Percutaneous aortic valve replacement (PAVR), also known as transcatheter aortic valve implantation (TAVI) or transcatheter aortic valve replacement (TAVR), is the replacement of the aortic valve of the heart through the blood vessels (as opposed to valve replacement by open heart surgery). The replacement valve is delivered via one of several access methods: transfemoral (in the upper leg), transapical (through the wall of the heart), subclavian (beneath the collar bone), direct aortic (through a minimally invasive surgical incision into the aorta), and transcaval (from a temporary hole in the aorta near the belly button through a vein in the upper leg). Severe symptomatic aortic stenosis carries a poor prognosis. Until recently, surgical aortic valve replacement was the standard of care in adults with severe symptomatic aortic stenosis. However, the risks associated with surgical aortic valve replacement are increased in elderly patients and those with concomitant severe systolic heart failure ...
BACKGROUND New generation transcatheter heart valves (THV) may improve clinical outcomes of transcatheter aortic valve implantation. METHODS AND RESULTS In a nationwide, prospective, multicenter cohort study (Swiss Transcatheter Aortic Valve Implantation Registry, NCT01368250), outcomes of consecutive transfemoral transcatheter aortic valve implantation patients treated with the Sapien 3 THV (S3) versus the Sapien XT THV (XT) were investigated. An overall of 153 consecutive S3 patients were compared with 445 consecutive XT patients. Postprocedural mean transprosthetic gradient (6.5±3.0 versus 7.8±6.3 mm Hg, P=0.17) did not differ between S3 and XT patients, respectively. The rate of more than mild paravalvular regurgitation (1.3% versus 5.3%, P=0.04) and of vascular (5.3% versus 16.9%, P,0.01) complications were significantly lower in S3 patients. A higher rate of new permanent pacemaker implantations was observed in patients receiving the S3 valve (17.0% versus 11.0%, P=0.01). There were no ...
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Compared to patients with a tricuspid aortic valve, patients with a bicuspid valve appear to have ascending aorta dilation that is out of proportion to the severity of aortic stenosis or regurgitation; further, patients with a bicuspid aortic valve are thought to be at greater risk of progressive aortic dilation after aortic valve replacement. These observations form the basis of a proposed genetic aortopathy associated with bicuspid aortic valve, and are the basis of current guideline recommendations for more aggressive treatment of proximal ascending aorta dilation among patients with bicuspid aortic valve at the time of surgical aortic valve replacement. However, other data suggest that flow abnormalities related to fusion patterns may be a major contributor to aortic dilation among patients with bicuspid valve (e.g., MM Bissell, et al. Circ Cardiovasc Imaging 2013;6:499-507). The present study suggests that patients with a bicuspid aortic valve undergoing aortic valve replacement for aortic ...
OBJECTIVES: The purpose of the present study was to test whether the cumulative knowledge from the field of transapical transcatheter aortic valve implantation, when incorporated into a structured training and then gradually dispersed by internal proctoring, might eliminate the negative effect of the learning curve on the clinical outcomes. METHODS: The present study was a retrospective, single-center, observational cohort study of prospectively collected data from all 500 consecutive high-risk patients undergoing transapical transcatheter aortic valve implantation at our institution from April 2008 to December 2011. Of the 500 patients, 28 were in cardiogenic shock. Differences during the study period in baseline characteristics, procedural and postprocedural variables, and survival were analyzed using different statistical methods, including cumulative sum charts. RESULTS: The overall 30-day mortality was 4.6% (95% confidence interval, 3.1%-6.8%) and was 4.0% (95% confidence interval, ...
Calcific aortic valve disease (CAVD) is a chronic pathological process involving inflammation, fibrosis and calcification. Pharmacological intervention for prevention of CAVD progression remains unavailable. Calcified aortic valves display higher levels of oxidized low-density lipoprotein (oxLDL), and oxLDL has the potential to interact with Toll-like receptors (TLRs). Interleukin (IL)-37 is an anti-inflammatory cytokine and has been shown to inhibit TLR4-mediated inflammatory responses. We tested the hypotheses that oxLDL induces the osteogenic responses in human aortic valve interstitial cells (AVICs) via TLRs and that IL-37 suppresses the responses and may have therapeutic potential for suppression of CAVD progression.. Methods and Results: Human AVICs from normal valves were treated with oxLDL (20-80 μg/ml) for 72 hours in vitro. OxLDL up-regulated the expression of bone morphogenetic protein-2 (BMP-2) and alkaline phosphatase (ALP) in a dose-dependent fashion. Further, oxLDL induced NF-κB ...
TY - JOUR. T1 - Linkage analysis of left ventricular outflow tract malformations (aortic valve stenosis, coarctation of the aorta, and hypoplastic left heart syndrome). AU - McBride, Kim L.. AU - Zender, Gloria A.. AU - Fitzgerald-Butt, Sara M.. AU - Koehler, Daniel. AU - Menesses-Diaz, Andres. AU - Fernbach, Susan. AU - Lee, Kwanghyuk. AU - Towbin, Jeffrey A.. AU - Leal, Suzanne. AU - Belmont, John W.. PY - 2009/1/15. Y1 - 2009/1/15. N2 - The left ventricular outflow tract (LVOT) malformations aortic valve stenosis (AVS), coarctation of the aorta (CoA), and hypoplastic left heart syndrome (HLHS) are significant causes of infant mortality. These three malformations are thought to share developmental pathogenetic mechanisms. A strong genetic component has been demonstrated earlier, but the underlying genetic etiologies are unknown. Our objective was to identify genetic susceptibility loci for the broad phenotype of LVOT malformations. We genotyped 411 microsatellites spaced at an average of 10 cM ...
