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Stroke after Aortic Valve Surgery: Results from a Prospective Cohort.
CONCLUSIONS: Clinical stroke after AVR was more common than previously reported, more than double for this same cohort in the STS database, and silent cerebral infarctions were detected in over half of patients undergoing AVR. Clinical stroke complicating AVR is associated with increased length of stay and mortality. PMID: 24690611 [PubMed - as supplied by publisher]
Source: Circulation - April 1, 2014 Category: Cardiology Authors: Messé SR, Acker MA, Kasner SE, Fanning M, Giovannetti T, Ratcliffe SJ, Bilello M, Szeto WY, Bavaria JE, Hargrove WC, Mohler ER, Floyd TF, for the Determining Neurologic Outcomes from Valve Operations (DeNOVO) investigators Tags: Circulation Source Type: research

Stroke after Aortic Valve Replacement: The Known and Unknown.
Abstract Stroke following aortic valve surgery is known as a devastating complication and is associated with increased morbidity and mortality.(1) Transcatheter aortic valve replacement (TAVR) has emerged as a valid alternative for surgical aortic valve replacement (SAVR) in both inoperable patients and in those at high risk for surgery; however, the encouraging results were hampered by various complications including stroke. In the pivotal Placement of AoRTic TraNscathetER (PARTNER) trial, the initial stroke rates of TAVR patients were almost double in comparison to patients who underwent SAVR (3.8% vs. 2.1%; p=0...
Source: Circulation - April 1, 2014 Category: Cardiology Authors: Waksman R, Minha S Tags: Circulation 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

Apixaban Compared with Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Findings From the ARISTOTLE Trial.
CONCLUSIONS: -More than a quarter of the patients in ARISTOTLE with "nonvalvular" atrial fibrillation had moderate or severe valvular heart disease. There was no evidence of a differential effect of apixaban over warfarin in reducing stroke or systemic embolism, causing less bleeding, and reducing death in patients with and without valvular heart disease. Clinical Trial Registration Information-clinicaltrials.gov. Identifier: NCT00412984. PMID: 26106009 [PubMed - as supplied by publisher]
Source: Circulation - June 23, 2015 Category: Cardiology Authors: Avezum A, Lopes RD, Schulte PJ, Lanas F, Gersh BJ, Hanna M, Pais P, Erol C, Diaz R, Bahit MC, Bartunek J, De Caterina R, Goto S, Ruzyllo W, Zhu J, Granger CB, Alexander JH Tags: Circulation Source Type: research

Clinical Outcomes in 3343 Children and Adults with Rheumatic Heart Disease from 14 Low and Middle Income Countries: 2-Year Follow-up of the Global Rheumatic Heart Disease Registry (the REMEDY study).
CONCLUSIONS: -Patients with clinical RHD have high mortality and morbidity despite being young; those from low and lower-middle income countries had a poorer prognosis associated with advanced disease and low education. Programs focused on early detection and treatment of clinical RHD are required to improve outcomes. PMID: 27702773 [PubMed - as supplied by publisher]
Source: Circulation - October 3, 2016 Category: Cardiology Authors: Zühlke L, Karthikeyan G, Engel ME, Rangarajan S, Mackie P, Cupido B, Mauff K, Islam S, Daniels R, Francis V, Ogendo S, Gitura B, Mondo C, Okello E, Lwabi P, Al-Kebsi MM, Hugo-Hamman C, Sheta SS, Haileamlak A, Daniel W, Goshu DY, Abdissa SG, Desta AG, Sha Tags: Circulation Source Type: research

