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Aortic stenosis guidelines

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https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#1
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29299604/association-of-acylcarnitines-with-left-ventricular-remodeling-in-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#2
Sammy Elmariah, Laurie A Farrell, Deborah Furman, Brian R Lindman, Xu Shi, Jordan E Morningstar, Eugene P Rhee, Robert E Gerszten
Importance: Clinical practice guidelines currently endorse a reliance on clinical symptoms of overt left ventricular (LV) failure to time aortic valve replacement for severe aortic stenosis; however, delayed aortic valve replacement can result in irreversible LV injury and adverse outcomes. Blood metabolomic signatures possess prognostic value in heart failure; this study assesses whether they are informative in aortic stenosis. Objective: To evaluate the value of metabolomic signatures in reflecting the extent of maladaptive LV remodeling in patients with end-stage aortic stenosis undergoing transcatheter aortic valve replacement, and to assess whether this procedure reverses metabolomic aberrations...
January 3, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29260369/predictors-of-right-ventricular-pacing-and-pacemaker-dependence-in-transcatheter-aortic-valve-replacement-patients
#3
Esseim Sharma, Antony F Chu
PURPOSE: Transcatheter aortic valve replacement (TAVR) is an increasingly prevalent therapy in patients with severe symptomatic aortic stenosis. Conduction disturbances requiring permanent pacemaker (PPM) implantation are a known complication of TAVR. This study investigated the progression of cardiac conduction disease in the post-TAVR pacemaker population and identified predictors of post-TAVR right ventricular (RV) pacing dependence. METHODS: Prospectively collected echocardiographic, ECG, and PPM interrogation data of 262 consecutive patients who underwent TAVR with placement of a balloon-expandable valve at one institution from March 2012 to October 2016 were analyzed...
December 19, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#4
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29188357/-management-of-valvular-heart-disease-esc-eacts-guidelines-2017
#5
REVIEW
M Haude
After 5 years the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have released an update on the guidelines for the management of valvular heart diseases. In recent years published results of randomized trials in patients with aortic valve stenosis have resulted in updated recommendations for catheter-based prosthesis implantation (TAVI), which is now extended to patients presenting without a low risk for conventional surgical valve replacement. In mitral or tricuspid valvular disease, the recommendations for catheter-based therapies are less strong because of a lack of supportive scientific data...
December 2017: Herz
https://www.readbyqxmd.com/read/29153618/advantages-of-a-prospective-multidisciplinary-approach-in-transcatheter-aortic-valve-implantation-eight-years-of-experience
#6
Cátia Costa, Rui Campante Teles, João Brito, José Pedro Neves, Henrique Mesquita Gabriel, Miguel Abecassis, Regina Ribeiras, João Abecasis, Tiago Nolasco, Maria da Conceição Furstenau, Nélson Vale, António Tralhão, Sérgio Madeira, João Mesquita, Carla Saraiva, Rita Calé, Manuel Almeida, Ana Aleixo, Miguel Mendes
INTRODUCTION: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008...
November 15, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#7
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#8
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29106494/impact-of-pulmonary-hypertension-on-long-term-outcome-in-patients-with-severe-aortic-stenosis
#9
Franck Levy, Yohann Bohbot, Khalil Sanhadji, Dan Rusinaru, Anne Ringle, Quentin Delpierre, Sondes Smaali, Mesut Gun, Sylvestre Marechaux, Christophe Tribouilloy
Aims: Pulmonary hypertension (PH) is common in severe symptomatic left-sided valvular disease, particularly in aging populations. Inconsistent results have been reported concerning the association between PH and adverse outcomes after aortic valve replacement for aortic stenosis (AS). We therefore retrospectively investigated the prognostic significance of PH using peak tricuspid regurgitation velocity (TRV), as defined by the current European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines, in a large cohort of patients with severe AS...
June 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#10
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29072064/transcatheter-aortic-valve-implantation-tavi-in-2017-recent-advances-and-future-development
#11
Florian Hecker, Mani Arsalan, Won-Keun Kim, Thomas Walther
Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis (AS) who are at high or prohibitive surgical risk. In the past years, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement (SAVR) in the treatment of intermediate risk patients. Besides optimized patient screening, advanced imaging and increased examiner experience, transcatheter heart valve (THV) design addressed several key issues like vascular complications, pacemaker implantation and paravalvular leakage rates and improved considerably over time...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29064293/transcatheter-aortic-valve-implantation-where-are-we-now
#12
Mark Mariathas, John Rawlins, Nick Curzen
Transcatheter aortic valve implantation (TAVI) was first used in clinical practice in 2002. Since 2002, there has been a rapid increase in TAVI activity in patients with symptomatic severe aortic stenosis. This has been supported by systematic randomized data comparing TAVI against the gold standard treatment for the last 50 years' surgical aortic valve replacement. TAVI is now currently a recommended therapeutic intervention in the treatment of severe aortic stenosis patients who are deemed either high risk or inoperable...
