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Transcatheter aortic valve intervention

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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/29400260/noteworthy-literature-published-in-2017-for-cardiothoracic-anesthesiologists
#3
Dirk J Varelmann, Jochen Daniel Muehlschlegel
The year 2017 was a year dominated by large-scale clinical studies reporting the outcome of various interventions in cardiac surgery and heart failure (HF) patients, relevant to all cardiothoracic anesthesiologists. Among them were studies investigating the addition of levosimendan, an alternative inotropic agent, to standard management of patients with HF undergoing cardiac surgery. Also, corticosteroids have been used for various purposes in cardiac patients. Here, a new study reports the effect of high-dose methylprednisolone on recovery and delirium...
March 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29397361/neurocognition-and-cerebral-lesion-burden-in-high-risk-patients-before-undergoing-transcatheter-aortic-valve-replacement-insights-from-the-sentinel-trial
#4
Ronald M Lazar, Marykathryn A Pavol, Tobias Bormann, Michael G Dwyer, Carlye Kraemer, Roseann White, Robert Zivadinov, Jeffrey C Wertheimer, Angelika Thöne-Otto, Lisa D Ravdin, Richard Naugle, Dawn Mechanic-Hamilton, William S Garmoe, Anthony Y Stringer, Heidi A Bender, Samir R Kapadia, Susheel Kodali, Alexander Ghanem, Axel Linke, Roxana Mehran, Renu Virmani, Tamim Nazif, Azin Parhizgar, Martin B Leon
OBJECTIVES: The authors sought to determine baseline neurocognition before transcatheter aortic valve replacement (TAVR) and its correlations with pre-TAVR brain imaging. BACKGROUND: TAVR studies have not shown a correlation between diffusion-weighted image changes and neurocognition. The authors wanted to determine the extent to which there was already impairment at baseline that correlated with cerebrovascular disease. METHODS: SENTINEL (Cerebral Protection in Transcatheter Aortic Valve Replacement) trial patients had cognitive assessments of attention, processing speed, executive function, and verbal and visual memory...
January 27, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29372398/transapical-approach-in-transcatheter-cardiovascular-interventions
#5
REVIEW
Minoru Tabata
The left ventricular apex has excellent accessibility to the aortic valve, mitral valve, left ventricular outflow tract and thoracic aorta. Although the number of transapical approach in transcatheter aortic valve replacement has been decreasing in recent years, it is still a useful option for patients with very poor peripheral vascular access. The apex has been chosen as a primary access site for many devices of transcatheter mitral valve repair/replacement and mitral valve-in-valve procedures. Additionally, the transapical approach has been used for other transcatheter cardiovascular interventions such as paravalvular leak repair after mitral or aortic valve replacement, pseudoaneurysm repair of the left ventricular outflow tract, and thoracic endovascular aortic repair...
January 25, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29370357/ultra-fast-track-minimally-invasive-aortic-valve-replacement-going-beyond-reduced-incisions
#6
Marco Di Eusanio, Walter Vessella, Roberto Carozza, Filippo Capestro, Alessandro D'Alfonso, Carlo Zingaro, Christopher Munch, Paolo Berretta
Aortic valve replacement (AVR) via a median sternotomy approach has been largely reported to be safe and long-term efficacious, and currently represents the 'gold standard' approach for aortic stenosis treatment. However, aortic valve surgery has undergone continuous development over the last years, involving less invasive techniques and new technologies to reduce the traumatic impact of the intervention and extend the operability toward increasingly high-risk patients. Indeed, minimally invasive AVR and transcatheter aortic valve replacement caseload have steadily increased leading to a paradigm shift in the treatment of aortic valve disease...
January 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29368369/recent-developments-and-controversies-in-transcatheter-aortic-valve-implantation
#7
REVIEW
Noman Ali, Peysh A Patel, Steven J Lindsay
Interventional cardiology has been revolutionised by transcatheter aortic valve implantation (TAVI), which has become established as the benchmark treatment for severe aortic stenosis in patients at high risk for surgical aortic valve replacement (AVR). Increased procedural familiarity and progression in device technology has enabled improvements to be made in complication rates, which have led to a commensurate expansion in the use of TAVI; it is now a viable alternative to AVR in patients at intermediate surgical risk, and has been used in cohorts such as those with bicuspid aortic valves or pure, severe aortic regurgitation...