The current treatment for aortic stenosis includes open surgical aortic valve replacement (SAVR) as well as endovascular transcatheter aortic valve replacement (TAVR). This study aims to compare the 1-year, 2-3 year and 5-year structural durability of TAVR valves with that of SAVR valves. A systematic literature search was conducted in July 2019 on Medline (via PubMed), Embase and Cochrane electronic databases according to the PRISMA guidelines. Thirteen randomized controlled trials were included. From the meta-analysis, we observed higher rates of 1-year (OR: 7.65, CI: 4.57 to 12.79, p | 0.00001), 2-3-year (OR: 13.49, CI: 5.66 to 32.16, p | 0.00001) and 5-year paravalvular regurgitation (OR: 14.51, CI: 4.47 to 47.09, p | 0.00001) associated with the TAVR valves than the SAVR valves. There were also higher rates of 1-year (OR: 5.00, CI: 3.27 to 7.67, p | 0.00001), 2-3-year (OR: 8.14, CI: 3.58 to 18.50, p | 0.00001) and 5-year moderate or severe aortic regurgitation (MD: 14.65, CI: 4.55 to 47.19, p | 0
TY - JOUR. T1 - Comparison of midterm outcomes of transcatheter aortic valve implantation in patients with and without previous coronary artery bypass grafting. AU - On behalf of the OCEAN-TAVI Investigators. AU - Kawashima, Hideyuki. AU - Watanabe, Yusuke. AU - Kozuma, Ken. AU - Kataoka, Akihisa. AU - Nakashima, Makoto. AU - Hioki, Hirofumi. AU - Nagura, Fukuko. AU - Nara, Yugo. AU - Shirai, Shinichi. AU - Tada, Norio. AU - Araki, Motoharu. AU - Naganuma, Toru. AU - Yamanaka, Futoshi. AU - Ueno, Hiroshi. AU - Tabata, Minoru. AU - Mizutani, Kazuki. AU - Higashimori, Akihiro. AU - Takagi, Kensuke. AU - Yamamoto, Masanori. AU - Hayashida, Kentaro. PY - 2018/4/21. Y1 - 2018/4/21. N2 - The midterm safety and feasibility of transcatheter aortic valve implantation (TAVI) for patients with a history of coronary artery bypass graft (CABG) and high operative risk are unclear. This study compared the midterm outcomes of patients undergoing TAVI with or without previous CABG surgery. Between October 2013 ...
Transcatheter Aortic Valve Replacement TAVR Program Information 541-222-1933 Transcatheter Aortic Valve Replacement (TAVR) is a minimally invasive procedure for select patients with severe symptomatic aortic stenosis who are not candidates for open chest surgery or are high-risk operable candidates. Sacred Heart is one of three hospitals in Oregon approved to provide this
TY - JOUR. T1 - Use of Double Stiff Wire Allows Successful Transfemoral Transcatheter Aortic Valve Implantation Through Extreme Thoracic Aorta Tortuosity. AU - Buzzatti, Nicola. AU - Mangieri, Antonio. AU - Cota, Linda. AU - Ruparelia, Neil. AU - Romano, Vittorio. AU - Alfieri, Ottavio. AU - Colombo, Antonio. AU - Montorfano, Matteo. PY - 2015/4/21. Y1 - 2015/4/21. KW - complication. KW - transcatheter aortic valve implantation. UR - http://www.scopus.com/inward/record.url?scp=84937484987&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84937484987&partnerID=8YFLogxK. U2 - 10.1161/CIRCINTERVENTIONS.114.002331. DO - 10.1161/CIRCINTERVENTIONS.114.002331. M3 - Article. C2 - 25794508. AN - SCOPUS:84937484987. VL - 8. JO - Circulation: Cardiovascular Interventions. JF - Circulation: Cardiovascular Interventions. SN - 1941-7640. IS - 4. M1 - e002331. ER - ...
Transcatheter aortic valve replacement (TAVR) is a minimally invasive treatment for severe aortic stenosis. Learn more about how TAVR (Transcatheter Aortic Valve Replacement) works, its benefits, and where to find available treatment options at Memorial Hermann Heart and Vascular Institute.
Transcatheter aortic valve replacement (TAVR - also known as TAVI or transcatheter aortic valve implantation) is a new technology for use in treating aortic stenosis. A bioprosthetic valve is inserted percutaneously using a catheter and implanted in the orifice of the native aortic valve ...
Introduction Permanent pacemaker implantation (PPM) following transcatheter aortic valve implantation (TAVI) is a recognised complication. However, the higher pacing rate post CoreValve TAVI compared to SAVR (33% vs 8%) is a cause for concern. Several factors including pre-existing bundle branch block (BBB), larger valve size, post dilatation and low implantation have been shown to independently impact on an increased risk of PPM requirement. Depth of CoreValve implantation below the aortic annulus can result in compression of conduction tissue and heart block and is therefore an important predictor of PPM requirement. A modified delivery catheter (ACCUTRAK) was introduced to address this by providing more controlled release of the prosthesis, preventing low implantation, thereby reducing the pacing rate. We evaluated the pacing rate in our cohort of patients (pts) and the effect of the new Accutrak catheter on the pacing rate. ...
Transcatheter aortic valve implantation (TAVI), also referred to as transcatheter aortic valve replacement (TAVR), is a procedure that replaces your diseased aortic valve with a man-made valve.
Transcatheter aortic valve replacement (TAVR) is a way to replace the aortic valve without open-heart surgery. This procedure is done to treat aortic valve stenosis.. TAVR is often done through an incision (cut) in the groin. But sometimes a small cut is made in the chest. The doctor uses a tube called a catheter and tools that fit inside the catheter. The doctor puts the catheter into a blood vessel and moves it through the blood vessel and into the heart. The artificial valve fits inside the catheter. The doctor then moves the new valve into the damaged aortic valve. The artificial valve expands and takes the place of the damaged valve.. You may have general anesthesia, which makes you sleep during the surgery. Or you may get a sedative that will help you relax.. To see if TAVR might be a choice for you, a team of doctors will check many things about your heart and your overall health. Together you can decide if you want to have the procedure.. ...
