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Tavi prognosis

Rocío González-Ferreiro, Antonio J Muñoz-García, Diego López-Otero, Pablo Avanzas, Isaac Pascual, Juan H Alonso-Briales, Ramiro Trillo-Nouche, Federico Pun, Manuel F Jiménez-Navarro, José M Hernández-García, César Morís, José R González Juanatey
OBJECTIVES: We aimed to determine whether body mass index (BMI) is a prognostic indicator for long-term, all-cause mortality in patients undergoing transcatheter aortic valve implantation (TAVI). BACKGROUND: Obesity in patients with established cardiovascular disease has previously been identified as an indicator of good prognosis, a phenomenon known as the "obesity paradox". The prognostic significance of BMI in patients with severe aortic stenosis (AoS) undergoing TAVI is a matter of current debate, as published studies are scarce and their results conflicting...
December 21, 2016: International Journal of Cardiology
Masanori Yamamoto, Tetsuro Shimura, Seiji Kano, Ai Kagase, Atsuko Kodama, Mitsuru Sago, Tatsuya Tsunaki, Yutaka Koyama, Norio Tada, Futoshi Yamanaka, Toru Naganuma, Motoharu Araki, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida
Hypoalbuminemia, a frailty criterion, belongs to a group of co-morbidities not captured as a traditional risk factor. We assessed its prognostic value in patients who underwent transcatheter aortic valve implantation (TAVI). The study included 1,215 consecutive patients from the Optimized Catheter Valvular Intervention -TAVI Japanese multicenter registry. Hypoalbuminemia was defined as serum albumin level <3.5 g/dl. Baseline characteristics, procedural outcomes, and all-cause, cardiovascular and noncardiovascular mortality rates after TAVI were compared between patients with albumin level <3...
December 2, 2016: American Journal of Cardiology
Sílvia Aguiar Rosa, Luísa Moura Branco, Ana Galrinho, Guilherme Portugal, Joäo Abreu, Duarte Cacela, José Fragata, Rui Cruz Ferreira
BACKGROUND: Aortic valve replacement (AVR) is the treatment of choice in patients with severe symptomatic aortic stenosis (AS). Patients with a low left ventricular ejection fraction (LVEF) represent a challenge for evaluation and therapeutic decision. Dobutamine stress echocardiography (DSE) allows the distinction to be made between fixed low-flow/low-gradient (LF/LG) AS and pseudosevere AS. METHODS: Between 2001 and 2014 a retrospective analysis was conducted of patients who underwent DSE to investigate severe AS...
March 2016: Journal of Heart Valve Disease
Yinghao Sun, Xianbao Liu, Yuxin He, Mengyao Tang, Qifeng Zhu, Xiaobin Xu, Dongyu Guo, Keda Shi, Po Hu, Lihan Wang, Huijia Kong, Jubo Jiang, Xiaoping Lin, Qiyuan Xu, Feng Gao, Jian'an Wang
To date, the impact of diabetes mellitus (DM) on prognosis after transcatheter aortic valve implantation (TAVI) is still contradictory and thus merits further investigation. The purpose of this meta-analysis was to evaluate the impact of DM on outcomes after TAVI. A systematic search of the PubMed database was performed. Primary end points were 30-day and 1-year all-cause mortality after TAVI. Risk ratios (RRs) and 95% CIs were calculated using the random-effect or fixed-effect model, depending on heterogeneity between studies, and p values <0...
November 16, 2016: American Journal of Cardiology
René Vollenbroich, Stefan Stortecky, Fabien Praz, Jonas Lanz, Anna Franzone, Katarzyna Zuk, Dik Heg, Marco Valgimigli, Crochan John O'Sullivan, Corinna Heinisch, Eva Roost, Peter Wenaweser, Stephan Windecker, Thomas Pilgrim
BACKGROUND: Among patients undergoing transcatheter aortic valve implantation (TAVI), concomitant mitral regurgitation (MR) has been associated with adverse prognosis. We aimed to assess long-term clinical outcomes according to MR etiology. METHODS: In a single-center registry of consecutive patients undergoing TAVI, we investigated the impact of functional (FMR) vs degenerative (DMR) MR on cardiovascular (CV) mortality throughout 2years of follow-up. RESULTS: Among 603 patients (mean age 82...
October 28, 2016: American Heart Journal
Federico Conrotto, Fabrizio D'Ascenzo, Maurizio D'Amico, Claudio Moretti, Marco Pavani, Paolo Scacciatella, Pierluigi Omedè, Antonio Montefusco, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Francesco Maisano, Fabian Nietlispach
BACKGROUND: The risk/benefit balance of transcatheter aortic valve implantation (TAVI) in patients with low-gradient aortic stenosis (LGAS) remains to be well defined. Aim of the study was to investigate the impact of LGAS in patients undergoing TAVI. METHODS: Medline, Cochrane Library, and Scopus were searched for articles reporting outcome of patients with LGAS undergoing TAVI. The primary endpoint was 12-months all-cause mortality and the secondary endpoint was 30-day all-cause mortality...
