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Pacemaker TAVI

Gennaro Giustino, Robert M A Van der Boon, Javier Molina-Martin de Nicolas, Nicolas Dumonteil, Alaide Chieffo, Peter P T de Jaegere, Didier Tchetche, Bertrand Marcheix, Damien Millischer, Romain Cassagneau, Didier Carrié, Nicolas M Van Mieghem, Antonio Colombo
AIMS: We sought to evaluate the impact of permanent pacemaker (PPM) implantation on two-year mortality and one-year left ventricular ejection fraction recovery (∆LVEFR=one-year LVEF-baseline LVEF) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We pooled patient-level data from four European institutions with significant TAVI volume. Outcomes were compared between patients without PPM (no-PPM), patients with PPM prior to TAVI (old-PPM) and patients with PPM implanted after TAVI (new-PPM)...
October 20, 2016: EuroIntervention
Anna Olasińska-Wiśniewska, Marek Grygier, Maciej Lesiak, Olga Trojnarska, Aleksander Araszkiewicz, Anna Komosa, Marcin Misterski, Marek Jemielity, Marek Proch, Stefan Grajek
BACKGROUND: In patients treated with transcatheter aortic valve implantation (TAVI), age is recognized as one of the most important risk factors. The aim of our study was to evaluate whether early and mid-term results of TAVI were worse in patients over 85 year old compared with the younger population. METHODS: From September 2010 to November 2015, 162 consecutive patients (mean age 78.4 ±7.1 years, 47.5 % females) underwent TAVI in our Institution. Patients were divided into two groups: 1) elderly (≥ 85 year old) and 2) younger patients (< 85 year old)...
October 17, 2016: Cardiology Journal
Roland Hilling-Smith, James Cockburn, Maureen Dooley, Jessica Parker, Andrea Newton, Andrew Hill, Uday Trivedi, Adam de Belder, David Hildick-Smith
: Transcatheter aortic valve implantation (TAVI) and balloon aortic valvuloplasty (BAV) are now well established percutaneous procedures. These procedures almost always require bursts of rapid ventricular pacing to temporarily reduce cardiac output to facilitate the procedure, usually done via a temporary pacing wire inserted into the right ventricle. We describe a case series of 132 cases of TAVI and 76 BAV done using ventricular pacing via the left ventricular lead by simply connecting one electrode to the patient's skin and one electrode through the left ventricular (LV) wire...
October 11, 2016: Catheterization and Cardiovascular Interventions
Claudia Fiorina, Giuseppe Bruschi, Luca Testa, Marco De Carlo, Federico De Marco, Giuseppe Coletti, Stefano Bonardelli, Marianna Adamo, Salvatore Curello, Giovanni Scioti, Paolo Panisi, Francesco Bedogni, Anna S Petronio, Federica Ettori
BACKGROUND: About one-third of candidates for transcatheter aortic valve implantation (TAVI) suffer from severe peripheral artery disease, making the routine femoral approach difficult or impossible. Aim was to compare the trans-axillary (TAx) and the trans-aortic (TAo) route for TAVI with Medtronic CoreValve Revalving System (CRS). METHODS: 242 (23%) out of 1049 consecutive TAVI with 18F CRS were treated in 4 high-volume Italian Centre through TAx (61%) and TAo (39%)...
October 4, 2016: Journal of Cardiovascular Surgery
C Moini, B Sidia, D Poindron, L Fiorina, A Farge, W Amara, M El Issa
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Reed A Siemieniuk, Thomas Agoritsas, Veena Manja, Tahira Devji, Yaping Chang, Malgorzata M Bala, Lehana Thabane, Gordon H Guyatt
OBJECTIVE:  To examine the effect of transcatheter aortic valve implantation (TAVI) versus surgical replacement of an aortic valve (SAVR) in patients with severe aortic stenosis at low and intermediate risk of perioperative death. DESIGN:  Systematic review and meta-analysis DATA SOURCES:  Medline, Embase, and Cochrane CENTRAL. STUDY SELECTION:  Randomized trials of TAVI compared with SAVR in patients with a mean perioperative risk of death <8%...
September 28, 2016: BMJ: British Medical Journal
Rodrigo Bagur, Patrick J Teefy, Bob Kiaii, Pantelis Diamantouros, Michael W A Chu
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative for patients presenting with severe symptomatic aortic stenosis and considered at high-surgical risk. Paravalvular leak (PVL), conduction disorders, and coronary obstruction remain unresolved procedure-related complications. The aim of this manuscript was to report the first North American experience with the ACURATE-neo(TM) aortic bioprosthesis and its ACURATE-TF(TM) delivery system (Symetis S...