Patients who are suffering with severe aortic stenosis, which is the narrowing of the hearts aortic valve opening that restricts blood flow, have a minimally invasive surgical option available at the Heart and Vascular Center at Manatee Memorial Hospital. Transcatheter Aortic Valve Replacement (TAVR) is an advanced heart valve replacement procedure that offers new hope to patients who have aortic valve stenosis and are at high or extreme risk for open-heart surgery. TAVR patient Eugene Vaadi describes his experience:
Since the pioneering works by Andersen et al. (1) and Cribier et al. (2), transcatheter aortic valve replacement (TAVR) has become a well-established and evidence-based therapy for severe and symptomatic aortic stenosis in patients at higher surgical risk. TAVR has been associated with lower all-cause mortality than best medical therapy in patients who were ineligible for surgical aortic valve replacement (SAVR) (3), as well as noninferiority or even superiority to SAVR with respect to all-cause mortality in patients at high surgical risk (4,5). In patients at intermediate risk, TAVR has been reported non-inferior to SAVR regarding death from any cause or disabling stroke (6). In addition, the first randomized trial comparing TAVR and SAVR in all-comer patients indicated that these findings may apply to patients at lower surgical risk (7). Furthermore, a meta-analysis of the 4 randomized clinical trials including 3,806 patients comparing TAVR and SAVR showed that TAVR was associated with a 13% ...
An 88 years-old woman admitted undergoing transcatheter aortic valve replacement (TAVR) because of severe aortic valve stenosis. Pre-procedural computed tomography demonstrated that annulus area was 345 mm2 (Figure 1A) and minimum diameter of Valsalva was 27.4 mm (Figure 1B). Calcification was present between the left atrium (LA) and aortic root (Figure 1C). Diameter of the lower limbs were suitable for transfemoral access. Based on these findings, transfemoral TAVR was performed under general anesthesia with transesophageal echocardiography guidance. After pre-dilatation using 20-mm balloon, a SAPIEN XT 23-mm (Edwards Lifesciences, Irvine, California) at 1 cm3 underfilling was successfully implanted under rapid pacing. However, after that, the patient became hemodynamically unstable and transesophageal echocardiography demonstrated pericardial effusion. Surgical repair was performed to achieve hemostasis and identified bleeding from the LA (Figure 1D). Post-procedural computed tomography showed ...
The heart has four chambers and four valves. The valves open and close to keep blood flowing through the heart. One of these valves, the aortic valve, usually has three flaps, or leaflets. But sometimes people are born with an aortic valve that has two flaps. This is called a bicuspid aortic valve.. A bicuspid aortic valve makes certain heart problems, like aortic valve stenosis and aortic valve regurgitation, more likely.. In aortic valve stenosis, the valve has narrowed. Your heart has to work harder to pump blood throughout your body. Symptoms may include chest pain, dizziness, fainting, or shortness of breath. In aortic valve regurgitation, the valve does not close properly. Some of the blood leaks back (regurgitates) through the valve into the heart. Your heart has to work harder to pump blood throughout your body. Symptoms may include weakness and tiredness, shortness of breath, or an uneven heartbeat. Although you have a bicuspid heart valve, your heart can work normally. But you have a ...
Risk assessment models for transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement in high-risk patients and TAVR versus palliation in inoperable patients are based on surgical data and have limited discrimination and calibration in the setting of TAVR. Several novel risk models specifically designed for TAVR have improved discrimination over existing models but require further validation. Several clinical and echocardiographic variables, such as chronic lung disease, mitral regurgitation, and stroke volume index, influence outcomes. This article reviews current and novel risk models and important predictors of TAVR outcomes and proposes a framework to integrate them into clinical decision-making for patients with severe, symptomatic aortic stenosis.
Twenty-one patients (age four to 25 years) with bicuspid aortic valves proved by surgery and angiography (12) or angiography alone (9) were studied by echocardiography. Seventeen patients had aortic valve disease (11 stenosis, 6 incompetence) and four had coarctation of the aorta with normally functioning aortic valves. A comparison group of 16 patients (9 with aortic valve disease and 7 without aortic valve disease) who had proven tricuspid aortic valves was also studied. Echocardiograms in tricuspid aortic valve patients showed the closed position of the cusps near the middle of the aortic lumen. In contrast marked eccentricity of the aortic valve cusp echoes in diastole could be demonstrated in all with bicuspid aortic valves. The Eccentricity Index (½ aortic lumen diameter/minimum distance of the diastolic cusp echo from the nearest aortic margin) was low (range 1.0-1.25) with tricuspid aortic valves and high (range 1.5-5.6) with bicuspid aortic valves (P , 0.001). This index was not ...
Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a narrowed aortic valve that fails to open properly (aortic valve stenosis). In this procedure, doctors insert a catheter in your leg or chest and guide it to your heart. A replacement valve is inserted through the catheter and guided to your heart. A balloon is expanded to press the valve into place. Some TAVR valves are self-expanding.. ...
The aortic valve controls blood flow from the heart to the body. In some people, the valve becomes stiff and has trouble opening. This condition is called aortic stenosis. It is a progressive disease. In aortic stenosis, the heart has to work harder to push blood through the valve to the rest of the body. Over time, the extra stress can cause the heart muscle to get weaker. People who have aortic stenosis can feel tired and short of breath and have chest pain and fainting.. At Hackensack University Medical Center, our multidisciplinary team is offering transcatheter aortic valve replacement (TAVR) as a life-changing option for many patients with aortic stenosis. TAVR is a minimally invasive procedure that allows our cardiac experts to repair a valve without removing it. If you have aortic stenosis and your doctor feels that traditional open-heart surgery may be a risk, TAVR can be an option for you. TAVR is sometimes recommended for people who are older, have a weaker heart, had previous heart ...
TY - JOUR. T1 - Silent cerebral injury after transcatheter aortic valve implantation and the preventive role of embolic protection devices. T2 - A systematic review and meta-analysis. AU - Pagnesi, Matteo. AU - Martino, Enrico A.. AU - Chiarito, Mauro. AU - Mangieri, Antonio. AU - Jabbour, Richard J.. AU - Van Mieghem, Nicolas M.. AU - Kodali, Susheel K.. AU - Godino, Cosmo. AU - Landoni, Giovanni. AU - Colombo, Antonio. AU - Latib, Azeem. N1 - Funding Information: Dr. Latib is a consultant for Medtronic and Direct Flow Medical. Dr. Van Mieghem is a consultant and has received research grants from Boston Scientific, Medtronic, Edwards Lifesciences, and Claret Inc. Dr. Kodali has received research grants from Edwards Lifesciences and Medtronic, is a consultant for Edwards Lifesciences and Claret Inc., and is on the scientific advisory boards of Thubrikar Aortic Valve Inc. Prof. Colombo is a minor shareholder of Direct Flow Medical. The other authors have no conflicts of interest to declare. PY - ...