November 10, 2016: Catheterization and Cardiovascular Interventions
Grégoire Massoullié, Pierre Bordachar, Didier Irles, Christophe Caussin, Antoine Da Costa, Pascal Defaye, Frédéric Jean, Alexis Mechulan, Pierre Mondoly, Géraud Souteyrand, Bruno Pereira, Sylvain Ploux, Romain Eschalier
INTRODUCTION: Percutaneous aortic valve replacement (transcatheter aortic valve implantation (TAVI)) notably increases the likelihood of the appearance of a complete left bundle branch block (LBBB) by direct lesion of the LBB of His. This block can lead to high-grade atrioventricular conduction disturbances responsible for a poorer prognosis. The management of this complication remains controversial. METHOD AND ANALYSIS: The screening of LBBB after TAVI persisting for more than 24 hours will be conducted by surface ECG...
October 26, 2016: BMJ Open
Gennaro Giustino, Robert M A Van der Boon, Javier Molina-Martin de Nicolas, Nicolas Dumonteil, Alaide Chieffo, Peter P T de Jaegere, Didier Tchetche, Bertrand Marcheix, Damien Millischer, Romain Cassagneau, Didier Carrié, Nicolas M Van Mieghem, Antonio Colombo
AIMS: We sought to evaluate the impact of permanent pacemaker (PPM) implantation on two-year mortality and one-year left ventricular ejection fraction recovery (∆LVEFR=one-year LVEF-baseline LVEF) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: We pooled patient-level data from four European institutions with significant TAVI volume. Outcomes were compared between patients without PPM (no-PPM), patients with PPM prior to TAVI (old-PPM) and patients with PPM implanted after TAVI (new-PPM)...
October 20, 2016: EuroIntervention
Giuseppe Tarantini, Marco Mojoli, Marina Urena, Alec Vahanian
Atrial fibrillation (AF) is a common arrhythmia in patients with aortic stenosis. When these patients are treated medically or by surgical aortic valve replacement, AF is associated with increased risk of adverse events including death. Growing evidence suggests a significant impact of AF on outcomes also in patients with aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). Conversely, limited evidence is available regarding the optimal management of this condition. This review aims to summarize prevalence, pathophysiology, prognosis, and treatment of AF in patients undergoing TAVI...
October 15, 2016: European Heart Journal
Marco Barbanti, Giuseppe Gargiulo, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) underwent progressive improvements until it became the default therapy for inoperable patients, and a recommended therapy in high-risk operable patients with symptomatic severe aortic stenosis. Recent evidence will further support TAVI as treatment for a growing number of patients. Areas covered: This review will discuss on the current knowledge about the role of both pre-procedural chronic kidney disease (CKD) and post-procedural acute kidney injury (AKI) in adult patients with severe aortic stenosis undergoing TAVI...
December 2016: Expert Review of Cardiovascular Therapy
Oliver Husser, Julio Núñez, Christof Burgdorf, Andreas Holzamer, Christian Templin, Thorsten Kessler, Vicente Bodi, Juan Sanchis, Costanza Pellegrini, Andreas Luchner, Lars S Maier, Christof Schmid, Thomas F Lüscher, Heribert Schunkert, Adnan Kastrati, Michael Hilker, Christian Hengstenberg
INTRODUCTION AND OBJECTIVES: Conventional risk scores have not been accurate in predicting peri- and postprocedural risk of patients undergoing transcatheter aortic valve implantation (TAVI). Elevated levels of the tumor marker carbohydrate antigen 125 (CA125) have been linked to adverse outcomes after TAVI. We studied the additional value of CA125 to that of the EuroSCORE in predicting long-term mortality after TAVI. METHODS AND RESULTS: During a median follow-up of 59 weeks, 115 of 422 patients (27%) died after TAVI...
September 9, 2016: Revista Española de Cardiología
F Vogt, S Wicklein, K Singler, S Pfeiffer, T Fischlein, J Schwab, M Pauschinger, J Jessl
The treatment of severe symptomatic aortic valve stenosis by conventional aortic valve replacement (AVR) or by transcatheter aortic valve implantation (TAVI) has a good perinterventional prognosis even for patients of advanced age. Having a heart team select the best management strategies based on current guidelines for each individual patient is essential for success. Especially in elderly and increasingly multimorbid patients with sometimes severe preconditions, the detection of functional deficits is relevant not only for the mortality but also for perioperative and postoperative complications as well as the functional outcome...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
Tomo Ando, Hisato Takagi
New-onset persistent left bundle branch block (NOP-LBBB) is one of the most common conduction disturbances after transcatheter aortic valve implantation (TAVI). We hypothesized that NOP-LBBB may have a clinically negative impact after TAVI. To find out, we conducted a systematic literature search of the MEDLINE/PubMed and Embase databases. Observational studies that reported clinical outcomes of NOP-LBBB patients after TAVI were included. The random-effects model was used to combine odds ratios, risk ratios, or hazard ratios (HRs) with 95% confidence intervals...
