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Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) has emerged as an effective therapy for patients with severe aortic stenosis, irrespective of surgical risks.1 Stroke due to cerebral embolization of debris is a devastating periprocedural complication of TAVR and is associated with poor outcomes. The risk of stroke could be decreased by capturing the debris using cerebral embolic protection (CEP) devices.2 An analysis of the TVT (Transcatheter Valve Therapy) Registry showed that CEPs were used in 28% of centers and 13% of all procedures.
Source: The American Journal of Cardiology - February 27, 2023 Category: Cardiology Authors: Ahmad Al-Abdouh, Mohammed Mhanna, Ahmad Jabri, Taha Ahmed, Ahmed M. Altibi, Fares Ghanem, Laith Alhuneafat, Ayman Albadawi, Mahmoud Barbarawi, Nakeya Dewaswala, Huzefa Bhopalwala, Amartya Kundu, Islam Y. Elgendy Source Type: research

Cerebral Embolic Protection in Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized Clinical Trials
Transcatheter aortic valve replacement (TAVR) has become a mainstay treatment option for most patients with severe symptomatic aortic stenosis. Although the majority of TAVR-related complications have decreased overtime, stroke rates remained relatively unchanged.1,2 Hence, numerous efforts have been devoted to developing effective strategies to mitigate the risk of post-TAVR strokes. We performed an updated meta-analysis to assess the efficacy and safety of cerebral embolic protection (CEP) during TAVR.
Source: The American Journal of Cardiology - November 14, 2022 Category: Cardiology Authors: Abdullah Al-Abcha, Yehia Saleh, Muhannad Abbasi, Edward El-Am, Mohamad Alkhouli Source Type: research

Meta-Analysis of 5-Year Risk of All-Cause Death or Stroke After Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement
Transcatheter aortic valve implantation (TAVI) is an established alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis.1,2 Its indication has expanded from high-risk to include a low surgical risk younger population. Although the short-term results of TAVI and SAVR in patients with intermediate or high surgical risk are similar,1,2 outcomes beyond short-term periods remain unclear. Recently, the results of 5-year follow-up of the Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial has been reported, which showed a similar rate of the compos...
Source: The American Journal of Cardiology - January 3, 2022 Category: Cardiology Authors: Yujiro Yokoyama, Toshiki Kuno, Tomo Ando, Tadahisa Sugiura, Azeem Latib Source Type: research

Prevalence of In-hospital Stroke Comparing MitraClip and Transcatheter Aortic Valve Implantation
Transcatheter aortic valve implantation (TAVI) and mitraclip (MC) are increasingly utilized for the treatment of aortic stenosis (AS) and mitral regurgitation (MR), respectively. Perioperative stroke is one of the most serious complications following TAVI given the valve calcification and possible embolization during valve implantation, and thus ongoing trials are assessing the use of embolic protection device following TAVI. On the other hand, no such trials are being conducted on MC as the evidence of stroke following MC is lacking and MC does not share the same etiology with TAVI 1.
Source: The American Journal of Cardiology - January 5, 2021 Category: Cardiology Authors: Anas M. Saad, Keerat Rai Ahuja, Omar M. Abdelfattah, Mohamed M. Gad, Toshiaki Isogai, Manpreet Kaur, Grant W. Reed, James Yun, Amar Krishnaswamy, Samir R. Kapadia Source Type: research

Meta-Analysis of Cerebral Embolic Protection During Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) has evolved as an important treatment option for patients with severe symptomatic aortic stenosis. Despite advancements with device design, procedural techniques, and improved operator experience, stroke rates after TAVR have not declined( ∼2.5%), as per the recent data from the national cardiovascular database registry.1 Embolic protection devices (EPDs) were introduced to prevent embolization of thrombotic or calcified debris during TAVR. However, randomized controlled trials (RCTs) that investigated the efficacy and safety of the se devices have been underpowered for clinical endpoints.
Source: The American Journal of Cardiology - October 23, 2020 Category: Cardiology Authors: Salik Nazir, Fnu Zafrullah, Hafeez U.H. Virk, Charnjeet Singh Sandhu, Muhammad Ameen, Keerat Rai Ahuja Source Type: research

