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Platelets and tavr

Jose F Condado, Parichart Junpaparp, Jose N Binongo, Yi Lasanajak, Christian F Witzke-Sanz, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, James Stewart, Robert Guyton, David Wheeler, Jessica Forcillo, Ateet Patel, Peter C Block, Vinod Thourani, Janani Rangaswami, Vasilis Babaliaros
BACKGROUND: Neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) mark systemic inflammation. Patients with high NLR and PLR have worse cardiovascular disease and outcomes. We assessed the role of these ratios in predicting outcomes after transcatheter aortic valve replacement (TAVR). METHODS: The association between NLR and PLR with baseline characteristics, 30-day outcomes, and 1-year readmission/survival was determined in patients that underwent TAVR between 2007 and 2014 and had baseline complete blood count with differential...
November 15, 2016: International Journal of Cardiology
Firas E Zahr, Steven R Lentz
No abstract text is available yet for this article.
July 28, 2016: New England Journal of Medicine
Julio F Marchini, Ayumi Aurea Miyakawa, Flavio Tarasoutchi, José Eduardo Krieger, Pedro Lemos, Kevin Croce
BACKGROUND: Patients with severe aortic stenosis have increased levels of prothrombotic and proinflammatory microparticles (MP), and MPs actively regulate pathological processes that lead to atherothrombotic cardiovascular events. Shear stress is a validated stimulus of MP production, and abnormal shear stress in aortic stenosis increases MP release in ex-vivo studies. We hypothesized that in patients with severe aortic stenosis, percutaneous replacement of the aortic valve (TAVR) would reduce abnormal shear stress and would decrease levels of circulating MPs...
2016: Journal of Negative Results in Biomedicine
Travis R Sexton, Eric L Wallace, Amy Chen, Richard J Charnigo, Hassan K Reda, Khaled M Ziada, John C Gurley, Susan S Smyth
Transcatheter aortic valve replacement (TAVR) has been increasingly used to treat patients with symptomatic aortic stenosis. Despite improvements in valve deployment, patients that have undergone TAVR are at high risk for major adverse events following the procedure. Blood cell numbers, platelet function, and biomarkers of systemic inflammation were analyzed in 58 patients undergoing TAVR with the Edward's SAPIEN valve. Following valve deployment, platelet count and agonist-induced platelet activity declined and plasma markers of systemic inflammation (interleukin-6 and S100A8/A9) increased...
April 2016: Journal of Thrombosis and Thrombolysis
Ioannis Mastoris, George D Dangas
While the main gist of research pertaining to TAVR procedure involves improvement of existing valve technologies, lower size delivery systems and post-procedure antithrombotic therapy, the optimal intra-procedure anticoagulation has not been sufficiently defined. Peri-procedural complications such as cerebrovascular events and bleeding are largely associated with the safety and efficacy of anticoagulation regimen. Current guidelines advocate the use of heparin for anticoagulation with a target activated clotting time ≥300 seconds and careful protamine infusion in patients with high estimated bleeding risk...
2016: Current Pharmaceutical Design
Suzanne Fateh-Moghadam, Sabrina Voesch, Patrik Htun, Rezo Jorbenadze, Tobias Geisler, Meinrad Gawaz, Wolfgang Bocksch
Stroke and thromboembolic events after transfemoral aortic valve replacement (TAVR) continue to be a problem. The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) observed with two different catheter valves, the ESV-XT and the newer ESV-3 valve in patients (pts) undergoing TAVR on dual antiplatelet therapy (DAPT). A total of 174 patients with severe aortic stenosis and high surgical risk successfully underwent TAVR (60 ESV-XT; 114 ESV-3). Platelet Agg and PA (CD62P expression) were evaluated before and the following three days after TAVR under DAPT...
January 2016: Thrombosis and Haemostasis
Philippe Généreux, David J Cohen, Michael Mack, Josep Rodes-Cabau, Mayank Yadav, Ke Xu, Rupa Parvataneni, Rebecca Hahn, Susheel K Kodali, John G Webb, Martin B Leon
BACKGROUND: The incidence and prognostic impact of late bleeding complications after transcatheter aortic valve replacement (TAVR) are unknown. OBJECTIVES: The aim of this study was to identify the incidence, predictors, and prognostic impact of major late bleeding complications (MLBCs) (≥30 days) after TAVR. METHODS: Clinical and echocardiographic outcomes of patients who underwent TAVR within the randomized cohorts and continued access registries in the PARTNER (Placement of Aortic Transcatheter Valves) trial were analyzed after stratifying by the occurrence of MLBCs...
