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Andras P Durko, Ruben L Osnabrugge, Nicolas M Van Mieghem, Milan Milojevic, Darren Mylotte, Vuyisile T Nkomo, A Pieter Kappetein
Aims: The number of transcatheter aortic valve implantation (TAVI) procedures is rapidly increasing. This has a major impact on health care resource planning. However, the annual numbers of TAVI candidates per country are unknown. The aim of this study was to estimate current and future number of annual TAVI candidates in 27 European countries, the USA and Canada. Methods and results: Systematic literature searches and meta-analyses were performed on aortic stenosis (AS) epidemiology and decision-making in severe symptomatic AS...
March 12, 2018: European Heart Journal
Tereza Losmanova, Ivo Tosoni, Stella Fahrni, Peter Ernst Ballmer
Aortic dissection is one of the severe but rare vascular complications arising from transcatheter aortic valve implantation (TAVI). This paper presents an autopsy case of an 81-year-old male patient with delayed aortic dissection with underlying haemorrhages and acute inflammation 3 years after TAVI.
March 15, 2018: BMJ Case Reports
Shumpei Mori, Justin T Tretter, Takayoshi Toba, Yu Izawa, Natsuko Tahara, Tatsuya Nishii, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata, Diane E Spicer, Farhood Saremi, Robert H Anderson
Introduction Knowledge of the anatomy of the membranous septum, as a surrogate to the location of the atrioventricular conduction axis, is a prerequisite for those undertaking transcatheter implantation of the aortic valve (TAVI). Equally important is its relationship of the virtual basal ring. This feature, however, has yet to be adequately described in the living heart. Materials and Methods We analyzed computed tomographic angiographic datasets from 107 candidates (84.1 ± 5.2 years, 68% women) for TAVI...
March 15, 2018: Clinical Anatomy
Toshinari Onishi, Kaoruko Sengoku, Yasuhiro Ichibori, Isamu Mizote, Koichi Maeda, Toru Kuratani, Yoshiki Sawa, Yasushi Sakata
Transcatheter aortic valve implantation (TAVI) is an effective and less invasive treatment for the increasing population of individuals with severe aortic stenosis (AS). Echocardiography is crucial in the assessment of AS patients from pre- to post-procedure. Transthoracic echocardiography (TTE) may be used to assess patient suitability for TAVI, as well as evaluate the severity of AS, the aortic valve complex, aortic valve morphology, mitral regurgitation (MR), and left ventricular function. Transesophageal echocardiography (TEE) is usually used as an intra-procedural monitoring tool to provide feedback during the procedure, to assess prosthetic valve function, and to detect complications rapidly before and after balloon aortic valvuloplasty (BAV) or transcatheter heart valve (THV) deployment...
February 2018: Cardiovascular Diagnosis and Therapy
Masao Takahashi, Nicolas Badenco, Jacques Monteau, Estelle Gandjbakhch, Fabrice Extramiana, Marina Urena, Nicole Karam, Eloi Marijon, Vincent Algalarrondo, Emmanuel Teiger, Nicolas Lellouche
OBJECTIVES: This study aimed to assess the impact of pacemaker mode programming on clinical outcomes in patients with high-degree atrioventricular conduction disturbance (AVCD) after transcatheter aortic valve implantation (TAVI). BACKGROUND: Although high-degree AVCD after TAVI can receive pacemaker, recovery of the AVCD is often observed. Specific pacemaker algorithms (AAI-DDD mode switch) are available which favor spontaneous atrioventricular conduction. METHODS: Of 1,621 consecutive multi-center TAVI patients, 269 (16...
March 14, 2018: Catheterization and Cardiovascular Interventions
Thomas Walther, Ganesh Manoharan, Axel Linke, Helge Möllmann, David Holzhey, Stephen G Worthley, Won-Keun Kim, Ulrich Schäfer
OBJECTIVES: To examine the incidence and timing of new-onset left bundle branch block (LBBB) and new permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve implantation (TAVI) using the repositionable, self-expanding Portico™ TAVI system (St. Jude Medical, St Paul, MN, USA). Clinical impact and periprocedural factors associated with new PPI were also assessed. METHODS: A total of 198 high-risk patients without pre-existing pacemaker [83...