TY - JOUR. T1 - Plasma lipids and risk of aortic valve stenosis. T2 - A Mendelian randomization study. AU - Nazarzadeh, Milad. AU - Pinho-Gomes, Ana-Catarina. AU - Bidel, Zeinab AU - Dehghan, Abbas AU - Canoy, Dexter. AU - Hassaine, Abdelaali. AU - Solares, Jose Roberto Ayala. AU - Salimi-Khorshidi, Gholamreza. AU - Davey Smith, George. AU - Otto, Catherine M. AU - Rahimi, Kazem. PY - 2020/2/20. Y1 - 2020/2/20. N2 - AimsAortic valve stenosis is commonly considered a degenerative disorder with no recommended preventive intervention, with only valve replacement surgery or catheter intervention as treatment options. We sought to assess the causal association between exposure to lipid levels and risk of aortic stenosis.Methods and resultsCausality of association was assessed using two-sample Mendelian randomization framework through different statistical methods. We retrieved summary estimations of 157 genetic variants that have been shown to be associated with plasma lipid levels in the Global ...
Background: Transfemoral access is regarded as the TAVI gold standard for the transcatheter aortic valve implantation (TAVI) procedure. However, other options for vascular access have developed in the last few years. Access via the carotid artery is one such alternative. Materials and methods: The study included 9 elderly patients who underwent transcarotid TAVI procedure at the Cardiac and Vascular Surgery Department of the Medical University of Gdańsk. Procedures were performed by a local Heart Team in a hybrid operating room under general anesthesia. Data was collected before the implantation and at discharge. Results: The mean patients age was 81 years of age (64-88) and the mean logistic EuroSCORE was 10.8 (7-16). Implantations were performed with 100% device success rate. Intra-operative valve-in-valve procedure was performed in one patient; there were no access-related and valve-related complications during the surgery. Post-procedural complications included minor bleeding, hematoma and ...
Technology Assessment Unit of the McGill University Health Centre (MUHC) Surgical aortic valve replacement with the ATS Enable sutureless aortic valve for aortic stenosis Report number: 71 DATE: September
TAVI has now become the standard of care for patients with symptomatic severe aortic stenosis who are considered at extreme risk for surgery and an acceptable alternative to surgery for those at high risk (19,20). Many patients with mixed aortic valve disease with severe aortic stenosis and at least moderate aortic regurgitation have been successfully treated with both balloon-expandable and self-expanding TAVI (3,21), but severe NAVR without aortic stenosis is still considered a contraindication to TAVI (22). Furthermore, we were aware that this therapy had been used anecdotally in small numbers of patients in individual centers (23-25). We thought that it was important to collect these data in a registry, which have not, to our knowledge, been reported before.. There are several reasons to explain why TAVI has not been used in large numbers of patients with NAVR. First, population surveys suggest that aortic stenosis is far more prevalent than aortic regurgitation (33.9% vs. 10.4% of patients ...
A prospective multi-center trial of patients undergoing aortic valve replacement for severe aortic stenosis. Patient cohorts will include the following groups based on operative risk for surgical aortic valve replacement: inoperable, high surgical risk (STS ≥ 8%), and intermediate risk (STS = 4-8%).. The Edwards SAPIEN XT transcatheter heart valve (THV) system will be studied in patients deemed inoperable or intermediate risk. A subset of inoperable patients will be randomized to receive transcatheter aortic valve replacement (TAVR) with either the SAPIEN XT THV or the SAPIEN THV. The SAPIEN XT will be studied in intermediate risk patients randomized to receive TAVR with the SAPIEN XT or surgical AVR.. The Edwards SAPIEN 3 THV will be studied in a non-randomized fashion in patients from all three risk groups.. Data will be collected from all patients for up to five years following the valve replacement procedure. ...
A prospective multi-center trial of patients undergoing aortic valve replacement for severe aortic stenosis. Patient cohorts will include the following groups based on operative risk for surgical aortic valve replacement: inoperable, high surgical risk (STS ≥ 8%), and intermediate risk (STS = 4-8%).. The Edwards SAPIEN XT transcatheter heart valve (THV) system will be studied in patients deemed inoperable or intermediate risk. A subset of inoperable patients will be randomized to receive transcatheter aortic valve replacement (TAVR) with either the SAPIEN XT THV or the SAPIEN THV. The SAPIEN XT will be studied in intermediate risk patients randomized to receive TAVR with the SAPIEN XT or surgical AVR.. The Edwards SAPIEN 3 THV will be studied in a non-randomized fashion in patients from all three risk groups.. Data will be collected from all patients for up to five years following the valve replacement procedure. ...
TY - JOUR. T1 - First in human percutaneous implantation of a balloon expandable transcatheter heart valve in a severely stenosed native mitral valve. AU - Guerrero, Mayra. AU - Greenbaum, Adam. AU - ONeill, William. PY - 2014/6/1. Y1 - 2014/6/1. N2 - Transcatheter implantation of a balloon expandable valve in calcified severely stenosed native mitral valves has recently been described. The two cases reported so far utilized the surgical transapical approach generally used for transapical transcatheter aortic valve replacement. A percutaneous approach has not been published. We report the first successful percutaneous implantation of a balloon expandable transcatheter valve in the native mitral valve without a surgical incision.. AB - Transcatheter implantation of a balloon expandable valve in calcified severely stenosed native mitral valves has recently been described. The two cases reported so far utilized the surgical transapical approach generally used for transapical transcatheter aortic ...
