Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience

AbstractAimsWe analysed the early and long-term clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation (TMVI) in an experienced centre.Methods and resultsAll patients undergoing TMVI from July 2010 to July 2017 in our centre were prospectively included. Indication for TMVI relied on the judgement of the local heart team. Patients were followed at 1  month, 1 year, and yearly thereafter. A total of 91 patients underwent TMVI. The median age was 73 (57–81) years and 70% of patients were women. Patients were at high risk for surgery with a median EuroSCORE II of 9.6 (4.0–14.6) %. Indication for TMVI was bioprosthesis failure (valve-in-val ve) in 37.3%, annuloplasty failure (valve-in-ring) in 33.0%, and severe mitral annulus calcification (MAC) in 29.7%. The transseptal approach was used in 92.3% of patients and balloon-expandable valves were used in all patients. Technical success was achieved in 84.6% of patients, one patient died d uring the procedure and haemodynamically significant left ventricular outflow tract obstruction occurred in three patients (3.3%). At 30 days, 7.7% of patients had died, without significant differences between groups, and a major stroke occurred in 2.2% of patients. The cumulative rates of all-cau se mortality at 1-year and 2-year follow-up were 21.0% [95% confidence interval (CI) 9.9–38.8] and 35.7% (95% CI 19.2–56.5), respectively, with a higher late mortality i...
Source: European Heart Journal - Category: Cardiology Source Type: research

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Publication date: Available online 23 January 2020Source: The Annals of Thoracic SurgeryAuthor(s): Malak Elbatarny, Derrick Y. Tam, J. James Edelman, Rodolfo V. Rocha, Michael W.A. Chu, Mark D. Peterson, Ismail El-Hamamsy, Jehangir J. Appoo, Jan O. Friedrich, Munir Boodhwani, Bobby Yanagawa, Maral Ouzounian, Canadian Thoracic Aortic Collaborative (CTAC) InvestigatorsAbstractBackgroundAortic valve sparing operations theoretically have fewer stroke and bleeding complications but may increase late reoperation risk, versus composite valve grafts.MethodsWe meta-analyzed all studies comparing aortic valve sparing (reimplantation...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract BACKGROUND: Aortic valve sparing operations theoretically have fewer stroke and bleeding complications but may increase late reoperation risk, versus composite valve grafts. METHODS: We meta-analyzed all studies comparing aortic valve sparing (reimplantation and remodelling) and composite valve grafting (bioprosthetic and mechanical) procedures. Early outcomes were: all-cause mortality, reoperation for bleeding, myocardial infarction, thromboembolism/stroke. Long-term outcomes included: all-cause mortality, reintervention, bleeding, and thromboembolism/stroke. Studies exclusively investigating dissec...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Aortic valve calcification is supposed to be a possible cause of embolic stroke or subclinical valve thrombosis after transcatheter aortic valve replacement (TAVR). We aimed to assess the role of aortic valve calcification in the occurrence of in-hospital clinical complications and survival after TAVR.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Source Type: research
Authors: Shiyovich A, Kornowski R Abstract BACKGROUND: Aortic stenosis (AS) is a common valvular pathology and is increasing in prevalence. Severe symptomatic AS is associated with serious outcomes if left untreated. Transcatheter aortic valve implantation (TAVI) is an innovative modality, which has revolutionized the treatment of AS. With growing experience and technological upgrades, TAVI has become a valid alternative to surgical valve replacement. However, TAVI is associates with increase non-negligible risks of mortality, stroke, physical disability, and healthcare expenditures. Furthermore, imaging modalities...
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Abstract BACKGROUND: Recently transcatheter aortic valve replacement (TAVR) has emerged as a feasible alternative for tranditional surgical aortic valve replacement (SAVR) in patients with intermediate to high risk. There is currently no clear consensus regarding the optimal antiplatelet strategy after TAVR. The primary objective of this updated meta-analyses was to compare the outcomes of dual antiplatelet therapy (DAPT) versus single antiplatelet therapy (SAPT) following TAVR. METHODS: A meta-analysis of eligible studies of patients undergoing TAVR which reported our outcomes of postoperative DAPT in compar...
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Authors: Overtchouk P, Piazza N, Granada JF, Modine T Abstract Introduction: Transcatheter mitral valve replacement (TMVR) is still a recent technology with numerous unknowns but also great promises. The risk of complications reported in observational studies have limited its adoption by interventional cardiology and surgical communities. Areas covered: Some of the major setbacks of TMVR are complications related to the devices and those related to the pathway. Device-related complications include left ventricle outflow tract (LVOT) obstruction, transcatheter heart valve (THV) dislocation or embolization, thrombosi...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
A 60-YEAR-OLD, 88-kg, 165-cm woman presented to a community hospital with heart failure 5 years after mitral valve repair for mitral regurgitation. The patient previously suffered an ischemic stroke and was currently treated with dual antiplatelet therapy. Transesophageal echocardiography revealed severe mitral stenosis with a mean transmitral gradient of 10 mmHg and thickening of the posterior left atrial wall. The patient was then transferred to the authors ’ institution for mitral valve replacement.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Diagnostic Dilemma Source Type: research
​BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; &AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regio...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Publication date: Available online 24 May 2019Source: Revista Española de Cardiología (English Edition)Author(s): Laura Galian-Gay, Blanca Gordon, Josep Ramón Marsal, Agnès Rafecas, Antonia Pijuan Domènech, Miguel Angel Castro, Maria T. Subirana Domènech, Carlos Sureda, Berta Miranda, Gerard Martí, David García-Dorado, Laura Dos SubiràAbstractIntroduction and objectivesAlthough pulmonary valve stenosis (PVS) is considered a low risk congenital heart disease, there have been reports of complications and the need for reintervention throughout follow-up. The aims ...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
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