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https://www.readbyqxmd.com/read/29445840/-serious-adverse-events-in-clinical-trials-with-tavr-and-savr
#1
U Barth
BACKGROUND: The expansion of the transcatheter aortic valve replacement (TAVR) indication towards patients with intermediate surgical risk (Ref. Society of Thoracic Surgeons, STS, score) was analyzed. The aim was to investigate if the complication rates particularly with respect to TAVR and surgical aortic valve replacement (SAVR) concerning patients with intermediate risk are comparable. METHODS: An analysis of serious adverse events (SAEs) and complication rates in clinical trials with TAVR and SAVR of these patients in comparison with high surgical risk patients was performed with the scientific literature and in the Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte, BfArM) database (2012-2017)...
February 14, 2018: Herz
https://www.readbyqxmd.com/read/29440625/safety-and-feasibility-of-a-novel-active-fixation-temporary-pacing-lead
#2
Mark Webster, Sanjeevan Pasupati, Nigel Lever, Martin Stiles
OBJECTIVE: This first-in-human study evaluated the safety and technical feasibility of the Tempo temporary cardiac pacing lead (BioTrace Medical), which includes a novel fixation mechanism and soft tip. BACKGROUND: Complications of temporary pacing leads include dislodgment, arrhythmias, and ventricular perforation. Temporary pacing applications have increased with transcatheter aortic valve replacement (TAVR) growth, for rapid pacing during balloon valvuloplasty (BAV) and valve deployment, and for periprocedural bradyarrhythmia support...
February 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29440192/impact-of-anticoagulation-therapy-on-valve-haemodynamic-deterioration-following-transcatheter-aortic-valve-replacement
#3
María Del Trigo, Antonio J Muñoz-García, Azeem Latib, Vincent Auffret, Harindra C Wijeysundera, Luis Nombela-Franco, Enrique Gutierrez, Asim N Cheema, Vicenç Serra, Ignacio J Amat-Santos, Joelle Kefer, Luis Miguel Benitez, Florence Leclercq, Antonio Mangieri, Hervé Le Breton, Pilar Jiménez-Quevedo, Bruno Garcia Del Blanco, Antonio Dager, Omar Abdul-Jawad Altisent, Rishi Puri, Philippe Pibarot, Josep Rodés-Cabau
OBJECTIVE: To evaluate the changes in transvalvular gradients and the incidence of valve haemodynamic deterioration (VHD) following transcatheter aortic valve replacement (TAVR), according to use of anticoagulation therapy. METHODS AND RESULTS: This multicentre study included 2466 patients (46% men; mean age 81±7 years) who underwent TAVR with echocardiography performed at 12-month follow-up. Anticoagulation therapy was used in 707 patients (28.7%) following TAVR (AC group)...
February 13, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29437037/comparative-analysis-of-cerebrovascular-events-in-transcatheter-and-surgical-aortic-valve-replacement-systematic-review-and-meta-analysis-of-randomized-trials
#4
Divyanshu Mohananey, Prasanna Sengodan, Kinjal Banerjee, Arnav Kumar, Yash Jobanputra, Kesavan Sankaramangalam, Amar Krishnaswamy, Stephanie Mick, Jonathon M White, Lars G Svensson, Samir R Kapadia
AIMS: Transcatheter aortic valve replacement (TAVR) has become the procedure of choice for inoperable patients and a safe alternative to surgical aortic valve replacement (SAVR) among moderate risk patients. We used meta-analysis to compare the incidence of cerebrovascular events amongst patients undergoing TAVR and SAVR in randomized controlled trials (RCT). METHODS AND RESULTS: Our search revealed 5 RCTs published between 2011 and 2017 with a total of 5414 patients...
February 13, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29435741/the-pivotal-role-of-imaging-in-tavr-procedures
#5
REVIEW
Caroline Bleakley, Mark J Monaghan
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) is underpinned by an array of imaging techniques designed to not only select an appropriately sized implant but also to identify potential obstacles to procedural success. This review presents currently important aspects of TAVR imaging, describing the salient features of each modality as well as recent developments in the field. RECENT FINDINGS: The latest data on TAVR outcomes reflects the increasing experience of operators and the significant role of pre-procedural imaging...
