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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/29332374/transcatheter-aortic-valve-replacement-in-bicuspid-aortic-valve-stenosis-where-do-we-stand
#1
Sung-Han Yoon, Rahul Sharma, Tarun Chakravarty, Masaki Miyasaka, Tomoki Ochiai, Takahiro Nomura, Norman Gellada, Shadi Nemanpour, Mamoo Nakamura, Wen Chen, Raj Makkar
Bicuspid aortic valve is the most common congenital cardiac defect in adults, and symptom typically develops in adulthood. In the majority of cases, bicuspid aortic valve disease progress with ages and surgical aortic valve replacement is performed with excellent operative outcomes. However, with the relatively slow progression of disease, surgical aortic valve replacement is required in elderly patients but the surgical risk often deemed extremely high due to old age and multiple comorbidities. Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for intermediate- and high-risk patients with symptomatic severe aortic valve stenosis (AS)...
January 11, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29326776/aorto-right-ventricular-fistula-following-percutaneous-transcatheter-aortic-valve-replacement-case-report-and-literature-review
#2
Monoj K Konda, Jagadeesh K Kalavakunta, Jerry W Pratt, David Martin, Vishal Gupta
An 88-year-old woman with a prior history of aortic stenosis and history of valvuloplasty presented with worsening symptoms of heart failure and dizziness. She underwent successful transcatheter aortic valve replacement (TAVR) without complications. Follow-up echocardiograms revealed a small fistula connecting aorta to the right ventricle. The patient was initially asymptomatic but 3 months later developed overload of the right ventricle and heart failure and chose to continue medical therapy. She died of progressive heart failure at 9 months from onset of fistula...
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29314625/long-term-pacemaker-dependency-and-impact-of-pacing-on-mortality-following-transcatheter-aortic-valve-replacement-with-the-lotus-valve
#3
Mohammad Alasti, Hashrul Rashid, Karthikeyan Rangasamy, Emily Kotschet, David Adam, Jeff Alison, Robert Gooley, Sarah Zaman
OBJECTIVES: To determine permanent pacemaker (PPM) dependency following transcatheter aortic valve replacement (TAVR) with the Lotus™ valve system (Boston Scientific), and the impact of PPM implantation on long-term morbidity and mortality. BACKGROUND: Conduction abnormalities are among the most common complications following TAVR. Limited studies have assessed pacing dependency following TAVR. METHODS: Consecutive patients (n = 166) with severe aortic stenosis who underwent TAVR with the Lotus valve system were prospectively recruited from a single-center...
January 4, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29314570/transubclavian-approach-a-competitive-access-for-transcatheter-aortic-valve-implantation-as-compared-to-transfemoral
#4
Ignacio J Amat-Santos, Paol Rojas, Hipólito Gutiérrez, Silvio Vera, Javier Castrodeza, Javier Tobar, L Renier Goncalves-Ramirez, Manuel Carrasco, Pablo Catala, José A San Román
AIMS: Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence. METHODS: We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017...
January 3, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29310382/the-safety-of-concomitant-transcatheter-aortic-valve-replacement-and-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#5
Yong Yang, Fang-Yang Huang, Bao-Tao Huang, Tian-Yuan Xiong, Xiao-Bo Pu, Shi-Jian Chen, Mao Chen, Yuan Feng
BACKGROUND: TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Significant coronary artery disease (CAD) is present in 40% to 75% of patients undergoing TAVR. However, when to treat the concomitant coronary artery lesions is controversial. METHODS: This is a systematic review comparing concomitant PCI and TAVR versus staged PCI and TAVR. The OVID database was systematically searched for studies reporting PCI in patients undergoing TAVR...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#6
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302950/use-of-impella-5-0-prior-to-transcatheter-aortic-valve-replacement-in-a-patient-with-severe-aortic-stenosis-and-cardiogenic-shock
#7
Dustin W Johnson, John P ErwinIII
The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc., Danvers, MA, USA), has also increased. These devices provide superior hemodynamic effects compared to intra-aortic balloon pumping...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29301644/sex-specific-outcomes-of-transcatheter%C3%A2-aortic-valve-replacement-with-the-sapien-3-valve-insights-from-the-partner-ii-s3-high-risk-and-intermediate-risk-cohorts
#8
