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Berhane Worku, Marie-Therese Valovska, Adham Elmously, Polydoros Kampaktsis, Catherine Castillo, Shing-Chiu Wong, Arash Salemi
OBJECTIVE: This study sought to analyze outcomes in patients with moderate-severe tricuspid regurgitation (TR) undergoing transcatheter aortic valve replacement (TAVR). The consequences of uncorrected significant TR in patients undergoing TAVR remain undefined. METHODS: Between 2009 and 2014, 369 patients underwent TAVR at our institution, and 58 of these had baseline moderate-severe TR. Preoperative, 30-day, and 1-year transthoracic echocardiograms were analyzed...
June 15, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Arash Salemi, Andrea De Micheli, Abdullah Aftab, Adham Elmously, Regis Chang, S Chiu Wong, Berhane M Worku
OBJECTIVES: Left atrial appendage thrombus (LAT) was an exclusion criterion in the seminal transcatheter aortic valve replacement (TAVR) trials; however, such patients do undergo TAVR in the 'real-world' setting. This study sought to analyse outcomes after TAVR in patients with LAT or spontaneous echo contrast (SEC). METHODS: All patients undergoing TAVR at our institution between March 2009 and December 2014 were prospectively analysed. The presence of LAT or SEC was determined via a retrospective chart review...
June 14, 2018: Interactive Cardiovascular and Thoracic Surgery
Harold L Lazar
No abstract text is available yet for this article.
June 17, 2018: Journal of Cardiac Surgery
Karen M Kim, Francis Shannon, Gaetano Paone, Shelly Lall, Sanjay Batra, Theodore Boeve, Alphonse DeLucia, Himanshu J Patel, Patricia F Theurer, Chang He, Melissa J Clark, Ibrahim Sultan, George Michael Deeb, Richard L Prager
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for the treatment of aortic stenosis in patients at intermediate, high, and extreme risk for mortality from SAVR. We examined recent trends in aortic valve replacement (AVR) in Michigan. METHODS: The Michigan Society of Thoracic and Cardiovascular Surgeons Quality Collaborative (MSTCVS-QC) database was used to determine the number of SAVR and TAVR cases performed from January 2012 through June 2017...
June 17, 2018: Journal of Cardiac Surgery
Marco Barbanti, Sergio Buccheri, Davide Capodanno, Paola D'Errigo, Marco Ranucci, Stefano Rosato, Gennaro Santoro, Danilo Fusco, Corrado Tamburino, Fausto Biancari, Fulvia Seccareccia
BACKGROUND: To assess clinical outcomes of patients with concomitant severe aortic stenosis (AS) and coronary artery disease (CAD) who underwent transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) or surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). METHODS: Data were extracted from the multicenter OBSERVANT study. For the purposes of the present analysis, we included only patients with established stable CAD meeting any of the following inclusion criteria: 1) TAVI patients with CAD undergoing staged PCI or TAVI and PCI in the same session; 2) SAVR patients undergoing combined SAVR and CABG in the same session...
June 7, 2018: International Journal of Cardiology
Jean-Philippe Collet, Sergio Berti, Angel Cequier, Eric Van Belle, Thierry Lefevre, Pascal Leprince, Franz-Josef Neumann, Eric Vicaut, Gilles Montalescot
BACKGROUND: Antithrombotic treatment regimen following transcatheter aortic valve replacement (TAVR) is not evidence-based. Apixaban, a non-vitamin K direct anticoagulant (NOAC) was shown to be superior to VKA and superior to aspirin to prevent cardioembolic stroke in non-valvular atrial fibrillation. It may have the potential to reduce TAVR-related thrombotic complications including subclinical valve thrombosis along with a better safety than the standard of care. DESIGN: ATLANTIS is a multicenter, randomized, phase IIIb, prospective, open-label, superiority study comparing standard of care (SOC Group) versus an apixaban-based strategy (Anti-Xa Group) after successful TAVR (ClinicalTrials...
June 2018: American Heart Journal
Arie Steinvil, Kyle D Buchanan, Sarkis Kiramijyan, Elizabeth Bond, Toby Rogers, Edward Koifman, Christian Shults, Linzhi Xu, Rebecca Torguson, Petros G Okubagzi, Augusto D Pichard, Lowell F Satler, Itsik Ben-Dor, Ron Waksman
BACKGROUND: The impact of frailty assessment on outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) remains unclear. Our aim was to evaluate the individual effect of each frailty test and the utility of an additive frailty index score on short- and long-term survival following TAVR. METHODS: Retrospective analysis of consecutive TAVR patients for whom a complete set of frailty tests was obtained: algorithm defined grip strength and 5-m walking tests, body mass index <20 kg/m2 , Katz activities of daily living ≤4/6, serum albumin <3...