Sex-Related Differences in Patients Undergoing Thoracic Aortic Surgery: Evidence from the Canadian Thoracic Aortic Collaborative.
CONCLUSIONS: Women experience worse outcomes following thoracic aortic surgery with hypothermic circulatory arrest. Further investigation is required to better delineate which measures may reduce sex-related outcome differences following complex aortic surgery. PMID: 30755026 [PubMed - as supplied by publisher]
Source: Circulation - February 13, 2019 Category: Cardiology Authors: Chung J, Stevens LM, Ouzounian M, El-Hamamsy I, Bouhout I, Dagenais F, Cartier A, Peterson M, Boodhwani M, Guo MH, Bozinovski J, Yamashita MH, Lodewyks C, Atoui R, Bittira B, Payne D, Tarola C, Chu MWA, Canadian Thoracic Aortic Collaborative Tags: Circulation Source Type: research

Flow-Gradient Patterns in Severe Aortic Stenosis with Preserved Ejection Fraction: Clinical Characteristics and Predictors of Survival.
CONCLUSIONS: NF/LG severe AS with preserved EF exhibits favorable survival with medical management and impact of AVR on survival was neutral. LF/LG severe AS is characterized by a high prevalence of atrial fibrillation, heart failure and reduced survival, and AVR was associated with improved survival. These findings have implications for evaluation of AS severity and subsequent management. PMID: 24048203 [PubMed - as supplied by publisher]
Source: Circulation - September 18, 2013 Category: Cardiology Authors: Eleid MF, Sorajja P, Michelena HI, Malouf JF, Scott CG, Pellikka PA Tags: Circulation Source Type: research

Outcomes of Transcatheter Aortic Valve Replacement in Patients with Bicuspid Aortic Valve Disease: A Report from the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry.
Conclusions: Using current generation devices, procedural, post-procedural, and 1-year outcomes were comparable following TAVR for bicuspid AV vs. tricuspid AV disease. With newer generation devices, TAVR is a viable treatment option for bicuspid AV patients. PMID: 32098500 [PubMed - as supplied by publisher]
Source: Circulation - February 25, 2020 Category: Cardiology Authors: Halim SA, Edwards FH, Dai D, Li Z, Mack MJ, Holmes DR, Tuzcu EM, Thourani VH, Harrison JK, Brennan JM Tags: Circulation Source Type: research

Paradoxical Low-Flow, Low-Gradient Aortic Stenosis: New Evidences, More Questions.
Abstract In the American Heart Association (AHA) / American College of Cardiology (ACC) and European Society of Cardiology (ESC) / European Association of Cardiothoracic Surgery (EACTS) guidelines,(1,2) severe aortic stenosis (AS) is defined as a peak aortic jet velocity >4.0 m/s, a mean gradient >40 mmHg, and/or an aortic valve area (AVA) <1.0 cm(2) and it is considered a class I indication for aortic valve replacement (AVR) if the patient has symptoms or LV systolic dysfunction defined as LV ejection fraction (LVEF) <50%. However, the cardiologist is often confronted with patients with discordant ech...
Source: Circulation - September 18, 2013 Category: Cardiology Authors: Pibarot P, Dumesnil JG Tags: Circulation Source Type: research

Propensity-Matched Comparisons of Clinical Outcomes after Transapical or Transfemoral TAVR: A PARTNER-I Trial Substudy.
CONCLUSIONS: -Likelihood of adverse periprocedural events and prolonged recovery is greater after TA-TAVR than TF-TAVR in vasculopathic patients after accounting for differences in cardiovascular risk factors, although stroke risk is equivalent and aortic regurgitation less. As smaller delivery systems permit TF-TAVR in many of these patients, we recommend a TF-first access strategy for TAVR when anatomically feasible. Clinical Trial Registration-www.clinicaltrials.gov. Identifier: NCT00530894. PMID: 25832034 [PubMed - as supplied by publisher]
Source: Circulation - April 1, 2015 Category: Cardiology Authors: Blackstone EH, Suri RM, Rajeswaran J, Babaliaros V, Douglas PS, Fearon WF, Miller DC, Hahn RT, Kapadia SR, Kirtane AJ, Kodali SK, Mack M, Szeto WY, Thourani VH, Tuzcu EM, Williams MR, Akin JJ, Leon MB, Svensson LG Tags: Circulation Source Type: research

