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Utility of Duranta, a wireless patch-type electrocardiographic monitoring system developed in Japan, in detecting covert atrial fibrillation in patients with cryptogenic stroke: A case report
Rationale: Subcutaneous implantable electrocardiographs are highly effective in detecting covert atrial fibrillation (AF) in cryptogenic stroke. However, these invasive devices are not indicated for all cryptogenic stroke patients, and noninvasive improvements over conventional Holter-type ambulatory electrocardiography are needed. We evaluated the clinical application and effectiveness of Duranta (ImageONE Co., Ltd.), a wireless patch-type electrocardiographic monitoring system developed in Japan for chronically ill patients or home-based patients at the end of life. A Duranta device was used to detect covert AF in patien...
Source: Medicine - February 1, 2017 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Replacement —Effective in Stroke Prevention?
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 - February 24, 2020 Category: Internal Medicine Source Type: research

At 5 years, transcatheter aortic valve replacement had similar rates of mortality and stroke as surgical aortic valve replacement in high-risk patients
Commentary on: Kapadia SR, Leon MB, Makkar RR, et al., PARTNER trial investigators. 5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 2015;385:2485–91 and Mack MJ, Leon MB, Smith CR, et al., PARTNER 1 trial investigators. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER1): a randomised controlled trial. Lancet 2015;385:2477–84. Context When calcific aortic stenosis is as...
Source: Evidence-Based Medicine - November 24, 2015 Category: Internal Medicine Authors: Reardon, M. J., Kleiman, N. S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Interventional cardiology, Valvar diseases Therapeutics/Prevention Source Type: research

In severe aortic stenosis, TAVR was noninferior to conventional surgery for death or disabling stroke at 2 years.
PMID: 27538182 [PubMed - in process]
Source: Annals of Internal Medicine - August 15, 2016 Category: Internal Medicine Authors: Eagle KA, Weinberg RL Tags: Ann Intern Med Source Type: research

In severe aortic stenosis with intermediate surgical risk, TAVR was noninferior to SAVR for death or disabling stroke.
PMID: 28630980 [PubMed - in process]
Source: Annals of Internal Medicine - June 20, 2017 Category: Internal Medicine Authors: Spencer FA, Guyatt GH Tags: Ann Intern Med Source Type: research

Impact of Stroke Volume Index and Left Ventricular Ejection Fraction on Mortality After Aortic Valve Replacement
To assess the impact of stroke volume index (SVI) and left ventricular ejection fraction (LVEF) on prognosis in patients with severe aortic stenosis, comparing those undergoing transcatheter aortic valve replacement (TAVR) and those with surgical AVR (SAVR).
Source: Mayo Clinic Proceedings - December 31, 2019 Category: Internal Medicine Authors: Saki Ito, Vuyisile T. Nkomo, David A. Orsinelli, Grace Lin, Joao Cavalcante, Jeffrey J. Popma, David H. Adams, Stanley J. Checuti, G. Michael Deeb, Michael Boulware, Jian Huang, Stephen H. Little, Sidney A. Cohen, Michael J. Reardon, Jae K. Oh Tags: Original article Source Type: research

Outcomes of Transcatheter Aortic Valve Implantation in High Surgical Risk and Inoperable Patients with Aortic Stenosis ‐ A Single Australian Centre Experience
ConclusionsTAVI with various valve systems, delivered via a number of approaches, is feasible in high surgical risk and inoperable patients with severe aortic stenosis, with acceptable outcomes at short‐ and intermediate‐term follow‐up.
Source: Internal Medicine Journal - October 1, 2015 Category: Internal Medicine Authors: Vijayakumar Subban, Dale Murdoch, Michael L Savage, James Crowhurst, Ramakrishna Saireddy, Karl K Poon, Alexander Incani, Nicholas Bett, Darryl J Burstow, Gregory M Scalia, Andrew Clarke, Owen Christopher Raffel, Constantine N Aroney, Darren L Walters Tags: Original Article Source Type: research

