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Transcatheter Valve Replacement

Masahiko Asami, Thomas Pilgrim
No abstract text is available yet for this article.
February 25, 2019: JACC. Cardiovascular Interventions
Anubodh S Varshney, Pratik Manandhar, Sreekanth Vemulapalli, Ajay J Kirtane, Verghese Mathew, Binita Shah, Angela Lowenstern, Andrzej S Kosinski, Tsuyoshi Kaneko, Vinod H Thourani, Deepak L Bhatt
OBJECTIVES: The aim of this study was to evaluate the association between pre-procedural left ventricular hypertrophy (LVH) patterns and clinical outcomes after transcatheter aortic valve replacement (TAVR). BACKGROUND: The association between pre-procedural LVH pattern and severity and clinical outcomes after TAVR is uncertain. METHODS: Patients (n = 31,199) across 422 sites who underwent TAVR from November 2011 through June 2016 as part of the Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapies) Registry linked with the Centers for Medicare and Medicaid Services database were evaluated by varying LVH patterns, according to sex-specific cutoffs for left ventricular mass index and relative wall thickness...
February 25, 2019: JACC. Cardiovascular Interventions
Eberhard Grube, Jan-Malte Sinning
No abstract text is available yet for this article.
February 25, 2019: JACC. Cardiovascular Interventions
Suzanne V Arnold, Yiran Zhang, Suzanne J Baron, Thomas C McAndrew, Maria C Alu, Susheel K Kodali, Samir Kapadia, Vinod H Thourani, D Craig Miller, Michael J Mack, Martin B Leon, David J Cohen
OBJECTIVES: The aim of this study was to examine the independent association of short-term complications of transcatheter aortic valve replacement (TAVR) with survival and quality of life at 1 year. BACKGROUND: Prior studies have examined the mortality and cost implications of various complications of TAVR. However, many of these complications may primarily affect patients' quality of life after TAVR, which has not been previously studied. METHODS: Among patients at intermediate or high surgical risk who underwent TAVR as part of the PARTNER (Placement of Aortic Transcatheter Valve) 2 studies and survived 30 days, the association between complications within the 30 days after TAVR and mortality and quality of life at 1 year was examined...
February 25, 2019: JACC. Cardiovascular Interventions
Zhe Li, Emily Dawson, Jessica Moodie, Janet Martin, Rodrigo Bagur, Davy Cheng, Bob Kiaii, Ava John-Baptiste
INTRODUCTION: Aortic stenosis is a significant cause of morbidity and mortality in older patients. The advent of transcatheter aortic valve implantation (TAVI) offers an alternative to surgical aortic valve replacement for patients with severe symptomatic aortic stenosis who are at high or intermediate risk of adverse events. Existing evidence highlights the importance of frailty as a predictor of poor outcomes post-TAVI. The objective of this study is to review the operationalisation of frailty instruments for TAVI recipients and determine clinical outcomes and the change in quality of life in frail patients undergoing TAVI...
February 19, 2019: BMJ Open
Rose Tompkins, Angela M Kelle, Allison K Cabalka, George K Lui, Jamil Aboulhosn, Danny Dvir, Doff B McElhinney
BACKGROUND: Transcatheter tricuspid valve-in-valve replacement (TVIV) is an emerging therapy for dysfunctional surgical valves in patients with congenital and acquired TV disease. The present study was performed to establish baseline quantitative data for echocardiographic and invasive parameters obtained pre- and immediately post-TVIV. METHODS: Patients were drawn from the VIVID Registry. This study included two cohorts. The registry cohort included all patients entered in the VIVID registry through February 2017 who had both echocardiographic and invasively measured gradients across the TV...
February 14, 2019: Journal of the American Society of Echocardiography
Arpandeep Randhawa, Tulika Gupta, Parmod Singh, Anjali Aggarwal, Daisy Sahni
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has emerged as a less invasive treatment than surgical aortic valve replacement in patients with aortic stenosis. Understanding the anatomy of aortic valve complex may help in optimal positioning of prosthetic valve and circumvent complications that can arise during its implantation. MATERIAL AND METHODS: The anatomy of aortic root was studied in 30 formalin-fixed cadavers. Aortic root and left ventricular cavity was opened to measure the diameter at the base of aortic root and sinotubular junction (STJ); distance of coronary ostia from base of aortic root and STJ; height and width of aortic valve leaflets; length and thickness of membranous septum (MS)...
