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Tavi review

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
C Moini, B Sidia, D Poindron, L Fiorina, A Farge, W Amara, M El Issa
Transcatheter aortic valve implantation (TAVI) is nowadays a worldwide technique in the field of treating aortic stenosis. One of the main side effects linked to the technique are mostly attached to rhythm disturbances, such as atrioventricular (AV) and intraventricular blocks. Consequently, a pacemaker implantation is often required. That implantation rate is estimated between 8 and 30%, depending on the valve chosen. Thanks to main meta analysis on the subject, it has been managed to isolate the following risks factors for AV block development: preoperative right bundle branch block (RBBB: the most powerful element), complete AV block during the procedure, male gender, a so-called porcelain aorta, the absence of previous valvular surgery, the aortic annulus size (i...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Lyubov Lytvyn, Gordon H Guyatt, Veena Manja, Reed A Siemieniuk, Yuan Zhang, Thomas Agoritsas, Per O Vandvik
OBJECTIVE: To investigate patients' values and preferences regarding aortic valve replacement therapy for aortic stenosis. SETTING: Studies published after transcatheter aortic valve insertion (TAVI) became available (2002). PARTICIPANTS: Adults with aortic stenosis who are considering or have had valve replacement, either TAVI or via surgery (surgical aortic valve replacement, SAVR). OUTCOME MEASURES: We sought quantitative measurements, or qualitative descriptions, of values and preferences...
2016: BMJ Open
Reed A Siemieniuk, Thomas Agoritsas, Veena Manja, Tahira Devji, Yaping Chang, Malgorzata M Bala, Lehana Thabane, Gordon H Guyatt
OBJECTIVE:  To examine the effect of transcatheter aortic valve implantation (TAVI) versus surgical replacement of an aortic valve (SAVR) in patients with severe aortic stenosis at low and intermediate risk of perioperative death. DESIGN:  Systematic review and meta-analysis DATA SOURCES:  Medline, Embase, and Cochrane CENTRAL. STUDY SELECTION:  Randomized trials of TAVI compared with SAVR in patients with a mean perioperative risk of death <8%...
September 28, 2016: BMJ: British Medical Journal
Davide Capodanno, Martin B Leon
Over the past decade, approximately 15,000 patients have been randomised in clinical trials of transcatheter aortic valve implantation (TAVI), and as many patients will be randomised in ongoing and future investigations aimed at broadening indications, comparing devices, simplifying the procedure, and optimising clinical outcomes. The purpose of this review is to summarise the rationale and design of upcoming studies in the field of TAVI.
September 18, 2016: EuroIntervention
Marco Barbanti, Corrado Tamburino
There is a growing body of evidence demonstrating the durability of current transcatheter aortic valve implantation (TAVI) devices up to 5 years. However, it is well known that transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. In this review we briefly discuss the modes of failure of trans-catheter aortic valves and their potential management.
September 18, 2016: EuroIntervention
Lennart van Gils, Didier Tchetche, Azeem Latib, Carmelo Sgroi, Ganesh Manoharan, Helge Möllmann, Nicolas M Van Mieghem
Transcatheter aortic valve implantation (TAVI) has evolved from an exclusive, highly complex and hazardous procedure into a mature, safe and streamlined therapy for patients with severe aortic stenosis (AS). Various successive device iterations and product refinements have created a dynamic and competitive field with a spectrum of different CE-marked transcatheter heart valve (THV) designs. This review provides a practical overview of current CE-marked THVs with a focus on respective sizing algorithms and delivery strategies...
September 18, 2016: EuroIntervention
Omar Abdul-Jawad Altisent, Rishi Puri, Josep Rodés-Cabau
Transcatheter aortic valve implantation (TAVI) is now the principal therapeutic option in patients with severe aortic stenosis deemed inoperable or at high surgical risk. Implementing TAVI in a lower risk profile population could be limited by relatively high cerebrovascular event rates related to the procedure. Diffusion-weighted magnetic resonance imaging studies have demonstrated the ubiquitous presence of silent embolic cerebral infarcts after TAVI, with some data relating these lesions to subsequent cognitive decline...