Severe symptomatic aortic stenosis is a serious condition of elderly, mostly geriatric patients with a poor prognosis if the valve is not replaced. Since geriatricians are able to provide major expertise in the prognostic assessment as well in the clinical management of these patients, they need to be more closely involved in the decision making process. For this reason the European Union Geriatric Medicine Society (EUGMS) represented by the authors phrased three propositions: (1) geriatricians need to be aware of the impact of severe aortic stenosis on patients outcomes and should be encouraged to take an active role in aortic stenosis management; (2) they need to be aware of treatment options and are required to support multidisciplinary teams with their expertise in assessing geriatric patients; (3) they should routinely perform a comprehensive geriatric assessment in patients with severe aortic stenosis scheduled to undergo surgical or transcatheter aortic valve replacement and during ...
To report the initial US experience with newly approved transcatheter aortic valve replacement, Mack and coauthors gathered outcome data, including all-cause in
BACKGROUND: Transcatheter aortic valve implantation was developed to provide a therapeutic option for patients considered to be ineligible for, and to mitigate mortality and morbidity associated with, high-risk surgical aortic valve replacement.. METHODS AND RESULTS: The Edwards SAPIEN Aortic Bioprosthesis European Outcome (SOURCE) Registry was designed to assess initial post commercial clinical transcatheter aortic valve implantation results of the Edwards SAPIEN valve in consecutive patients in Europe. Cohort 1 consists of 1038 patients enrolled at 32 centers. One-year outcomes are presented. Patients with the transapical approach (n=575) suffered more comorbidities than transfemoral patients (n=463) with a significantly higher logistic EuroSCORE (29% versus 25.8%; P=0.007). These groups are different; therefore, outcomes cannot be directly compared. Total Kaplan Meier 1-year survival was 76.1% overall, 72.1% for transapical and 81.1% for transfemoral patients, and 73.5% of surviving patients ...
Aortic valve disease affects nearly one-third of adults over the age of 60. The aortic valve is responsible for controlling the flow of blood as it leaves the heart and travels to the rest of the body. When valve disease occurs, the leaflets - or flaps - that open and close with each heartbeat become damaged, causing the heart to work harder and less efficiently. Patients suffering from aortic stenosis, a narrowing of the aortic valve, may notice symptoms such as shortness of breath, chest pain or pressure, dizziness, fatigue and swelling of the feet, legs or abdomen.. Without treatment, aortic valve disease can lead to a significantly decreased quality of life and life-threatening complications. In order to fix the problem, the aortic valve must be replaced.. There are multiple options for valve replacement, including open-heart surgery and TAVR. ...
The first-in-human transcatheter aortic valve implantation (TAVI) was successfully performed in 2002. In excess of 50,000 TAVI procedures have been performed to date using the Edwards SAPIEN or...
Advanced chronic kidney disease (CKD) is an independent predictor of mortality in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to identify predictors of 1-year mortality in patients after TAVI stratified by the presence or absence of advanced CKD (defined as estimated glomerular filtration rate ≤30 ml/min/1.73 m2 or permanent renal replacement therapy). Patients (n = 1204) from 10 centers in Europe, Japan, and Israel were included: 464 with and 740 without advanced CKD. Advanced CKD was associated with a 2-fold increase in the adjusted risk of 1-year all-cause death (p |0.001), and a 1.9-fold increase in cardiovascular death (p = 0.016). Interaction-term analysis was used to identify and compare independent predictors of 1-year mortality in both groups. Impaired left ventricular ejection fraction and poor functional class were predictive of death in the advanced CKD group (odds ratio [OR] 2.27, p = 0.002 and OR 3.87, p = 0.003, respectively) but not in patients without
Learn how MedStar Heart & Vascular Institute uses transcatheter aortic valve replacement (TAVR) to treat some patients with severe aortic stenosis.
OBJECTIVES: The SOURCE XT Registry (Edwards SAPIEN XT Aortic Bioprosthesis Multi-Region Outcome Registry) assessed the use and clinical outcomes with the SAPIEN XT (Edwards Lifesciences, Irvine, California) valve in the real-world setting.. BACKGROUND: Transcatheter aortic valve replacement is an established treatment for high-risk/inoperable patients with severe aortic stenosis. The SAPIEN XT is a balloon-expandable valve with enhanced features allowing delivery via a lower profile sheath.. METHODS: The SOURCE XT Registry is a prospective, multicenter, post-approval study. Data from 2,688 patients at 99 sites were analyzed. The main outcome measures were all-cause mortality, stroke, major vascular complications, bleeding, and pacemaker implantations at 30-days and 1 year post-procedure.. RESULTS: The mean age was 81.4 ± 6.6 years, 42.3% were male, and the mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) was 20.4 ± 12.4%. Patients had a high burden of coronary ...
The purpose of the study is to investigate the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with severe,...
OHSU heart surgeons perform Transcatheter Aortic Valve Replacement (TAVR), a minimally invasive approach to replacing the aortic valve. Learn more.
Trans Aortic Valve Implantation is done by administering local anesthesia by an experienced cardiac surgeon and typically takes between 45 to 60 minutes. TAVI is a minimally invasive procedure to repair the aortic valve functioning without removing the old, damaged valve. Instead, bioprosthetic valve is implanted as a replacement valve. TAVI involves the insertion of the catheter via either of the three approaches (Transfemora, Transapical and Transaortic) to access the heart. A hollow tube, called catheter, is inserted through the incision and guided to the heart. Ultrasound (high frequency sound wave imaging) and X-ray imaging is used by the doctor to guide the catheter during the procedure. After carefully positioning the catheter, the replacement valve is passed through it. This valve pushes away the damaged vessel and uses it as an anchor to sit in its place. Once the doctor is sure the valve is securely in place, the catheter is withdrawn. One of the advantages of this technique is that ...
TY - JOUR. T1 - Imaging Guidance for Transcatheter Aortic Valve Replacement. T2 - Is Transoesophageal Echocardiography the Gold Standard?. AU - Xu, Bo. AU - Mottram, Philip M.. AU - Lockwood, Siobhan. AU - Meredith, Ian T.. PY - 2017/10/1. Y1 - 2017/10/1. N2 - Transcatheter aortic valve replacement (TAVR) is traditionally performed under cardiac imaging guidance. In the early TAVR experience, intra-procedural transoesophageal echocardiography (TOE) is recommended to guide device deployment, in the context of general anaesthesia (GA). Intra-procedural TOE imaging is particularly useful during TAVR deployment as a contrast-saving strategy for patients with renal impairment. Evidence has emerged recently demonstrating that in selected patients, transthoracic echocardiography (TTE) can be used to provide intra-procedural guidance for TAVR. Additionally, there is a growing body of evidence supporting the performance of TAVR using fluoroscopy alone, without additional cardiac imaging. This article ...
