Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis in people with low surgical risk.

CONCLUSIONS: Our meta-analysis indicates that, in the short term, TAVI probably has little or no mortality difference compared to SAVR for severe AS in individuals with low surgical risk. Similarly, there is probably little or no difference in risk of stroke, MI, and cardiac death between the two approaches. TAVI may reduce the risk of rehospitalisation, but we are uncertain about the effects on LOS. TAVI reduces the risk of atrial fibrillation, AKI, and bleeding. However, this benefit is offset by the increased risk of PPM implantation. Long-term follow-up data are needed to further assess and validate these outcomes, especially durability, in the low surgical risk population. PMID: 31860123 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research

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CONCLUSION About one third of the injuries previously classified as grade III will be upgraded to grade IV using the 2018 AAST, which adds to the heterogeneity of grade IV injuries. Although the 2018 AAST grading provides more anatomic details on injury patterns and includes important radiologic findings, it did not outperform the 1989 AAST grading in predicting bleeding interventions. LEVEL OF EVIDENCE Prognostic and Epidemiological Study, level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: AAST 2019 PODIUM PAPER Source Type: research
INTRODUCTION Admission computed tomography (CT) is a widely used diagnostic tool for patients with pelvic fractures. In this pilot study, we hypothesized that pelvic hematoma volumes derived using a rapid automated deep learning-based quantitative visualization and measurement algorithm predict interventions and outcomes including (a) need for angioembolization (AE), pelvic packing (PP), or massive transfusion (MT), and (b) in-hospital mortality. METHODS We performed a single-institution retrospective analysis of 253 patients with bleeding pelvic fractures who underwent admission abdominopelvic trauma CT between 2008 ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
CONCLUSION: In this study, we could not detect an advantage in survival when SAVR or TAVR were utilized in intermediate to high surgical risk patients needing aortic valve replacement for severe aortic stenosis. PMID: 31596707 [PubMed - in process]
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
Conclusions: TAVR is comparable to SAVR in terms of mortality and disabling stroke in severe AS patients at low and intermediate risk, but higher proportion of AV re-intervention observed in TAVR. Those results should encourage caution when extending the indications of TAVR into low risk patients, especially for young low risk patients. Systematic review registration: PROSPERO CRD 42018112626. PMID: 31285888 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Publication date: November 2018Source: American Heart Journal, Volume 205Author(s): Nicolas M. Van Mieghem, Martin Unverdorben, Marco Valgimigli, Roxana Mehran, Eric Boersma, Usman Baber, Christian Hengstenberg, Minggao Shi, Cathy Chen, Shigeru Saito, Roland Veltkamp, Pascal Vranckx, George D. DangasTranscatheter aortic valve implantation, also called transcatheter aortic valve replacement (TAVR), is the treatment of choice for patients with severe aortic stenosis and intermediate to high operative risk. A significant portion of TAVR patients have atrial fibrillation (AF) requiring chronic oral anticoagulation. In moderate...
Source: American Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: In patients at low to intermediate surgical risk, midterm clinical outcomes of TAVR were similar to SAVR in survival and stroke rate, superior in reducing life-threatening bleeding, acute kidney injury, and new-onset atrial fibrillation, but inferior in increasing permanent pacemaker implantation. PMID: 29655505 [PubMed - in process]
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Conclusions ATLANTIS tests the superiority of an apixaban-based strategy versus the recommended standard of care strategy to reduce the risk of post-TAVR thromboembolic and bleeding complications in an all comer population.
Source: American Heart Journal - Category: Cardiology Source Type: research
CONCLUSION: We showed that a history of CVEs in patients with severe AS undergoing TAVI is associated with a higher long-term mortality. PMID: 29468958 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Time limit: 0 Quiz-summary 0 of 30 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Information This new test series requires ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Conclusions: Many unnecessary tests are obtained to evaluate syncope. Selecting tests based on history and examination and prioritizing less expensive and higher yield tests would ensure a more informed and cost-effective approach to evaluating older patients with syncope._____________________________________________________________________________4)    Reed MJ.  The ROSE (Risk Stratification of syncope in the emergency department) Study.  J Am Coll Cardiol, 2010; 55:713-721, doi:10.1016/j.jacc.2009.09.049  Objectives: The aim of this study was to develop and validate a clinical deci...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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