October 2016: Revista Española de Cardiología
Marco Barbanti, Giuseppe Gargiulo, Corrado Tamburino
INTRODUCTION: 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...
September 20, 2016: Expert Review of Cardiovascular Therapy
Kim L Lavoie, Joshua A Rash, Tavis S Campbell
Widespread acceptance of evidence-based medicine has led to the proliferation of clinical practice guidelines as the primary mode of communicating current best practices across a range of chronic diseases. Despite overwhelming evidence supporting the benefits of their use, there is a long history of poor uptake by providers. Nonadherence to clinical practice guidelines is referred to as clinical inertia and represents provider failure to initiate or intensify treatment despite a clear indication to do so. Here we review evidence for the ubiquity of clinical inertia across a variety of chronic health conditions, as well as the organizational and system, patient, and provider factors that serve to maintain it...
September 7, 2016: Annual Review of Pharmacology and Toxicology
Javier Castrodeza, Ignacio J Amat-Santos, Vicenç Serra, Luis Nombela-Franco, Derek Ralph Brinster, Enrique Gutiérrez-Ibanes, Paol Rojas, Pilar Tornos, Manuel Carnero, Carlos Cortes, Javier Tobar, Salvatore Di Stefano, Itziar Gomez, José A San Román
BACKGROUND: We aimed to analyze causes, management, and outcomes of the unexpected need to abort sternotomy in aortic stenosis (AS) patients accepted for surgical aortic valve replacement (SAVR) in the transcatheter aortic valve implantation (TAVI) era. METHODS: Cases of aborted sternotomy (AbS) were gathered from 5 centers between 2009 and 2014. A systematic review of all published cases in the same period was performed. RESULTS: A total of 31 patients (71% males, 74±8years, LogEuroSCORE 11...
November 15, 2016: International Journal of Cardiology
M-R Ghovanloo, K Aimar, R Ghadiry-Tavi, A Yu, P C Ruben
Voltage-gated sodium channels are present in different tissues within the human body, predominantly nerve, muscle, and heart. The sodium channel is composed of four similar domains, each containing six transmembrane segments. Each domain can be functionally organized into a voltage-sensing region and a pore region. The sodium channel may exist in resting, activated, fast inactivated, or slow inactivated states. Upon depolarization, when the channel opens, the fast inactivation gate is in its open state. Within the time frame of milliseconds, this gate closes and blocks the channel pore from conducting any more sodium ions...
2016: Current Topics in Membranes
Sanjeewa Kularatna, Joshua Byrnes, Merehau Cindy Mervin, Paul A Scuffham
OBJECTIVES: Made available since 2002, transcatheter aortic valve implantation (TAVI) is a minimally invasive new intervention which can provide significant survival improvement to patients with aortic stenosis. However, TAVI is expensive and currently not reimbursed by many governments. Some governments and institutions have been conducting health technology assessments (HTAs) to inform their reimbursement decisions. The aim of the present study is to review HTAs that have relied on a cost-effectiveness analysis to inform reimbursement decisions of TAVI...
January 2016: International Journal of Technology Assessment in Health Care
Tom Kai Ming Wang, David Hm Choi, Tharumenthiran Ramanathan, Peter N Ruygrok
BACKGROUND: With the introduction of transcatheter aortic valve implantation (TAVI), there is increasing interest in evaluating outcomes of aortic valve replacement (AVR) with or without (+/-) concurrent coronary artery bypass grafting (CABG) particularly in high-risk patients. We reviewed the characteristics and outcomes of octogenarians undergoing isolated AVR and AVR+CABG. METHODS: All patients 80 years of age or older undergoing AVR+/-CABG at Auckland City Hospital during 2005-2012 were included, and their characteristics and outcomes analysed...