June 2018: American Heart Journal
Nader Makki, Scott M Lilly
OBJECTIVE: Chronic kidney (CKD) is associated with worse outcomes in high-surgical risk patients undergoing transcatheter aortic valve replacement (TAVR). However, it is unclear whether this relationship is apparent in lower surgical risk patients. Herein we sought to analyze existing literature to assess whether or not advanced CKD is associated with increased mortality, or a greater incidence of adverse events (specifically major stroke, bleeding and vascular complications). METHODS: We searched PubMed and EMBASE (2008-2017) for relevant studies...
June 12, 2018: Clinical Cardiology
Napatt Kanjanahattakij, Benjamin Horn, Wasawat Vutthikraivit, Sylvia Marie Biso, Mary Rodriguez Ziccardi, Marvin Louis Roy Lu, Pattara Rattanawong
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become an alternative treatment to surgery in patients with severe aortic stenosis (AS). However, patients with Bicuspid aortic stenosis (BiAV) are usually excluded from major TAVR studies. The aim of this study is to reexamine the current evidence of TAVR in patients with severe AS and BiAV comparing to tricuspid aortic valve (TriAV). METHOD: Databases were systematically searched for relevant articles according to the following criteria...
June 12, 2018: Clinical Cardiology
Ajar Kochar, Zhuokai Li, J Kevin Harrison, G Chad Hughes, Vinod H Thourani, Michael J Mack, Roland A Matsouaka, David J Cohen, Eric D Peterson, W Schuyler Jones, Sreekanth Vemulapalli
BACKGROUND: Stroke is a serious complication of both transcatheter aortic valve replacement (TAVR) and carotid artery disease (CD). The implications of CD in patients undergoing TAVR are unclear. METHODS AND RESULTS: The Society of Thoracic Surgeons and American College of Cardiology Transcatheter Valve Therapies Registry, consisting of data from consecutive US TAVR cases during the years 2013 to 2015, was linked to Medicare claims data to ascertain 30-day and 1-year cumulative incidence rates of stroke and all-cause mortality...
June 2018: Circulation. Cardiovascular Interventions
Ismail Ates, Mehmet Cilingiroglu
Transcatheter aortic valve replacement is now the standard of care for severe symptomatic aortic stenosis patients who are at high-surgical risk. Percutaneous approach without a surgical cut down has been increasingly adapted by some centers in USA. Percutaneous approach seems to be associated with shorter hospital stay, similar short and late vascular complications, less disabling stroke, similar mortality as well as significantly less hospital cost. However, this technique also requires operators to be able to manage any vascular complications using advanced endovascular interventions to achieve complete hemostasis...
June 2018: Catheterization and Cardiovascular Interventions
Mohamad Kabach, Abdulah Alrifai, Lawrence Lovitz, Mark Rothenberg, Cristiano Faber, Marcos Nores
Transcatheter aortic valve replacement has been recently approved for patients who are high or intermediate risk for surgical aortic valve replacement. The procedure is associated with several known complications including coronary related complications. Coronary obstruction is rare but disastrous complication, and it is associated with a high mortality rate. Coronary protection technique has emerged as a preemptive technique to avoid this complication. We present a case of successful coronary protection during TAVR in severely calcified left cusp in patient with short and low left ostium...
2018: Case Reports in Cardiology
M Gastl, P Behm, S Haberkorn, L Holzbach, V Veulemans, C Jacoby, B Schnackenburg, T Zeus, M Kelm, F Bönner
BACKGROUND: Patients with severe aortic stenosis (AS) are subjected to left ventricular hypertrophy (LVH) with increasing morbidity and mortality. Transcatheter aortic valve replacement (TAVR) induces reverse left ventricular remodeling which can be monitored by cardiovascular magnetic resonance (CMR). CMR is able to analyze myocardial tissue properties by magnetic relaxation times (parametric CMR). The objective of this study was to study myocardial T2 relaxation in reverse ventricular remodeling after TAVR...
September 1, 2018: International Journal of Cardiology
C Liebetrau, L Gaede, W K Kim, M Arsalan, J M Blumenstein, U Fischer-Rasokat, J S Wolter, S Kriechbaum, M T Huber, A van Linden, A Berkowitsch, O Dörr, H Nef, C W Hamm, T Walther, H Möllmann
BACKGROUND: N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) levels correlate with higher peri-procedural mortality after transcatheter aortic valve replacement (TAVR). The long-term prognostic value of NT-proBNP within the first days after TAVR, however, remains unclear. This study examined early changes in NT-proBNP prior to and within 6 days after TAVR, the diagnostic value of this biomarker regarding aortic regurgitation (AR), and its prognostic value regarding one-year mortality...
