Safety and efficacy of a self-expanding versus a balloon-expandable bioprosthesis for transcatheter aortic valve replacement in patients with symptomatic severe aortic stenosis: a randomised non-inferiority trial

Publication date: Available online 27 September 2019Source: The LancetAuthor(s): Jonas Lanz, Won-Keun Kim, Thomas Walther, Christof Burgdorf, Helge Möllmann, Axel Linke, Simon Redwood, Christian Thilo, Michael Hilker, Michael Joner, Holger Thiele, Lars Conzelmann, Lenard Conradi, Sebastian Kerber, Gerhard Schymik, Bernard Prendergast, Oliver Husser, Stefan Stortecky, Dik Heg, Peter JüniSummaryBackgroundTranscatheter aortic valve replacement (TAVR) is the preferred treatment option for older patients with symptomatic severe aortic stenosis. Differences in the properties of available TAVR systems can affect clinical outcomes. Among patients undergoing TAVR, we compared the self-expanding ACURATE neo TAVR system with the balloon-expandable SAPIEN 3 TAVR system with regard to early safety and efficacy.MethodsIn this randomised non-inferiority trial, patients (aged ≥75 years) undergoing transfemoral TAVR for treatment of symptomatic severe aortic stenosis, and who were deemed to be at increased surgical risk, were recruited at 20 tertiary heart valve centres in Germany, the Netherlands, Switzerland, and the UK. Participants were randomly assigned (1:1) to receive treatment with the ACURATE neo or the SAPIEN 3 with a computer-based randomly permuted block scheme, stratified by study centre and Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) category. The primary composite safety and efficacy endpoint comprised all-cause death, any stroke, life-threa...
Source: The Lancet - Category: General Medicine Source Type: research

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Publication date: Available online 21 February 2020Source: Neuroscience &Biobehavioral ReviewsAuthor(s): Jennifer Grau-Sánchez, Thomas F. Münte, Eckart Altenmüller, Esther Duarte, Antoni Rodríguez-FornellsAbstractMusic-based interventions have emerged as a promising tool in stroke motor rehabilitation as they integrate most of the principles of motor training and multimodal stimulation. This paper aims to review the use of music in the rehabilitation of upper extremity motor function after stroke. First, we review the evidence supporting current music-based interventions including Music-supporte...
Source: Neuroscience and Biobehavioral Reviews - Category: Neuroscience Source Type: research
We report a case of migration of arterial stent, placed in the right iliac vein into the right pulmonary artery which was diagnosed there and subsequently not removed for at least 3 years. Despite reports in the literature for the removal of migrated stents by mini-invasive interventional methods, in our case, this was not possible, because of the long period for which the foreign body was in the right pulmonary artery and the proximal partial occlusion of organized mural thrombus.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Authors: De Vecchis R, Paccone A, Di Maio M Abstract INTRODUCTION: The guidelines of the Scientific Societies of Cardiology suggest limiting water intake in the diet as one of the non-pharmacological measures for the management of chronic heart failure. However, many patients with heart failure may suffer from severe thirst, even irrespective of a possible restricted fluid intake, and this has received relatively little attention in clinical studies. Moreover, definitive and irrefutable evidence that documents the efficacy of the limitation in water consumption on major cardiovascular outcomes is lacking. Therefore...
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
CONCLUSIONS: Not all interventional procedures result in a mortality benefit. Medical therapy alone increases survival in many cardiac diseases. PMID: 32083425 [PubMed - as supplied by publisher]
Source: Minerva Cardioangiologica - Category: Cardiology Tags: Minerva Cardioangiol Source Type: research
Discussion IAB is a rather frequent finding in the general population. IAB is a risk factor for AF and is associated with an increased risk of stroke or TIA independently of associated AF. Key messagesBoth partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population.Advanced interatrial block is an independent risk factor for stroke and transient ischemic attack.The clinical significance of interatrial block is dependent on the subtype classification. PMID: 32077319 [PubMed - as supplied by publisher]
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
Authors: Herold A Abstract Hemorrhoidal disease is one of the most common illnesses in industrialized nations. Up to 70% of adults suffer from the disease once in their lifetime. This underlines the necessity and importance of knowing about the differential diagnosis of hemorrhoids. One can differentiate between differential diagnoses of symptoms (bleeding, pain, itching, tumor) and differential diagnoses of the phenotype findings (anal prolapse, mucosal prolapse and rectal prolapse, skin tags, hypertrophied anal papillae, condylomata acuminata, anal fissure, perianal venous thrombosis, anal cancer). PMID: 3207...
Source: Der Hautarzt: Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete - Category: Dermatology Tags: Hautarzt Source Type: research
Motives for cannabis use are hardly generated by users themselves nor are they validated for German users. We therefore aimed to replicate the motive structure of established questionnaires (e.g., MMM and CMMQ) in young German adults. In a cross-sectional ...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
Authors: Szułdrzyński K, Jankowski M, Potaczek DP, Undas A Abstract Aims: Fibrin formation and histidine-rich glycoprotein (HRG) are involved in primary hemostasis and wound healing. Little is known regarding the relationship of clot characteristics, bleeding time, and wound healing. Methods and Results: We studied 154 patients with coronary artery disease (CAD) and 154 subjects free of CAD matched for age, obesity, and current smoking. We evaluated bleeding time (BT) using standardized skin incisions on a forearm, along with plasma clot permeability (K s), clot lysis time (CLT), and histidine-rich glycoprote...
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Publication date: March 2020Source: European Journal of Surgical Oncology, Volume 46, Issue 3Author(s): Laura M. Legué, Felice N. van Erning, Geert-Jan Creemers, Ignace H.J.T. de Hingh, Valery E.P.P. Lemmens, Clément J. HuysentruytAbstractBackgroundThe aim of this population-based study was to determine the prognostic value of the histologic subtypes mucinous (MAC), non-mucinous (AC) and signet ring cell (SRCC) adenocarcinoma among patients with appendiceal cancer.Methods and materialsData from the Netherlands Cancer Registry (NCR) of patients with primary appendiceal adenocarcinomas with MAC, AC and SRCC his...
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionsPhysiological fatigue seems to have no impact on shooting accuracy, but rather affects shooting times in expert biathletes. Furthermore, the duration of the final fixation does not seem to moderate shooting accuracy in elite biathletes.
Source: Journal of Science and Medicine in Sport - Category: Sports Medicine Source Type: research
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