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Aortic stenosis TAVR

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https://www.readbyqxmd.com/read/28941139/comparative-outcomes-of-transcatheter-aortic-valve-replacement-in-african-american-and-caucasian-patients-with-severe-aortic-stenosis
#1
Fahad Alqahtani, Sami Aljohani, Ahmad Almustafa, Mohammed Alhijji, Oluseun Ali, David R Holmes, Mohamad Alkhouli
BACKGROUND: Racial disparities in cardiovascular care have been extensively investigated. The introduction of transcatheter aortic valve replacement (TAVR) revolutionized the treatment of aortic stenosis (AS) in the last decade. Whether a racial disparity in the utilization and outcome of TAVR exists is unknown. METHODS: We utilized the nationwide inpatient sample (NIS) to compare utilization rates, and in-hospital outcomes of Caucasians and African American (AA) patients who underwent TAVR between August 2011 and December 2014...
September 23, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#2
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28934519/intra-pericardial-use-of-recombinant-factor-viia-in-a-patient-with-acute-hemorrhagic-pericardial-effusion-following-transcutaneous-aortic-valve-replacement-a-case-report
#3
Vanya Jaitly, Kimberly Klein, Hlaing Tint, Alice Chen, Paul Allison, Bindu Akkanti, Pranav Loyalka, Brian Castillo
Perioperative bleeding can be a serious life-threatening complication in adult patients undergoing cardiac surgery, given the older age and additional comorbidities present in this patient population. The standard treatment options include transfusion of blood components and surgical re-exploration. We report the first case of an elderly female patient treated with local administration of recombinant factor VIIa (rFVIIa) for intractable hemorrhagic pericardial effusion, which developed following a transcutaneous aortic valve replacement (TAVR) procedure for severe aortic stenosis...
August 1, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28903993/mitral-regurgitation-in-patients-with-severe-aortic-stenosis-diagnosis-and-management
#4
REVIEW
Anna Sannino, Paul A Grayburn
Severe aortic stenosis (AS) and mitral regurgitation (MR) frequently coexist. Although some observational studies have reported that moderate or severe MR is associated with higher mortality, the optimal management of such patients is still unclear. Simultaneous replacement of both aortic and mitral valves is linked to significantly higher morbidity and mortality. Recent advances in minimally invasive surgical or transcatheter therapies for MR allow for staged procedures in which surgical or transcatheter aortic valve replacement (SAVR/TAVR) is done first and MR severity re-evaluated afterwards...
September 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28895294/pathology-of-self-expanding-transcatheter-aortic-valves-findings-from-the-corevalve-us-pivotal-trials
#5
Kazuyuki Yahagi, Sho Torii, Elena Ladich, Robert Kutys, Maria E Romero, Hiroyoshi Mori, Frank D Kolodgie, Jeffrey J Popma, Renu Virmani, Aloke V Finn
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has recently become an alternative to surgical aortic valve replacement for patients with severe aortic stenosis. However, paravalvular leaks, possible leaflet thrombosis, and device durability following TAVR remain unresolved issues. METHODS AND RESULTS: We conducted the first systematic microscopic and macroscopic pathologic analysis of self-expanding CoreValve transcatheter aortic valves removed at autopsy or surgically from the U...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28895061/valvular-heart-disease-in-women-differential-remodeling-and-response-to-new-therapies
#6
REVIEW
Jaya Chandrasekhar, George Dangas, Roxana Mehran
In the United States, valvular heart disease (VHD) has a prevalence of 2.5%, most commonly presenting as aortic stenosis (AS) or mitral valve regurgitation (MR) and increasingly observed to be of a degenerative etiology. Women frequently have latent symptoms despite significant disease, and it is therefore pertinent to consider both clinical symptoms and imaging findings for decision-making on treatment. Indeed, significant advances have been made in noninvasive imaging allowing for more accurate diagnosis and disease prognostication...
September 11, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28893961/conduction-disturbances-after-transcatheter-aortic-valve-replacement-current-status-and-future-perspectives
#7
REVIEW
Vincent Auffret, Rishi Puri, Marina Urena, Chekrallah Chamandi, Tania Rodriguez-Gabella, François Philippon, Josep Rodés-Cabau
Transcatheter aortic valve replacement (TAVR) has become a well-accepted option for treating patients with aortic stenosis at intermediate to high or prohibitive surgical risk. TAVR-related conduction disturbances, mainly new-onset left bundle-branch block and advanced atrioventricular block requiring permanent pacemaker implantation, remain the most common complication of this procedure. Furthermore, improvements in TAVR technology, akin to the increasing experience of operators/centers, have translated to a major reduction in periprocedural complications, yet the incidence of conduction disturbances has remained relatively high, with perhaps an increasing trend over time...