February 12, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29434631/transcatheter-aortic-valve-replacement-and-stroke-a-comprehensive-review
#6
REVIEW
Periklis A Davlouros, Virginia C Mplani, Ioanna Koniari, Grigorios Tsigkas, George Hahalis
Transcatheter aortic valve implantation (TAVR) has emerged as an alternative, rapidly evolving treatment option for patients with severe aortic stenosis and high surgical risk. Stroke is a devastating complication being confined mainly in the periprocedural and 30-day period following TAVR, with a lower and relatively constant frequency thereafter. Early stroke is mainly due to debris embolization during the procedure, whereas later events are associated with patient specific factors. Despite the fact that the rate of clinical stroke has been constantly decreasing compared to initial TAVR experience, modern neuro-imaging with MRI suggests that new ischemic lesions post-TAVR are almost universal...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29434629/transcatheter-versus-surgical-aortic-valve-replacement-in-severe-symptomatic-aortic-stenosis
#7
REVIEW
Tsigkas Grigorios, Despotopoulos Stefanos, Makris Athanasios, Koniari Ioanna, Armylagos Stylianos, Davlouros Periklis, Hahalis George
Aortic stenosis (AS) is the most common type of valvular heart disease in the elderly. Surgical aortic valve replacement (SAVR) has been the standard practice for treating severe, symptomatic AS, but recently new treatment options have emerged. Transcatheter aortic valve replacement (TAVR) is now an established treatment option in patients at high surgical risk. In this review, we focus on recent developments and compare the two treatment methods in specific populations in terms of efficacy and safety (e.g...
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29434626/tavr-in-2017-what-we-know-what-to-expect
#8
Panagiota Kourkoveli, Konstantinos Spargias, George Hahalis
No abstract text is available yet for this article.
January 2018: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29430888/early-post-approval-experience-with-transcatheter-aortic-valve-replacement-in-the-united-states
#9
Jennifer M Burg, Nora F Fino, Frederick A Tibayan, Victor Rodriguez, Jaishankar Raman, Firas Zahr, Howard K Song
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is changing the treatment of aortic stenosis. We compared cost and clinical outcomes of TAVR versus surgical aortic valve repair (SAVR) in the real-world setting since US TAVR approval in 2012. METHODS: The Nationwide Inpatient Sample (NIS) dataset was analyzed by quarter (Jun 2012- Dec 2014). Patients (>65yo) undergoing TAVR or SAVR were identified and risk stratified based on APR-DRG Mortality risk score...
February 8, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29430779/editorial-who-when-and-how-to-bav-in-the-tavr-era
#10
EDITORIAL
Bruce J Rutkin
No abstract text is available yet for this article.
February 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29421017/temporal-trends-in-patient-referral-for-transcatheter-aortic-valve-replacement-and-reasons-for-exclusion-at-a-high-volume-center-in-the-united-states
#11
Kyle D Buchanan, Toby Rogers, M Chadi Alraies, Arie Steinvil, Edward Koifman, Ricardo O Escárcega, Arpi Tavil-Shatelyan, Joelle Salmon, Jiaxiang Gai, Linzhi Xu, Rebecca Torguson, Petros Okubagzi, Augusto Pichard, Itsik Ben-Dor, Lowell F Satler, Ron Waksman
BACKGROUND: Clinical indications for transcatheter aortic valve replacement (TAVR) and elements of the implantation procedure, including delivery system miniaturization and novel access options, have evolved over time. The reasons patients are excluded from TAVR also have changed. The impact of these changes on patient referral for and exclusion from TAVR is unknown. METHODS: We retrospectively analyzed patients referred to our center for TAVR from January 2010 to August 2016 to evaluate reasons for patient exclusion...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29413244/long-term-outcomes-in-patients-with%C3%A2-new-permanent-pacemaker-implantation-following-transcatheter-aortic-valve-replacement
#12
Chekrallah Chamandi, Marco Barbanti, Antonio Munoz-Garcia, Azeem Latib, Luis Nombela-Franco, Enrique Gutiérrez-Ibanez, Gabriela Veiga-Fernandez, Asim N Cheema, Ignacio Cruz-Gonzalez, Vicenç Serra, Corrado Tamburino, Antonio Mangieri, Antonio Colombo, Pilar Jiménez-Quevedo, Jaime Elizaga, Gerard Laughlin, Dae-Hyun Lee, Bruno Garcia Del Blanco, Tania Rodriguez-Gabella, Josep-Ramon Marsal, Mélanie Côté, François Philippon, Josep Rodés-Cabau
OBJECTIVES: This study sought to evaluate the long-term clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Conduction disturbances leading to PPI are common following TAVR. However, no data exist regarding the impact of PPI on long-term outcomes post-TAVR. METHODS: This was a multicenter study including a total of 1,629 patients without prior PPI undergoing TAVR (balloon- and self-expandable valves in 45% and 55% of patients, respectively)...
February 12, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29405600/conscious-sedation-for-tavr-a-wave-of-the-future
#13
EDITORIAL
Christina Tan, Larry S Dean
As indications for TAVR continue to grow, experienced centers strive to adopt further minimally invasive techniques and continue to improve outcomes. Meta-analysis of the available data demonstrate that conscious sedation is associated with decreased ICU and hospitalization time, and is not associated with decreased procedural efficacy or safety. Randomized Controlled clinical Trial data will be needed to confirm observational findings suggesting decreased mortality with conscious sedation versus general anesthesia...
