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Intravenous Recombinant Tissue Plasminogen Activator Therapy for Acute Basilar Artery Ischemic Stroke Following Transfemoral Transcatheter Aortic Valve Implantation.
Authors: Montarello NJ, Nelson AJ, Sidharta SL, Worthley SG Abstract Transcatheter aortic valve implantation (TAVI) can now be considered a standard of care for inoperable and high-risk surgical patients with severe aortic stenosis, and its uptake worldwide is rapidly increasing. Indeed, many centers performing the procedure have now moved towards treating intermediate-risk patients with TAVI rather than referring them for surgical aortic valve replacement. Although the incidence of peri-procedural acute and subacute stroke following TAVI has fallen to 2-5%, its occurrence can be life-threatening and life-changing,...
Source: Journal of Heart Valve Disease - December 21, 2016 Category: Cardiology Tags: J Heart Valve Dis Source Type: research

Agreement between stroke volume measured by oesophageal Doppler and uncalibrated pulse contour analysis during fluid loads in severe aortic stenosis
Abstract The purpose of this analysis was to study agreement and trending of stroke volume measured by oesophageal Doppler and 3rd generation Vigileo during fluid loads in patients with severe aortic stenosis. Observational study in 32 patients (30 analyzed) scheduled for aortic valve replacement due to severe aortic stenosis. After induction of anesthesia and before start of surgery, hemodynamic registrations for 1 min were obtained before and after a fluid load. Agreement between stroke volume measured by oesophageal Doppler (SVOD) and Vigileo (SVVig) was evaluated in Bland–Altman plot and trending in four-qu...
Source: Journal of Clinical Monitoring and Computing - January 31, 2015 Category: Information Technology Source Type: research

Measurement of stroke volume with echocardiography compared to gold standard cardiac magnetic resonance imaging An observational study
The assessment of Doppler-derived left ventricular outflow tract (LVOT) stroke volume (SV) is fundamental in outpatient, perioperative and critical care echocardiography.1 Calculation of SV allows assessment of the severity of aortic stenosis (AS) and evaluation of the haemodynamic state during undifferentiated hypotension.2 The use of focused transthoracic echocardiography (TTE) has appeal in a critical care environment, where after a single measurement of the LVOT area, pulsed wave Doppler velocity time integral (VTI) in the LVOT is used to calculate LVOT SV.
Source: Journal of Cardiothoracic and Vascular Anesthesia - May 16, 2023 Category: Anesthesiology Authors: Brian Cowie, Leah Wright, Ben Costello, Kristel Janssens, Erin Howden, Darragh Flannery, Steve Foulkes, Roman Kluger, Andre La Gerche Tags: Original Article Source Type: research

Dynamic variables and fluid responsiveness in patients for aortic stenosis surgery
ConclusionsThe arterial pressure‐based variables had moderate predictive values before valve replacement, but it predicted fluid responsiveness well postoperatively. Pleth variability index did not predict fluid responsiveness preoperatively, and it had a moderate predictive value postoperatively. These results indicate that arterial pressure‐based dynamic variables have limited potential to guide fluid therapy in patients with aortic stenosis. Their ability to guide fluid therapy after aortic valve replacement seems better.
Source: Acta Anaesthesiologica Scandinavica - April 29, 2014 Category: Anesthesiology Authors: L. Ø. HØISETH, I. E. HOFF, O. A. HAGEN, S. A. LANDSVERK, K. A. KIRKEBØEN Tags: Original Article Source Type: research

Analysis of Neurologic Complications After Surgical Versus Transcatheter Aortic Valve Replacement
Ove the last decade, transcatheter aortic valve replacement (TAVR) has emerged as the recommended approach over surgical aortic valve replacement (SAVR) for many patients with aortic stenosis. While initial trials demonstrated a higher incidence of stroke with TAVR compared to SAVR, the incidence of stroke appears to have improved over time. With the increasing number of patients expected to undergo TAVR in the coming decades, it is important to review the incidence and etiology of stroke after SAVR and TAVR.
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 27, 2018 Category: Anesthesiology Authors: Sundar Krishnan, Archit Sharma, Sudhakar Subramani, Lovkesh Arora, Divyanshu Mohananey, Pedro Villablanca, Harish Ramakrishna Tags: Expert Review Source Type: research

A Case of Successful Treatment of Cerebral Embolism Using Endovascular Thrombectomy Immediately After Transcatheter Aortic Valve Implantation
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 - December 17, 2019 Category: Anesthesiology Authors: Shunichi Murakami, Kazuyoshi Ishida, Hideyuki Ishihara, Takayuki Okamura, Tetsuro Oda, Ryo Suzuki, Atsuo Yamashita, Satoshi Yamashita, Hiroshi Kurazumi, Michiyasu Suzuki, Mishiya Matsumoto Tags: Case Report Source Type: research

General versus Local Anesthesia with Conscious Sedation in Transcatheter Aortic Valve Implantation: The Randomized SOLVE-TAVI Trial.
Conclusions: Among patients with aortic stenosis undergoing transfemoral TAVR, use of CS compared with GA resulted in similar outcomes for the primary efficacy endpoint. These findings suggest that CS can be safely applied for TAVR. Clinical Trial Registration: URL: https://clinicaltrials.gov Unique Identifier: NCT02737150. PMID: 32819145 [PubMed - as supplied by publisher]
Source: Circulation - August 20, 2020 Category: Cardiology Authors: Thiele H, Kurz T, Feistritzer HJ, Stachel G, Hartung P, Lurz P, Eitel I, Marquetand C, Nef H, Doerr O, Vigelius-Rauch U, Lauten A, Landmesser U, Treskatsch S, Abdel-Wahab M, Sandri M, Holzhey D, Borger M, Ender J, Ince H, Öner A, Meyer-Saraei R, Hambrech Tags: Circulation Source Type: research