December 23, 2014: Journal of the American College of Cardiology
Peter C Block
No abstract text is available yet for this article.
January 1, 2015: Catheterization and Cardiovascular Interventions
Madan Raj Aryal, Paras Karmacharya, Anil Pandit, Fayaz Hakim, Ranjan Pathak, Naba Raj Mainali, Anene Ukaigwe, Maryam Mahmood, Madan Badal, F David Fortuin
BACKGROUND: Although dual antiplatelet therapy (DAPT) with clopidogrel and aspirin is a widely accepted strategy in patients undergoing transcatheter aortic valve replacement (TAVR), this approach is not evidence based. We therefore sought to systematically review the current evidence for this practice in terms of 30-day outcome looking at stroke, MI, bleeding, and death. METHODS: Relevant studies were identified through electronic literature search. Studies involving single antiplatelet therapy (SAPT) and DAPT in patients undergoing TAVR were included...
February 2015: Heart, Lung & Circulation
Michael P Flaherty, Amr Mohsen, Joseph B Moore, Carlo R Bartoli, Erik Schneibel, Wasiq Rawasia, Matthew L Williams, Kendra J Grubb, Glenn A Hirsch
BACKGROUND: Data are limited regarding transcatheter aortic valve replacement (TAVR)-related thrombocytopenia (TP). We sought to thoroughly characterize the presence, clinical impact, and severity of TP associated with TAVR. METHODS AND RESULTS: Data were collected from 90 patients who underwent TAVR using the Edwards SAPIEN valve (59 TF, 29 TA, 2 Tao). Platelet counts were evaluated peri-procedurally and for 8 days following TAVR. Platelet levels were compared and patients were divided into a no TP (No-TP) group 1, acquired (new) TP (NTP) group 2, pre-existing (pre-TAVR) TP (PTP) group 3, and further stratified based on the severity of TP: mild (M) TP (100-149 × 10(3) cell/µL) and moderate-severe (MS) TP (<100 × 10(3) cell/µL)...
January 1, 2015: Catheterization and Cardiovascular Interventions
Hasan Jilaihawi, Niraj Doctor, Tarun Chakravarty, Mohammad Kashif, James Mirocha, Wen Cheng, Michael Lill, Mamoo Nakamura, Mitch Gheorghiu, Raj R Makkar
OBJECTIVES: We sought to investigate the magnitude and clinical importance of thrombocytopenia post transcatheter aortic valve replacement (TAVR). BACKGROUND: Thrombocytopenia has been observed after TAVR but has not been well studied. METHODS: Major thrombocytopenia (platelet count <100 × 10(9) /L) was studied following aortic valve interventions in a single center. Changes in platelets were compared in 246 patients undergoing balloon-expandable TAVR and a similar population of 57 cases undergoing surgical aortic valve replacement (SAVR in the US PARTNER IA trial)...
January 1, 2015: Catheterization and Cardiovascular Interventions
Danny Dvir, Philippe Généreux, Israel M Barbash, Susheel Kodali, Itsik Ben-Dor, Mathew Williams, Rebecca Torguson, Ajay J Kirtane, Sa'ar Minha, Salem Badr, Lakshmana K Pendyala, Joshua P Loh, Petros G Okubagzi, Jessica N Fields, Ke Xu, Fang Chen, Rebecca T Hahn, Lowell F Satler, Craig Smith, Augusto D Pichard, Martin B Leon, Ron Waksman
AIMS: This study aimed to evaluate incidence and correlates for low platelet count after transcatheter aortic valve replacement (TAVR) and to determine a possible association between acquired thrombocytopenia and clinical outcomes. METHODS AND RESULTS: Patients undergoing TAVR from two medical centres were included in the study. They were stratified according to nadir platelet count post procedure: no/mild thrombocytopenia, ≥100 × 10(9)/L; moderate, 50-99 × 10(9)/L; and severe, <50 × 10(9)/L...
October 7, 2014: European Heart Journal
James M McCabe, Pei-Hsiu Huang, Lauren A Riedl, Srikanth R Devireddy, Jennifer Grondell, Annie C Connors, Michael J Davidson, Andrew C Eisenhauer, Frederick G P Welt
OBJECTIVES: To determine the incidence and etiology of thrombocytopenia following transcatheter Aortic valve replacement (TAVR). BACKGROUND: the use of TAVR in the United States has grown rapidly. Anecdotally, thrombocytopenia following TAVR with the Sapien valves has been observed, though little is known about this phenomenon. METHODS: All patients treated with TAVR using a Sapien valve or who underwent isolated balloon aortic valvuloplasty (BAV) at Brigham and Women's Hospital from October 2009 through November 2012 were analyzed...