Transcatheter aortic valve replacement (TAVR) Market - Global Industry Analysis, Size, Share, Trends and Forecast, 2014 - 2022 Transcatheter aortic valve replacement (TAVR) Market - - Market research report and industry analysis - 10925577
Methods and Results-Data were obtained using the national inpatient sample between the years 2011 and 2014. We used the International Classification of Diseases, Ninth Edition, Clinical Modification procedure codes 350.5 and 350.6 to identify patients undergoing transcatheter aortic valve replacement. Primary outcome of interest was in-hospital mortality. A 2-tailed P value ,0.01 was considered to denote statistical significance for all analyses. We identified 42 189 patients who underwent transcatheter aortic valve replacement between the years 2011 and 2014. Of these, 62.1% (n=26 229) had no CKD/ESRD, 33.7% (n=14 252) had CKD, and 4% (n=1708) had ESRD. Patients with CKD or ESRD had greater in-hospital mortality, hospital length of stay, hemorrhage requiring transfusion, and permanent pacemaker implantation (P,0.001). ...
BACKGROUND: Patients undergoing surgical aortic valve replacement (SAVR) are considered at high risk of infective endocarditis (IE). However, data on the risk of IE following transcatheter aortic valve replacement (TAVR) are sparse and limited by the lack of long-term follow-up as well as a direct comparison with patients undergoing SAVR.. OBJECTIVES: This study sought to investigate the long-term incidence of IE in patients undergoing TAVR and to compare the long-term risk of IE with patients undergoing isolated SAVR.. METHODS: In this nationwide observational cohort study, all patients undergoing TAVR and isolated SAVR from January 1, 2008, to December 31, 2016, with no history of IE and alive at discharge were identified using data from Danish nationwide registries.. RESULTS: A total of 2,632 patients undergoing TAVR and 3,777 patients undergoing isolated SAVR were identified. During a mean follow-up of 3.6 years, 115 patients (4.4%) with TAVR and 186 patients (4.9%) with SAVR were admitted ...
Currently, aortic valve replacement procedures require a sternotomy and use of cardiopulmonary bypass (CPB) to arrest the heart and provide a bloodless field in which to operate. A less invasive alternative to open heart surgery is transapical or transcatheter aortic valve replacement (TAVR), already emerging as a feasible treatment for patients with high surgical risk. The bioprosthetic valves are delivered via catheters using transarterial or transapical approaches and are implanted within diseased aortic valves. This paper reports the development of a new self-expanding stent for minimally invasive aortic valve replacement and its delivery device for the transapical approach under real-time magnetic resonance imaging (MRI) guidance. Made of nitinol, the new stent is designed to implant and embed a commercially available bioprosthetic aortic valve in aortic root. An MRI passive marker was affixed onto the stent and an MRI active marker to the delivery device. These capabilities were tested in ...
Treatment of Pulmonary valve stenosis is a narrowing of the pulmonary valve, the flap that separates the lower right chamber (right ventricle) of your heart from the pulmonary artery. During circulation, oxygen-poor blood returning from your body is pumped from your heart, through the pulmonary valve and into the pulmonary artery, which carries the blood to your lungs to pick up oxygen and drop off carbon dioxide. If the pulmonary valve is constricted (stenosed), your heart has to pump harder to push blood through the valve and into the pulmonary artery, The disorder is usually present since birth (congenital). Its one of the more common heart birth defects, with the majority of the cases being mild. Pulmonary valve stenosis occurs in about one of 10 children, and females are slightly more likely to be affected than males. Adults occasionally have pulmonary valve stenosis as a complication of another illness, Pulmonary valve stenosis ranges from mild and without symptoms to severe and debilitating.
Transcatheter aortic valve implantation for failing surgical aortic bioprosthetic valve: from concept to clinical application and evaluation (part 2). JACC Cardiovasc Interv. 2011 Jul; 4(7):733-42 ...
Valve replacement surgery is the replacement of one or more of the heart valves with either an artificial heart valve or a bioprosthesis (homograft from human tissue or xenograft e.g. from pig). It is an alternative to valve repair. There are four procedures Aortic valve replacement Mitral valve replacement Tricuspid valve replacement Pulmonary valve replacement Current aortic valve replacement approaches include closed heart surgery, Very invasive cardiac surgery (VICS) and Very invasive, Scapulae-based aortic valve replacement. Catheter replacement of the aortic valve (called trans-aortic valve replacement or implementation [TAVR or TAVI]) is a minimally invasive option for those suffering from aortic valve stenosis. TAVR is commonly performed by guiding a catheter from the groin to the narrowed valve via the aorta using realtime x-ray technology. A metal stent containing a valve is then deployed using a balloon to press the stent into the valve in effect opening the stenosed (or narrowed) ...
Edwards SAPIEN XT transcatheter heart valve with the NOVAFLEX+ delivery system. Indications: The Edwards SAPIEN XT transcatheter heart valve is indicated for use in patients with symptomatic heart disease due to either severe native calcific aortic stenosis or failure (stenosed, insufficient, or combined) of a surgical bioprosthetic aortic valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., Society of Thoracic Surgeons operative risk score ≥ 8% or at a ≥ 15% risk of mortality at 30 days).. Contraindications: The THV and delivery systems are contraindicated in patients who cannot tolerate an anticoagulation/antiplatelet regimen or who have active bacterial endocarditis or other active infections.. Warnings: Observation of the pacing lead throughout the procedure is essential to avoid the potential risk of pacing lead perforation. There is an increased risk of stroke in transcatheter aortic valve replacement ...