Molly Szerlip, Sarah Gualano, Elizabeth Holper, John J Squiers, Jonathon M White, Darshan Doshi, Mathew R Williams, Rebecca T Hahn, John G Webb, Lars G Svensson, Ajay J Kirtane, David J Cohen, Pamela S Douglas, Maria C Alu, Aaron Crowley, E Murat Tuzcu, Raj R Makkar, Howard C Herrmann, Vasilis Babaliaros, Vinod H Thourani, Martin B Leon, Susheel K Kodali, Michael J Mack
OBJECTIVES: The purpose of this study was to identify sex-specific outcomes of intermediate risk patients undergoing transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: A survival difference has been observed in women as compared with men in inoperable and high-risk patients receiving early-generation balloon-expandable valves for transcatheter aortic valve replacement (TAVR). Whether a sex-specific outcome difference persists with newer-generation valves and in lower-risk patients is unknown...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29301640/1-year-clinical-outcomes-in-women-after-transcatheter-aortic-valve-replacement-results-from-the-first-win-tavi-registry
#9
Alaide Chieffo, Anna Sonia Petronio, Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuele Meliga, Nicholas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Samin Sharma, Maria Cruz Ferrer, Christoph Naber, Peter Kievit, Usman Baber, Clayton Snyder, Madhav Sharma, Marie Claude Morice, Roxana Mehran
OBJECTIVES: This study sought to examine the safety and performance of contemporary transcatheter aortic valve replacement (TAVR) in an exclusive all-women TAVR population, and to further investigate the potential impact of female sex-specific characteristics on composite 1-year clinical outcomes. BACKGROUND: Women comprise ≥50% patients undergoing TAVR. Several data have shown the noninferiority of TAVR compared with surgical aortic valve replacement for symptomatic significant aortic stenosis, but no study so far has been specifically powered to detect differences by sex...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#10
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29290898/first-in-man-implantation-of-the-retrievable-and-repositionable-venusa-plus-valve
#11
Xian-Bao Liu, Yu-Xin He, Chun-Hui Liu, Li-Han Wang, Feng Gao, Lei Yu, Ai-Qiang Dong, Min-Jian Kong, Ji-Fang Chen, Yong Xu, Qi-Jing Zhou, Min Yan, Jian-An Wang
BACKGROUND: No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve. METHODS: A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk (STS 13.8%) was recommended for transcatheter aortic valve replacement (TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29285810/von-willebrand-factor-revisited
#12
Senan J Yasar, Obai Abdullah, William Fay, Sudarshan Balla
Degenerative aortic valve stenosis is the most common valvular heart disease seen in developed countries. Since the implementation of transcatheter aortic valve replacement, there has been a surge of efforts to improve procedural technique as well as reduce mortality. Until recently, the mainstay method of assessment of valve implantation as well as paravalvular regurgitation has relied heavily on imaging techniques including transesophageal echocardiography and aortic root angiography. There has been a lot of scientific inquiry to identify biomarkers in the management of patients with aortic stenosis...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29285803/balloon-aortic-valvuloplasty-to-improve-candidacy-of-patients-evaluated-for-transcatheter-aortic-valve-replacement
#13
Mani Arsalan, Samir Khan, Jake Golman, Molly Szerlip, Cecile Mahoney, Morley Herbert, David Brown, Michael Mack, Elizabeth M Holper
OBJECTIVES: Evaluate the role of balloon aortic valvuloplasty (BAV) in improving candidacy of patients for transcatheter aortic valve replacement (TAVR). BACKGROUND: Patients who are not candidates for TAVR may undergo BAV to improve functional and clinical status. METHODS: 117 inoperable or high-risk patients with critical aortic stenosis underwent BAV as a bridge-to-decision for TAVR. Frailty measures including gait speed, serum albumin, hand grip, activities of daily living (ADL); and NYHA functional class before and after BAV were compared...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29284509/should-high-risk-patients-with-concomitant-severe-aortic-stenosis-and-mitral-valve-disease-undergo-double-valve-surgery-in-the-tavr-era
#14
Pey-Jen Yu, Allan Mattia, Hugh A Cassiere, Rick Esposito, Frank Manetta, Nina Kohn, Alan R Hartman
BACKGROUND: Significant mitral regurgitation in patients undergoing transcatheter aortic valve replacement (TAVR) is associated with increased mortality. The aim of this study is to determine if surgical correction of both aortic and mitral valves in high risk patients with concomitant valvular disease would offer patients better outcomes than TAVR alone. METHODS: A retrospective analysis of 43 high-risk patients who underwent concomitant surgical aortic valve replacement and mitral valve surgery from 2008 to 2012 was performed...
