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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28441641/low-volume-contrast-ct-angiography-via-pulmonary-artery-injection-for-measurement-of-aortic-annulus-in-patients-undergoing-transcatheter-aortic-valve-replacement
#1
Vien T Truong, Joseph Choo, Luke McCoy, Adam Mussman, Stephanie Ambach, Dean Kereiakes, Ian Sarembock, Wojciech Mazur
OBJECTIVES: To investigate the feasibility and image quality of low-dose contrast computed tomography (CT) angiography with pulmonary artery (PA) protocol. BACKGROUND: Aortic stenosis is the most common valvular heart disease and transcatheter aortic valve replacement (TAVR) has evolved as an alternative method for surgical valve replacement in intermediate-risk and high-risk surgical patients. CT is essential for measurement of aortic annulus prior to TAVR. METHODS: Twenty patients underwent a low-dose contrast study with PA protocol and 20 patients underwent a traditional-dose study (traditional protocol)...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28437243/impact-of-pulmonary-hypertension-on-in-hospital-outcome-after-surgical-or-transcatheter-aortic-valve-replacement
#2
Anja Gutmann, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Wolfgang Bothe, Constantin von Zur Mühlen, Manfred Zehender, Jochen Reinöhl, Christoph Bode, Peter Stachon
AIMS: The impact of pulmonary hypertension (PH) on in-hospital outcome of either surgical (SAVR) or transcatheter aortic valve replacement (TAVR) was analyzed. METHODS AND RESULTS: Data from all 107,057 patients undergoing isolated SAVR or TAVR in Germany between 2007 and 2014 was provided by the German Federal Bureau of Statistics. About 18% of patients with aortic valve stenosis suffered from PH. Patients with PH had more co- morbidities with consequently increased EuroSCORE (TAVR without PH: 12...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28433492/is-tavr-ready-for-the-global-aging-population
#3
REVIEW
Travis Bergmann, Partho P Sengupta, Jagat Narula
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR)...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#4
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#5
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#6
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28410995/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-non-high-surgical-risk-severe-aortic-stenosis-a-systematic-review
#7
REVIEW
Tariq H Enezate, Arun Kumar, Mazen Abu Fadel, Mitul Patel, Ashraf Al Dadah, Jad Omran
OBJECTIVE: Transcatether aortic valve replacement (TAVR) has emerged as an acceptable alternative to surgical aortic valve replacement (SAVR) in patients with high-risk surgical profile. In this analysis, we compare both approaches in non-high surgical risk severe aortic stenosis. METHODS: Only studies comparing SAVR and TAVR and enrolling patients with low-intermediate risk were included from January 2000 through May 2016. Primary endpoints were assessed at 1 and 12months including: mortality, cerebrovascular accident (CVA) and myocardial infarction (MI)...
February 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28408203/surgeon-involvement-in-transcatheter-aortic-valve-replacement-in-the-united-states-a-2016-society-of-thoracic-surgeons-survey
#8
Joseph E Bavaria, Richard L Prager, Keith S Naunheim, Mark S Allen, Robert S D Higgins, Vinod H Thourani, Thomas E MacGillivray, Natalie Boden, Joseph F Sabik
BACKGROUND: The Society of Thoracic Surgeons (STS) surveyed cardiothoracic surgeon participants in its Adult Cardiac Surgery Database (ACSD) to learn the extent of surgeon involvement in transcatheter aortic valve replacement (TAVR) procedures. METHODS: An electronic survey was delivered to 2,594 surgeons in June 2016. When the survey closed 2 weeks later, 487 completed surveys had been submitted for a response rate of 18.8%. RESULTS: Among the 487 participants in the ACSD who responded to the survey, 410 (84...
