Propensity-Matched Comparison of Evolut R Transcatheter Aortic Valve Implantation with Surgery in Intermediate-Risk Patients (From the SURTAVI Trial)

The Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial demonstrated the noninferiority of transcatheter aortic valve implantation (TAVI) using a self-expanding bioprosthesis to surgical aortic valve replacement (SAVR) for the primary endpoint of all-cause mortality or disabling stroke at 2 years in patients with severe, symptomatic aortic stenosis at intermediate risk for surgery.1 The majority of TAVI patients in the SURTAVI trial (84%) received the first generation CoreValve bioprosthesis (Medtronic, Minneapolis, MN).
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research

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AbstractBackgroundA significant proportion of patients with aortic stenosis (AS) have discordance in severity by mean gradient/peak velocity and aortic valve area. Low gradient aortic stenosis (LG-AS) is defined when the aortic valve area is
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
CONCLUSION: We observed that valve-in-valve TAVI was associated with good short- and long-term outcomes. No significant differences were observed compared with native valve TAVI regarding clinical follow-up. PMID: 32532695 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - Category: Cardiology Authors: Tags: Arch Cardiovasc Dis Source Type: research
Abstract Background: Recent clinical trial results showed that transcatheter aortic valve replacement (TAVR) is non-inferior and may be superior to surgical aortic valve replacement (SAVR) for mortality, stroke, and rehospitalization. However, the impact of transcatheter valve durability remains uncertain. Methods: Discrete event simulation (DES) was used to model hypothetical scenarios of TAVR versus SAVR durability where TAVR failure times were varied to determine the impact of TAVR valve durability on life-expectancy in a cohort of low risk patients similar to those in recent trials. DES modeling was used to es...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
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
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...
Source: Cardiovascular Intervention and Therapeutics - Category: Cardiology 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
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