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Transcatheter Valve Replacement

Jubo Jiang, Xianbao Liu, Yuxin He, Qiyuan Xu, Qifeng Zhu, Sanjay Jaiswal, Lihan Wang, Po Hu, Feng Gao, Yinghao Sun, Chunhui Liu, Xiaoping Lin, Jie Liang, Kaida Ren, Jian Apos An Wang
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a recent and an effective treatment option for high- or extreme-surgical-risk patients with symptomatic severe aortic stenosis. However, pure severe native aortic valve regurgitation (NAVR) without aortic stenosis remains a contraindication to TAVR. The aim of our systemic review analysis was to evaluate TAVR in patients with pure NAVR. METHODS: We searched the published articles in the PubMed and Web of Science databases (2002-2017) using the Boolean operators for studies of NAVR patients undergoing TAVR...
December 5, 2018: Cardiology
John D Carroll
No abstract text is available yet for this article.
December 5, 2018: JAMA Cardiology
Harun Kundi, Jeffrey J Popma, Kamal R Khabbaz, Louis M Chu, Jordan B Strom, Linda R Valsdottir, Changyu Shen, Robert W Yeh
Importance: Hospital outcomes for transcatheter aortic valve replacement (TAVR) may be dependent on the quality of evaluation, personnel, and procedural and postprocedural care common to patients undergoing cardiac surgery. Objectives: We sought to assess whether those hospitals with better patient outcomes for surgical aortic valve replacement (SAVR) subsequently achieved better TAVR outcomes after launching TAVR programs. Design, Setting, and Participants: This national cohort included US patients 65 years and older...
December 5, 2018: JAMA Cardiology
E Russo, D R Potenza, M Casella, R Massaro, G Russo, M Braccio, A Dello Russo, M Cassese
Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis who are at high surgical risk. Recently, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement in the treatment of intermediate risk patients and greater adoption of this procedure is to be expected in a wider patients population, including younger patients and low surgical risk patients...
December 4, 2018: Current Cardiology Reviews
Jiaqi Fan, Xianbao Liu, Lei Yu, Yinghao Sun, Sanjay Jaiswal, Qifeng Zhu, Han Chen, Yuxin He, Lihan Wang, Kaida Ren, Jian'an Wang
BACKGROUND: Far less attention has been paid to the prognostic effect of right-side heart disease on outcomes after transcatheter aortic valve replacement (TAVR) when compared with the left side. Therefore, we performed a systematic review and meta-analysis on the impact of tricuspid regurgitation (TR) and right ventricular (RV) dysfunction on outcomes after TAVR. HYPOTHESIS: We hypothesized that TR and RV dysfunction may have a deleterious effect on outcomes after TAVR...
December 4, 2018: Clinical Cardiology
Taku Inohara, Pratik Manandhar, Andrzej S Kosinski, Roland A Matsouaka, Shun Kohsaka, Robert J Mentz, Vinod H Thourani, John D Carroll, Ajay J Kirtane, Joseph E Bavaria, David J Cohen, Todd L Kiefer, Jeffrey G Gaca, Samir R Kapadia, Eric D Peterson, Sreekanth Vemulapalli
Importance: Data are lacking on the effect of a renin-angiotensin system (RAS) inhibitor prescribed after transcatheter aortic valve replacement (TAVR). Treatment with a RAS inhibitor may reverse left ventricular remodeling and improve function. Objective: To investigate the association of prescription of a RAS inhibitor and outcomes after TAVR. Design, Setting, and Participants: Retrospective cohort study of TAVR procedures performed in the United States (using the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapies Registry) between July 2014 and January 2016 that were linked to Medicare claims data (final date of follow-up: March 31, 2017)...