BACKGROUND: Aortic regurgitation (AR) is an important limitation of transcatheter aortic valve replacement (TAVR) with ill-defined predictors and unclear long term impact on outcomes. We sought to analyze currently published literature to establish t
Introduction The development of transcatheter aortic valve replacement (TAVR) can certainly be considered one of the most fascinating examples of successful translational research in medicine. Thanks to an outstanding partnership between multidisciplinary clinicians and engineers, we could move from concept to bench, bench to bedside, bedside to clinical feasibility trials, then on to larger clinical registries and evidence based trials, leading ultimately to a breakthrough technology with durable impact on the pattern of medical practice. This disruptive technology evoked scepticism and criticism in the beginning, but thanks to innumerable clinical trials and evidence based investigations, it is now widely accepted by the medical community and its acceptance is continuing to grow. In the last fourteen years, TAVR has been performed in around 300,000 patients in 65 countries and adoption is increasing by 40% year on year. The field of TAVR is rapidly evolving, with major
This report provides in-depth analysis of the Global Transcatheter Aortic Valve Replacement (TAVR) Market in terms of value and segments. Also assesses the key opportunities in this (TAVR) Market and outlines the factors that are and will be driving the growth of the industry..
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Trans-apical Transcatheter Aortic Valve Replacement in a Patient with Severe and Complex Left Main Coronary Artery Disease (LMCAD) Writer: Larry H Bernstein, MD, FCAP and Curator: Aviva Lev-Ari, PhD, RN Significant, defined as a greater than 50 percent narrowing, left main coronary artery disease (LMCAD) is found in 4 to 6 percent of all patients who…
One of our new heart treatments is the Transcatheter aortic valve replacement. It is one of the minimally invasive heart procedures. Find out more.
Adequate presentation of risks and benefits of medical therapies is essential to informed decision making by patients. Transcatheter aortic valve replacement (T
Several studies have shown that TEA is very effective in ensuring appropriate pain control following thoracic surgery, and some authors consider this anaesthesic technique to be the gold standard for postoperative analgesia following thoracic interventions.8-12 ,16 Since lateral thoracotomy may be more painful than mid-sternotomy due to rib spreading and intercostal nerve injury,17 optimization of postoperative analgesia might be even more important in such cases. Nonetheless, the use of TEA in patients undergoing TA-TAVI has been limited to a single case report,12 and no studies, to date, have evaluated the efficacy and safety of this technique of anaesthesia in this setting. The present study showed that TEA was highly effective in providing postoperative analgesia following TA-TAVI. About 50% of the patients treated with TEA experienced either no pain or only minimal pain within the first 48 h following the procedure, and ,90% at later time-points, and these pain score levels were far lower ...
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The purpose of this study was to compare contemporary results of balloon dilatation and surgery for valvar aortic stenosis in infants and children in the five years between August 1988 and October 1993. Thirty four children underwent attempted balloon valvuloplasty (age 1 day-16 years, weight 1720 g-68 kg) (group 1), eight of whom were neonates with critical aortic stenosis. During the same period, 17 children underwent direct surgical valvotomy (group 2) (seven neonates). Successful balloon valvuloplasty was achieved in 33 (97%) with immediate reduction in the instantaneous systolic pressure gradient from 82 to 34 mm Hg (mean). There were two deaths in this group (both neonates), the second in a preterm neonate from necrotising enterocolitis. Complications requiring intervention in group 1 were aortic regurgitation in one and femoral artery injury in two. Follow up from four months to five years showed sustained results in most cases. There were two neonatal deaths in the surgical group. When ...
Background: Recent studies showed that the assessment of aortic valve calcification (AVC) by multidetector computed tomography (MDCT) is useful to corroborate hemodynamic severity of aortic stenosis (AS). AVC load might provide incremental value beyond clinical and echocardiographic parameters of AS severity to predict hemodynamic progression and occurrence of valve-related events.. Methods: Three hundred twenty three patients (68±13 yrs, 70% men) with AS were prospectively enrolled in 2 academic centers. Hemodynamic AS progression was assessed by annualized increase in mean gradient (MG) measured by echocardiography. AVC was measured by MDCT using the Agatston method and was indexed to the cross-sectional area of the aortic annulus to obtain AVC density (AVCd).. Results: Patients with rapid progression (MG progression ≥3.0 mmHg/yr, median for the cohort) had higher AVCd at baseline as compared to those with slow progression (median [IQR]: AVCd: 322 [160-508] vs 175 [84-309] AU/cm2; ...
TY - JOUR. T1 - Outcomes of aortic valve repair according to valve morphology and surgical techniques. AU - Corrado, Egle. AU - Fattouch, Khalil. AU - Nasso, Giuseppe. AU - Fattouch, Khalil. AU - Speziale, Giuseppe. PY - 2012. Y1 - 2012. N2 - OBJECTIVES: The aim of this study was to assess the impact of aortic valve morphology and different surgical aortic valve repair techni-ques on long-term clinical outcomes.METHODS: Between February 2003 and May 2010, 216 patients with aortic insufficiency underwent aortic valve repair in our institu- tion. Ages ranged between 26 and 82 years (mean 53 ± 15 years). Aortic valve dysfunctions, according to functional classification, were: type I in 55 patients (25.5%), type II in 126 (58.3%) and type III in 35 (16.2%). Sixty-six patients (27.7%) had a bicuspid valve. Aortic valve repair techniques included sub-commissural plasty in 138 patients, plication in 84, free-edge reinforcement in 80, resection of raphe plus re-suturing in 40 and the chordae technique ...
TY - JOUR. T1 - Hemodynamic evaluation and midterm outcome of aortic valve replacement with size 19 Perimount prosthetic valve. AU - Narayan, P. AU - Reeves, BC. AU - Rizvi, SIA. AU - Shokrollahi, K. AU - Ismail, H. AU - Angelini, G. AU - Nightingale, AK. AU - Caputo, M. N1 - Publisher: Elsevier. PY - 2008/12. Y1 - 2008/12. N2 - BACKGROUND: We sought to investigate the effect of patient prosthesis mismatch on hemodynamic profile using dobutamine stress echocardiography, and to evaluate midterm survival of patients undergoing aortic valve replacement with 19-mm Perimount (Baxter Healthcare, Santa Ana, California) aortic prosthetic valves. METHODS: Between December 1, 1999, and August 17, 2005, 147 patients (mean age, 76.8 +/- 5.51 years) had aortic valves replaced with 19-mm Perimount prostheses. Dobutamine stress echocardiography was performed in a subgroup of 24 patients (mean age, 76.6 +/- 5.60 years). Univariable predictors of peak transprosthetic gradient (PTG) under maximum stress, adjusted ...