March 9, 2018: European Journal of Cardio-thoracic Surgery
Unzue Leire, García Eulogio, Rodríguez Rodrigo Francisco José, Parra Jiménez Francisco Javier, Medina Peralta Juan, Díaz-Antón Belen, Rodríguez Del Río Miguel, Fontenla Adolfo, Teijeiro Rodrigo, Rubio-Alonso Belén
OBJECTIVES: The aim of this study is to describe electrocardiographic changes and conduction abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS: 76 patients who underwent TAVI using Edwards Sapien 3 prosthesis were included, comparing electrocardiographic registries at admission, post-procedure and before discharge. RESULTS: Patients after TAVI presented a longer PR interval, a wider QRS, and a longer corrected QT, with a left deviation of QRS axis and T waves; reversible changes that tended to correct in the following days after TAVI...
February 20, 2018: Journal of Electrocardiology
Ross Arena, Amy McNeil, Carl J Lavie, Cemal Ozemek, Daniel Forman, Jonathan Myers, Deepika R Laddu, Dejana Popovic, Codie R Rouleau, Tavis S Campbell, Andrew P Hills
Being physically active or, in a broader sense, simply moving more throughout each day is one of the most important components of an individual's health plan. In conjunction with regular exercise training, taking more steps in a day and sitting less are also important components of one's movement portfolio. Given this priority, health care professionals must develop enhanced skills for prescribing and guiding individualized movement programs for all their patients. An important component of a health care professional's ability to prescribe movement as medicine is competency in assessing an individual's risk for untoward events if physical exertion was increased...
April 2018: Current Problems in Cardiology
Tavis A Read, Aaron Smith, Janine Thomas, Michael David, Matthew Foote, Michael Wagels, Andrew Barbour, B Mark Smithers
BACKGROUND: Patients with in-transit melanoma metastases frequently experience high rates of recurrence, limited overall survival and reduced quality of life. After promising results within a Phase II, multi-center study, PV-10 treatment was continued at our institution for patients with in-transit disease. METHODOLOGY: An open-label, non-randomized, prospective study was performed at the Princess Alexandra Hospital, Queensland, Australia. Patients were treated with PV-10 in accordance with the treatment protocol established during a previous Phase II study...
March 12, 2018: Journal of Surgical Oncology
Vincent Johan Nijenhuis, Joyce Peper, Veronique M M Vorselaars, Martin J Swaans, Thom De Kroon, Jan A S Van der Heyden, Benno J W M Rensing, Robin Heijmen, Willem-Jan W Bos, Jurrien M Ten Berg
Transcatheter aortic valve implantation (TAVI) is associated with acute kidney injury (AKI), but can also improve the kidney function (IKF). We assessed the effects of kidney function changes in relation to baseline kidney function on 2-year clinical outcomes after TAVI. In total, 639 consecutive patients with aortic stenosis who underwent TAVI were stratified into 3 groups according to the ratio of serum creatinine post- to pre-TAVI: IKF (≤0.80; n = 95 [15%]), stable kidney function (0.80 to 1.5; n = 477 [75%]), and AKI (≥1...
February 12, 2018: American Journal of Cardiology
Mohammad Abdelghani, Robbert J de Winter, Yosuke Miyazaki, Rodrigo Modolo, Hiroki Tateishi, Rafael Cavalcante, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Osama I I Soliman, Yoshinobu Onuma, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
OBJECTIVES: To explore the rate, the determinants of success, and the hemodynamic impact of balloon postdilatation (BPD) of self-expanding transcatheter heart valves (SE-THVs) BACKGROUND: BPD is commonly used to optimize valve expansion and reduce paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) without clearly knowing its hemodynamic benefits. METHODS: Patients (n = 307) who received a SE-THV were stratified according to whether a BPD was performed or not...
March 9, 2018: Catheterization and Cardiovascular Interventions
Patrizia Presbitero, Loredana Iannetta, Paolo Pagnotta, Bernhard Reimers, Marco L Rossi, Dennis Zavalloni Parenti, Giovanni Bianchi, Francesco Bedogni
BACKGROUND: It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers...
April 2018: Minerva Cardioangiologica
Marco Barbanti, Simona Gulino, Giuliano Costa, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) is now a widely adopted therapy for the treatment of elderly patients with severe aortic stenosis. Improved pre-procedural screening, increased operators' experience and technology advancement have made this technique highly reliable and standardized. Areas covered: The purpose of this review article is to provide an overview of the strategies that can be adopted to optimize the TAVI procedure (pre-interventional work-up and procedural simplification and early discharge)...
March 9, 2018: Expert Review of Cardiovascular Therapy
Jasmin Ortak, Giuseppe D'Ancona, Hüseyin Ince, Hüseyin U Agma, Erdal Safak, Alper Öner, Stephan Kische
BACKGROUND: Permanent pacemaker implantation (PPMI) after transcatheter aortic valve implantation (TAVI) remains an issue open for criticism. Aim of this study is to investigate a strategy to reduce PPMI rate after TAVI in general and more specifically after implantation of the LOTUS® prosthesis. METHODS: Through our learning curve, we have developed a structured protocol to reduce PPMI rate. The protocol includes: shallow implantation depth within the native annulus, strict adherence to the international guidelines for PPMI, PPMI not earlier than 5 days after TAVI, and intravenous chronotropic and steroidal treatment (orciprenaline 0...