December 4, 2018: JAMA: the Journal of the American Medical Association
Paul Guedeney, Didier Tchétché, Anna Sonia Petronio, Julinda Mehilli, Samantha Sartori, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Sabato Sorrentino, Bimmer E P M Claessen, Jaya Chandrasekhar, Birgit Vogel, Deborah N Kalkman, Emanuele Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Maria-Cruz Ferrer-Grazia, Christoph Naber, Peter Kievit, Usman Baber, Samin Sharma, Marie-Claude Morice, Alaide Chieffo, Roxana Mehran
OBJECTIVES: To evaluate the impact of coronary artery disease (CAD) with or without recent (≤ 30 days) percutaneous coronary intervention (PCI) in women undergoing transcatheter aortic valve replacement (TAVR). BACKGROUND: Although women display a specific risk-profile for both PCI and TAVR, the impact of CAD and PCI in the setting of TAVR in women is unclear. METHODS: The multinational Women's International Transcatheter Aortic Valve implantation registry enrolled consecutive female patients undergoing contemporary TAVR in 19 centers between 2013 and 2015...
December 4, 2018: Catheterization and Cardiovascular Interventions
Hideki Nagata, Ryu Kanzaki, Takashi Kanou, Naoko Ose, Soichiro Funaki, Yasushi Shintani, Masato Minami, Isamu Mizote, Yasushi Sakata, Koichi Maeda, Toru Kuratani, Yoshiki Sawa, Meinoshin Okumura
BACKGROUND: The age of patients with lung cancer is advancing, and the number of patients with lung cancer who have cardiac diseases is expected to increase. Recently, the rate of transcatheter aortic valve implantation (TAVI) has increased as treatment for aortic stenosis (AS). TAVI is minimally invasive compared with conventional aortic valve replacement. We herein report two patients with lung cancer who underwent lobectomy after TAVI for severe AS. CASE PRESENTATION: Two patients with AS and lung cancer were treated with two-stage surgery of TAVI followed by lobectomy...
December 3, 2018: Surgical Case Reports
Massimiliano Povero, Antonio Miceli, Lorenzo Pradelli, Matteo Ferrarini, Matteo Pinciroli, Mattia Glauber
Background: Meta-analyses of studies comparing transcatheter aortic valve implants (TAVIs) and sutureless aortic valve replacement (SU-AVR) show differing effectiveness and safety profiles. The approaches also differ in their surgical cost (including operating room and device). Objective: The objective of this study was to assess the incremental cost-utility of SU-AVR vs TAVIs for the treatment of intermediate- to high-risk patients in the US, Germany, France, Italy, UK, and Australia...
2018: ClinicoEconomics and Outcomes Research: CEOR
Konstantin S German, Ankur Kalra
PURPOSE OF REVIEW: Highlight the difficulties patients, physicians, and the global economy face in relation to treatment of structural heart diseases. It is easy to be carried away by the excitement of medical advancement; however, it is difficult to demonstrate restraint. Transcatheter aortic valve replacement (TAVR) is a modern marvel that can help many patients when utilized appropriately. This article highlights the work that has been done to facilitate decision-making in this challenging patient population...
December 4, 2018: Current Opinion in Supportive and Palliative Care
Elise Bakelants, Ann Belmans, Peter Verbrugghe, Tom Adriaenssens, Steven Jacobs, Johan Bennett, Bart Meuris, Walter Desmet, Filip Rega, Paul Herijgers, Marie-Christine Herregods, Christope L Dubois
AIMS: Transcatheter aortic valve implantation (TAVI) is the preferred treatment modality for patients with severe aortic stenosis at high or prohibitive risk for surgical aortic valve replacement (SAVR). We aimed to evaluate real-world outcomes after treatment according to the decisions of the multidisciplinary heart team in a Belgian health-economic context. METHODS AND RESULTS: Four hundred and five high-risk patients referred to a tertiary centre between 1 March 2008 and 31 December 2015 were screened and planned to undergo SAVR, TAVI or medical treatment (MT)...
December 3, 2018: Acta Cardiologica
Fiachra McHugh, Khalid Ahmed, Antoinette Neylon, Faisal Sharif, Darren Mylotte
Transcatheter aortic valve implantation (TAVI) is now the accepted standard of care for patients with symptomatic severe aortic stenosis at elevated risk for conventional surgical valve replacement. Currently, societal guidelines propose the use of dual antiplatelet therapy for the prevention of thromboembolic events after TAVI in patients without an indication for oral anticoagulation. This strategy is empiric and largely based on expert consensus extrapolated from the arena of percutaneous coronary intervention...
