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Economic Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with Severe Aortic Stenosis and Low Surgical Risk: Results from the PARTNER 3 Trial
CONCLUSIONS: For patients with severe aortic stenosis and low surgical risk similar to those enrolled in the PARTNER 3 trial, transfemoral TAVR with the SAPIEN 3 valve is cost saving compared with SAVR at 2 years and is projected to be economically attractive in the long run as long as there are no substantial differences in late death between the 2 strategies. Long-term follow-up will be critical to ultimately determine the preferred treatment strategy for low-risk patients from both a clinical and economic perspective.PMID:37154049 | DOI:10.1161/CIRCULATIONAHA.122.062481
Source: Circulation - May 8, 2023 Category: Cardiology Authors: Benjamin Z Galper Khaja M Chinnakondepalli Kaijun Wang Elizabeth A Magnuson Michael Lu Vinod H Thourani Susheel Kodali Raj Makkar Howard C Herrmann Samir Kapadia Mathew Williams John Webb Craig R Smith Michael J Mack Martin B Leon David J Cohen PARTNER In Source Type: research

< em > A < /em > ortic < em > V < /em > alve Repl < em > A < /em > cemen < em > T < /em > versus Conservative Treatment in < em > A < /em > symptomatic Seve < em > R < /em > e Aortic Stenosis: The AVATAR Trial
Conclusions: In asymptomatic patients with severe AS, early surgery reduced a primary composite of all-cause death, acute myocardial infarction, stroke or unplanned hospitalization for heart failure compared with conservative treatment. This randomized trial provides preliminary support for early SAVR once AS becomes severe, regardless of symptoms.PMID:34779220 | DOI:10.1161/CIRCULATIONAHA.121.057639
Source: Circulation - November 15, 2021 Category: Cardiology Authors: Marko Banovic Svetozar Putnik Martin Penicka Gheorghe Doros Marek A Deja Radka Kockova Martin Kotrc Sigita Glaveckaite Hrvoje Gasparovic Nikola Pavlovic Lazar Velicki Stefano Salizzoni Wojtek Wojakowski Guy Van Camp Serge D Nikolic Bernard Iung Jozef Bart Source Type: research

Evaluation and Management of Aortic Stenosis in Chronic Kidney Disease: A Scientific Statement From the American Heart Association
Circulation. 2021 May 13:CIR0000000000000979. doi: 10.1161/CIR.0000000000000979. Online ahead of print.ABSTRACTAortic stenosis with concomitant chronic kidney disease (CKD) represents a clinical challenge. Aortic stenosis is more prevalent and progresses more rapidly and unpredictably in CKD, and the presence of CKD is associated with worse short-term and long-term outcomes after aortic valve replacement. Because patients with advanced CKD and end-stage kidney disease have been excluded from randomized trials, clinicians need to make complex management decisions in this population that are based on retrospective and observ...
Source: Circulation - May 13, 2021 Category: Cardiology Authors: Gautam R Shroff Sripal Bangalore Nicole M Bhave Tara I Chang Santiago Garcia Roy O Mathew Janani Rangaswami Julien Ternacle Vinod H Thourani Philippe Pibarot American Heart Association Council on the Kidney in Cardiovascular Disease and Stroke Council Source Type: research

A Composite Metric for Benchmarking Site Performance in TAVR: Results from the STS/ACC TVT Registry
Conclusions: There are substantial variations in the quality of TAVR care received in the United States, and 11% of sites were identified as providing care below the average level of performance. Further study is necessary to determine structural, process-related, and technical factors associated with high- and low-performing sites.PMID:33947202 | DOI:10.1161/CIRCULATIONAHA.120.051456
Source: Circulation - May 5, 2021 Category: Cardiology Authors: Nimesh D Desai Sean M O'Brien David J Cohen John Carroll Sreekanth Vemulapalli Suzanne V Arnold John K Forrest Vinod H Thourani Ajay J Kirtane Brian O'Neill Pratik Manandhar David M Shahian Vinay Badhwar Joseph E Bavaria Source Type: research

