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Laura J Davidson, Charles J Davidson
Stroke leads to significant morbidity, disability, and mortality after TAVR. CKD and prior stroke are risk factors for stroke. Stratification of stroke risk would improve outcomes associated with TAVR. Ongoing prospective randomized trials on embolic protection and post implant anticoagulation are promising strategies to reduce stroke risk and new brain MRI lesions.
October 2016: Catheterization and Cardiovascular Interventions
Francesco Nappi, Cristiano Spadaccio, Jean Louis Sablayrolles
The recent literature on transcatheter aortic valve replacement (TAVR) is shedding new light on the perspective to extend this procedure to other lower risk-category of patients, leading in fact to a potential erosion of the current guidelines. Notwithstanding the warnings provided in the literature regarding the risk of severely impairing complications, unclear survival advantage and cost-inefficiency, many observational studies, especially performed in high-volume centers, support a general drive toward the recruitment of intermediate-low risk patients in the expectation of clinical advantages versus standard surgical replacement...
October 6, 2016: JACC. Cardiovascular Interventions
Lars Sondergaard
During the last decade transcatheter aortic valve replacement (TAVR) has been established as a treatment for patients with severe aortic stenosis, who are at particularly high surgical risk. As compared with surgical aortic valve replacement (SAVR), TAVR has been associated with lower early risk of mortality, atrial fibrillation, acute kidney injury and bleeding. Furthermore, device and peri-procedural improvements have addressed most of the initial limitations for TAVR, including the Achilles' heel, paravalvular leakage...
October 6, 2016: JACC. Cardiovascular Interventions
Lorin Arie Schwartz, Zach Rozenbaum, Ehab Ghantous, Judith Kramarz, Simon Biner, Michael Ghermezi, Jason Shimiaie, Ariel Finkelstein, Shmuel Banai, Galit Aviram, Meirav Ingbir, Gad Keren, Yan Topilsky
BACKGROUND: Right ventricular (RV) dysfunction and tricuspid regurgitation (TR) may coexist with aortic stenosis. The aim of this study was to assess the association between RV dysfunction, TR, associated comorbidities, and outcomes following transcatheter aortic valve replacement (TAVR). METHODS: A retrospective analysis was conducted of baseline and 6-month clinical and echocardiographic parameters, including TR grade, RV size (grade, end-diastolic and end-systolic areas, annular diameter), and function (grade, tricuspid annular plane systolic excursion [TAPSE], fractional area change, Tei index), in 519 consecutive TAVR patients...
October 11, 2016: Journal of the American Society of Echocardiography
Pedro A Villablanca, Verghese Mathew, Vinod H Thourani, Josep Rodés-Cabau, Sripal Bangalore, Mohammed Makkiya, Peter Vlismas, David F Briceno, David P Slovut, Cynthia C Taub, Patrick M McCarthy, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic-valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at high operative risk. We sought to determine the long-term (≥1year follow-up) safety and efficacy TAVR compared with SAVR in patients with severe AS. METHODS: A comprehensive search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 10 April 2016...
October 6, 2016: International Journal of Cardiology
Pablo Codner, Amos Levi, Giuseppe Gargiulo, Fabien Praz, Kentaro Hayashida, Yusuke Watanabe, Darren Mylotte, Nicolas Debry, Marco Barbanti, Thierry Lefèvre, Thomas Modine, Johan Bosmans, Stephan Windecker, Israel Barbash, Jan-Malte Sinning, Georg Nickenig, Alon Barsheshet, Ran Kornowski
Patients with advanced chronic renal dysfunction were excluded from randomized trials of transcatheter aortic valve replacement (TAVR). The potential impact of chronic renal disease on TAVR prognosis is not fully understood. We aim to evaluate outcomes within a large cohort of patients who underwent TAVR distinguished by renal function. Baseline characteristics, procedural data, and clinical follow-up findings were collected from 10 high-volume TAVR centers in Europe, Israel, and Japan. Data were analyzed according to renal function...
