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Stroke After Transcatheter Aortic Valve Replacement
This study reported about a 7% risk of stroke, which was not surprising given the patient population and the likelihood of particulate embolization when expanding a new valve within the annulus of the stenosed and calcified native valve. Nevertheless, even with this stroke risk, there was a clear mortality benefit and quality of life was improved as well. After the PARTNER 1A high-risk cohort demonstrated similar or improved outcomes relative to open surgical aortic valve replacement (SAVR) in patients at high (but not inoperable) surgical risk, the US Food and Drug Administration (FDA) approved TAVR in 2011 and the proced...
Source: JAMA - June 18, 2019 Category: General Medicine Source Type: research

Papillary fibroelastoma of the aortic valve presenting with chronic angina and acute stroke: a case report
ConclusionsTo the best of our knowledge, this is the first case report describing a patient with a cardiac papillary fibroelastoma who presented with both chronic angina and acute stroke.
Source: Journal of Medical Case Reports - January 17, 2017 Category: Journals (General) Source Type: research

Early Stroke After TAVR in US Practice
This cohort study uses registry data to describe trends and incidence of 30-day stroke among patients who had undergone transcatheter aortic valve replacement (TAVR) in the first 5 years the procedure ’s use in US clinical practice.
Source: JAMA - June 18, 2019 Category: General Medicine Source Type: research

Cardiopulmonary Exercise Testing in Aortic Stenosis.
CONCLUSIONS: In this group of patients, where clinical assessment is difficult and conventional exercise testing is regarded as less useful, CPX showed high feasibility and reproducibility. CPX therefore has potential as a useful tool for serial monitoring. In general, the stroke volume increased during exercise, including in patients with severe aortic stenosis or decreased resting stroke volume. CPX gives information on hemodynamics and the physiologic components that determine decreased pVO2. CPX seems useful to identify 1) patients with a low risk of cardiac death and low risk of progression to symptoms from the aortic...
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Regional differences in the utilization and outcomes of cerebral embolic protection during transcatheter aortic valve replacement: an analysis of the National Inpatient Sample from 2017 through 2019
Conclusion: Within the USA, there are regional differences in the utilization and outcomes of CEP use during TAVR. To prevent regional disparities and ensure consistent quality of care in the USA, further research is needed to determine what variable(s) may be responsible for regional differences in TAVR outcomes, with or without CEP.PMID:37724712 | DOI:10.57264/cer-2023-0010
Source: Journal of Comparative Effectiveness Research - September 19, 2023 Category: General Medicine Authors: Elisa M Amoroso Source Type: research

Clinical Outcomes at 1 Year Following Transcatheter Aortic Valve Replacement
ImportanceIntroducing new medical devices into routine practice raises concerns because patients and outcomes may differ from those in randomized trials.ObjectiveTo update the previous report of 30-day outcomes and present 1-year outcomes following transcatheter aortic valve replacement (TAVR) in the United States.Design, Setting, and ParticipantsData from the Society of Thoracic Surgeons/American College of Cardiology (STS/ACC) Transcatheter Valve Therapies Registry were linked with patient-specific Centers for Medicare & Medicaid Services (CMS) administrative claims data. At 299 US hospitals, 12 182 patients linked wit...
Source: JAMA - March 10, 2015 Category: Journals (General) Source Type: research

Transcatheter Aortic Valve Implantation in Patients With Severe Aortic Valve Stenosis at Low Surgical Risk: A Health Technology Assessment.
Conclusions: Both TAVI (transfemoral route) and SAVR resulted in improved patient symptoms and quality of life during the 1 year of follow-up. The TAVI procedure is less invasive and resulted in greater symptom improvement and quality of life than SAVR 30 days after surgery. The TAVI procedure also resulted in a small improvement in mortality and disabling stroke at 30 days. At 1 year, TAVI and SAVR were similar with regard to mortality, although TAVI may result in a slightly lower risk of disabling stroke. According to the study authors, longer follow-up is needed to better understand how long TAVI valves last and to draw...
Source: Ontario Health Technology Assessment Series - November 27, 2020 Category: General Medicine Tags: Ont Health Technol Assess Ser Source Type: research

Transcatheter aortic valve implantation versus surgical aortic valve replacement in patients with severe aortic stenosis: a systematic review and meta-analysis
Conclusions No overall change in the risk of death from any cause or cardiovascular mortality was identified but 95% CIs were often wide, indicating uncertainty. TAVI may reduce the risk of certain side effects while SAVR may reduce the risk of others. Most long-term (5-year) results are limited to older patients at high surgical risk (ie, early trials), therefore more data are required for low risk populations. Ultimately, neither surgical technique was considered dominant, and these results suggest that every patient with SAS should be individually engaged in SDM to make evidence-based, personalised decisions around thei...
Source: BMJ Open - December 6, 2021 Category: General Medicine Authors: Swift, S. L., Puehler, T., Misso, K., Lang, S. H., Forbes, C., Kleijnen, J., Danner, M., Kuhn, C., Haneya, A., Seoudy, H., Cremer, J., Frey, N., Lutter, G., Wolff, R., Scheibler, F., Wehkamp, K., Frank, D. Tags: Open access, Cardiovascular medicine Source Type: research

Transcatheter Aortic Valve Implantation for Treatment of Aortic Valve Stenosis: A Health Technology Assessment.
CONCLUSIONS: Moderate quality evidence showed that TAVI and SAVR had similar mortality rates in patients who were eligible for surgery. Information about quality of life showed similar results for TAVI and SAVR in the first year, but was based on low quality evidence. Moderate quality evidence also showed that TAVI was associated with higher rates of adverse events than SAVR. In patients who were not suitable candidates for surgery, moderate quality evidence showed that TAVI improved survival compared with balloon aortic valvuloplasty. When TAVI was compared with SAVR, the incremental cost-effectiveness ratio was $51,988 p...
Source: Ontario Health Technology Assessment Series - December 21, 2016 Category: Journals (General) Tags: Ont Health Technol Assess Ser Source Type: research

Postoperative thrombotic effects of tranexamic acid in open heart surgery
ConclusionsIn patients receiving tranexamic acid infusion at 50  mg/kg dose, reexploration rates remained at 4.1% even after major cardiac surgeries. No thrombosis, stroke, or seizure were reported. Our findings support that tranexamic acid is a safe drug which has positive effect on reducing perioperative bleeding.
Source: Irish Journal of Medical Science - February 28, 2019 Category: General Medicine Source Type: research

Transcatheter aortic valve implantation versus surgical aortic valve replacement for severe aortic stenosis in people with low surgical risk.
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 - December 19, 2019 Category: General Medicine Authors: Kolkailah AA, Doukky R, Pelletier MP, Volgman AS, Kaneko T, Nabhan AF Tags: Cochrane Database Syst Rev Source Type: research

Effects of short-term oral anticoagulation following surgical bioprosthetic aortic valve replacement
CONCLUSION: Our study demonstrated that short-term OAC use after bAVR was associated with lower all-cause mortality. The prevalence of 1-year embolism/ischemic stroke/ICH were comparable despite of OAC use.PMID:36057527 | DOI:10.1016/j.jfma.2022.08.006
Source: J Formos Med Assoc - September 3, 2022 Category: General Medicine Authors: Tsung-Yu Ko Jui-Hsiang Lin Kuan-Chih Huang Ling-Yi Wei Yi-Lwun Ho Hsien-Li Kao Hsi-Yu Yu Source Type: research

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