April 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28400918/patient-selection-for-transcatheter-aortic-valve-replacement-a-combined-clinical-and-multimodality-imaging-approach
#9
REVIEW
Rosangela Cocchia, Antonello D'Andrea, Marianna Conte, Massimo Cavallaro, Lucia Riegler, Rodolfo Citro, Cesare Sirignano, Massimo Imbriaco, Maurizio Cappelli, Giovanni Gregorio, Raffaele Calabrò, Eduardo Bossone
Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28398671/transcatheter-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-evidence-from-a-meta-analysis
#10
Partha Sardar, Amartya Kundu, Saurav Chatterjee, Dmitriy N Feldman, Theophilus Owan, Nikolaos Kakouros, Ramez Nairooz, Linda A Pape, Ted Feldman, J Dawn Abbott, Sammy Elmariah
OBJECTIVES: We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. BACKGROUND: TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer data regarding efficacy of TAVR in intermediate-risk patients. METHODS: Databases were searched through April 30, 2016 for studies that compared TAVR with SAVR for the treatment of intermediate-risk patients with severe AS...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28391560/adjuvant-antithrombotic-therapy-in-tavr
#11
REVIEW
Ryan G O'Malley, Kenneth W Mahaffey, William F Fearon
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has developed into an important alternative to surgical aortic valve replacement (SAVR) for patients with severe aortic stenosis (AS). Adjuvant antithrombotic therapies are commonly used during and after TAVR to decrease the risk of valve thrombosis and thromboembolic cerebrovascular events (CVEs) but consequently increase the risk of bleeding. This article reviews the past and current clinical data regarding adjuvant antithrombotic therapies in TAVR...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28379981/improved-costs-and-outcomes-with-conscious-sedation-vs-general-anesthesia-in-tavr-patients-time-to-wake-up
#12
William Toppen, Daniel Johansen, Sohail Sareh, Josue Fernandez, Nancy Satou, Komal D Patel, Murray Kwon, William Suh, Olcay Aksoy, Richard J Shemin, Peyman Benharash
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become a commonplace procedure for the treatment of aortic stenosis in higher risk surgical patients. With the high cost and steadily increasing number of patients receiving TAVR, emphasis has been placed on optimizing outcomes as well as resource utilization. Recently, studies have demonstrated the feasibility of conscious sedation in lieu of general anesthesia for TAVR. This study aimed to investigate the clinical as well as cost outcomes associated with conscious sedation in comparison to general anesthesia in TAVR...
2017: PloS One
https://www.readbyqxmd.com/read/28376985/a-clinical-review-of-surgical-vs-transcatheter-aortic-valve-replacement-in-geriatric-patients
#13
Laura V Tsu, Andrew J Berry, Neda Krunic, Sarah Penny, Sonny Le
OBJECTIVE: To provide an up-to-date review of the available evidence regarding management of elderly patients after transcatheter aortic valve replacement (TAVR). DATA SOURCES: A PubMed search of articles published (September 1969-December 2016) was done using a combination of the following words: aortic valve stenosis, geriatric, elderly, transcatheter aortic valve replacement, surgical aortic valve replacement, transcatheter aortic valve implantation (TAVI), and dual antiplatelet therapy...
April 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28345211/3d-echocardiographic-analysis-of-aortic-annulus-for-transcatheter-aortic-valve-replacement-using-novel-aortic-valve-quantification-software-comparison-with-computed-tomography
#14
Anuj Mediratta, Karima Addetia, Diego Medvedofsky, Robert J Schneider, Eric Kruse, Atman P Shah, Sandeep Nathan, Jonathan D Paul, John E Blair, Takeyoshi Ota, Husam H Balkhy, Amit R Patel, Victor Mor-Avi, Roberto M Lang
BACKGROUND: With the increasing use of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS), computed tomography (CT) remains the standard for annulus sizing. However, 3D transesophageal echocardiography (TEE) has been an alternative in patients with contraindications to CT. We sought to (1) test the feasibility, accuracy, and reproducibility of prototype 3DTEE analysis software (Philips) for aortic annular measurements and (2) compare the new approach to the existing echocardiographic techniques...
May 2017: Echocardiography
https://www.readbyqxmd.com/read/28332218/changes-in-myocardial-deformation-after-transcatheter-and-surgical-aortic-valve-replacement
#15
REVIEW
Vinisha Garg, Jonathan K Ho, Gabriel Vorobiof
Speckle tracking echocardiography (STE) has emerged as a novel angle-independent modality in assessing myocardial velocity, deformation, and strain. Its role in assessing change before and after aortic valve replacement in patients with aortic stenosis (AS) has recently generated interest. This review summarizes the practical utility and clinical implications of myocardial deformation by STE after surgical or transcatheter aortic valve replacement (TAVR). Overall, atrial strain and ventricular strain as measured by STE improve after surgical and transcatheter aortic intervention in short- and long-term follow-up with evidence of a more pronounced acute improvement in patients who undergo TAVR...
