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https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#1
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28633252/delayed-management-of-partial-aortic-valve-avulsion-after-transcatheter-aortic-valve-replacement
#2
Dimitri Sherev, Khalid Azizi, Nassir A Azimi, Susan Van Nordheim, Ricardo Moreno-Cabral
We report a case of delayed treatment of a partial aortic valve leaflet avulsion during transcatheter aortic valve replacement (TAVR) and its successful management by a percutaneous snare retrieval technique. Post-TAVR transesophogeal echocardiography showed an avulsed native valve leaflet. We deferred retrieval of the mass with anticoagulant agents. One month later, a 30-mm EN-Snare was used to snare the mass. This case report demonstrates that the management of an avulsed aortic valve leaflet can be safely deferred with the use of an anticoagulant agent...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28630980/in-severe-aortic-stenosis-with-intermediate-surgical-risk-tavr-was-noninferior-to-savr-for-death-or-disabling-stroke
#3
Frederick A Spencer, Gordon H Guyatt
No abstract text is available yet for this article.
June 20, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28625366/feasibility-of-transcatheter-aortic-valve-replacement-in-low-risk-patients-with-symptomatic-severe-aortic-stenosis-rationale-and-design-of-the-low-risk-tavr-lrt-study
#4
Toby Rogers, Rebecca Torguson, Roshni Bastian, Paul Corso, Ron Waksman
BACKGROUND: Safety and effectiveness of transcatheter aortic valve replacement (TAVR) in low-risk patients with symptomatic severe aortic stenosis have not yet been established. HYPOTHESIS: Transcatheter aortic valve replacement is feasible in patients with symptomatic severe aortic stenosis and low risk for surgical aortic valve replacement. DESIGN: The LRT study is the first US Food and Drug Administration-approved Investigational Device Exemption prospective multicenter feasibility trial of TAVR in low-risk patients...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28623173/outcomes-of-transcatheter-and-surgical-aortic-valve-replacement-in-patients-on-maintenance-dialysis
#5
Fahad Alqahtani, Sami Aljohani, Khaled Boobes, Elad Maor, Assem Sherieh, Charanjit S Rihal, David R Holmes, Mohamad Alkhouli
BACKGROUND: the introduction of transcatheter aortic valve replacement (TAVR) expanded definitive therapy of aortic stenosis to many high-risk patients, but it has not been fully evaluated in the dialysis population. OBJECTIVES: We aimed to evaluate the current trend and in-hospital outcome of Surgical aortic valve replacement (SAVR) and TAVR in the dialysis population. METHODS: Severe aortic stenosis patients on maintenance dialysis who underwent SAVR or TAVR in the Nationwide Inpatient Sample database (NIS) from January 1, 2005, through December 31, 2014, were included in our comparative analysis...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28622944/effect-of-ascending-aortic-dimension-on-acute-procedural-success-following-self-expanding-transcatheter-aortic-valve-replacement-a-multicenter-retrospective-analysis
#6
Yoshio Maeno, Sung-Han Yoon, Yigal Abramowitz, Yusuke Watanabe, Hasan Jilaihawi, Mao-Shin Lin, Jason Chan, Rahul Sharma, Hideyuki Kawashima, Sharjeel Israr, Hiroyuki Kawamori, Masaki Miyasaka, Tanya Rami, Yoshio Kazuno, Geeteshwar Mangat, Mohammad Kashif, Tarun Chakravarty, Hsien-Li Kao, Michael Kang-Yin Lee, Mamoo Nakamura, Ken Kozuma, Wen Cheng, Raj R Makkar
AIMS: Self-expanding (SE) valves are characterized with long stent frame design and the radial force of the device exists both in the inflow and outflow level. Therefore, we hypothesized that device success of SE-valves may be influenced by ascending aortic dimensions (AAD). The aim of this study was to determine the influence of AAD on acute device success rates following SE transcatheter aortic valve replacement (TAVR). METHODS & RESULTS: In 4 centers in the United States and Asia, 214 consecutive patients underwent SE-TAVR...
June 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28612418/the-problem-of-delirium-following-transcatheter-aortic-valve-replacement
#7
EDITORIAL
Katia Orvin, Ran Kornowski
Delirium is a common condition among elderly patients, particularly those hospitalized following surgical procedures. A study indicates that delirium occurs in 1 out of 5 patients following TAVR and it was found to be associated with diminished survival, prolonged hospitalization, and increased healthcare utilization. Delirium is potentially preventable and treatable clinical syndrome.
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28606675/unlike-for-pci-for-tavr-smaller-is-better
#8
EDITORIAL
Francesco Meucci, Pierluigi Stefàno, Carlo Di Mario
No abstract text is available yet for this article.
