience-in-patients-with-severe-aortic-stenosis
#18
Tannas Jatene, Antonio Castro-Filho, Rafael A Meneguz-Moreno, Dimytri A Siqueira, Alexandre A C Abizaid, Auristela I O Ramos, Magaly Arrais, David C S Le Bihan, Rodrigo B M Barretto, Adriana C Moreira, Amanda G M R Sousa, J Eduardo Sousa
OBJECTIVE: We sought to compare the new transcatheter aortic valve replacement (TAVR) device ACURATE neo (ACT) with the already established CoreValve (MCV) and SAPIEN XT (SXT) for the treatment of severe aortic stenosis (AS). BACKGROUND: Very few data on TAVR devices are available beyond MCV and SAPIEN and there is no previous study comparing ACT with MCV and SXT. METHODS: We prospectively evaluated consecutive patients who underwent transfemoral TAVR for the treatment of severe AS...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28009955/a-left-to-right-shunt-after-transfemoral-tavr-using-edwards-sapien-3
#19
Julius Steffen, Anton Köhler, Florian Schwarz, Sebastian Sadoni, Christian Hagl, Steffen Massberg, Martin Greif
Transcatheter aortic valve replacement (TAVR) is used for the treatment of aortic stenosis (AS). Besides major bleeding, conduction blocks, stroke or atrial fibrillation, complications include cardiac perforation with possible left-to-right-shunts. Herein is reported the sixth case of a left-to-right shunt in an 87-year-old man who underwent TAVR using a 29 mm Edwards SAPIEN S3 prosthesis to treat AS. Soon after the procedure, a small channel evolving from the right coronary cusp could be detected on echocardiography...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009944/suture-forces-for-closure-of-transapical-transcatheter-aortic-valve-replacement-a-mathematical-model
#20
Liang Ge, Henrik Haraldsson, Michael D Hope, David Saloner, Julius M Guccione, Mark B Ratcliffe, Elaine E Tseng
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis in intermediate, high-risk, and inoperable patients. TAVR has multiple access routes, including transfemoral (TF), transapical (TA), direct aortic (DA), axillary, transcarotid, and transcaval. The most commonly applied algorithm is a TF-first approach, where only when patients are unsuitable for TF are alternatives such as TA considered. An infrequent - but dreaded - risk is left ventricular (LV) apical bleeding from tearing or rupture with the TA approach...
July 2016: Journal of Heart Valve Disease
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