Coronary revascularization during treatment of severe aortic stenosis: A meta ‐analysis of the complete percutaneous approach (PCI plus TAVR) versus the complete surgical approach (CABG plus SAVR)

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.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: REVIEW ARTICLE Source Type: research

Related Links:

echt R, Fach A, Augenstein T, Frey N, König IR, Vonthein R, Rückert Y, Funkat AK, Desch S, Desch S, Berggreen AE, Heringlake M, de Waha-Thiele S, SOLVE-TAVI Investigators Abstract Background: In clinical practice, local anesthesia with conscious sedation (CS) is performed in roughly 50% of patients undergoing transcatheter aortic valve replacement (TAVR). However, no randomized data assessing the safety and efficacy of CS versus general anesthesia (GA) are available. Methods: SOLVE-TAVI is a multicenter, open-label, 2x2 factorial, randomized trial of 447 patients with aortic stenosis undergoing transfemo...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
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...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE 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
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
New-generation devices such as Evolut and Portico have provided favorable results in patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing on long-term outcomes, including major adverse events (i.e., the composite of death, stroke, myocardial infarction, major vascular complication, or major bleeding).
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
New-generation devices such as Evolut and Portico have provided favorable results in patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing long-term outcomes, including the major adverse events (i.e. the composite of death, stroke, myocardial infarction, major vascular complication or major bleeding).
Source: The American Journal of Cardiology - Category: Cardiology Authors: 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
Publication date: Available online 21 November 2019Source: Canadian Journal of CardiologyAuthor(s): Gabriele Crimi, Claudio Montalto, Luca Angelo Ferri, Luigi Piatti, Irene Bossi, Nuccia Morici, Alessandro Mandurino-Mirizzi, Daniele Grosseto, Giovanni Tortorella, Stefano Savonitto, Stefano De Servi, Elderly-ACS 2 InvestigatorsABSTRACTBackgroundElderlies are underrepresented in clinical trials and registries and a gap of evidence exists for clinical decision making in the setting of acute coronary syndromes (ACS). We aimed to assess the prevalence and independent prognostic impact of valvular heart disease (VHD) diagnosed d...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Conclusion In very old patients undergoing coronary revascularization owing to LMCA disease, PCI was associated with worse cardiovascular outcomes compared with CABG, influenced by a more severe and comorbid population selected for PCI. Baseline disability, presentation with STEMI, and distal LMCA bifurcation disease were additional independent outcome predictors.
Source: Coronary Artery Disease - Category: Cardiology Tags: PCI Source Type: research
AbstractPurpose of ReviewWe conducted a comprehensive and updated overview on complications occurring after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis.Recent FindingsDespite remarkable improvements in patient selection, devices, procedures, and ancillary management, complications may still occur in patients undergoing TAVI. On top of most commonly described adverse events such as death, myocardial infarction, stroke, bleeding, vascular complication, renal failure, pacemaker implantation and residual valve regurgitation, other less common but similarly severe complications may still occur. The...
Source: Current Emergency and Hospital Medicine Reports - Category: Emergency Medicine Source Type: research
More News: Angioplasty | Aortic Stenosis | Cardiovascular & Thoracic Surgery | Coronary Angioplasty | Coronary Artery Bypass Graft | Databases & Libraries | Heart Attack | Heart Valve Surgery | Percutaneous Coronary Intervention | Stroke | Study