December 29, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29281606/expanding-indications-for-tavr-the-preferred-procedure-in-intermediate-risk-patients
#15
REVIEW
David L Brown
Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29260369/predictors-of-right-ventricular-pacing-and-pacemaker-dependence-in-transcatheter-aortic-valve-replacement-patients
#16
Esseim Sharma, Antony F Chu
PURPOSE: Transcatheter aortic valve replacement (TAVR) is an increasingly prevalent therapy in patients with severe symptomatic aortic stenosis. Conduction disturbances requiring permanent pacemaker (PPM) implantation are a known complication of TAVR. This study investigated the progression of cardiac conduction disease in the post-TAVR pacemaker population and identified predictors of post-TAVR right ventricular (RV) pacing dependence. METHODS: Prospectively collected echocardiographic, ECG, and PPM interrogation data of 262 consecutive patients who underwent TAVR with placement of a balloon-expandable valve at one institution from March 2012 to October 2016 were analyzed...
December 19, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29251657/transcatheter-aortic-valve-replacement-optimizing-outcomes-for-healthy-recovery
#17
Kashish Goel, David R Holmes
Transcatheter aortic valve replacement (TAVR) has been approved in the United States for intermediate and high-risk patients with severe symptomatic aortic stenosis. More than 80 000 TAVR procedures have been performed in the United States and the number is growing every year. Two valve designs are approved in the United States including the balloon expandable Edwards Sapien prosthesis and self-expanding CoreValve prosthesis. The PARTNER trial of the Sapien valve, involving patients who were considered inoperable, reported a 19% absolute risk reduction in mortality compared with medical therapy, with a number needed to treat of 5...
December 14, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29251358/acute-kidney-injury-post-transcatheter-aortic-valve-replacement
#18
REVIEW
Pradhum Ram, Kenechukwu Mezue, Gregg Pressman, Janani Rangaswami
Transcatheter aortic valve replacement (TAVR) is a treatment option in high-risk patients with severe aortic stenosis who are not surgical candidates. In light of emerging evidence, it is being increasingly performed even in intermediate-risk patients in recent years. Patients who develop acute kidney injury (AKI) following TAVR are known to have worse outcomes. The objective of this concise review was to identify the prevalence and the impact of AKI following TAVR on patient outcomes by including the most recent literature in our search...
December 18, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29247516/impact-of-coronary-artery-disease-in-patients-undergoing-transcatheter-aortic-valve-replacement-insights-from-the-france-2-registry
#19
Etienne Puymirat, Romain Didier, Hélène Eltchaninoff, Bernard Lung, Jean-Philippe Collet, Dominique Himbert, Eric Durand, Alain Leguerrier, Pascal Leprince, Jean Fajadet, Emmanuel Teiger, Karine Chevreul, Michel Lièvre, Didier Tchetché, Florence Leclercq, Stéphan Chassaing, Hervé Le Breton, Patrick Donzeau-Gouge, Thierry Lefèvre, Didier Carrié, Martine Gillard, Didier Blanchard
BACKGROUND: Coronary artery disease (CAD) is common in patients undergoing transcatheter aortic valve replacement (TAVR). However, the impact of CAD distribution before TAVR on short- and long-term prognosis remains unclear. HYPOTHESIS: We hypothesized that the long-term clinical impact differs according to CAD distribution in patients undergoing TAVR using the FRench Aortic National CoreValve and Edwards (FRANCE-2) registry. METHODS: FRANCE-2 is a national French registry including all consecutive TAVR performed between 2010 and 2012 in 34 centers...
December 16, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29246428/comparison-of-procedural-clinical-and-valve-performance-results-of-transcatheter-aortic-valve-replacement-in-patients-with-bicuspid-versus-tricuspid-aortic-stenosis
#20
Yan-Biao Liao, Yi-Jian Li, Tian-Yuan Xiong, Yuan-Weixiang Ou, Wen-Yu Lv, Jia-Ling He, Yi-Ming Li, Zhen-Gang Zhao, Xin Wei, Yuan-Ning Xu, Yuan Feng, Mao Chen
BACKGROUND: Limited date describing the procedural, clinical and valve performance results of transcatheter aortic valve replacement (TAVR) in patients with bicuspid versus tricuspid aortic stenosis (TAV). METHODS: Procedural and clinical results were defined and reported according to VARC-2 criteria. RESULTS: Consecutive 87 patients with BAV and 70 patients with TAV were included. Compared to patients with TAV, patients with BAV had similar incidence of second valve implantation (14...
December 9, 2017: International Journal of Cardiology
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