September 12, 2017: Circulation
https://www.readbyqxmd.com/read/28886850/transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-lower-surgical-risk-patients-with-chronic-obstructive-pulmonary-disease
#8
Vincent Auffret, Victor Becerra Munoz, Aurélie Loirat, Eric Dumont, Hervé Le Breton, Jean-Michel Paradis, Daniel Doyle, Robert De Larochellière, Siamak Mohammadi, Jean-Philippe Verhoye, François Dagenais, Marc Bedossa, Dominique Boulmier, Guillaume Leurent, Lluis Asmarats, Ander Regueiro, Chekrallah Chamandi, Tania Rodriguez-Gabella, Emile Voisine, Anne-Sophie Moisan, Martin Thoenes, Mélanie Côté, Rishi Puri, Pierre Voisine, Josep Rodés-Cabau
Respiratory complications are a major factor contributing to postoperative morbidity and mortality, especially in patients with chronic obstructive pulmonary disease (COPD). Our objective was to compare the rate of respiratory complications in patients with COPD with severe aortic stenosis who underwent transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR). Low-to-intermediate surgical-risk patients with moderate or severe COPD who underwent TAVI or SAVR at 2 tertiary centers were included in this study...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28885378/radial-force-an-underestimated-parameter-in-oversizing-transcatheter-aortic-valve-replacement-prostheses-in-vitro-analysis-with-five-commercialized-valves
#9
Sandrine Egron, Buntaro Fujita, Lucía Gullón, Pott Désirée, Thomas Schmitz-Rode, Stephan Ensminger, Ulrich Steinseifer
The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance...
September 5, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28885112/management-of-failing-bioprosthesis-in-elderly-patients-who-have-undergone-transcatheter-aortic-valve-replacement
#10
Ozan M Demir, Neil Ruparelia, Angela Frame, Sayan Sen, Ghada W Mikhail, Michael Fertleman, Iqbal S Malik
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of symptomatic aortic stenosis. The number of TAVR procedures is expected to increase exponentially in the next decade. Therefore, patients will inevitably present with signs and symptoms attributable to TAVR bioprosthesis failure many years after an acutely successful procedure. Their management will become increasing important moving forward. Areas covered: The aim of this article is to review the causes of bioprosthesis failure and outline optimal management strategies in elderly patients...
September 15, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28870874/characteristics-and-outcome-following-transcatheter-aortic-valve-replacement-of-patients-with-severe-aortic-stenosis-with-low-flow
#11
Yigal Abramowitz, Tarun Chakravarty, Philippe Pibarot, Yoshio Maeno, Hiroyuki Kawamori, David Anderson, Geeteshwar Mangat, Mamoo Nakamura, Wen Cheng, Raj R Makkar
AIMS: Only few studies examined the respective impact of low flow (LF), low gradient (LG) and low ejection fraction (LEF) on outcomes following transcatheter aortic valve replacement (TAVR). The purpose of this study was to assess the impact of pre-procedural stroke volume index, aortic valve gradient, left ventricular ejection fraction (LVEF) and different flow/gradient/LVEF patterns on the clinical outcomes of patients with severe aortic stenosis (AS) that undergo TAVR. METHODS AND RESULTS: We analyzed the clinical, echocardiographic, and outcome data collected in 770 patients with AS that underwent TAVR...
September 5, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28862381/a-systematic-review-of-reported-cases-of-combined-transcatheter-aortic-and-mitral-valve-interventions
#12
Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Tesfaye Telila, David P Slovut, Luis Afonso, Cindy L Grines, Theodore Schreiber
OBJECTIVES: To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI). BACKGROUND: CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28843328/transcatheter-vs-surgical-aortic-valve-replacement-for-aortic-stenosis-in-low-intermediate-risk-patients-a-meta-analysis
#13
REVIEW
Derrick Y Tam, Thin Xuan Vo, Harindra C Wijeysundera, Dennis T Ko, Rodolfo Vigil Rocha, Jan Friedrich, Stephen E Fremes
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as the treatment of choice for patients with severe aortic stenosis at high surgical risk; the role of TAVR compared with surgical aortic valve replacement (SAVR) in the low-intermediate surgical risk population remains uncertain. Our primary objective was to determine differences in 30-day and late mortality in patients treated with TAVR compared with SAVR at low-intermediate risk (Society of Thoracic Surgeons Predicted Risk of Mortality < 10%)...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28843323/should-tavr-replace-surgery-for-aortic-stenosis-in-low-to-intermediate-risk-patients
#14
REVIEW
Colin M Barker, Michael J Reardon
Transcatheter aortic valve replacement (TAVR) was initially envisioned as a less invasive option for patients with severe symptomatic aortic stenosis who either were not candidates or were very high-risk candidates for surgical aortic valve replacement (SAVR). Based on data from the original Placement of Aortic Transcatheter Valve (PARTNER) trials as well as the CoreValve Pivotal trials, TAVR is now approved and accepted in the treatment of severe symptomatic aortic stenosis in extreme-risk and high-risk patient populations...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28843322/latest-generation-transcatheter-aortic-valve-replacement-devices-and-procedures
#15
REVIEW
Chekrallah Chamandi, Rishi Puri, Tania Rodriguez-Gabella, Josep Rodés-Cabau
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28838702/long-term-outlook-for-transcatheter-aortic-valve-replacement
#16
REVIEW
Andras P Durko, Ruben L Osnabrugge, A Pieter Kappetein
Transcatheter aortic valve replacement (TAVR) revolutionized the treatment of severe symptomatic aortic stenosis (AS). TAVR is increasingly offered for lower-risk patients. The role and place of TAVR in the future treatment of AS is not clear yet. In this review, we discuss the long-term outlook for TAVR, its challenges and its relationship to conventional surgical aortic valve replacement.