March 1, 2014: Catheterization and Cardiovascular Interventions
Thomas E Claiborne, Jawaad Sheriff, Maximilian Kuetting, Ulrich Steinseifer, Marvin J Slepian, Danny Bluestein
Calcific aortic valve disease is the most common and life threatening form of valvular heart disease, characterized by stenosis and regurgitation, which is currently treated at the symptomatic end-stages via open-heart surgical replacement of the diseased valve with, typically, either a xenograft tissue valve or a pyrolytic carbon mechanical heart valve. These options offer the clinician a choice between structural valve deterioration and chronic anticoagulant therapy, respectively, effectively replacing one disease with another...
February 2013: Journal of Biomechanical Engineering
Melissa Fusari
OBJECTIVES: This paper reviews literary evidence on antithrombotic therapies currently employed in TAVR to assess validity and efficacy; duration and modality are also considered. In the absence of firm guidelines and reliable trial results, we analyze current knowledge of interaction between PPI and antithrombotic drugs. BACKGROUND: TAVR has been associated with Double Antiplatelet Therapy since 2002. This was an empirical approach for a new stentmounted tissue valve to prevent early and late MACCE that affect survival and quality of life...
2013: Current Pharmaceutical Design
Philippe Généreux, Susheel K Kodali, Philip Green, Jean-Michel Paradis, Benoit Daneault, Garvey Rene, Irene Hueter, Isaac Georges, Ajay Kirtane, Rebecca T Hahn, Craig Smith, Martin B Leon, Mathew R Williams
Acute kidney injury (AKI) is associated with a poor prognosis after transcatheter aortic valve replacement (TAVR). A paucity of data exists regarding the incidence and effect of AKI after TAVR using the new recommended Valve Academic Research Consortium criteria. At Columbia University Medical Center, 218 TAVR procedures (64.2% transfemoral, 35.8% transapical) were performed from 2008 to July 2011. The creatinine level was evaluated daily until discharge. Using the Valve Academic Research Consortium definitions, the 30-day and 1-year outcomes were compared between patients with significant AKI (AKI stage 2 or 3) and those without significant AKI (AKI stage 0 or 1)...
January 1, 2013: American Journal of Cardiology
Susheel K Kodali, Mathew R Williams, Craig R Smith, Lars G Svensson, John G Webb, Raj R Makkar, Gregory P Fontana, Todd M Dewey, Vinod H Thourani, Augusto D Pichard, Michael Fischbein, Wilson Y Szeto, Scott Lim, Kevin L Greason, Paul S Teirstein, S Chris Malaisrie, Pamela S Douglas, Rebecca T Hahn, Brian Whisenant, Alan Zajarias, Duolao Wang, Jodi J Akin, William N Anderson, Martin B Leon
BACKGROUND: The Placement of Aortic Transcatheter Valves (PARTNER) trial showed that among high-risk patients with aortic stenosis, the 1-year survival rates are similar with transcatheter aortic-valve replacement (TAVR) and surgical replacement. However, longer-term follow-up is necessary to determine whether TAVR has prolonged benefits. METHODS: At 25 centers, we randomly assigned 699 high-risk patients with severe aortic stenosis to undergo either surgical aortic-valve replacement or TAVR...
May 3, 2012: New England Journal of Medicine
Raj R Makkar, Gregory P Fontana, Hasan Jilaihawi, Samir Kapadia, Augusto D Pichard, Pamela S Douglas, Vinod H Thourani, Vasilis C Babaliaros, John G Webb, Howard C Herrmann, Joseph E Bavaria, Susheel Kodali, David L Brown, Bruce Bowers, Todd M Dewey, Lars G Svensson, Murat Tuzcu, Jeffrey W Moses, Matthew R Williams, Robert J Siegel, Jodi J Akin, William N Anderson, Stuart Pocock, Craig R Smith, Martin B Leon
BACKGROUND: Transcatheter aortic-valve replacement (TAVR) is the recommended therapy for patients with severe aortic stenosis who are not suitable candidates for surgery. The outcomes beyond 1 year in such patients are not known. METHODS: We randomly assigned patients to transfemoral TAVR or to standard therapy (which often included balloon aortic valvuloplasty). Data on 2-year outcomes were analyzed. RESULTS: A total of 358 patients underwent randomization at 21 centers...
May 3, 2012: New England Journal of Medicine
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