August 15, 2018: International Journal of Cardiology
Kenichi Shibata, Masanori Yamamoto, Seiji Kano, Yutaka Koyama, Tetsuro Shimura, Ai Kagase, Sumio Yamada, Toshihiro Kobayashi, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Akihiro Higashimori, Yusuke Watanabe, Toshiaki Otsuka, Kentaro Hayashida
BACKGROUND: Nutritional condition is one marker of patients' frailty. The Geriatric Nutritional Risk Index (GNRI) is a well-known marker of nutritional status. This study sought to assess the clinical outcomes of GNRI after transcatheter aortic valve replacement (TAVR). METHODS: We evaluated the GNRI value of 1,613 patients who underwent TAVR using data from a Japanese multicenter registry. According to baseline GNRI, patients were classified into 3 groups: GNRI ≥92 (n = 1,085; 67...
May 15, 2018: American Heart Journal
Imad Hameedullah, Elnazeer O Ahmed, Abdalla Alzoobiy, Osama Elkhateeb
Underexpansion of an aortic bioprosthetic valve is common after transcatheter aortic valve replacement (TAVR). Significant discrepancy between invasive hemodynamic gradients and echocardiographic Doppler gradients in an underexpanded bioprosthesis can be attributed to pressure recovery phenomenon. This case emphasizes the importance of echocardiographic guidance in implantation and assessment of bioprosthetic valve during TAVR.
June 2018: Clinical Case Reports
Gabriela Tirado-Conte, Josep Rodés-Cabau, Ramón Rodríguez-Olivares, Marco Barbanti, Thibault Lhermusier, Ignacio Amat-Santos, Stefan Toggweiler, Asim N Cheema, Antonio J Muñoz-García, Vicenc Serra, Francesca Giordana, Gabriela Veiga, Pilar Jiménez-Quevedo, Francisco Campelo-Parada, Lucca Loretz, Denise Todaro, María Del Trigo, José M Hernández-García, Bruno García Del Blanco, Francesco Bruno, José M de la Torre Hernández, Pieter Stella, Corrado Tamburino, Carlos Macaya, Luis Nombela-Franco
BACKGROUND: Chronic liver disease is a known risk factor for perioperative morbidity and mortality in patients undergoing cardiac surgery. Very little data exist about such patients treated with transcatheter aortic valve replacement (TAVR). Our objective was to evaluate early and late clinical outcomes in a large cohort of patients with liver disease undergoing TAVR and to determine predictive factors of mortality among these patients. METHODS AND RESULTS: This multicenter study collected data from 114 patients with chronic liver disease who underwent TAVR in 12 institutions...
March 2018: Circulation. Cardiovascular Interventions
Dominik Zinsser, Alena B Baumann, Katharina Stella Winter, Fabian Bamberg, Philipp Lange, Konstantin Nikolaou, Maximilian Reiser, Christian Kupatt, Thomas Kröncke, Florian Schwarz
To compare a semi-automatic software tool for the measurement of aortic annulus dimensions with manual measurements by expert readers and to analyze whether and to what extent interchangeability exists between semi-automatic and manual measurements. We retrospectively included 374 consecutive patients with high-grade aortic stenosis who had undergone CT-angiography of the heart prior to trans-catheter aortic valve replacement (TAVR). In independent analyses, two expert readers manually measured aortic annulus dimensions (long axis, short axis, circumference, area) as well as the distance of the coronary ostia from the annulus plane...
June 5, 2018: International Journal of Cardiovascular Imaging
Nevena Zivkovic, Gabby Elbaz-Greener, Feng Qiu, Yaron Arbel, Asim N Cheema, Danny Dvir, Paul Fefer, Ariel Finkelstein, Stephen E Fremes, Sam Radhakrishnan, Josep Rodés-Cabau, Mony Shuvy, Harindra C Wijeysundera
Background: Acute kidney injury (AKI) is a common post-transcatheter aortic valve replacement (TAVR) complication associated with a poor prognosis. We sought to create a risk calculator using information that would be available during the work-up period. Methods: Data were obtained from a multicentre TAVR registry (n=1993) with cases from 1 January 2012 to 31 December 2015. We used logistic regression to create a risk calculator to predict AKI as defined by the Valve Academic Research Consortium Guidelines...
2018: Open Heart
Suzanne J Baron, Vinod H Thourani, Susheel Kodali, Suzanne V Arnold, Kaijun Wang, Elizabeth A Magnuson, Augusto D Pichard, Vasilis Babaliaros, Isaac George, D Craig Miller, Murat Tuzcu, Kevin Greason, Howard C Herrmann, Craig R Smith, Martin B Leon, David J Cohen
OBJECTIVES: The aim of this study was to evaluate whether transcatheter aortic valve replacement (TAVR) with the SAPIEN 3 valve (S3-TAVR) results in improved quality of life (QoL) compared with previous-generation TAVR devices or surgical aortic valve replacement (SAVR). BACKGROUND: In patients with severe aortic stenosis at intermediate surgical risk, TAVR using the SAPIEN XT valve (XT-TAVR) results in similar QoL compared with SAVR. Compared with SAPIEN XT, the SAPIEN 3 valve offers a lower delivery profile and modifications to reduce paravalvular regurgitation...
May 25, 2018: JACC. Cardiovascular Interventions
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