September 28, 2016: Catheterization and Cardiovascular Interventions
Praveen Indraratna, David H Tian, Tristan D Yan, Mathew P Doyle, Christopher Cao
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a widely utilized method of treatment of severe aortic valve stenosis. The present meta-analysis included all published relevant randomized controlled trials (RCTs) and aimed to compare the safety and efficacy of TAVI compared to surgical aortic valve replacement (AVR). METHOD: Nine electronic databases were comprehensively searched. Eligible studies were required to be randomized controlled trials which reported comparative endpoints on both TAVI and AVR...
September 15, 2016: International Journal of Cardiology
José López-Aguilera, José M Segura Saint-Gerons, Francisco Mazuelos Bellido, Javier Suárez de Lezo Herreros de Tejada, Soledad O Pineda, Manuel Pan Álvarez-Ossorio, Miguel Ángel Romero Moreno, Djordje Pavlovic, José Suárez de Lezo Cruz Conde
New-onset conduction disturbances are common after transcatheter aortic valve implantation (TAVI). The most common complication is left bundle branch block (LBBB). The clinical impact of new-onset LBBB after TAVI remains controversial. The aim of this study was to analyze the clinical impact of new-onset LBBB in terms of mortality and morbidity (need for pacemakers and admissions for heart failure) at long-term follow-up. From April 2008 to December 2014, 220 patients who had severe aortic stenosis were treated with the implantation of a CoreValve prosthesis...
August 12, 2016: American Journal of Cardiology
Gidon Y Perlman, Philipp Blanke, John G Webb
Bicuspid aortic stenosis (AS) is not rare in patients treated with transcatheter aortic valve implantation (TAVI). Bicuspid valves have unique anatomy which could affect the results of TAVI; however, multiple recent reports have shown that TAVI is safe and effective in this population. Paravalvular aortic regurgitation was initially found to be more frequent in bicuspid patients, but newer-generation devices have shown superior results in this respect. Higher rates of pacemaker implantation after TAVI in bicuspid AS do require further investigation...
September 18, 2016: EuroIntervention
Krzysztof Wilczek, Rafał Reguła, Kamil Bujak, Piotr Chodór, Michał Długaszek, Mariusz Gąsior
Transcatheter aortic valve implantation (TAVI) has become a safe and efficient alternative to cardiac surgery in patients with severe aortic stenosis. In many countries the number of performed TAVI procedures equals the number of surgical implantations. Indications for TAVI are becoming more liberal, allowing a wider spectrum of patients to benefit from the advantages of transcatheter therapy. Due to its invasive nature, TAVI is associated with some complications such as conduction disturbances. Although these disturbances are usually not lethal, they have a great influence on patients' state and long term-survival...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Jonathan Engborg, Casper Riechel-Sarup, Oke Gerke, Hans Mickley, Niels Christian Sandgaard, Henrik Nissen, Axel Cosmus Pyndt Diederichsen
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is an established treatment for high-grade aortic valve stenosis in patients found unfit for open heart surgery. The method may cause cardiac conduction disorders requiring permanent pacemaker (PPM) implantation, and the long-term effect of PPM implantation remains ambiguous. Design One hundred sixty-eight patients who underwent TAVI from 2008 to 2012 were included. Patient characteristics, ECGs and PPM data were collected through medical records...
October 3, 2016: Scandinavian Cardiovascular Journal: SCJ
Birgid Gonska, Julia Seeger, Justus Baarts, Christoph Rodewald, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual paravalvular moderate or severe aortic regurgitation (AR) has been an independent risk factor for mortality after transcatheter aortic valve implantation (TAVI). The design of the third generation Edwards Sapien 3 (ES3; Edwards Lifesciences, Irvine, CA, USA) valve was optimized with an outer skirt to address the issue of paravalvular AR. METHODS AND RESULTS: We compared 100 consecutive patients treated with the ES3 for severe aortic stenosis with 100 patients treated with the Medtronic CoreValve (CV; Medtronic, Minneapolis, MN, USA) (Clinical Trial Registration: NCT02162069)...