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29405594/maximal-efficiency-is-required-to-minimize-complications-and-hospital-stay-after-tavr
#14
EDITORIAL
Carlo Di Mario, Carlotta Sorini Dini
When TAVR is performed with transfemoral percutaneous approach, local anesthesia, no routine post-procedural intensive care admission, an early discharge (<3 days) can be adopted in most TAVR patients Avoiding peri-procedural complications and minimizing pace-maker implantation rate are key to allow early patient discharge When properly selected, patients discharged early have low discharge have low risk of adverse events and readmissions in the first 30 days.
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29404360/access-site-complications-in-transcutaneous-aortic-valve-replacement-frequency-outcomes-prevention-and-treatment
#15
REVIEW
Samuel Latham, Tamunoinemi Bob-Manuel, Arindam Sharma, Amit Nanda, Devareshi Ardeshna, Rami N Khouzam
Aortic stenosis (AS) is a common cause of valvular heart disease with heavy disease burden in elderly patients. It is present in almost 7% of patients older than 65. The mortality rate increases significantly once it becomes symptomatic with average life expectancy of around 1-year. Symptoms include angina, syncope, or heart failure. This requires either surgical or transcutaneous replacement. Transcutaneous aortic valve replacement (TAVR) use has increased in recent years from high risk patients to now even including intermediate risk patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29404357/permanent-pacemaker-insertion-in-patients-with-conduction-abnormalities-post-transcatheter-aortic-valve-replacement-a-review-and-proposed-guidelines
#16
REVIEW
Tamunoinemi Bob-Manuel, Amit Nanda, Samuel Latham, Issa Pour-Ghaz, William Paul Skelton, Rami N Khouzam
Conduction abnormalities are a common and serious complication of transcatheter aortic valve replacement (TAVR) with well-established predictive factors. Current guidelines are not concrete, leaving several questions unanswered about indications, timing and risks of pacemaker implantation post-TAVR. In this review article, we discuss current guidelines, predictors of pacemaker implantation, clinical implications of this procedure and our recommendations for reducing the pacemaker implantation rate post-TAVR...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29404356/a-review-of-racial-disparities-in-transcatheter-aortic-valve-replacement-tavr-accessibility-referrals-and-implantation
#17
REVIEW
Tamunoinemi Bob-Manuel, Arindam Sharma, Amit Nanda, Devarshi Ardeshna, William Paul Skelton, Rami N Khouzam
Racial disparities in transcatheter aortic valve replacement (TAVR) implantation results from several factors, including socioeconomic disparities, inherent biases in healthcare provision, fewer referrals to specialists and language barriers in some minority populations. In this review article, we discuss the current data on the racial disparities in TAVR, explore the prevalence of aortic stenosis in different demographics in the United States and we proffer practical solutions to these problems.
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29404354/outcomes-following-transcatheter-aortic-valve-replacement-in-patients-with-native-aortic-valve-regurgitation
#18
REVIEW
Tamunoinemi Bob-Manuel, Siri Kadire, Mark R Heckle, Jiajing Wang, Uzoma N Ibebuogu
Due to the absence of annular calcification for device anchoring, it is presumed that transcatheter aortic valve replacement (TAVR) is not suitable for the treatment of native aortic valve regurgitation (NAVR) resulting in very limited data and experience concerning its safety and efficacy. We sought to review published data on the safety and efficacy of TAVR in high-risk patients with NAVR. Studies including case reports, case series and original articles published between 2002 and 2016 on TAVR in patients with NAVR were identified with a systematic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29404348/impact-of-smoking-in-patients-undergoing-transcatheter-aortic-valve-replacement
#19
Manyoo Agarwal, Sahil Agrawal, Lohit Garg, Guy L Reed, Rami N Khouzam, Uzoma N Ibebuogu
Background: The paradox that smokers have better clinical outcomes in cardiovascular diseases remains controversial. No literature exists studying impact of smoking on outcomes following transcatheter aortic valve replacement (TAVR). Methods: We performed an electronic search of the 2011-2012 National Inpatient Sample (NIS) database to identify all TAVR hospitalizations. Outcomes were measured comparing smokers to non-smokers. Results: A total of 8,345 TAVR hospitalizations were identified with 24% being smokers...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29399947/supra-annular-structure-assessment-for-self-expanding-transcatheter-heart-valve-size-selection-in-patients-with-bicuspid-aortic-valve
#20
Xianbao Liu, Yuxin He, Qifeng Zhu, Feng Gao, Wei He, Lei Yu, Qijing Zhou, Minjian Kong, Jian'an Wang
OBJECTIVES: To explore assessment of supra-annular structure for self-expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS). BACKGROUND: Annulus-based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra-annular deformity, device selection for bicuspid AS has not been systemically studied. METHODS: Twelve patients with bicuspid AS who underwent TAVR with self-expanding THVs were included in this study...
February 5, 2018: Catheterization and Cardiovascular Interventions
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