September 15, 2016: American Journal of Cardiology
Jeremy Ben-Shoshan, Arie Steinvil, Yaron Arbel, Yan Topilsky, Leehee Barak, Michal Entin-Meer, Ran Levy, Arie Lorin Schwartz, Gad Keren, Ariel Finkelstein, Shmuel Banai
BACKGROUND: Transcatheter aortic valve replacement (TAVR) exposes the systemic vasculature to increased mechanical forces. Endothelial adaptation to mechanical stimuli is associated with angiogenic activation through various growth factors. We studied the potential angiogenic shift evoked by TAVR. METHODS: From a cohort of 69 consecutive patients undergoing TAVR, we excluded patients with conditions known to affect angiogenic factors, and serum vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-1 and Ang-2 were assessed by ELISA...
June 25, 2016: Canadian Journal of Cardiology
Jose F Condado, Hanna A Jensen, Aneel Maini, Yi-An Ko, Mohammad H Rajaei, Lillian L Tsai, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert A Guyton, Vasilis Babaliaros, Edward P Chen, Michael Halkos, Amy Simone, Patricia Keegan, Peter C Block, Vinod H Thourani
BACKGROUND: Screening for internal carotid artery stenosis (ICAS) with Doppler ultrasound is commonly used before cardiovascular surgery. Nevertheless, the relationship between ICAS and procedure-related stroke in isolated aortic valve replacement is unclear. METHODS: We retrospectively reviewed patients with artery stenosis who underwent ICAS screening before surgical (SAVR) or transcatheter aortic valve replacement (TAVR) between January 2007 and August 2014. Logistic regression models were used to determine the relation between post-procedure stroke and total (sum of left and right ICAS) and maximal unilateral ICAS...
October 4, 2016: Annals of Thoracic Surgery
Kimberly Naden Hollander, Mario Montealegre-Gallegos, Feroze Mahmood
In recent years, the use of transcatheter aortic valve replacement (TAVR) has extended beyond the treatment of native aortic valve stenosis in patients with high surgical risk. TAVR is increasingly being performed for bioprosthetic aortic valve failure, i.e., the valve-in-valve (VIV) procedure. Establishing the success of a VIV procedure can be challenging in these cases. Furthermore, the limited availability of prostheses sizes further complicates the management of these patients. We present an unusual case of a repeat TAVR in a patient who previously had a VIV procedure in an aortic homograft...
October 2016: Annals of Cardiac Anaesthesia
John D Carroll
No abstract text is available yet for this article.
October 11, 2016: Journal of the American College of Cardiology
Martine Gilard, Hélène Eltchaninoff, Patrick Donzeau-Gouge, Karine Chevreul, Jean Fajadet, Pascal Leprince, Alain Leguerrier, Michel Lievre, Alain Prat, Emmanuel Teiger, Thierry Lefevre, Didier Tchetche, Didier Carrié, Dominique Himbert, Bernard Albat, Alain Cribier, Arnaud Sudre, Didier Blanchard, Gilles Rioufol, Frederic Collet, Remi Houel, Pierre Dos Santos, Nicolas Meneveau, Said Ghostine, Thibaut Manigold, Philippe Guyon, Dominique Grisoli, Herve Le Breton, Stephane Delpine, Romain Didier, Xavier Favereau, Geraud Souteyrand, Patrick Ohlmann, Vincent Doisy, Gilles Grollier, Antoine Gommeaux, Jean-Philippe Claudel, Francois Bourlon, Bernard Bertrand, Marc Laskar, Bernard Iung
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized management of high-risk patients with severe aortic stenosis. However, survival and the incidence of severe complications have been assessed in relatively small populations and/or with limited follow-up. OBJECTIVES: This report details late clinical outcome and its determinants in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. METHODS: The FRANCE-2 registry prospectively included all TAVRs performed in France...
October 11, 2016: Journal of the American College of Cardiology
Peter Dovjak
No abstract text is available yet for this article.