July 6, 2016: Heart, Lung & Circulation
Baldomero Álvarez-Fernández, Francesç Formiga, Manuel de Mora-Martín, Fernando Calleja, Ricardo Gómez-Huelgas
Aortic stenosis (AS) is the most frequent valve disease in the elderly population Treatment is valve replacement either by open surgery, or in the case of patients at high surgical risk, by TAVI (Transcatheter Aortic Valve Implantation). However, almost 40% of patients who have undergone TAVI show poor health outcomes, either due to death or because their clinical status does not improved. This review examines the non-cardiac aspects of patients with AS, which may help answer three key questions in order to evaluate this condition pre-surgically: 1) Are the symptoms presented by the patient exclusively explained by the AS, or are there other factors or comorbidities that could justify or increase them?, 2) What possibilities for improvement of health status and quality of life has the patient after the valve replacement?, and 3) How can we reduce the risk of a futile valve replacement?...
July 15, 2016: Revista Española de Geriatría y Gerontología
Joshua A Rash, David J T Campbell, Marcello Tonelli, Tavis S Campbell
Suboptimal adherence to statin medication is common and leads to serious negative health consequences but may respond to intervention. This review evaluated the effectiveness of interventions intended to improve adherence to statin medication. Data sources included peer-reviewed publications from Cochrane Register of Randomized Controlled Trials (RCTs), PubMed, CINAHL, and EMBase indexed between 01 October 2008 and 18 October 2015 and studies from reference lists and technical experts. RCTs that evaluated an intervention targeting adherence to self-administered statin medication for primary or secondary prevention were eligible...
September 2016: Preventive Medicine
Rodrigo Bagur, Chun Shing Kwok, Luis Nombela-Franco, Peter F Ludman, Mark A de Belder, Sandro Sponga, Mark Gunning, James Nolan, Pantelis Diamantouros, Patrick J Teefy, Bob Kiaii, Michael W A Chu, Mamas A Mamas
BACKGROUND: Preimplantation balloon aortic valvuloplasty (BAV) is considered a routine procedure during transcatheter aortic valve implantation (TAVI) to facilitate prosthesis implantation and expansion; however, it has been speculated that fewer embolic events and/or less hemodynamic instability may occur if TAVI is performed without preimplantation BAV. The aim of this study was to systematically review the clinical outcomes associated with TAVI undertaken without preimplantation BAV...
June 2016: Journal of the American Heart Association
Serkan Asil, Levent Şahiner, Necla Özer, E Barış Kaya, Banu Evranos, Uğur Canpolat, Hikmet Yorgun, Heves Karagöz, Kudret Aytemir
OBJECTIVES: Following the encouraging results of several registries and trials, transcatheter aortic valve implantation (TAVI) has been recognized as a valid option in patients with severe aortic stenosis deemed at high or prohibitive risk for surgical treatment. Good procedural success and good clinical outcomes have been showed and very limited data exist on TAVI in the setting of a preexisting mitral prosthesis regarding the technique, potential complications, and outcomes. METHODS: Here, we report six cases of transfemoral TAVI with a self-expanding bioprosthesis (CoreValve; Medtronic, Inc) in patients who had previously undergone mitral valve replacement...
October 15, 2016: International Journal of Cardiology
Matteo Pagnesi, Enrico A Martino, Mauro Chiarito, Antonio Mangieri, Richard J Jabbour, Nicolas M Van Mieghem, Susheel K Kodali, Cosmo Godino, Giovanni Landoni, Antonio Colombo, Azeem Latib
BACKGROUND: The aims of this study were: 1) to evaluate silent cerebral injury detected by cerebral diffusion weighted magnetic resonance imaging (DW-MRI) after transcatheter aortic valve implantation (TAVI); and 2) to assess the efficacy of embolic protection devices (EPDs) on DW-MRI endpoints. METHODS: We included in a pooled analysis 25 prospective studies reporting post-procedural cerebral DW-MRI data after TAVI (n=1225). Among these studies, we included in a meta-analysis 6 studies investigating TAVI performed with versus without EPDs (n=384)...
October 15, 2016: International Journal of 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
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