January 25, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29360062/intracardiac-shunts-following-transcatheter-aortic-valve-implantation-a-multicentre-study
#8
Ignacio J Amat-Santos, Paol Rojas, Peter R Stella, Luis Nombela-Franco, Roman Lezáun-Burgui, Antonio J Muñoz-García, Vicenç Serra, Enrique Gutierrez-Ibanes, Mariano Larman, Ramón Rodriguez-Olivares, Nynke H M Kooistra, Hipólito Gutiérrez, José A San Román
AIMS: To describe the incidence, mechanisms, management and outcomes of intracardiac shunts (ICS) following TAVI. METHODS AND RESULTS: Multicentre registry across 10 centres aimed to gather all cases of ICS (1.1%) including infection-related (IRICS, 0.3%) or aseptic (AICS, 0.8%) shunts. Patients presented porcelain aorta (24% vs. 6.8%, p=0.024) and had been treated with pre- (88% vs. 68.5%, p=0.037) or post-dilation (59.1% vs. 19.3%, p<0.001) more often. Median time from intervention to diagnosis of ICS was 10 days [IQR: 2-108], being longer for IRICS (171 [63-249] vs...
January 23, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29352588/pulmonary-reinterventions-after-complete-unifocalization-and-repair-in-infants-and-young-children-with-tetralogy-of-fallot-with-major-aortopulmonary-collaterals
#9
Holly Bauser-Heaton, Alejandro Borquez, Ritu Asija, Lisa Wise-Faberowski, Yulin Zhang, Laura Downey, Stanton B Perry, Andrew Koth, Lynn F Peng, Claudia A Algaze, Frank L Hanley, Doff B McElhinney
BACKGROUND: Our institutional approach to tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCAs) emphasizes unifocalization and augmentation of the reconstructed pulmonary arterial (PA) circulation and complete intracardiac repair in infancy, usually in a single procedure. This approach yields a high rate of complete repair with excellent survival and low right ventricular (RV) pressure. However, little is known about remodeling of the unifocalized and reconstructed pulmonary circulation or about reinterventions on the reconstructed PAs or the RV outflow tract conduit...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29350378/eq-5d-studies-in-cardiovascular-diseases-in-eight-central-and-eastern-european-countries-a-systematic-review-of-the-literature
#10
Paulina Batóg, Fanni Rencz, Márta Péntek, László Gulácsi, Krzysztof J Filipiak, Valentina Prevolnik Rupel, Judit Simon, Valentin Brodszky, Petra Baji, Jakub Závada, Guenka Petrova, Alexandru Rotar, Dominik Golicki
BACKGROUND: The measurement of health-related quality of life (HRQOL) by validated generic instruments, such as EQ-5D, becomes an increasingly important tool for the assessment of health care in a wide range of different diagnoses. AIM: To systematically review EQ-5D literature generated in cardiovascular diseases in eight selected Central and Eastern Europe (CEE) countries. METHODS: A structured literature search was conducted in MEDLINE, EMBASE, Web of Science, CINAHL, PsycINFO, the Cochrane Library and the EuroQol website up to November 2016...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29339677/acute-myocardial-infarction-shortly-after-valve-in-valve-transcatheter-aortic-valve-implantation-successfully-managedwith-challenging-percutaneous-coronary-intervention
#11
Kenan Yalta, Çağlar Kaya, Yüksel Aksoy, Mustafa Yılmaztepe, Fatih Kardaş
In recent years, transcatheter aortic valve implantation (TAVI) has been considered a novel option for the management of surgically high-risk patients requiring aortic valve replacement. Presently described is a case of acute coronary syndrome (ACS) managed with a challenging primary percutaneous coronary intervention (PCI) shortly after a valve-in-valve TAVI intervention. This case highlights 2 important issues: PCI may be an option for the management of coronary heart disease in patients after TAVI even in the setting of demanding features associated with coronary osteal engagement, and secondly, TAVI may serve as a potential risk factor for future coronary ischemic syndromes, largely due to its potential adverse effects on coronary flow dynamics, etc...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29336972/general-anesthesia-for-transcatheter-aortic-valve-replacement-total-intravenous-anesthesia-is-associated-with-less-delirium-as-compared-to-volatile-agent-technique
#12
Allie E Goins, Alan Smeltz, Cassandra Ramm, Paula D Strassle, Emily G Teeter, John P Vavalle, Lavinia Kolarczyk
OBJECTIVE: Investigate the effect of volatile anesthesia versus total intravenous anesthesia on the incidence of postoperative delirium and length of stay in patients undergoing transcatheter aortic valve replacement under general anesthesia. DESIGN: Retrospective study. SETTING: Single institution, academic medical center. PARTICIPANTS: Adult patients who underwent transcatheter aortic valve replacement under general anesthesia between November 2014 and February 2017...
