Valve-Sparing Root Replacement vs Composite Valve Grafting in Aortic Root Dilation: A Meta-Analysis

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 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 dissection or pediatric populations were excluded.ResultsA total of 3,794 patients undergoing composite valve grafting and 2,424 undergoing aortic valve sparing procedures were included from 9 adjusted and 17 unadjusted observational studies. Mean follow-up was 5.8±3.0 years. Aortic valve sparing was not associated with any difference in early mortality, bleeding, myocardial infarction or thromboembolic complications. Late mortality was significantly lower following valve sparing (incident risk ratio: 0.68, 95% con...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

Related Links:

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
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
CONCLUSIONS: Platelet-mediated thromboembolism following MAP installation can be treated with antiplatelet agents. The 16-year results of the present study suggested that antiplatelet agents can reduce thromboembolic events in patients with MAP. Strokes can be prevented in patients with MAP if treated with the correct antiplatelet agent, if the patient responds to the agent employed and is strictly compliant. PMID: 30207122 [PubMed - in process]
Source: Journal of Heart Valve Disease - Category: Cardiology Tags: J Heart Valve 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
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
CONCLUSIONS: OAC after TAVR seems to reduce the risk of clinical valve thrombosis without a statistically significant increase in bleeding complications. PMID: 28497845 [PubMed - as supplied by publisher]
Source: Cardiology Journal - Category: Cardiology Authors: Tags: Cardiol J Source Type: research
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy–based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - Category: Cardiology Source Type: research
Authors: Robson A, Sturman J, Williamson P, Conboy P, Penney S, Wood H Abstract This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. (R) • Patients with hyp...
Source: Journal of Laryngology and Otology - Category: ENT & OMF Tags: J Laryngol Otol Source Type: research
Conclusions GALILEO will test the hypothesis that a rivaroxaban-based antithrombotic strategy reduces the risk of thromboembolic complications post-TAVR with an acceptable risk of bleeding compared with the currently recommended antiplatelet therapy-based strategy in subjects without need of chronic oral anticoagulation.
Source: American Heart Journal - Category: Cardiology 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
More News: Bleeding | Canada Health | Cardiovascular & Thoracic Surgery | Heart Attack | Heart Valve Surgery | Pediatrics | Stroke | Study | Thrombosis