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28603718/impact-of-sleep-apnea-on-in-hospital-outcomes-after-transcatheter-aortic-valve-replacement-insight-from-national-inpatient-sample-database-2011-2014
#9
Ilhwan Yeo, Hasan Ahmad, Wilbert S Aronow
BACKGROUND: Sleep apnea is associated with worse outcomes following various kinds of surgeries. There is a paucity of data on the association of sleep apnea with clinical outcomes after transcatheter aortic valve replacement (TAVR). METHODS: We used National Inpatient Sample (NIS) data 2011-2014 to identify patients undergoing TAVR. Association between sleep apnea and in-hospital postoperative outcomes were assessed by multivariate logistic regression and 1:1 propensity score matching analyses...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28597767/increased-mortality-from-complications-of-pulmonary-hypertension-in-patients-undergoing-transcatheter-aortic-valve-replacement
#10
Raj Parikh, Benson Varghese, Huma N Khatoon, Julie A Kovach, Clifford J Kavinsky, Rajive Tandon
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28593421/interventional-treatment-of-the-aortic-valve-current-evidence
#11
F Jansen, N Werner
Transcatheter aortic valve replacement (TAVR) has become a standard treatment for patients with severe, symptomatic aortic stenosis. Whereas its use was first limited to inoperable high-risk patients, recent studies demonstrated that TAVR was not inferior to standard surgical aortic valve replacement (SAVR) for intermediate-risk patients. Besides equivalent outcomes, the type and rates of complications differ between the two procedures. Here, we provide an overview of the latest randomized study results comparing TAVR with SAVR and describe possible future directions in transcatheter aortic valve treatment...
June 7, 2017: Herz
https://www.readbyqxmd.com/read/28589708/modified-continuity-equation-using-left-ventricular-outflow-tract-three-dimensional-imaging-for-aortic-valve-area-estimation
#12
Pedro Pinto Teixeira, Ruben Ramos, Pedro Rio, Luísa Moura Branco, Guilherme Portugal, Ana Abreu, Ana Galrinho, Hugo Marques, Luísa Figueiredo, Rui Cruz Ferreira
PURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT...
June 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28588078/walking-as-a-window-to-risk-and-resiliency
#13
Karen P Alexander
Walking is fundamental to preserving health and independence. An individual's usual pace of walking is also recognized as an indicator of health, risk for dependency, and a predictor of long-term survival. Reducing gait speed by just 0.1m/sec provides important information about outcomes in older adults that goes beyond chronologic age, sex, comorbidity, and self-reported function combined. This small reduction in gate speed is significant because each individual sets the pace necessary to accommodate a host of integrated functions that allow him or her to walk...
June 6, 2017: Circulation
https://www.readbyqxmd.com/read/28588077/predictors-and-association-with-clinical-outcomes-of-the-changes-in-exercise-capacity-following-transcatheter-aortic-valve-replacement
#14
Omar Abdul-Jawad Altisent, Rishi Puri, Ander Regueiro, Chekrallah Chamandi, Tania Rodriguez-Gabella, Maria Del Trigo, Francisco Campelo-Parada, Thomas Couture, Josep R Marsal, Mélanie Côté, Jean-Michel Paradis, Robert DeLarochellière, Daniel Doyle, Siamak Mohammadi, Eric Dumont, Josep Rodés-Cabau
Background -There are presently no objective data specifically examining variations in exercise capacity post-TAVR. We describe the changes in exercise capacity between baseline and 6 months post-TAVR, and ascertain factors associated with a lack of improvement in exercise capacity post-TAVR. Methods -A total of 305 patients (mean age: 79±9 years; 44% men; STS score: 6.7%±4.2%) undergoing TAVR completed both baseline and follow-up exercise capacity assessments at 6 months post-TAVR. Exercise capacity was evaluated by the six-minute walk test (6MWT)...
