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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28728688/transcatheter-versus-surgical-aortic%C3%A2-valve%C3%A2-replacement-propensity-matched-comparison
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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...
June 28, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
July 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
#18
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...
August 1, 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
#19
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
#20
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
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