Cerebral Embolic Protection and Outcomes of Transcatheter Aortic Valve Replacement: Results from the TVT Registry
Conclusions: In this nationally-representative observational study, we did not find an association between EPD use for TAVR and in-hospital stroke in our primary IV analysis, and found only a modestly lower risk of in-hospital stroke in our secondary propensity-weighted analysis. These findings provide a strong basis for large-scale RCTs to test whether EPDs provide meaningful clinical benefit for patients undergoing TAVR.PMID:33619968 | DOI:10.1161/CIRCULATIONAHA.120.052874
Source: Circulation - February 23, 2021 Category: Cardiology Authors: Neel M Butala Raj Makkar Eric A Secemsky Dianne Gallup Guillaume Marquis-Gravel Andrzej S Kosinski Sreekanth Vemulapalli Javier A Valle Steven M Bradley Tarun Chakravarty Robert W Yeh David J Cohen Source Type: research

Benefit-Risk Tradeoffs in Assessment of New Drugs and Devices.
Abstract Balancing benefits and risks is a complex task that poses a major challenge, both to the approval of new medicines and devices by regulatory authorities and in therapeutic decision-making in practice. Several analysis methods and visualization tools have been developed to help evaluate and communicate whether the benefit-risk profile is favorable or unfavorable. In this White Paper, we describe approaches to benefit-risk assessment using qualitative approaches such as the Benefit Risk Action Team framework developed by the Pharmaceutical Research and Manufacturers of America, and the Benefit-Risk Framewor...
Source: Circulation - November 17, 2020 Category: Cardiology Authors: Kaul S, Stockbridge N, Butler J Tags: Circulation Source Type: research

Contemporary Diagnosis and Management of Rheumatic Heart Disease: Implications for Closing the Gap: A Scientific Statement From the American Heart Association.
Stroke Nursing; and Council on Clinical Cardiology Abstract The global burden of rheumatic heart disease continues to be significant although it is largely limited to poor and marginalized populations. In most endemic regions, affected patients present with heart failure. This statement will seek to examine the current state-of-the-art recommendations and to identify gaps in diagnosis and treatment globally that can inform strategies for reducing disease burden. Echocardiography screening based on World Heart Federation echocardiographic criteria holds promise to identify patients earlier, when prophylaxis is more...
Source: Circulation - October 19, 2020 Category: Cardiology Authors: Kumar RK, Antunes MJ, Beaton A, Mirabel M, Nkomo VT, Okello E, Regmi PR, Reményi B, Sliwa-Hähnle K, Zühlke LJ, Sable C, American Heart Association Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Tags: Circulation Source Type: research

Comparison of Self-Expanding Bioprostheses for Transcatheter Aortic Valve Replacement in Patients with Symptomatic Severe Aortic Stenosis: The SCOPE 2 Randomized Clinical Trial.
Conclusions: Transfemoral TAVR with the self-expanding ACURATE neo did not meet non-inferiority compared to the self-expanding CoreValve Evolut in terms of all-cause death or stroke at 1 year, and was associated with a lower incidence of new permanent pacemaker implantation. In secondary analyses, the ACURATE neo was associated with more moderate or severe aortic regurgitation at 30 days and cardiac death at 30 days and 1 year. Clinical Trial Registration: URL: https://clinicaltrials.gov/ Unique Identifier: NCT03192813. PMID: 33054367 [PubMed - as supplied by publisher]
Source: Circulation - October 15, 2020 Category: Cardiology Authors: Tamburino C, Bleiziffer S, Thiele H, Scholtz S, Hildick-Smith D, Cunnington M, Wolf A, Barbanti M, Tchetché D, Garot P, Pagnotta P, Gilard M, Bedogni F, Van Belle E, Vasa-Nicotera M, Chieffo A, Deutsch O, Kempfert J, Søndergaard L, Butter C, Trillo-Nouc Tags: Circulation 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

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