Propensity-Matched Comparison of Evolut-R Transcatheter Aortic Valve Implantation With Surgery in Intermediate-Risk Patients (from the SURTAVI Trial)
The Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial demonstrated the noninferiority of transcatheter aortic valve implantation (TAVI) using a self-expanding bioprosthesis to surgical aortic valve replacement (SAVR) for the primary end point of all-cause mortality or disabling stroke at 2 years in patients with severe, symptomatic aortic stenosis at intermediate risk for surgery.1 The majority of TAVI patients in the SURTAVI trial (84%) received the first generation CoreValve bioprosthesis (Medtronic, Minneapolis, Minnesota).
Source: The American Journal of Cardiology - June 28, 2020 Category: Cardiology Authors: Steven J. Yakubov, Nicolas M. Van Mieghem, Michael J. Reardon, Patrick W. Serruys, Hemal Gada, Mubashir Mumtaz, G. Michael Deeb, Susheel Kodali, Isaac George, Stephan Windecker, Neal Kleiman, Stanley J. Chetcuti, Carlos Sanchez, Harold L. Dauerman, Shuzhe Source Type: research

Propensity-Matched Comparison of Evolut R Transcatheter Aortic Valve Implantation with Surgery in Intermediate-Risk Patients (From the SURTAVI Trial)
The Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) trial demonstrated the noninferiority of transcatheter aortic valve implantation (TAVI) using a self-expanding bioprosthesis to surgical aortic valve replacement (SAVR) for the primary endpoint of all-cause mortality or disabling stroke at 2 years in patients with severe, symptomatic aortic stenosis at intermediate risk for surgery.1 The majority of TAVI patients in the SURTAVI trial (84%) received the first generation CoreValve bioprosthesis (Medtronic, Minneapolis, MN).
Source: The American Journal of Cardiology - June 28, 2020 Category: Cardiology Authors: Steven J. Yakubov, Nicolas M. Van Mieghem, Michael J. Reardon, Patrick W. Serruys, Hemal Gada, Mubashir Mumtaz, G. Michael Deeb, Susheel Kodali, Isaac George, Stephan Windecker, Neal Kleiman, Stanley J. Chetcuti, Carlos Sanchez, Harold L. Dauerman, Shuzhe Source Type: research

Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices
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 - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Long-term Follow-up of Transcatheter Aortic Valve Implantation with Portico vs. Evolut devices
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 - January 28, 2020 Category: Cardiology Authors: Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano Source Type: research

Meta-Analysis Comparing Results of Transcatheter versus Surgical Aortic-Valve Replacement in Patients with Severe Aortic Stenosis
Transcatheter aortic-valve replacement (TAVR) has emerged as a promising strategy for treating patients with severe aortic stenosis. We aimed to compare TAVR with surgical aortic-valve replacement (SAVR) and determine the performance of TAVR over time and within several subgroups. We included 8 randomized trials comparing TAVR vs. SAVR. Compared with SAVR, TAVR was associated with a lower rate of all-cause mortality or disabling stroke at 30-day (odds ratio [OR], 0.72; P=0.004), 1-year (OR, 0.83; P=0.01) and 2-year (OR, 0.86; P=0.02), but not at long-term follow-up (rate ratio [RR], 1.02 [CI, 0.92 to 1.13]; P=0.67).
Source: The American Journal of Cardiology - November 6, 2019 Category: Cardiology Authors: Xinlin Zhang, Tingyu Wang, Rongfang Lan, Qing Dai, Lina Kang, Lian Wang, Yong Wang, Wei Xu, Biao Xu Source Type: research

Relation of Body Mass Index to Risk of Death or Stroke in Patients Who Underwent Transcatheter Aortic Valve Implantation
Obesity and overweight have been associated with better clinical outcomes in different populations with a diverse spectrum of cardiovascular disease (obesity paradox). However, conflicting data exist about the relation between body mass index (BMI) and outcomes after transcatheter aortic valve implantation (TAVI). The aim of this study is to evaluate the association of body mass index with clinical outcomes in patients with severe aortic stenosis (AS) who underwent TAVI. The study cohort included 379 consecutive patients with symptomatic severe AS who underwent TAVI between March 2010 and February 2017 in 3 centers in East Asia.
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: Sang Yong Om, Euihong Ko, Jung-Min Ahn, Do-Yoon Kang, Kyusup Lee, Osung Kwon, Pil Hyung Lee, Seung-Whan Lee, Ho Jin Kim, Joon Bum Kim, Suk Jung Choo, Duk-Woo Park, Seung-Jung Park Source Type: research