October 24, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29021260/risk-stratification-of-severe-aortic-stenosis-with-preserved-left-ventricular-ejection-fraction-using-peak-aortic-jet-velocity-an-outcome-study
#13
Yohann Bohbot, Dan Rusinaru, Quentin Delpierre, Sylvestre Marechaux, Christophe Tribouilloy
BACKGROUND: Current guidelines consider aortic valve replacement reasonable in asymptomatic patients with very severe aortic stenosis (AS); however, the definition of very severe AS based on peak aortic jet velocity (Vmax) remains unclear with a 5-m/s cutoff in US guidelines and 5.5 m/s in European guidelines. Because ≈20% of patients with severe AS and preserved left ventricular ejection fraction have Vmax in this range, we aimed to assess the relationship between Vmax and mortality and determine the best threshold to define very severe AS...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29020347/transcatheter-aortic-valve-implantation-in-lower-risk-patients-what-is-the-perspective
#14
Giuseppe Tarantini, Luca Nai Fovino, Bernard J Gersh
In the last decade, transcatheter aortic valve implantation (TAVI), a disruptive technology, has revolutionized the therapy of symptomatic severe aortic stenosis, and current guidelines state that the recommendations for TAVI and surgical aortic valve replacement (SAVR) are equivalent in patients at high-risk. Increased operator experience, technical advances in the new generation of transcatheter heart valves (THV) and excellent TAVI results in recently published randomized controlled trials have led to the expansion of TAVI indication as an alternative to SAVR in intermediate-risk subjects, given appropriate patient selection...
August 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28988212/updated-2017-european-and-american-guidelines-for-prosthesis-type-and-implantation-mode-in-severe-aortic-stenosis
#15
EDITORIAL
Catherine M Otto, Helmut Baumgartner
No abstract text is available yet for this article.
October 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28943483/permanent-decline-of-renal-function-after-infrarenal-abdominal-aortic-aneurysm-repair-frequency-and-risk-factors
#16
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Andreas Kribben, Stefan Herget-Rosenthal
BACKGROUND: Permanent renal function decline, and development and deterioration of chronic kidney disease (CKD) are associated with serious complications. How frequent is renal function decline after infrarenal abdominal aortic aneurysm (iAAA) repair according to current definitions and what are its risk factors, especially potentially modifiable ones? METHODS: Retrospective observational study including all patients with elective or urgent iAAA repair from 2007 to 2011...
September 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28910289/how-tavi-registries-report-clinical-outcomes-a-systematic-review-of-endpoints-based-on-varc-2-definitions
#17
REVIEW
Shixuan Zhang, Peter L Kolominsky-Rabas
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has been demonstrated to be an alternative treatment for severe aortic stenosis in patients considered as high surgical risk. Since its first human implantation by Cribier et al., TAVI has been shown to increase survival rate and quality of life for high surgical risks patients. The objective of this study is to provide an overview of TAVI registries and the reporting clinical outcomes based on the VARC-2 definitions. In addition, the comparability and adherence of VARC-2 reporting within the identified TAVI registries was reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28877303/association-of-guideline-adherence-for-serial-evaluations-with-survival-and-adverse-clinical-events-in-patients-with-asymptomatic-severe-aortic-stenosis
#18
Aisha Ahmed, Paul Sorajja, Ross F Garberich, R Saeid Farivar, Kevin M Harris, Mario Gössl
Importance: For patients with asymptomatic severe aortic stenosis and normal left ventricular function, current practice guidelines empirically recommend serial evaluations every 6 to 12 months. The benefit of this clinical monitoring is unknown. Objective: To determine the association of guideline adherence with clinical outcomes in patients with asymptomatic severe aortic stenosis. Design, Setting, and Participants: This retrospective cohort study involved 300 patients with asymptomatic severe aortic stenosis who were seen in the ambulatory Minneapolis Heart Institute at Abbott Northwestern Hospital...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28872094/-transcatheter-aortic-valve-implantation-present-and-development-trend
#19
Yi He, Haiting Zhou, Shuqiang Zhu, Yongbing Wu
Currently, although surgical aortic valve replacement (SAVR) is still the golden standard in treatment of severe aortic stenosis according to the guideline, transcatheter aortic valve implantation (TAVI) is gradually becoming a common treatment for patients who are prohibitive or in high risk for SAVR. Recently, the valve manufacturers, including medical companies in China, are making their utmost to develop valve device, leading remarkable results achieved by TAVI. With the complications being controlled, TAVI displays promising future...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28856517/bicuspid-aortic-valve-related-aortopathy
#20
REVIEW
Sina Stock, Salah A Mohamed, Hans-Hinrich Sievers
Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. Recent studies have provided new insights into the etiology and clinical impacts of bicuspid aortic valve related aortopathy in different clinical settings, leading to a growing body of opinion towards a more individualized surgical approach than currently provided by the guidelines...
August 30, 2017: General Thoracic and Cardiovascular Surgery
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