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Transcatheter aortic valve intervention

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https://www.readbyqxmd.com/read/29055632/intervention-versus-observation-in-symptomatic-patients-with-normal-flow-low-gradient-severe-aortic-stenosis
#1
Oren Zusman, Gregg S Pressman, Shmuel Banai, Ariel Finkelstein, Yan Topilsky
OBJECTIVES: To describe patients with severe symptomatic aortic stenosis with normal flow and low gradients and determine whether they benefit from intervention. BACKGROUND: Severe symptomatic aortic stenosis is a progressive disease with high mortality. Although surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) are indicated for patients with high gradients (>40 mm Hg) or low gradients due to low flow, the approach for patients with normal flow and low gradients is poorly defined...
October 14, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29055556/transcatheter-aortic-valve-impella-and-complex-coronary-intervention
#2
Isaac Pascual, Pablo Avanzas, César Morís
No abstract text is available yet for this article.
October 18, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29049839/pusher-preventing-maximum-expansion-of-transfemoral-transcatheter-valves
#3
Josepha Koehne, Mirko Doss, Won-Keun Kim, Thomas Walther
To report on 2 rare cases of balloon-expandable transfemoral transcatheter aortic valve implantation, where a trapped balloon led to complications requiring acute intervention. Both patients were elderly with increased risk profile and had been discussed by the heart team. After standard positioning of the valves using a transfemoral approach, retrieval of the pusher before deployment of the valve was missed. In 1 patient, rapid pacing was continued, the balloon deflated, the pusher pulled back and the balloon repositioned and reinflated...
August 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29041893/-transcatheter-implantation-of-mitral-valve-prostheses-current-status-of-the-problem
#4
M A Karaskov, Y I Zhuravleva, V A Bogachev-Prokophiev, P D Demidov
Mitral valve disease is highly prevalent and quickly leads to development of severe heart failure. Mitral valve disease of degenerative or ischemic etiology affects 7.5 and 9.3% of population older than 65 and 75 years, respectively. "Open" (with cardiopulmonary bypass) surgical repair or valve replacement are not possible in almost half of affected patients because of their complications and concomitant diseases responsible for extremely high risk of these interventions. In the last decade, minimally invasive endovascular technology - transcatheter aortic valve implantation (TAVI) - has been widely introduced for correction of aortic valve disease in similar category of patients...
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/29037446/transcatheter-aortic-valve-implantation-futility-risk-model-development-and-validation-among-treated-patients-with-aortic-stenosis
#5
Oren Zusman, Ran Kornowski, Guy Witberg, Adi Lador, Katia Orvin, Amos Levi, Abid Assali, Hana Vaknin-Assa, Ram Sharony, Yaron Shapira, Alexander Sagie, Uri Landes
Risk-benefit assessment for transcatheter aortic valve implantation (TAVI) is still evolving. A sizeable group of patients do not fully benefit from intervention despite a technically successful procedure. All patients who underwent TAVI with device success and with no Valve Academic Research Consortium (VARC)-2 defined complications were included. Various demographic data, clinical details, and echocardiographic findings were examined. The outcome was defined as 1-year composite of mortality, stroke, lack of functional-class improvement (by New York Heart Association class), and readmissions (≥1 month after the procedure)...
September 18, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29036717/evaluation-of-occupational-radiation-dose-in-transcatheter-aortic-valve-implantation
#6
Anette Aarsnes, Gry Dahle, Erik Fosse, Kjell Arne Rein, Lars Aaberge, Anne Catrine T Martinsen
Occupational doses during fluoroscopy in interventional procedures vary largely (Kim et al. (Occupational radiation doses to operators performing cardiac catheterization procedures. Health Phys. 2008;94:211-227)). In transcatheter aortic valve implantation, the operators' positions and use of radiation shielding are particularly related to the entry choice on the patient's heart. This study evaluates how occupational doses depend on operator positioning during transfemoral and transaortal access. Occupational dosimetric readings were collected with electronic dosemeters on two cardiothoracic surgeons and one cardiologist during 31 procedures...
September 23, 2017: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/29024382/comparison-of-outcomes-with-surgical-cut-down-versus-percutaneous-transfemoral-transcatheter-aortic-valve-replacement-tavr-transfemoral-access-comparisons-between-surgical-cut-down-and-percutaneous-approach
#7
Brandon C Drafts, Charles H Choi, Kunal Sangal, Michael W Cammarata, Robert J Applegate, Sanjay K Gandhi, Edward H Kincaid, Neal Kon, David X Zhao
OBJECTIVES: The objective is to compare the short-term (30 days) and late (12 months) vascular adverse events in patients undergoing transfemoral (TF)-transcatheter aortic valve replacement (TAVR) by surgical cut-down (SC) vs. percutaneous (PC) approaches. BACKGROUND: Programs continue to utilize both approaches in TF-TAVR. There are limited data comparing outcomes by SC vs. PC approaches and long-term effects of endovascular intervention facilitated hemostasis on late vascular adverse events...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29020344/standardized-definitions-of-structural-deterioration-and-valve-failure-in-assessing-long-term-durability-of-transcatheter-and-surgical-aortic-bioprosthetic-valves-a-consensus-statement-from-the-european-association-of-percutaneous-cardiovascular-interventions
#8
Davide Capodanno, Anna S Petronio, Bernard Prendergast, Helene Eltchaninoff, Alec Vahanian, Thomas Modine, Patrizio Lancellotti, Lars Sondergaard, Peter F Ludman, Corrado Tamburino, Nicolò Piazza, Jane Hancock, Julinda Mehilli, Robert A Byrne, Andreas Baumbach, Arie Pieter Kappetein, Stephan Windecker, Jeroen Bax, Michael Haude
No abstract text is available yet for this article.