January 21, 2019: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Ignacio Cruz González, Rocío González Ferreiro, Javier Martín Moreiras, Blanca Trejo Velasco, Manuel Barreiro Pérez, Alejandro Diego Nieto, Jesús Herrero Garibi, Javier Rodríguez Collado, Pedro Luis Sánchez Fernández
No abstract text is available yet for this article.
February 7, 2019: JACC. Cardiovascular Interventions
Jaffar M Khan, Uday Trivedi, Arionilson Gomes, Robert J Lederman, David Hildick-Smith
No abstract text is available yet for this article.
February 7, 2019: JACC. Cardiovascular Interventions
Pavel Overtchouk, Thierry Folliguet, Frédéric Pinaud, Oliver Fouquet, Mathieu Pernot, Guillaume Bonnet, Maxime Hubert, Joël Lapeze, Jean Philippe Claudel, Said Ghostine, Alexandre Azmoun, Christophe Caussin, Konstantinos Zannis, Majid Harmouche, Jean-Philippe Verhoye, Antoine Lafont, Chekrallah Chamandi, Vito Giovanni Ruggieri, Alessandro Di Cesare, Florence Leclercq, Thomas Gandet, Thomas Modine
OBJECTIVES: This study sought to describe the procedural and clinical outcomes of patients undergoing transcarotid (TC) transcatheter aortic valve replacement (TAVR) with the Edwards Sapien 3 device. BACKGROUND: The TC approach for TAVR holds the potential to become the optimal alternative to the transfemoral gold standard. Limited data exist regarding safety and efficacy of TC-TAVR using the Edwards Sapien 3 device. METHODS: The French Transcarotid TAVR prospective multicenter registry included patients between 2014 and 2018...
February 7, 2019: JACC. Cardiovascular Interventions
Asaad Khan, George Dangas
The anatomic interplay between aortic valve, ascending aorta, left ventricular outflow tract and peripheral vasculature play a major role in determining device related outcomes in transcatheter aortic valve replacement. Factors such as the alignment angle (prosthesis-ascending aorta), pre-dilatation, operating team experience and chronic kidney disease may play a role in valve displacement. Careful analysis of all imaging modalities while sizing and selecting a valve type, and attention to newer deployment techniques may improve outcomes...
February 15, 2019: Catheterization and Cardiovascular Interventions
Billy Chen, Larry S Dean
As indications for TAVR expand, there is a need for predictive models of procedural complications. Application of the HAS-BLED score demonstrated patient comorbidities that contribute to increased bleeding events and mortality. Further adequately powered studies will be needed to validate the HAS-BLED score for use in the TAVR population or further elucidate important risk factor to incorporate into future predictive risk models.
February 15, 2019: Catheterization and Cardiovascular Interventions
Hisato Takagi, Yosuke Hari, Norikazu Kawai, Toshiki Kuno, Tomo Ando
AIMS: To evaluate whether liver disease is associated with increased mortality after transcatheter aortic valve implantation (TAVI) and whether TAVI is associated with decreased mortality compared to surgical aortic valve replacement (SAVR) in patients with liver disease, we performed meta-analyses of currently available studies. METHODS: Studies reporting mortality in TAVI patients with liver disease versus those without liver disease and mortality after TAVI versus SAVR in patients with liver disease were eligible to be included...
February 11, 2019: Journal of Cardiovascular Medicine
François Huchet, Jacques Chan-Peng, Fanny d'Acremont, Patrice Guerin, Gael Grimandi, Jean-Christian Roussel, Julien Plessis, Vincent Letocart, Thomas Senage, Thibaut Manigold
BACKGROUND: Current scientific guidelines have extended the indication for transcatheter aortic valve replacement (TAVR) to patients who present an intermediate risk for surgery and have been so far considered for conventional surgery. We previously demonstrated that the TAVR procedure generated profits despite elevated costs, but comparison with surgery has not been performed. The objective of this study was to assess the profitability of the TAVR procedure compared with conventional surgery in a high-volume French hospital...
February 14, 2019: Health Economics Review
Min Ji Kwak, Viraj Bhise, Mark T Warner, Prakash Balan, Tom C Nguyen, Anthony L Estrera, Richard W Smalling, Abhijeet Dhoble
OBJECTIVES: We aimed to trend the utilization of transcatheter aortic valve replacement (TAVR) among COPD patients, compare its outcomes to surgical aortic valve replacement (SAVR), and assess any social disparities of its outcomes. BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have been increasingly undergoing TAVR, but studies to evaluate the national trend of TAVR utilization and outcome still are lacking. METHODS: We conducted a retrospective observational study using a nationally representative data, National Inpatient Sample (NIS)...