September 2016: Clinical Cardiology
Tomo Ando, Hisato Takagi
Paravalvular regurgitation (PVR) remains one of the drawbacks of transcatheter aortic valve implantation (TAVI). Details of percutaneous closure (PCC) of PVR after TAVI remain obscure. We aimed to explore the patient characteristics, procedural details, closure devices used, and outcomes of PCC after TAVI. A systematic search of the MEDLINE/PubMed and Embase databases from January 2002 to September 2015 was conducted. Reports considered to include same patient were excluded and only the studies with largest cohorts were included...
July 11, 2016: Clinical Cardiology
Hugo González-Saldivar, Carlos Rodriguez-Pascual, Gonzalo de la Morena, Covadonga Fernández-Golfín, Carmen Amorós, Mario Baquero Alonso, Luis Martínez Dolz, Albert Ariza Solé, Gabriela Guzmán-Martínez, Juan José Gómez-Doblas, Antonio Arribas Jiménez, María Eugenia Fuentes, Laura Galian Gay, Martin Ruiz Ortiz, Pablo Avanzas, Emad Abu-Assi, Tomás Ripoll-Vera, Oscar Díaz-Castro, Eduardo P Osinalde, Manuel Martínez-Sellés
The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77...
July 15, 2016: American Journal of Cardiology
Karin Olsson, Johan Nilsson, Åsa Hörnsten, Ulf Näslund
BACKGROUND: Aortic stenosis is the most common valve disease in western countries and has poor prognosis without treatment. Surgical aortic valve replacement (SAVR) is the gold standard, and transcatheter aortic valve implantation (TAVI) is a new method that is used in high-risk patients who are denied surgery. The purpose of treatment is not only to save life, but also to reduce symptoms and increase health-related quality of life (HRQoL). OBJECTIVE: The aim of this study was to describe patients' self-reported outcomes in terms of physical function, symptoms, dependence, HRQoL, and cognitive function after TAVI and SAVR...
May 11, 2016: European Journal of Cardiovascular Nursing
Federico Conrotto, Fabrizio D'Ascenzo, Pieter Stella, Marco Pavani, Marco Luciano Rossi, Nedy Brambilla, Massimo Napodano, Elisa Covolo, Francesco Saia, Giuseppe Tarantini, Pierfrancesco Agostoni, Antonio Marzocchi, Patrizia Presbitero, Francesco Bedogni, Stefano Salizzoni, Maurizio D'Amico, Claudio Moretti, Mauro Rinaldi, Fiorenzo Gaita
BACKGROUND: Several factors have been identified as predictors of events after transcatheter aortic valve implantation (TAVI) but the impact of left ventricular ejection fraction (LVEF) and mean transaortic gradient (MTG) is controversial. This multicenter study aimed to clarify the prognostic role of low LVEF and low MTG after TAVI. METHODS: From 2007 to 2012, 764 consecutive patients with severe symptomatic aortic valve stenosis underwent TAVI at participating hospitals...
February 2017: Journal of Cardiovascular Medicine
Jakub Sulženko, Petr Toušek, Viktor Kočka, František Bednář, Hana Línková, Robert Petr, Marek Laboš, Petr Widimský
BACKGROUND: Little is known about the valve degeneration process after transcutaneous aortic valve implantations (TAVI) that can have an important impact on patients' long-term prognosis. AIM: To evaluate degenerative changes of TAVI using computed tomography (CT) compared to findings in patients that underwent surgical aortic valve replacement (SAVR). Subsequently, to compare the level of immune and inflammatory markers in both groups and test their possible role in the valve degeneration process...
February 2017: Journal of Cardiology
Milan A Nedeljković, Branko Beleslin, Milorad Tesić, Vladan Vukcević, Goran Stanković, Sinisa Stojković, Dejan Orlić, Ilija Bilbija, Milos Matković, Tijana Simić, Nemanja Menković, Igor Mrdović, Gian Paolo Ussia, Zoran Perisić, Momcilo Babić
BACKGROUND/AIM: Aortic stenosis (AS) is the most common valvular heart disease in elderly people, with rather poor prognosis in symptomatic patients. Surgical valve replacement is the therapy of choice, but a significant number of patients cannot undergo surgical procedure. We presented initial experience of transcatheter aortic valve implantation (TAVI) performed in Catheterization Laboratory of the Clinic for Cardiology, Clinical Center of Serbia. METHODS: The procedures were performed in 5 patients (mean age 76 ± 6 years, 2 males, 3 female) with severe and symptomatic AS with contraindication to surgery or high surgical risk...
February 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Yigal Abramowitz, Hasan Jilaihawi, Tarun Chakravarty, Geeteshwar Mangat, Yoshio Maeno, Yoshio Kazuno, Nobuyuki Takahashi, Hiroyuki Kawamori, Wen Cheng, Raj R Makkar
Several clinical variables have been identified as predictors of clinical outcome after transcatheter aortic valve implantation (TAVI). Nonetheless, there is limited and contradictive data on the impact of diabetes mellitus (DM) on the prognosis of patients who undergo TAVI. We aimed to investigate the clinical characteristics and the early and midterm outcomes after TAVI according to DM status. From 802 consecutive patients who underwent TAVI, we compared 548 patients with no DM to 254 patients with diabetes (177 orally treated and 77 insulin treated)...
May 15, 2016: American Journal of Cardiology
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