July 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28988450/feasibility-of-coronary-angiography-and-percutaneous-coronary-intervention-after-transcatheter-aortic-valve-replacement-using-a-medtronic%C3%A2-self-expandable-bioprosthetic-valve
#9
Wah Wah Htun, Cindy Grines, Theodore Schreiber
BACKGROUND AND OBJECTIVE: With aging, the progression of atherosclerosis in the coronary arteries is expected. The Medtronic™ self-expandable aortic bioprosthetic valve is deployed in the supra-annular position, and it has been challenging to selectively engage coronary arteries post-transcatheter aortic valve replacement (TAVR) even though there are diamond-shaped spaces in the mesh frame within the valve. Given the scarcity of data, we analyzed angiographic and clinical data from all patients requiring coronary angiography (CA) or intervention post-TAVR...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28986405/renin-angiotensin-system-blockade-therapy-after-transcatheter-aortic-valve-implantation
#10
Tomoki Ochiai, Shigeru Saito, Futoshi Yamanaka, Koki Shishido, Yutaka Tanaka, Tsuyoshi Yamabe, Shinichi Shirai, Norio Tada, Motoharu Araki, Toru Naganuma, Yusuke Watanabe, Masanori Yamamoto, Kentaro Hayashida
OBJECTIVE: The persistence of left ventricular (LV) hypertrophy is associated with poor clinical outcomes after transcatheter aortic valve implantation (TAVI) for aortic stenosis. However, the optimal medical therapy after TAVI remains unknown. We investigated the effect of renin-angiotensin system (RAS) blockade therapy on LV hypertrophy and mortality in patients undergoing TAVI. METHODS: Between October 2013 and April 2016, 1215 patients undergoing TAVI were prospectively enrolled in the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVI registry...
October 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28985898/the-impact-of-transcatheter-aortic-valve-implantation-on-quality-of-life-a-mixed-methods-study
#11
Felicity Astin, Judith Horrocks, Jim McLenachan, Daniel J Blackman, John Stephenson, S José Closs
OBJECTIVE: To provide an in-depth understanding of patients' views about the impact of transcatheter aortic valve implantation on self-reported quality of life. BACKGROUND: Transcatheter aortic valve implantation is considered to be the gold standard of care for inoperable patients diagnosed with severe symptomatic aortic stenosis. Mid- to long-term clinical outcomes are favourable and questionnaire data indicates improvements in quality of life but an in-depth understanding of how quality of life is altered by the intervention is missing...
October 3, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28969897/current-status-of-endovascular-training-for-cardiothoracic-surgery-residents-in-the-united-states
#12
Panos N Vardas, Ada C Stefanescu Schmidt, Xiaoying Lou, Andrew B Goldstone, Gregory Pattakos, Amy G Fiedler, Elizabeth H Stephens, Vakhtang Tchantchaleishvili
BACKGROUND: Endovascular interventions for cardiovascular pathology are becoming increasingly relevant to cardiothoracic surgery. This study assessed the perceived prevalence and efficacy of endovascular skills training and identified differences among training paradigms. METHODS: Trainee responses to questions in the 2016 In-Service Training Examination survey regarding endovascular training were analyzed based on the four different cardiothoracic surgery training pathways: traditional 2- and 3-year thoracic, integrated 6-year, and combined 4+3 general and thoracic residency programs...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28965619/transcatheter-aortic-valve-replacement-in-patients-with-aortic-stenosis-and-mitral-regurgitation
#13
Kreton Mavromatis, Vinod H Thourani, Amanda Stebbins, Sreekanth Vemulapalli, Chandan Devireddy, Robert A Guyton, Roland Matsouaka, Nima Ghasemzadeh, Peter C Block, Bradley G Leshnower, James P Stewart, John S Rumsfeld, Stamatios Lerakis, Vasilis Babaliaros
BACKGROUND: Many patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis also have significant mitral regurgitation (MR). We sought to understand the association of concomitant MR with TAVR clinical outcomes, as well changes in MR following TAVR. METHODS: Patients who underwent TAVR in the US Transcatheter Valve Therapy Registry from January 3, 2012, to December 31, 2013, were studied, with longer-term clinical outcomes from Center for Medicare Services data...
