Transcatheter treatment of native aortic valve regurgitation: Results from an international registry using the transfemoral ACURATE neo valve

Publication date: April 2020Source: IJC Heart &Vasculature, Volume 27Author(s): Paola Angela Maria Purita, Luisa Salido Tahoces, Chiara Fraccaro, Luca Nai Fovino, Won-Keun Kim, Cláudio Espada-Guerreiro, Ole De Backer, Morritz Seiffert, Luis Nombela-Franco, Raul Moreno Gomez, Antonio Mangieri, Anna Franzone, Francesco Bedogni, Fausto Castriota, Tiziana Attisano, Lars Søndergaard, Rosana Hernandez Antolin, Giuseppe TarantiniAbstractBackgroundTranscatheter aortic valve replacement (TAVR) has been validated for the treatment of severe symptomatic aortic stenosis in patients at high and intermediate surgical risk. Recently, TAVR has been proposed as an alternative to medical therapy in inoperable patients with severe native aortic valve regurgitation (NAVR). This multicenter international registry sought to evaluate safety and efficacy of TAVR with the self-expandable ACURATE neo valve in a cohort of patients with NAVR.MethodsA total of 24 patients with severe NAVR treated by TAVR between September 2016 and October 2018 in 13 European centers were included. Clinical, procedural and follow up data were inserted in a dedicated database. Outcomes were codified according to Valve Academic Research Consortium-2 criteria.ResultsMean age was 79.4 years, 58.4% were female. Mean EuroSCORE II and STS score were 5% and 3.9%, respectively. Device success was 87.5%. Moderate paravalvular leak (PVL) was found in two (8.3%) of patients, both with a perimeter oversizing ind...
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research

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ConclusionsThis initial experience suggests TAVR can be safely performed in patients with BAV achieving similar short-term procedural and clinical outcomes when compared with patients with TAV.Condensed AbstractThe outcomes of 50 patients (8.8%) with bicuspid aortic stenosis (BAV) undergoing TAVR were compared with those of 517 patients (91.2%) with trileaflet aortic valve (TAV) stenosis. Patients with BAV were younger, had higher prevalence of COPD, lower prevalence of CAD, higher BMI and lower STS score. Major complications were similar between the groups, including stroke (2.0% vs. 1.5, P = .567), 30-day all-c...
Source: American Heart Journal - Category: Cardiology Source Type: research
Transcatheter aortic valve replacement (TAVR) has become the preferred method for management of severe aortic stenosis in patients who are at high and intermediate surgical risk. Short-term data have been presented from two studies comparing TAVR versus surgical aortic valve replacement (SAVR) in low surgical risk patients. The Placement of Aortic Transcatheter Valves 3 (PARTNER 3) trial compared TAVR using a balloon expandable valve with standard SAVR. The primary endpoint was a composite of all-cause mortality, stroke, or re-hospitalization at 1 year post-procedure.
Source: Radcliffe Cardiology - Category: Cardiology Authors: Source Type: research
TUESDAY, Feb. 4, 2020 -- There is no significant difference in the incidence of death or disabling stroke at five years among patients with aortic stenosis at intermediate surgical risk who undergo transcatheter aortic valve replacement (TAVR) or...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
AbstractBackgroundPatients with underlying interstitial lung disease (ILD) who undergo cardiac surgery are at high risk of postoperative pulmonary complications. It remains unclear if transcatheter aortic valve replacement (TAVR) offers any benefit over surgical aortic valve replacement (SAVR) in ILD patients with severe aortic stenosis.MethodsAll adult patients with a diagnosis of ILD who underwent either a TAVR or isolated SAVR between January 2002 and December 2017 were retrospectively reviewed. Operative mortality, 30 ‐day readmissions, and adjusted 1‐year survival were compared between the two cohorts.ResultsThe o...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
To assess the impact of stroke volume index (SVI) and left ventricular ejection fraction (LVEF) on prognosis in patients with severe aortic stenosis, comparing those undergoing transcatheter aortic valve replacement (TAVR) and those with surgical AVR (SAVR).
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Original article Source Type: research
Publication date: January 2020Source: Canadian Journal of Cardiology, Volume 36, Issue 1Author(s): Mohammad Alkhalil, Paul Brennan, Conor McQuillan, Reuben Jeganathan, Ganesh Manoharan, Colum G. Owens, Mark S. SpenceAbstractBackgroundTools are needed to identify patients at increased risk after transcatheter aortic valve replacement (TAVR). Indexed stroke volume (SVi) is an echocardiographic measurement that is used for low-gradient aortic stenosis. We studied whether low SVi is a high-risk marker in patients with high-gradient aortic stenosis (HG-AS) and assessed the relationship between SVi and left ventricle (LV) systol...
Source: Canadian Journal of Cardiology - Category: Cardiology 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
ConclusionsThis analysis shows that there are 3 distinct phases of cost accumulation from referral to post-TAVR with some potentially modifiable cost drivers in each phase.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
TRANSCATHETER aortic valve implantation (TAVI) is a less invasive alternative to surgical aortic valve replacement in high-risk patients with severe aortic stenosis. However, there are increasing concerns about the potential complications of TAVI now that its indications have been expanded to include patients with low-to-intermediate surgical risk.1,2 One of the serious complications of TAVI is stroke. It is known that there is an increase in 30-day mortality, rates of respiratory insufficiency and postprocedural delirium, and duration of hospital stay if stroke occurs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research
Publication date: January 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 1Author(s): Mostafa R. Amer, Wassim Mosleh, Saurabh Joshi, Jeffery F. Mather, Wael El-Mallah, Mohiuddin Cheema, Raymond G. McKayBackgroundPrevious reports described successful use of transcarotid and transsubclavian approaches for the performance of transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis who cannot be treated with transfemoral access. The purpose of the present study was to compare these two alternative approaches with respect to safety, efficacy, and procedural efficiency.MethodsA retrospe...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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