September 7, 2016: Journal of Cardiology
Rainer Petzina, Georg Lutter, Christin Wolf, Constantin Kühl, Sandra Freitag-Wolf, Bernd Panholzer, Peter Bramlage, Norbert Frey, Jochen Cremer, Derk Frank
OBJECTIVES: To evaluate the efficacy and safety of Edwards SAPIEN-XT or SAPIEN-3 transcatheter heart valves via transaortic (TAo) access. METHODS: A total of 100 consecutive patients with severe symptomatic aortic stenosis undergoing TAo-transcatheter aortic valve implantation (TAVI) were included in this observational registry (November 2012-December 2014). Periprocedural and post-procedural outcomes were assessed. RESULTS: Of these 100 patients, 1 received a Medtronic CoreValve...
September 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Nicolas Debry, Arnaud Sudre, Ibrahim Elquodeimat, Cédric Delhaye, Guillaume Schurtz, Antoine Bical, Mohamad Koussa, Khalil Fattouch, Thomas Modine
BACKGROUND: Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an issue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of consecutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. METHODS: From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien(®) or Corevalve devices(®)...
September 2016: Journal of Geriatric Cardiology: JGC
Francesco Giannini, Matteo Montorfano, Vittorio Romano, Neil Ruparelia, Richard J Jabbour, Susanna Benincasa, Azeem Latib, Antonio Colombo
Valve embolization during transcatheter aortic valve implantation is a rare but potentially fatal complication of first generation transcatheter valves. As a result, second generation valves were designed to be fully retrievable and minimize this complication. We report a first case of embolization with a second-generation fully-retrievable and repositionable Lotus valve. In this case, the presence of severe left ventricular hypertrophy and a sigmoid septum may have contributed to prosthesis embolization with the initial 23mm Lotus valve...
November 15, 2016: International Journal of Cardiology
Ganesh Manoharan, Axel Linke, Helge Moellmann, Simon Redwood, Christian Frerker, Jan Kovac, Thomas Walther
AIMS: The aim of this study was to evaluate the safety and performance of the resheathable and repositionable St. Jude Medical Portico self-expanding transfemoral TAVI system. METHODS AND RESULTS: This prospective, single-arm, multicentre study evaluated the 18 Fr Portico system with either a 23 or a 25 mm valve. Patient follow-up was at 30, 90, 180 days and one year. Results up to 30 days are presented. Adverse events were categorised by VARC definitions and adjudicated by an independent events committee...
August 20, 2016: EuroIntervention
Jochen Wöhrle, Birgid Gonska, Christoph Rodewald, Julia Seeger, Dominik Scharnbeck, Wolfgang Rottbauer
AIMS: The aim of the study was to evaluate the procedural and 30-day results for the repositionable Lotus valve in patients undergoing transfemoral aortic valve implantation in a single-centre experience. METHODS AND RESULTS: We prospectively enrolled 110 patients with severe symptomatic aortic stenosis (NCT02162069). All procedures were performed without general anaesthesia by the transfemoral approach. Patients were followed for 30 days. Patients received the 23 mm (n=20), 25 mm (n=43) or 27 mm (n=47) Lotus device...
August 20, 2016: EuroIntervention
Hardy Baumbach, Samir Ahad, Christian Rustenbach, Stephan Hill, Tim Schäufele, Kristina Wachter, Ulrich Friedrich Wilhelm Franke
Background The incidence of degenerative aortic valve diseases has increased along with the life expectancy of our population. Although conventional aortic valve replacement (AVR) is the gold standard for symptomatic aortic stenosis, transcatheter procedures have proven to be a valid therapeutic option in high-risk patients. The aim of this study was to compare these procedures in a high-risk cohort. Methods We retrospectively analyzed all symptomatic (dyspnea or angina) high-risk patients (logistic EuroSCORE ≥ 15%) fulfilling the transcatheter aortic valve implantation (TAVI) indications...
August 12, 2016: Thoracic and Cardiovascular Surgeon
Nicholas Chew, Jimmy Kim Fatt Hon, Wei Luen James Yip, Siew Pang Chan, Kian-Keong Poh, William Kok-Fai Kong, Kristine Leok Kheng Teoh, Tiong Cheng Yeo, Huay Cheem Tan, Edgar Lik Wui Tay
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) is an effective treatment for high-risk or inoperative patients with severe aortic stenosis. Given the unique characteristics of Asian populations, questions regarding mid-term outcomes in Asians undergoing TAVI have yet to be addressed. This registry evaluated the two-year clinical outcomes of TAVI in an Asian population using Valve Academic Research Consortium-2 definitions. METHODS: This prospective study recruited 59 patients from a major academic medical centre...
August 12, 2016: Singapore Medical Journal
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