Valve-in-Valve Transcatheter Implantation versus Redo Surgical Aortic Valve Replacement

Valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) for a failing prosthesis is an appealing alternative to redo surgical AVR. We utilized data from the US National Inpatient Sample for the period 2012-2016 to identify hospitalizations for either ViV-TAVI or redo-SAVR. The primary outcomes of interest were in-hospital adverse events composite outcome (comprising of mortality, myocardial infarction, stroke, or acute kidney injury) and all-cause mortality. We used propensity score matching to adjust for the baseline differences between ViV-TAVI and redo-SAVR cohorts.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research

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RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
RARITAN, N.J., March 20, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that it will unveil late-breaking data from its leading cardiovascular and metabolism portfolio during the virtual American College of Cardiology’s 69th Annual Scientific Session together with the World Congress of Cardiology (ACC.20/WCC) on March 28-30, 2020. Notably, four late-breaking abstracts for XARELTO® (rivaroxaban) will be presented, including data from the Phase 3 VOYAGER PAD study in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization.Click to ...
Source: Johnson and Johnson - Category: Pharmaceuticals Source Type: news
CONCLUSIONS: In patients who underwent AVR for aortic stenosis, positive intraoperative fluid balance was associated with decreased odds of AKI. Patients developing AKI had increased 30- and 90-day mortality. While the overall incidence was low, increased intraoperative fluid balance was associated with MI and 30-day mortality, while increased ultrafiltration volume was associated with 30- and 90-day morality. Prospective studies are needed to better define proper intraoperative fluid management in patients undergoing cardiac surgery. PMID: 32151580 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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
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, esp...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
This study shows that CA are released from periventricular and subpial regions to the cerebrospinal fluid and are present in the cervical lymph nodes, into which cerebrospinal fluid drains through the meningeal lymphatic system. We also show that CA can be phagocytosed by macrophages. We conclude that CA can act as containers that remove waste products from the brain and may be involved in a mechanism that cleans the brain. Moreover, we postulate that CA may contribute in some autoimmune brain diseases, exporting brain substances that interact with the immune system, and hypothesize that CA may contain brain markers that m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Abstract BACKGROUND: Full aortic root replacement with biological conduit has limited options. This non-randomized cohort study aims to compare mid-term clinical and hemodynamic results of the BioIntegral (BI) composite biological versus the stentless Freestyle (FS) conduits in patients undergoing full aortic root replacement. METHODS: From February 2013 to July 2017, 265 patients underwent aortic root replacement at a single institution (BI n=202, FS n=65). Preoperative, intraoperative and postoperative parameters, complications including stroke, myocardial infarction (MI), endocarditis and reoperation were ...
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Conclusion The current study demonstrates that in patients with severe aortic valve stenosis or regurgitation and mitral valve prosthesis, the implantation of a self-expanding aortic valve via the transfemoral route is safe and feasible, with maintained long-term results.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Structural heart intervention Source Type: research
Publication date: Available online 23 October 2019Source: The Annals of Thoracic SurgeryAuthor(s): Vinod H. Thourani, John J. Kelly, David Cervantes, Sreekanth Vemulapalli, Pratik Manandhar, Jessica Forcillo, David Holmes, David J. Cohen, Ajay Kirtane, Susheel Kodali, Martin Leon, Vasilis Babaliaros, Ron Waksman, Lowell Satler, Christian Shults, Itsik Ben-Dor, Toby Rogers, Samir Kapadia, Micheal Reardon, S. Chris MalaisrieAbstractBackgroundDue to perceived technical challenges, patients with previous surgical mitral valve repair or replacement (SMVR) have been excluded from most transcatheter aortic valve replacement (TAVR...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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