December 11, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29325012/systematic-review-of-the-cost-effectiveness-of-transcatheter-interventions-for-valvular-heart-disease
#13
Gialama Fotini, Prezerakos Panagiotis, Apostolopoulos Vasilis, Nikolaos Maniadakis
Objectives: Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. Methods: The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29322611/impact-of-pre-procedural-hyponatremia-on-clinical-outcomes-after-transcatheter-aortic-valve-replacement-a-propensity-matched-analysis
#14
Ai Kagase, Masanori Yamamoto, Tetsuro Shimura, Atsuko Kodama, Seiji Kano, Yutaka Koyama, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida
BACKGROUND: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR). METHODS: We investigated 1,215 consecutive patients (mean age: 84.4 ± 5.0 years) who underwent TAVR using data from the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVR Japanese multicenter registry...
January 11, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29317993/transcatheter-aortic-valve-implantation-operators-get-involved-in-imaging
#15
Miriam Brinkert, Stefan Toggweiler
Pre-procedural planning is the key element of transcatheter aortic valve implantation (TAVI). Multislice computed tomography of the chest, abdomen and pelvis with the ability to perform a 3-dimensional reconstruction has become the cornerstone of pre-procedural planning. We would like to encourage TAVI operators (interventional cardiologist and surgeons) to get involved in imaging. All TAVI operators should know how to assess the annulus, the annular root, and the iliofemoral access. We strongly believe that this will improve outcomes of this evolving procedure...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29310382/the-safety-of-concomitant-transcatheter-aortic-valve-replacement-and-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#16
REVIEW
Yong Yang, Fang-Yang Huang, Bao-Tao Huang, Tian-Yuan Xiong, Xiao-Bo Pu, Shi-Jian Chen, Mao Chen, Yuan Feng
BACKGROUND: TAVR is a rapidly spreading treatment option for severe aortic valve stenosis. Significant coronary artery disease (CAD) is present in 40% to 75% of patients undergoing TAVR. However, when to treat the concomitant coronary artery lesions is controversial. METHODS: This is a systematic review comparing concomitant PCI and TAVR versus staged PCI and TAVR. The OVID database was systematically searched for studies reporting PCI in patients undergoing TAVR...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29302950/use-of-impella-5-0-prior-to-transcatheter-aortic-valve-replacement-in-a-patient-with-severe-aortic-stenosis-and-cardiogenic-shock
#17
Dustin W Johnson, John P ErwinIII
The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc., Danvers, MA, USA), has also increased. These devices provide superior hemodynamic effects compared to intra-aortic balloon pumping...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302949/simultaneous-transcatheter-intervention-for-coarctation-of-the-aorta-and-bicuspid-aortic-valve
#18
Yukiko Mizutani, Norio Tada, Takahiko Masuda, Masaki Hata
Coarctation of the aorta (CoA) is a relatively common congenital heart anomaly, and bicuspid aortic valve (BAV) is a common congenital heart disease that coexists with CoA. In larger children and adults with CoA, transcatheter intervention has gained acceptance, but for surgical high-risk patients with aortic stenosis, the use of transcatheter aortic valve implantation (TAVI) has been established. Recently, although favorable data have been reported for TAVI when treating BAV, simultaneous transcatheter intervention for CoA and BAV will prove to be a challenge because of the unique anatomy involved requires multiple procedural steps and also has problems of site access...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29301640/1-year-clinical-outcomes-in-women-after-transcatheter-aortic-valve-replacement-results-from-the-first-win-tavi-registry
#19
Alaide Chieffo, Anna Sonia Petronio, Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuele Meliga, Nicholas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, Ghada Mikhail, Samin Sharma, Maria Cruz Ferrer, Christoph Naber, Peter Kievit, Usman Baber, Clayton Snyder, Madhav Sharma, Marie Claude Morice, Roxana Mehran
OBJECTIVES: This study sought to examine the safety and performance of contemporary transcatheter aortic valve replacement (TAVR) in an exclusive all-women TAVR population, and to further investigate the potential impact of female sex-specific characteristics on composite 1-year clinical outcomes. BACKGROUND: Women comprise ≥50% patients undergoing TAVR. Several data have shown the noninferiority of TAVR compared with surgical aortic valve replacement for symptomatic significant aortic stenosis, but no study so far has been specifically powered to detect differences by sex...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29284171/post-tavi-follow-up-with-mdct-of-the-valve-prosthesis-technical-application-regular-findings-and-typical-local-post-interventional-complications
#20
Martin Soschynski, Fabio Capilli, Philipp Ruile, Franz-Josef Neumann, Mathias Langer, Tobias Krauss
BACKGROUND:  Transcatheter aortic valve implantation (TAVI) has evolved into an alternative procedure to surgical valve replacement for high-risk patients with aortic valve stenosis. Despite technical innovations, there is still a risk of complications during and after the intervention. After a TAVI procedure, ECG-gated multidetector computed tomography (MDCT) plays an important role in the early diagnosis of local complications. In this article, we explain for the first time how the technical acquisition of MDCT in the region of the aortic root is performed as post-interventional control of the TAVI prosthesis...
December 28, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
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