One-Year Clinical Outcomes With SAPIEN 3 Transcatheter Aortic Valve Replacement in High-Risk and Inoperable Patients With Severe Aortic Stenosis.
CONCLUSIONS: In this large, adjudicated registry of SAPIEN 3 HR and inoperable patients, the very low rates of important complications resulted in a strikingly low mortality rate at 1 year. Between 30 and 365 days, the incidence of moderate paravalvular aortic regurgitation did not increase, and no association between mild paravalvular leak and 1-year mortality was observed, although a small increase in disabling stroke occurred. These results, which likely reflect device iteration and procedural evolution, support the use of transcatheter aortic valve replacement as the preferred therapy in HR and inoperable patients with...
Source: Circulation - July 11, 2016 Category: Cardiology Authors: Herrmann HC, Thourani VH, Kodali SK, Makkar RR, Szeto WY, Anwaruddin S, Desai N, Lim S, Malaisrie SC, Kereiakes DJ, Ramee S, Greason KL, Kapadia S, Babaliaros V, Hahn RT, Pibarot P, Weissman NJ, Leipsic J, Whisenant BK, Webb JG, Mack MJ, Leon MB, PARTNER Tags: Circulation Source Type: research

Long-Term Outcomes of the Ross Procedure versus Mechanical Aortic Valve Replacement: Propensity-Matched Cohort Study.
CONCLUSIONS: -Long-term survival and freedom from reintervention were comparable between the Ross procedure and mechanical AVR. However, the Ross procedure was associated with improved freedom from cardiac and valve-related mortality as well as a significant reduction in the incidence of stroke and major bleeding. In specialized centers, the Ross procedure represents an excellent option and should be considered for young and middle-aged adults undergoing AVR. PMID: 27496856 [PubMed - as supplied by publisher]
Source: Circulation - August 4, 2016 Category: Cardiology Authors: Mazine A, David TE, Rao V, Hickey E, Christie S, Manlhiot C, Ouzounian M Tags: Circulation Source Type: research

Transcatheter Treatment of Severe Tricuspid Regurgitation with the Edge-to-Edge: MitraClip Technique.
Conclusions -Transcatheter treatment of TR with the MitraClip system seems to be safe and feasible in this cohort of preselected patients. Initial efficacy analysis showed encouraging reduction of TR, which may potentially result in improved clinical outcomes. PMID: 28336788 [PubMed - as supplied by publisher]
Source: Circulation - March 23, 2017 Category: Cardiology Authors: Nickenig G, Kowalski M, Hausleiter J, Braun D, Schofer J, Yzeiraj E, Rudolph V, Friedrichs K, Maisano F, Taramasso M, Fam NP, Bianchi G, Bedogni F, Denti P, Alfieri O, Latib A, Colombo A, Hammerstingl C, Schueler R Tags: Circulation Source Type: research

Conscious Sedation versus General Anesthesia for Transcatheter Aortic Valve Replacement: Insights from the NCDR ® STS/ACC TVT Registry.
Conclusions -In U.S. practice, conscious sedation is associated with briefer length of stay and lower in-hospital and 30-day mortality compared to TAVR with general anesthesia in both unadjusted and adjusted analyses. These results suggest the safety of conscious sedation in this population, though comparative effectiveness analyses using observational data cannot definitively establish the superiority of one technique over another. PMID: 28864443 [PubMed - as supplied by publisher]
Source: Circulation - September 1, 2017 Category: Cardiology Authors: Hyman MC, Vemulapalli S, Szeto WY, Stebbins A, Patel PA, Matsouaka RA, Herrmann HC, Anwaruddin S, Kobayashi T, Desai ND, Vallabhajosyula P, McCarthy FH, Li R, Bavaria JE, Giri J Tags: Circulation Source Type: research

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