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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

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

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

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

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

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

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

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