Adverse Effects Associated With Transcatheter Aortic Valve Implantation: A Meta-analysis of Contemporary Studies.
CONCLUSION: The most common adverse effects associated with TAVI are heart block, vascular complications, and renal failure. The type of transcatheter valve and the route of implantation are associated with observed variations in the risks for some adverse effects. PRIMARY FUNDING SOURCE: Heart and Stroke Foundation of Canada. PMID: 23277899 [PubMed - in process]
Source: Annals of Internal Medicine - January 1, 2013 Category: Internal Medicine Authors: Khatri PJ, Webb JG, Rodés-Cabau J, Fremes SE, Ruel M, Lau K, Guo H, Wijeysundera HC, Ko DT Tags: Ann Intern Med Source Type: research

Transcatheter aortic valve implantation in nonagenarians: Effective and safe.
CONCLUSIONS: TAVI is safe and effective even in a selected population of nonagenarians. Consequently, these patients should not be refused such a procedure based only on their age. Multi-disciplinary assessment is essential in order to properly select candidates. PMID: 23932885 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - August 7, 2013 Category: Internal Medicine Authors: Noble S, Frangos E, Samaras N, Ellenberger C, Frangos C, Cikirikcioglu M, Bendjelid K, Frei A, Myers P, Licker M, Roffi M Tags: Eur J Intern Med Source Type: research

Presentation on US Hospital Websites of Risks and Benefits of Transcatheter Aortic Valve Replacement Procedures
Adequate presentation of risks and benefits of medical therapies is essential to informed decision making by patients. Transcatheter aortic valve replacement (TAVR) has been recently approved by the US Food and Drug Administration for the treatment of severe aortic stenosis among carefully selected patients; recent randomized clinical trials have identified important positive and negative outcomes of TAVR in these populations, including twice the risk of stroke for patients undergoing TAVR vs those undergoing open aortic valve replacement. Since 78% of all adults in the United States seek out health information online, we ...
Source: JAMA Internal Medicine - January 12, 2015 Category: Internal Medicine Source Type: research

Transfemoral transcatheter aortic-valve replacement should be preferred over surgery in most intermediate-risk patients
Commentary on: Leon MB, Smith CR, Mack MJ, et al.., PARTNER 2 Investigators. Transcatheter or surgical aortic-valve replacement in intermediate-risk patients. N Engl J Med 2016;374:1609–20 . Context Evidence derived from randomised clinical trials support transcatheter aortic valve replacement (TAVR) as a choice for patients with aortic stenosis with a prohibitive surgical risk and as a valid alternative therapy for those at high-risk of surgical mortality. Owing to increases in operator experience as well as improvements with transcatheter techniques and devices associated with reduction in procedural complications,...
Source: Evidence-Based Medicine - September 22, 2016 Category: Internal Medicine Authors: Tamburino, C., Capranzano, P. Tags: Epidemiologic studies, Drugs: cardiovascular system, Stroke, Arrhythmias Therapeutics/Prevention Source Type: research

Transthyretin cardiac amyloidosis.
Authors: Eicher JC, Audia S, Damy T Abstract Transthyretin (TTR) cardiac amyloidosis results from the dissociation of the tetrameric, liver-synthetized transport protein, either because of a mutation (hereditary CA), or spontaneously due to ageing (wild type CA). Monomers self-associate into amyloid fibrils within the myocardium, causing heart failure, arrhythmias and conduction defects. This overlooked disease must be recognized in case of unexplained increased thickness of the myocardium, particularly in subjects of African descent, in patients with heart failure and preserved ejection fraction, and in those with...
Source: Revue de Medecine Interne - August 23, 2020 Category: Internal Medicine Tags: Rev Med Interne Source Type: research

Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement: How Would You Manage This Patient With Severe Aortic Stenosis? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center
Ann Intern Med. 2021 Apr 13. doi: 10.7326/M21-0724. Online ahead of print.ABSTRACTAortic stenosis (AS) is common, especially among the elderly. Left untreated, severe symptomatic AS is typically fatal. Surgical aortic valve replacement (SAVR) was the standard of care until transcatheter aortic valve replacement (TAVR) was shown to have lower mortality rates in patients at the highest surgical risk and was recommended for this group in the 2014 American Heart Association/American College of Cardiology (AHA/ACC) guidelines. In the 2017 AHA/ACC focused update, evidence of benefit and noninferiority extended the use of TAVR to...
Source: Annals of Internal Medicine - April 12, 2021 Category: Internal Medicine Authors: Eileen E Reynolds Suzanne J Baron Tsuyoshi Kaneko Howard Libman Source Type: research

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