Relation of Body-Mass Index to Risk of Death or Stroke Among Patients Undergoing Transcatheter Aortic Valve Implantation
Obesity and overweight have been associated with better clinical outcomes in different populations with a diverse spectrum of cardiovascular disease ( “obesity paradox”). However, conflicting data exist about the relation between BMI and outcomes after transcatheter aortic valve implantation (TAVI). The aim of this study is to evaluate the association of body mass index (BMI) with clinical outcomes in patients with severe aortic stenosis (AS) undergoing TAVI. The study cohort included 379 consecutive patients with symptomatic severe AS who underwent TAVI between March 2010 and February 2017 in 3 centers in East Asia.
Source: The American Journal of Cardiology - November 24, 2018 Category: Cardiology Authors: Sang Yong Om, Euihong Ko, Jung-Min Ahn, Do-Yoon Kang, Kyusup Lee, Osung Kwon, Pil Hyung Lee, Seung-Whan Lee, Ho Jin Kim, Joon Bum Kim, Suk Jung Choo, Duk-Woo Park, Seung-Jung Park Source Type: research

Temporal-Trends in Sex-Related Differences and Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation (From the Israeli TAVI Multicentre Registry)
We evaluated temporal trends in sex-related differences in patients undergoing trans-catheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis (AS) from a multicentre TAVI registry during the years 2008-2016. Our final cohort included 1,159 males and 1,370 females, with a median follow-up of 2.3 (IQR 1.2, 4.4) years. For temporal trends analysis, the entire population was divided according to period of procedure: 2008-2012 and 2013-2016. During the 2008-2012 period, the rates of in-hospital aortic paravalvular leak, myocardial infarction, pacemaker implantation, and stroke were higher among males tha...
Source: The American Journal of Cardiology - October 3, 2018 Category: Cardiology Authors: Osnat Itzhaki Ben Zadok, Ran Kornowski, Ariel Finkelstein, Israel Barbash, Haim Danenberg, Amit Segev, Victor Guetta, Amir Halkin, Hana Vaknin, David Planer, Abid Assali, Alon Barsheshet, Katia Orvin Source Type: research

Temporal Trends in Gender-Related Differences and Outcomes in Patients Who Underwent Transcatheter Aortic Valve Implantation (from the Israeli Transcatheter Aortic Valve Implantation Multicenter Registry)
We evaluated temporal trends in gender-related differences in patients who underwent transcatheter aortic valve implantation (TAVI) for severe symptomatic aortic stenosis from a multicenter TAVI registry during the years 2008 to 2016. Our final cohort included 1,159 males and 1,370 females, with a median follow-up of 2.3 (IQR 1.2, 4.4) years. For temporal trends analysis, the entire population was divided according to period of procedure: 2008 to 2012 and 2013 to 2016. During the 2008 to 2012 period, the rates of in-hospital aortic paravalvular leak, myocardial infarction, pacemaker implantation, and stroke were higher amo...
Source: The American Journal of Cardiology - October 3, 2018 Category: Cardiology Authors: Osnat Itzhaki Ben Zadok, Ran Kornowski, Ariel Finkelstein, Israel Barbash, Haim Danenberg, Amit Segev, Victor Guetta, Amir Halkin, Hana Vaknin, David Planer, Abid Assali, Alon Barsheshet, Katia Orvin Source Type: research

Usefulness of the CHA2DS2-Vasc Score to Predict Outcome in Patients Undergoing Transcatheter Aortic Valve Implantation
Risk assessment for transcatheter aortic valve implantation (TAVI) patients remains challenging, especially among elderly and high-risk candidates. Although several risk factors contribute to increased morbidity and mortality following TAVI, simple risk scores for routine use are lacking. Applying the CHA2DS2-VASC score as a novel risk stratification tool for conditions other than atrial fibrillation (AF) and stroke prevention has been previously examined; however, its usefulness in a population of patients with aortic stenosis following TAVI has not been established.
Source: The American Journal of Cardiology - October 19, 2017 Category: Cardiology Authors: Katia Orvin, Amos Levi, Uri Landes, Tamir Bental, Alexander Sagie, Yaron Shapira, Hana Vaknin-Assa, Abid Assali, Ran Kornowski Source Type: research

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