Assessment of the left ventricular outflow tract during cardiac anaesthesia with biplane transoesophageal echocardiography: An observational study
BACKGROUND Assessment of left ventricular outflow tract (LVOT) area is a key component of quantification of aortic stenosis and stroke volume. Current international guidelines recommend measurement of the LVOT diameter with two-dimensional (2D) echocardiography and assume a circle. This may lead to erroneous measures of aortic valve area and adversely affect peri-operative decision making. Multiplane orthogonal (biplane) and three-dimensional (3D) echocardiography imaging may allow more accurate calculation of LVOT, aortic valve area and stroke volume. OBJECTIVE To evaluate the shape and area of the LVOT with co...
Source: European Journal of Anaesthesiology - November 19, 2021 Category: Anesthesiology Tags: Haemodynamics Source Type: research

Self-Expanding versus Balloon Expandable Valve – Are we at the Cusp of Delivering a Perfect Transcatheter Aortic Valve?
Transcatheter aortic valve replacement (TAVR) has become a leading and dominant treatment alternative to surgical aortic valve replacement (SAVR) for high- and intermediate-risk patients with aortic stenosis.1 –5 The follow up trials for both the core valve as well as the balloon-expanding valve showed similar mid-term survival and stroke rates in high-risk patients following TAVR vs SAVR.6–8 With the recent results of the PARTNER 3 and EVOLUT low risk trials, it is evident that, among patients with s evere aortic stenosis with low surgical risks, the rate of composite death, stroke and rehospitalization at 1 year was ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 26, 2021 Category: Anesthesiology Authors: Ankit Jain Tags: Editorial Source Type: research

Self-Expanding Versus Balloon-Expandable Valve: Are We at the Cusp of Delivering a Perfect Transcatheter Aortic Valve?
Transcatheter aortic valve replacement (TAVR) has become a leading and dominant treatment alternative to surgical aortic valve replacement (SAVR) for intermediate- and high-risk patients with aortic stenosis.1-5 The follow-up trials for both the core valve, as well as the balloon-expanding valve, showed similar midterm survival and stroke rates in high-risk patients following TAVR versus SAVR.6-8 With the recent results of the PARTNER 3 and EVOLUT low-risk trials, it is evident that, among patients with severe aortic stenosis with low surgical risks, the rates of composite death, stroke, and rehospitalization at 1 year wer...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 26, 2021 Category: Anesthesiology Authors: Ankit Jain Tags: Editorial Source Type: research

Two-Year Outcomes for Patients With Severe Symptomatic Aortic Stenosis Treated With Transcatheter Aortic Valve Implantation
In conclusion, the clinical outcome of TAVI is favorable. The use of both procedural devices and multiple techniques in the same institution is feasible and potentially desirable.
Source: The American Journal of Cardiology - February 18, 2013 Category: Cardiology Authors: Pablo Codner, Abid Assali, Danny Dvir, Hana Vaknin-Assa, Eyal Porat, Yaron Shapira, Marina Kupershmidt, Tamir Bental, Alexander Battler, Alexander Sagie, Ran Kornowski Tags: Valvular Heart Disease Source Type: research

Transcatheter Aortic Valve Replacement
The percutaneous transcatheter aortic valve replacement (TAVR) procedure, introduced in 2002, has emerged as a successful and comparable treatment option for many patients with aortic stenosis. Balanced general anesthesia or monitored anesthesia care in addition to local anesthesia have been used during transfemoral and transapical approaches. The results of different TAVR registries and the PARTNER trial have shown excellent success and survival rates, but stroke and paravalvular insufficiency represent major concerns. The key for successful procedural outcome involves thorough preparedness and knowledge of the pertinent procedural details.
Source: Anesthesiology Clinics - June 1, 2013 Category: Anesthesiology Authors: Andrej Alfirevic, Anand R. Mehta, Lars G. Svensson Source Type: research

Chronic Pressure-Overload Hypertrophy Attenuates Vortex Formation Time in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Systolic Function Undergoing Aortic Valve Replacement
Objective: Transmitral blood flow produces a vortex ring that enhances the hydraulic efficiency of early left ventricular (LV) filling. The effect of pressure-overload hypertrophy on the duration of LV vortex ring formation (vortex formation time [VFT]) is unknown. The current investigation tested the hypothesis that chronic LV pressure-overload hypertrophy produced by severe aortic stenosis (AS) reduces VFT in patients with preserved LV systolic function undergoing aortic valve replacement.Design: Observational study.Setting: Veterans Affairs Medical Center.Participants: After the Institutional Review Board's approval, 8 ...
Source: Journal of Cardiothoracic and Vascular Anesthesia - June 3, 2013 Category: Anesthesiology Authors: Paul S. Pagel, Judith A. Hudetz Tags: Original Articles Source Type: research

141 * mini-thoracotomy direct aortic self-expanding transcatheter aortic valve implantation: a single-centre experience
Conclusions: Transcatheter aortic valve implantation with the direct aortic approach is safe and feasible, offering a new, attractive option for treating selected high-risk patients with severe aortic stenosis and peripheral vasculopathy, including those requiring a redo procedure.
Source: Interactive CardioVascular and Thoracic Surgery - September 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Bruschi, G., Botta, L., De Marco, F., Colombo, P., Barosi, A., Mondino, M., Klugmann, S., Martinelli, L. Tags: Transcatheter aortic valve implantation: Expanding indications and techniques Source Type: research

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