What Is New in Low Gradient Aortic Stenosis: Surgery, TAVR, or Medical Therapy?
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
CONCLUSIONS: This report on TAVR risk assessment within the VA system demonstrates that despite a large proportion of patients classified as prohibitive risk, TAVR was associated with favorable 30-day and 1-year all-cause mortality rates when compared with published outcomes from the STS/ACC TVT registry. PMID: 32737265 [PubMed - as supplied by publisher]
CONCLUSIONS: Aortic valve replacement, either by surgical or transcatheter approach, appears similarly effective and safe for males and females at intermediate surgical risk. Functional status appears to improve most in females after TAVI. PMID: 32715995 [PubMed - as supplied by publisher]
Conclusion Oversizing reduces the risk of device failure and intraprocedural postdilation but increases the risk of PPI. Early and midterm morbidity and mortality after OS and nOS with S3 are comparable. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents | Abstract | Full text
ConclusionsWhen comparing the total percutaneous and total surgical treatment, no significant difference in short ‐term safety outcomes or early and late mortality was observed. More evidence is needed to guide the clinical decision.
AbstractBackgroundTransfemoral aortic valve replacement (TAVR) has been studied extensively in patients with improving safety and efficacy in high to intermediate ‐risk patients with aortic stenosis. TAVR has been now approved for patients with low surgical risk.ObjectiveThe purpose of this study is to integrate the evidence from randomized controlled trials (RCT) and large registry data comparing TAVR to surgical aortic valve repair (SAVR).MethodsSeven studies (three RCTs, one post hoc study of a RCT, and three registries) were included. Incidence rate ratios (IRR) of outcomes of interest (overall mortality, 30 ‐day m...
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 end point 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, Minnesota).
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).
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]
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...
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...