August 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28836953/efficacy-and-safety-of-transcatheter-aortic-valve-replacement-in-aortic-stenosis-patients-at-low-to-moderate-surgical-risk-a-comprehensive-meta-analysis
#17
Ahmed Elmaraezy, Ammar Ismail, Abdelrahman Ibrahim Abushouk, Moutaz Eltoomy, Soha Saad, Ahmed Negida, Osama Mahmoud Abdelaty, Ahmed Ramadan Abdallah, Ahmed Magdy Aboelfotoh, Hossam Mahmoud Hassan, Aya Gamal Elmaraezy, Mahmoud Morsi, Farah Althaher, Moath Althaher, Ammar M AlSafadi
BACKGROUND: Recently, transcatheter aortic valve replacement (TAVR) has become the procedure of choice in high surgical risk patients with aortic stenosis (AS). However, its value is still debated in operable AS cases. We performed this meta-analysis to compare the safety and efficacy of TAVR to surgical aortic valve replacement (SAVR) in low-to-moderate surgical risk patients with AS. METHODS: A systematic search of five authentic databases retrieved 11 eligible studies (20,056 patients)...
August 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28832195/update-on-the-significance-of-postprocedural-aortic-regurgitation-after-transcatheter-aortic-valve-replacement-on-postprocedural-prognosis
#18
Maximilian Schmidt-Salzmann, Michael Schlüter, Karl-Heinz Kuck, Christian Frerker
Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with aortic stenosis and a high surgical risk. Recent data on intermediate-risk patients will probably enlarge the indication for TAVR. In the beginning of the TAVR era, relevant (>mild) aortic regurgitation (AR) was a common finding after TAVR; it was associated with worse outcome compared with patients without significant AR. To date, several improvements in imaging, grading of severity and treatment have been done and will be discussed in this article...
August 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28829829/intermediate-cd14-cd16-monocytes-decline-after-transcatheter-aortic-valve-replacement-and-correlate-with-functional-capacity-and-left-ventricular-systolic-function
#19
Jonas Neuser, Paolo Galuppo, Daniela Fraccarollo, Jens Willig, Tibor Kempf, Dominik Berliner, Johann Bauersachs, Julian Daniel Widder
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is the method of choice for patients with severe aortic valve stenosis, who are ineligible or at high risk for surgery. Though TAVR leads to a significant reduction in mortality, a notable amount of patients are re-hospitalized early after TAVR. Parameters or biomarkers predicting outcome are therefore needed to identify patients who benefit most. Specific monocyte subsets have been associated with cardiovascular diseases and were shown to possess prognostic value...
2017: PloS One
https://www.readbyqxmd.com/read/28828046/modern-use-of-echocardiography-in-transcatheter-aortic-valve-replacement-an-up-date
#20
Cristina Caldararu, Serban Balanescu
Echocardiography is the cornerstone in the diagnosis of any valvular heart disease. The accurate diagnosis of aortic stenosis, the left ventricle function and the other heart valves evaluation are currently done by ultrasound alone. Prosthetic valve choice and dimensions prior to implantation can be done solely by proper use of echocardiography. The emergence of new methods to cure aortic stenosis such as trans-catheter aortic valve replacement (TAVR) emphasized the diagnostic value of cardiac ultrasound. The usefulness of echocardiography in TAVR can be divided in the baseline assessment (common to patients treated by conventional surgery), intra-procedural guidance of valve deployment and post-procedural follow-up...
December 2016: Mædica
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