March 5, 2018: European Journal of Medical Research
Mani Arsalan, Won-Keun Kim, Arnaud Van Linden, Christoph Liebetrau, Benjamin D Pollock, Giovanni Filardo, Mathias Renker, Helge Möllmann, Mirko Doss, Ulrich Fischer-Rasokat, Adalbert Skwara, Christian W Hamm, Thomas Walther
OBJECTIVES: Due to increasing clinical experience with transcatheter aortic valve implantation (TAVI) procedures, sophisticated imaging and advanced device technology, TAVI complication rates are low; however, patients requiring conversion to surgery are confronted with an increased mortality risk. In this retrospective study, we evaluated the predictors for conversion and the outcomes of these patients. METHODS: We analysed the records of all patients undergoing TAVI in our centre from 2011 to 2016 and focused on cases that required conversion to sternotomy...
March 1, 2018: European Journal of Cardio-thoracic Surgery
Ian Jun Yan Wee, Thomas Stonier, Michael Harrison, Andrew M T L Choong
BACKGROUND: The carotid artery is a novel access route for transcatheter aortic valve implantation (TAVI), especially useful in patients unsuitable for traditional access routes including transfemoral (TF), subclavian, transapical (TAp), and aortic (TAo). This systematic review summarizes the evidence on TAVI via the carotid artery for its efficacy and safety. METHODS: A systematic review was conducted as per the Preferred Reporting Instructions for Systematic Reviews and Meta-analysis (PRISMA) guidelines on three online databases: Medline (via Pubmed), SCOPUS, and Cochrane Database...
February 27, 2018: Journal of Cardiology
M Marwan, F Ammon, D Bittner, J Röther, N Mekkhala, M Hell, A Schuhbaeck, G Gitsioudis, R Feyrer, C Schlundt, S Achenbach, M Arnold
INTRODUCTION: We assessed the potential of CT strain to detect changes in myocardial function in patients referred for TAVI pre and post intervention. PATIENTS AND METHODS: 25 consecutive patients with symptomatic aortic valve stenosis in whom TAVI had been performed were included in this analysis. Functional CT data sets acquired before and 3 to 6 months after TAVI were available. Multiphase reconstructions in increments of 10% of the cardiac cycle were rendered and transferred to a dedicated workstation (Ziostation2, Ziosoft Inc...
February 3, 2018: Journal of Cardiovascular Computed Tomography
Majd Ibrahim, Keattiyoat Wattanakit, Marco Barzallo, Sudhir Mungee
To our knowledge, this is the first documented case of successful TAVI for severe quadricuspid aortic valve (QAV) stenosis performed in the U.S. and the first documented Sapien 3 valve implantation in a severely stenotic QAV.
March 2018: Journal of Invasive Cardiology
Smita Scholtz, Cornelia Piper, Dieter Horstkotte, Jan Gummert, Stephan M Ensminger, Jochen Börgermann, Werner Scholtz
OBJECTIVES: We present our single center experience with Medtronic CoreValve and Evolut R regarding procedural outcome and 3 years follow-up in patients with degenerated bioprostheses. METHODS: From 1645 patients who underwent transfemoral TAVI at our institution between February 2009 and December 2016, 37 patients with degenerated bioprosthesis were treated with Medtronic CoreValve/Evolut R. All data concerning baseline characteristic, procedural outcomes and follow-up were entered into a dedicated database...
February 28, 2018: Journal of Interventional Cardiology
Kaveh Eghbalzadeh, Elmar W Kuhn, Anton Sabashnikov, Carolyn Weber, Cherif Sahyoun, Tanja Rudolph, Stephan Baldus, Thorsten C W Wahlers, Navid Mader
BACKGROUND:  Advanced visualization software tools have been used in clinics to improve the safety and accuracy of transcatheter procedure. Imaging techniques have greatly evolved during the era of transcatheter aortic valve implantation (TAVI). In a retrospective analysis, we investigated the feasibility of augmented fluoroscopy for iliofemoral access using a novel "Vascular Outlining" roadmapping technology. METHODS:  The Vascular Outlining prototype device (Philips Healthcare) application was used with iliofemoral angiography of 10 patients undergoing transfemoral TAVI...
February 28, 2018: Thoracic and Cardiovascular Surgeon
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