March 23, 2017: Echocardiography
https://www.readbyqxmd.com/read/28330793/procedural-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-for-bicuspid-versus-tricuspid-aortic-valve-stenosis
#16
Sung-Han Yoon, Sabine Bleiziffer, Ole De Backer, Victoria Delgado, Takahide Arai, Johannes Ziegelmueller, Marco Barbanti, Rahul Sharma, Gidon Y Perlman, Omar K Khalique, Erik W Holy, Smriti Saraf, Florian Deuschl, Buntaro Fujita, Philipp Ruile, Franz-Josef Neumann, Gregor Pache, Masao Takahashi, Hidehiro Kaneko, Tobias Schmidt, Yohei Ohno, Niklas Schofer, William K F Kong, Edgar Tay, Daisuke Sugiyama, Hiroyuki Kawamori, Yoshio Maeno, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Shingo Kuwata, Gerald Yong, Hsien-Li Kao, Michael Lee, Hyo-Soo Kim, Thomas Modine, S Chiu Wong, Francesco Bedgoni, Luca Testa, Emmanuel Teiger, Christian Butter, Stephan M Ensminger, Ulrich Schaefer, Danny Dvir, Philipp Blanke, Jonathon Leipsic, Fabian Nietlispach, Mohamed Abdel-Wahab, Bernard Chevalier, Corrado Tamburino, David Hildick-Smith, Brian K Whisenant, Seung-Jung Park, Antonio Colombo, Azeem Latib, Susheel K Kodali, Jeroen J Bax, Lars Søndergaard, John G Webb, Thierry Lefèvre, Martin B Leon, Raj Makkar
BACKGROUND: Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is being increasingly performed. OBJECTIVES: From the Bicuspid AS TAVR multicenter registry, the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS were compared. METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity-score matching assembling 546 pairs of patients with similar baseline characteristics...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329317/patient-prosthesis-mismatch-in-new-generation-trans-catheter-heart-valves-a-propensity-score-analysis
#17
Alexis Theron, Johan Pinto, Dominique Grisoli, Karolina Griffiths, Erwan Salaun, Nicolas Jaussaud, Eléonore Ravis, Marc Lambert, Lyna Messous, Cecile Amanatiou, Thomas Cuisset, Vlad Gariboldi, Roch Giorgi, Gilbert Habib, Frederic Collart
Aims: When compared with the former Sapien XT (XT-THV), the Sapien 3 trans-catheter heart valve (S3-THV) embeds an outer annular sealing cuff to prevent para-valvular regurgitation (PVR). The consequences of this new feature on valve haemodynamics have never been evaluated. We aimed to compare both types of prostheses regarding patient-prosthesis mismatch (PPM). Methods and results: Patients who underwent a TAVR for aortic stenosis were retrospectively included...
February 27, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329200/clinical-trends-in-surgical-minimally-invasive-and-transcatheter-aortic-valve-replacement%C3%A2
#18
Tom C Nguyen, Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Nidal Ganim, Carson Hoffmann, Monica Justo, Anthony L Estrera, Richard W Smalling, Prakash Balan, Joseph Lamelas
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (MIAVR) have emerged as alternatives to surgical aortic valve replacement (SAVR) via traditional sternotomy. However, their effect on clinical practice remains unclear. The study's objective is to describe clinical trends between TAVR, MIAVR and SAVR in patients with severe aortic stenosis (AS). METHODS: This retrospective observational study analyzed trends in isolated severe aortic valve replacement (AVR) among three high volume TAVR, MIAVR and SAVR centres in the United States...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28326675/utilization-and-outcomes-of-transcatheter-aortic-valve-replacement-in-the-united-states-shortly-after-device-approval
#19
Michael N Young, Sammy Elmariah, Kevin F Kennedy, Ignacio Inglessis, Robert W Yeh
OBJECTIVE: The objective of this study was to assess the national uptake of TAVR, associated in-hospital outcomes, and the effect of procedural experience on outcomes in the first two years following device approval. BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a newly established therapy for high-risk patients with severe aortic stenosis. Evaluating the manner in which TAVR has disseminated into real-world practice is essential for understanding its impact on population health...
March 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28321002/five-year-outcomes-of-the-first-pivotal-clinical-trial-of-balloon-expandable-transcatheter-aortic-valve-replacement-in-japan-prevail-japan
#20
Yoshiki Sawa, Morimasa Takayama, Tsuyoshi Goto, Shuichiro Takanashi, Tatsuhiko Komiya, Tetsuya Tobaru, Koichi Maeda, Toru Kuratani, Yasushi Sakata
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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