November 2018: Journal of Thoracic Disease
Amit N Vora, Sunil V Rao
Transcatheter aortic valve implantation is an important therapeutic option for patients with symptomatic, severe aortic stenosis at increased risk for open surgical aortic valve replacement. Although a number of alternative vascular access sites have been developed, transfemoral access is overwhelmingly the dominant access strategy for this procedure. Access was achieved in the initial clinical experience primarily via surgical cutdown, but more recently, there has been increasing use of a fully percutaneous approach...
November 2018: Journal of Thoracic Disease
Keita Sato, Philip M Jones
There is currently significant controversy regarding the best anesthesia management for patients undergoing transcatheter aortic valve replacement (TAVR). Some institutions primarily use general anesthesia (GA) but many institutions primarily use moderate sedation. Much of the controversy is due to the limited evidence base available to inform this decision and the strong feelings and pre-conceived notions about the optimal anesthesia technique which exist amongst anesthesiologists, cardiologists, and cardiac surgeons...
November 2018: Journal of Thoracic Disease
Sergio Perez, Torin P Thielhelm, Mauricio G Cohen
Concomitant coronary artery disease (CAD) and aortic stenosis occur in approximately 60-75% of patients referred for surgical or transcatheter aortic valve replacement (TAVR). Current guidelines support simultaneous surgical aortic valve replacement and bypass surgery with a class IIa recommendation, based on observational, non-randomized data. With the inception of TAVR, this strategy has been challenged, as observational studies have not shown significant outcome differences in patients with and without CAD treated with TAVR...
November 2018: Journal of Thoracic Disease
Amisha Patel, Martin B Leon
Transcatheter aortic valve replacement (TAVR) for the treatment of severe symptomatic aortic stenosis (AS) has rapidly become the standard of care for expanding clinical indications based on the results of multiple large-scale randomized trials. Patients with bicuspid aortic valve (BAV) have been largely excluded from these trials for a variety of reasons. However, case series and registry data has shown TAVR in BAV to be a safe and efficacious alternative to surgical aortic valve replacement (SAVR) with the possible caveats of increased paravalvular regurgitation (PVR) and need for permanent pacemaker (PPM) implantation...
November 2018: Journal of Thoracic Disease
Glen P Martin, Matthew Sperrin, Mamas A Mamas
Transcatheter aortic valve implantation (TAVI) has emerged as the standard treatment option for patients with symptomatic aortic stenosis who are considered intermediate to high surgical risk. Nonetheless, optimal clinical outcomes following the procedure require careful consideration of procedural risk by the Heart Team. While this decision-making could be supported through the development of TAVI-specific clinical prediction models (CPMs), current models remain suboptimal. In this review paper, we aimed to outline the performance of several recently derived TAVI CPMs that predict mortality and present some future research directions...
November 2018: Journal of Thoracic Disease
Philippe Pibarot
No abstract text is available yet for this article.
November 23, 2018: JACC. Cardiovascular Interventions
Sachin Khambadkone
No abstract text is available yet for this article.
November 23, 2018: JACC. Cardiovascular Interventions
Hope Caughron, Dennis Kim, Norihiko Kamioka, Stamatios Lerakis, Altayyeb Yousef, Aneesha Maini, Shawn Reginauld, Anurag Sahu, Subhadra Shashidharan, Maan Jokhadar, Fred H Rodriguez, Wendy M Book, Michael McConnell, Peter C Block, Vasilis Babaliaros
OBJECTIVES: This study compares 30-day, 1-year, and 3-year echocardiographic findings and clinical outcomes of transcatheter pulmonary valve-in-valve replacement (TPVR) and repeat surgical pulmonary valve replacement (SPVR). BACKGROUND: In patients with adult congenital heart disease and previous pulmonary valve replacement (PVR) who require redo PVR, it is unclear whether TPVR or repeat SPVR is the preferred strategy. METHODS: We retrospectively identified 66 patients (TPVR, n = 36; SPVR, n = 30) with bioprosthetic pulmonary valves (PVs) who underwent either TPVR or repeat SPVR at Emory Healthcare from January 2007 to August 2017...
November 23, 2018: JACC. Cardiovascular Interventions
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