October 5, 2016: Zeitschrift Für Gerontologie und Geriatrie
Ted Feldman, Michael J Reardon
No abstract text is available yet for this article.
October 2016: Journal of Invasive Cardiology
Tomo Ando, Alexandros Briasoulis, Anthony A Holmes, Hisato Takagi, David P Slovut
BACKGROUND: The transfemoral (TF) approach has become the preferred approach for transcatheter aortic valve replacement (TAVR) because of its low risk profile. However, the relative safety of the percutaneous approach (PC) compared to surgical cut-down (SC) remains unclear. Our aim was to compare the outcomes between PC versus SC access in patients undergoing TF-TAVR using a meta-analysis. METHODS: We conducted a systematic electronic database search for studies reporting major and minor vascular complications (VC), major and minor bleeding, and perioperative all-cause mortality, in PC versus SC TF-TAVR cases...
October 3, 2016: Journal of Cardiac Surgery
Swaroop Margale, Sarvesh Natani
No abstract text is available yet for this article.
July 19, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Vincent Auffret, Francisco Campelo-Parada, Ander Regueiro, María Del Trigo, Olivier Chiche, Chekrallah Chamandi, Ricardo Allende, Juan G Cordoba-Soriano, Jean-Michel Paradis, Robert De Larochellière, Daniel Doyle, Eric Dumont, Siamak Mohammadi, Mélanie Côté, Alier Marrero, Rishi Puri, Josep Rodés-Cabau
BACKGROUND: Data regarding the mid- to long-term cognitive trajectory of transcatheter aortic valve (TAVR) recipients are scarce. OBJECTIVES: Changes in global cognition and specific cognitive domains up to 1 year post-TAVR were evaluated. METHODS: Fifty-one patients (median age 80.0 [interquartile range: 72.0 to 85.0] years; 37% women) underwent TAVR and prospective assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) at baseline, short-term (30 days), and 1 year post-TAVR...
September 22, 2016: Journal of the American College of Cardiology
Philippe Généreux
No abstract text is available yet for this article.
September 22, 2016: Journal of the American College of Cardiology
Avais Jabbar, Ayush Khurana, Ashfaq Mohammed, Rajiv Das, Azfar Zaman, Richard Edwards
Transcatheter aortic valve replacement (TAVR) is conventionally performed under general anesthesia (GA) allowing intraoperative transoesophageal echocardiogram imaging. We present our experience in patients having the procedure under local anesthesia (LA), who were subsequently transferred to a low dependency unit postprocedure, to assess safety and length of hospital stay. We retrospectively assessed all the transfemoral TAVR procedures conducted at our center from January 03, 2011. Of 216 patients, 145 had the procedure under GA and 71 under LA...
August 30, 2016: American Journal of Cardiology
Kevin Phan, Joshua M Haswell, Joshua Xu, Yusuf Assem, Stephanie L Mick, Samir R Kapadia, Anson Cheung, Frederick S Ling, Tristan D Yan, Vakhtang Tchantchaleishvili
De novo progressive aortic insufficiency (AI) is a side effect frequently related to prolonged support with continuous-flow left ventricular assist devices (CF-LVAD). Its progression can result in recurrent clinical heart failure symptoms and significantly increased mortality. Recently, percutaneous intervention methods such as transcatheter aortic valve replacement (TAVR) and percutaneous occluder devices have emerged, However, given the very scarce global experience with these approaches, evidence in the literature is lacking...
September 22, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
George Makdisi, Peter B Makdisi, I-Wen Wang
The superiority of transcatheter aortic valve replacement (TAVR) compared with medical therapy for patients with aortic stenosis (AS) who are not suitable candidates for surgery had been proven. Cardiopulmonary bypass (CPB) is rarely used in TAVR. Reports of early use of extracorporeal membranous oxygenator (ECMO) have promising outcomes. ECMO offers the option of cardiac support rescue in case of intraoperative hemodynamic instability and can be instituted in advance when hemodynamic instability is expected...
August 2016: Annals of Translational Medicine
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