February 14, 2019: Current Medical Research and Opinion
Kerstin Piayda, Verena Veulemans, Katharina Hellhammer, Shazia Afzal, Alexander Blehm, Malte Kelm, Tobias Zeus
We present the case of a 71-year-old woman who showed recurrent signs of congestive heart failure with the need of rehospitalization after double valve (mitral and aortic) replacement. Extensive diagnostic workup revealed a moderate aortic stenosis and additionally a significant left ventricular outflow tract obstruction. The tissue overgrowth might be attributed to an inflammatory reaction with extensive pannus deposit after aortic valve surgery. With no-option for re-do surgery we performed the first-in-man off-label valve-in-left ventricular outflow tract procedure with an Edwards Sapien III 23 mm in deep orientation...
February 2019: Canadian Journal of Cardiology
Ali Fatehi Hassanabad, Vishnu Vasanthan, William D T Kent
Aortic valve replacement (AVR) is the only definitive treatment for severe aortic stenosis. Options for valve replacement include surgical AVR (SAVR) and percutaneous transcatheter AVR. Although transcatheter AVR has recently been shown to be the optimal approach for high-risk patients, SAVR is the gold standard for patients with low and intermediate surgical risk. Advances in technique and innovations in rapid-deployment and sutureless valves have facilitated the development of a third alternative. Accumulating evidence suggests that minimally invasive SAVR can be performed as safely as conventional SAVR, and perhaps with less morbidity, allowing patients a quicker return to their productive lives...
February 2019: Canadian Journal of Cardiology
Julinda Mehilli, Jaya Chandrasekhar, Samantha Sartori, Alaide Chieffo, Anna S Petronio, Thierry Lefèvre, Patrizia Presbitero, Piera Capranzano, Didier Tchetche, Alessandro Iadanza, Gennaro Sardella, Nicolas M Van Mieghem, Emanuela Meliga, Nicolas Dumonteil, Chiara Fraccaro, Daniela Trabattoni, David Jochheim, Magda Zadrozny, Ghada W Mikhail, Samin Sharma, Maria C Ferrer, Christoph Naber, Peter Kievit, Kamilia Moalem, Usman Baber, Clayton Snyder, Madhav Sharma, Marie C Morice, Roxana Mehran
BACKGROUND: Several clinical and procedural factors determine outcomes after transcatheter aortic valve replacement (TAVR), but data are scarce on the impact of post-TAVR discharge disposition on long-term outcomes. We sought to analyse whether discharge location after TAVR is associated with 1-year outcomes in women undergoing contemporary TAVR. METHODS: The Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) registry is the first all-female TAVR registry to study the safety and performance of contemporary TAVR in women (n = 1019)...
February 2019: Canadian Journal of Cardiology
Taishi Okuno, Kazuyuki Yahagi, Yu Horiuchi, Yu Sato, Tetsu Tanaka, Keita Koseki, Akira Osanai, Motoi Yokozuka, Sumio Miura, Kengo Tanabe
Severe aortic stenosis (AS) is considered as an independent risk factor for perioperative cardiac complications of non-cardiac surgery. Surgical aortic valve replacement should be considered before non-cardiac surgery in patients with symptomatic severe AS. However, recently, transcatheter aortic valve replacement (TAVR) has emerged as an alternative approach for selected AS patients. We sought to determine the safety and efficacy of TAVR in preparation for major non-cardiac surgery. From our retrospective database, seven patients who underwent TAVR in preparation for major non-cardiac surgery were identified, and their clinical and hemodynamic data were collected...
February 13, 2019: Cardiovascular Intervention and Therapeutics
Benyamin Rahmani, Christopher McGregor, Guerard Byrne, Gaetano Burriesci
Bioprosthetic leaflets made from animal tissues are used in the majority of surgical and transcatheter cardiac valve replacements. This study develops a new surgical bioprosthesis, using porcine pericardial leaflets. Porcine pericardium was obtained from genetically engineered pigs with a mutation in the GGTA-1 gene (GTKO) and fixed in 0.6% glutaraldehyde, and used to develop a new surgical valve design. The valves underwent in vitro hydrodynamic test in a pulse duplicator and high-cycled accelerated wear testing and were evaluated for acute haemodynamics and thrombogenicity in a juvenile sheep implant study for 48 h...
February 12, 2019: Journal of Cardiovascular Translational Research
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