June 6, 2017: Circulation
https://www.readbyqxmd.com/read/28583682/outcome-of-stent-graft-implantation-for-treatment-of-access-site-bleeding-after-transfemoral-transcatheter-aortic-valve-replacement
#15
Adi Segal, Moshe Y Flugelman, Nader Khader, Ronen Rubinshtein, Idit Lavi, Ron Karmeli, Ayman Jubran, Avinoam Shiran, Ronen Jaffe
Vascular complications are common after transcatheter aortic valve replacement (TAVR) and are associated with increased morbidity and mortality. Stent graft implantation enables percutaneous treatment of access site bleeding; however, the efficacy and durability and of this approach are unknown. We studied the immediate outcome of stent graft implantation for control of access site bleeding and the need for repeat vascular interventions after stenting, in a cohort of consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28583399/acute-aortic-arch-perforation-during-transcatheter-aortic-valve-replacement-in-bicuspid-aortic-stenosis-and-a-gothic-aortic-arch
#16
Oscar Millan-Iturbe, Fadi J Sawaya, Gintautas Bieliauskas, Danny H F Chow, Ole De Backer, Lars Søndergaard
Transcatheter aortic valve replacement (TAVR) has evolved from a novel technology to an established therapy for high/intermediate-risk patients with severe symptomatic aortic stenosis (AS). Although TAVR is used to treat bicuspid severe AS, the large randomized trials typically excluded bicuspid AS because of its unique anatomic features. This case report describes an acute aortic perforation during delivery of a transcatheter heart valve to treat a severe bicuspid AS with a "gothic aortic arch"; more careful evaluation of the preprocedural multislice computed tomographic scan would have unveiled a sharply angulated aortic arch...
March 28, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28579163/use-of-two-dimensional-ultrasonographically-guided-access-to-reduce-access-related-complications-for-transcatheter-aortic-valve-replacement
#17
Gabby Elbaz-Greener, Nevena Zivkovic, Yaron Arbel, Sam Radhakrishnan, Stephen E Fremes, Harindra C Wijeysundera
BACKGROUND: Major vascular complications have been associated with increased mortality and morbidity in patients undergoing transcatheter aortic valve replacement (TAVR). Our objective was to compare vascular and bleeding outcomes with the routine use of 2-dimensional ultrasonography (2D-US) guided femoral artery access in percutaneous transfemoral TAVR compared with traditional anatomic landmark palpation with angiographically-guided access. METHODS: This single-centre retrospective cohort study was conducted in Ontario, Canada...
April 4, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28577851/impact-of-liver-indicators-on-clinical-outcome-in-patients-undergoing-transcatheter-aortic-valve-implantation
#18
Daniel Wendt, Philipp Kahlert, Ali Canbay, Stephan Knipp, Martin Thoenes, Gordina Cremer, Fadi Al-Rashid, Rolf-Alexander Jánosi, Karim El-Chilali, Markus Kamler, Mohamed El Gabry, Philipp Marx, Daniel Sebastian Dohle, Konstantinos Tsagakis, Jaroslav Benedik, Guido Gerken, Tienush Rassaf, Heinz Jakob, Matthias Thielmann
BACKGROUND: Liver dysfunction increases death and morbidity after cardiac operations. There are currently no data evaluating liver function in patients undergoing transcatheter aortic valve replacement (TAVR). We aimed therefore to evaluate our TAVR results in regard to liver function. METHODS: A total of 640 consecutive TAVR patients were evaluated. Of those, 11 patients presented with chronic liver disease before TAVR. The Model for End-Stage Liver Disease score was used to measure liver function in these patients...
June 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28576265/incidence-and-outcomes-of-heparin-induced-thrombocytopenia-in-patients-undergoing-transcatheter-aortic-valve-replacement
#19
Tesfaye Telila, Emmanuel Akintoye, Tomo Ando, Obsinet Merid, Sagar Mallikethi-Reddy, Alexandros Briasoulis, Cindy Grines, Luis Afonso
The main objective of this study was to investigate the incidence and magnitude of impact of heparin-induced thrombocytopenia (HIT) on outcomes of patients undergoing transcatheter aortic valve placement (TAVR). The impact of HIT on procedural outcomes after cardiac surgery has been described. We sought to investigate the incidence and outcomes of HIT after TAVR using the Nationwide Inpatient Sample (NIS) database. We identified patients who underwent TAVR from 2011 to 2014. The primary outcome was the effect of HIT on inpatient mortality...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28575079/comparison-of-forced-air-and-water-circulating-warming-for-prevention-of-hypothermia-during-transcatheter-aortic-valve-replacement
#20
Benjamin Rohrer, Emily Penick, Farhad Zahedi, Hocine Tighiouart, Brian Kelly, Frederick Cobey, Stefan Ianchulev
INTRODUCTION: Transcatheter Aortic Valve Replacement (TAVR) procedures at our institution were complicated by perioperative hypothermia despite use of the standard of care forced-air convective warming device (the BairHugger, Augustine Medical Inc, Eden Prairie, MN, USA). To remedy this problem, we initiated a quality improvement process that investigated the use of a conductive warm water-circulating device (the Allon ThermoWrap, Menen Medical Corporation, Trevose, PA, USA), and hypothesized that it would decrease the incidence of perioperative hypothermia...
2017: PloS One
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