Clinical outcome after surgical aortic valve replacement in low-risk Japanese patients with severe aortic stenosis

AbstractTwo randomized control trials demonstrated that transcatheter aortic valve implantation was associated with 1 –2 year clinical outcomes comparable or even superior to surgical aortic valve replacement (SAVR) in low surgical risk patients with severe aortic stenosis (AS). However, no previous study has reported the clinical outcomes after SAVR in Japanese patients with low surgical risk. From 3815 consecu tive patients enrolled in the CURRENT AS registry, we retrieved 220 patients who underwent SAVR in reference to the inclusion and exclusion criteria of the PARTNER 3 trial. Age and surgical risk score in the current study population were comparable to those in the PARTNER 3 trial (Age: 75 years ver sus 74 years, and STS-PROM score: 2.3 versus 1.9). The cumulative incidence of a composite all-cause death or stroke was comparable between the current study population and the SAVR patients in the PARTNER 3 trial both at 30-day (2.3% versus 3.3%), and at 1-year (4.1% versus 4.9%). The clinical out comes of SAVR in low surgical risk patients with severe AS selected from a real world Japanese registry according to the inclusion and exclusion criteria of the PARTNER 3 trial was favorable and numerically comparable to those of SAVR patients in the PARTNER 3 trial.
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology Source Type: research

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Authors: Mas-Peiro S, Fichtlscherer S, Walther C, Vasa-Nicotera M Abstract Aortic stenosis is the most common valvular disease worldwide. With transcatheter aortic valve replacement (TAVR) being increasingly expanded to lower-risk populations, several challenging issues remain to be solved. The present review aims at discussing modern approaches to such issues as well as the current status of TAVR. TAVR has undergone several developments in the recent years: an increased use of transfemoral access, the development of prostheses in order to adapt to challenging anatomies, improved delivery systems with repositioning...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
The objective of this study is to compare echocardiographic findings in low risk patients with severe aortic stenosis (AS) following surgical (SAVR) or transcatheter aortic valve replacement (TAVR). Methods: The Placement of Aortic Transcatheter Valves 3 (PARTNER 3) trial randomized 1000 patients with severe AS and low surgical risk to undergo either transfemoral TAVR with the balloon-expandable SAPIEN 3 valve or SAVR. Transthoracic echocardiograms obtained at baseline, and at 30 days and 1 year post-procedure were analyzed by a consortium of 2 echocardiography core laboratories. Results: The percentage of moderate/severe ...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
Thorac cardiovasc Surg DOI: 10.1055/s-0040-1708478 Background Numerous studies have documented the safety of alternatives access (AA) transcatheter aortic valve replacement (TAVR) for patients who are not candidates for transfemoral or surgical approach. There is a scarcity of studies relating use of AA TAVR in nonagenarian patients, a high-risk, frail group. Our study sought to investigate the clinical outcomes of nonagenarians who underwent AA TAVR for aortic stenosis, with comparison of nonagenarians age ≥90 years with patients age
Source: The Thoracic and Cardiovascular Surgeon - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Original Cardiovascular Source Type: research
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
Abstract BACKGROUND: Transcatheter Aortic Valve Replacement (TAVR) has evolved as an alternative therapy to open AVR in most patients with aortic stenosis. Stroke associated with TAVR can be a devastating complication in the short-term, however, little is known regarding mid-term outcomes. METHODS: All patients undergoing TAVR from 2011-2018 were included. Modified Rankin Scales (mRS) as a measurement of stroke related disability were extracted for patients who had neurologic deficits. RESULTS: A total of 51 (4.3%) patients (out of 1193) developed neurologic events (NE) during study period (32 [2.7%] dis...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
ConclusionBoth TTR ‐ and AL‐CA can accompany severe AS. Parameters solely based on ECG and echocardiography allow for the identification of the majority of CA‐AS. In the present cohort, CA did not significantly worsen prognosis 15.3 months after TAVR.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
Transcatheter aortic valve replacement (TAVR) has become the mainstay of treatment for severe symptomatic aortic stenosis. Despite advances in device technology and procedural techniques, periprocedural stroke remains a severe complication of TAVR, affecting 2% of patients. The embolization of calcific debris from the degenerated aortic valve and atherosclerotic plaque from the aorta, both of which are manipulated during TAVR, is the likely mechanism of periprocedural stroke. Accordingly, cerebral embolic protection devices (EPDs) have been designed to prevent stroke by sequestering embolic debris during TAVR.
Source: JAMA Internal Medicine - Category: Internal Medicine Source Type: research
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 r...
Source: IJC Heart and Vasculature - Category: Cardiology Source Type: research
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
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