September 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28963761/does-mild-paravalvular-regurgitation-post-transcatheter-aortic-valve-implantation-affect-survival-a-meta-analysis
#14
Tomo Ando, Alexandros Briasoulis, Tesfaye Telila, Luis Afonso, Cindy L Grines, Hisato Takagi
BACKGROUND: To assess the impact of post transcatheter aortic valve implantation (TAVI) mild paravalvular regurgitation (PVR) on mortality. More than moderate PVR after TAVI has decreased with the advent of new-generation prosthetic valves. However, mild PVR remains common and its clinical impact has been inconsistent. We aimed to assess the impact of mild PVR through meta-analysis. METHODS AND RESULTS: A systematic literature search was conducted through PUBMED and EMBSE...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28942382/transcatheter-aortic-valve-implantation-in-2017-state-of-the-art
#15
Marco Barbanti, John G Webb, Martine Gilard, Davide Capodanno, Corrado Tamburino
In the last 15 years, transcatheter aortic valve implantation (TAVI) technology has met with rapid uptake, with >350,000 procedures performed in >70 countries. Over the same period, this technique has evolved from a challenging intervention to a standardised, simple, and streamlined procedure. The purpose of this review article is to provide an overview on the rapidly changing field of TAVI therapy, exploring past achievements, current issues and future perspectives. The discussion has been subdivided into three sections: 1) the evolution of clinical and anatomical indications for TAVI, 2) the description of procedural advances and complication rate trends over time, and 3) the progressive adoption of a minimalist approach...
September 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28941149/management-of-left-main-coronary-artery-obstruction-after-transcatheter-aortic-valve-replacement-utilizing-a-periscope-approach
#16
Todd Drexel, Gregory Helmer, Santiago Garcia, Ganesh Raveendran
Coronary obstruction is a rare but potentially fatal complication of transcatheter aortic valve replacement (TAVR). It can result from native leaflet or stent frame obstruction of the coronary ostia. There are reports detailing the difficulty of percutaneous coronary intervention following TAVR, but none that describe a periscope approach to access the left main ostia in the presence of a braided nitinol frame. This report describes an alternative approach to access a coronary artery when the valve stent struts are prohibitive to equipment delivery...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28929044/transcatheter-tricuspid-valve-in-ring-and-aortic-valve-in-valve-implantation
#17
Daniel Reichart, Niklas Schofer, Florian Deuschl, Andreas Schaefer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
Background  Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce. Case Description  Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc...
January 2017: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28927635/coronary-access-following-tavi-selective-coronary-engagement-using-balloon-assisted-tracking-of-a-guide-catheter-extension
#18
Matthew Jackson, Paul D Williams
performing percutaneous coronary intervention (PCI) following transcatheter aortic valve implantation (TAVI) will become more frequent with the increasing use of TAVI in lower surgical risk populations. The ideal management strategy for coronary artery disease (CAD) in the setting of TAVI is not well defined and CAD is often left untreated prior to TAVI. Engaging the coronary ostia through the TAVI side cells can be challenging; techniques for rapid coronary cannulation, especially in the acute setting, need to be developed...
July 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28927173/the-relationship-between-preoperative-frailty-and-outcomes-following-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#19
Atul Anand, Catherine Harley, Akila Visvanathan, Anoop S V Shah, Joanna Cowell, Alasdair MacLullich, Susan Shenkin, Nicholas L Mills
Aims: Transcatheter aortic valve implantation (TAVI) is an increasingly common intervention for patients with aortic stenosis deemed high risk for major cardiac surgery, but identifying those who will benefit can be challenging. Frailty reflects physiological reserve and may be a useful prognostic marker in this population. We performed a systematic review and meta-analysis of the association between frailty and outcomes after TAVI. Methods and Results: Five databases were searched between January 2000 and May 2015...
April 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28916601/gait-speed-can-predict-advanced-clinical-outcomes-in-patients-who-undergo-transcatheter-aortic-valve-replacement-insights-from-a-japanese-multicenter-registry
#20
Seiji Kano, Masanori Yamamoto, Tetsuro Shimura, Ai Kagase, Masanao Tsuzuki, Atsuko Kodama, Yutaka Koyama, Toshihiro Kobayashi, Kenichi Shibata, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Akihiro Higashimori, Toshiaki Otsuka, Yusuke Watanabe, Kentaro Hayashida
BACKGROUND: Gait speed reflects an important factor of frailty and is associated with an increased risk of late mortality in patients with cardiac disease. This study sought to assess the prognostic value of gait speed in elderly patients who underwent transcatheter aortic valve replacement. METHODS AND RESULTS: We investigated the 5-m or 15-feet gait speed (m/sec) in 1256 patients who underwent transcatheter aortic valve implantation using data from the OCEAN-TAVI Japanese multicenter registry (Optimized Catheter Valvular Intervention-Transcatheter Aortic Valve Implantation)...
September 2017: Circulation. Cardiovascular Interventions
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