Valve replacement surgery has a high rate of success and a low risk of causing other problems if you are otherwise healthy. Although most people have successful outcomes, there is a risk of death and serious problems during surgery. Valve replacement surgery is high-risk for people who have a failing left ventricle and who have had a heart attack. About 5 or less out of 100 people who have valve surgery die.footnote 3. If you have severe aortic valve regurgitation or stenosis, the risks of not replacing the valve may be greater than the risks of surgery, unless you have other health problems that make surgery too dangerous.. Even if valve replacement surgery is a success, you may have problems after surgery, such as:. ...
McKellar S.H., Tester D.J., Yagubyan M., Majumdar R., Ackerman M.J., Sundt T.M.. OBJECTIVES: Bicuspid aortic valve is a common condition and is associated with a significantly increased risk of developing thoracic aortic aneurysms and acute aortic dissection. Patient-specific prediction of the risk of developing thoracic aortic aneurysm, however, is imprecise. We hypothesize that genotypic variations in patients with bicuspid aortic valves contribute to this observed variability in aortic phenotype. We, therefore, investigated the potential relationship between mutations in regions of NOTCH1 recently reported to be associated with bicuspid aortic valve and the phenotype of bicuspid aortic valve and thoracic aortic aneurysms in unrelated patients undergoing surgical repair. METHODS: We performed a targeted mutational analysis of NOTCH1 using genomic DNA from 48 unrelated subjects with concomitant bicuspid aortic valve and thoracic aortic aneurysm using denaturing high-performance liquid ...
Methods and Results-This multicenter, propensity score-matched study compared hemodynamics and early clinical outcomes in 246 patients with an aortic annulus area ,400 mm2 undergoing transcatheter aortic valve replacement with either a self-expanding transcatheter heart valve (Symetis ACURATE neo, n=129) or a balloon-expandable transcatheter heart valve (Edwards SAPIEN 3, n=117). The 1:1 propensity score matching resulted in 92 matched pairs. For ACURATE neo versus SAPIEN 3-treated patients, 30-day mortality (0.0% versus 1.0%), 1-year mortality (8.3% versus 13.3%), incidence of stroke (3.3% versus 2.2%), life-threatening bleeding (1.1% versus 1.1%), and major vascular complications (2.2% versus 6.5%), as well as pacemaker implantation rate (12.0% versus 15.2%), were similar. Paravalvular regurgitation ≥moderate was rare in both groups (4.5% versus 3.6%). The ACURATE neo presented lower mean transvalvular gradients (9.3 versus 14.5 mm Hg; P,0.001), larger indexed effective orifice areas (0.96 ...
To establish the safety and effectiveness of the Edwards SAPIEN 3 Transcatheter Heart Valve in patients with severe, symptomatic aortic stenosis who are at low operative risk for standard aortic valve replacement (AVR). Prospective, randomized, controlled, multi-center trial. Patients having an operative mortality , 2% (low operative risk) for surgical aortic valve replacement will be randomized 1:1 to receive either transcatheter heart valve replacement (TAVR) with the Edwards SAPIEN 3 or aortic valve replacement with a commercially available surgical bioprosthetic valve. Patients will be seen for follow-up visits at discharge, 30 days, 6 months, and annually through 10 years.. If you would like additional information regarding this trial please visit the website below or contact [email protected]. https://www.clinicaltrials.gov/ct2/show/NCT02675114. ...
Get an overview of pulmonary valve stenosis, a type of congenital heart defect, including causes of pulmonary valve stenosis, associated symptoms, and pulmonary valve stenosis treatment.
Women undergoing transcatheter aortic valve replacement (TAVR) have better survival rates than men at one year, according to a study published in Annals of Internal Medicine. These results are the opposite of those seen in surgical aortic valve replacement (SAVR), for which female sex has been shown to be associated with poorer outcomes.
Aortic valve and mitral valve are commonly replaced valves. The pulmonary and the tricuspid valve replacements also are uncommon among adults.. Replacing narrowed valve:. Most common valve procedure is the aortic valve replacement Singapore for the aortic stenosis, and narrowing of aortic valve. The mitral stenosis is one more condition that at times need valve replacement method.. Replacing leaky valve:. The aortic regurgitation, (at times referred as the aortic insufficiency) is one common valve problem, which might need valve replacement. The regurgitation means valve allows the blood to go back through valve and in heart rather than moving it ahead and out to your body. The aortic regurgitation will eventually lead to the heart failure.. ...
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Aortic Valve Replacement in Bicuspid Aortic Valve with a Single Coronary Artery. . Download books free in pdf. Online library with books, university works and thousands of documents available to read online and download.
Bicuspid aortic valves (BAVs) represent a wide morphologic and functional spectrum. In coarctation of the aorta, BAVs are common, but the proportion of BAV subtypes and their relation to aortic dimensions and development of late valve dysfunction are unknown. Sixty-two cardiovascular magnetic resonance investigations of patients with coarctation of the aorta were reviewed with respect to aortic valve morphology, aortic valve function, and aortic dimensions. BAVs were identified in 45 patients (72.6 %), of which 13 (20.9 %) were type-0 (two commissures), 28 (45.1 %) type-1 (three commissures but fusion of one commissure with a raphe) and 4 (6.5 %) valves were bicuspid but not possible to classify further. Patients with BAVs type-0 had larger dimensions in their sinus of Valsalva (35.5 ± 6.8 vs. 29.7 ± 2.7 mm, p = 0.002), ascending aorta (33.1 ± 6.2 vs. 26.0 ± 4.3 mm, p = 0.005) and sino-tubular junction (29.3 ± 7.4 vs. 24.2 ± 3.5 mm, p = 0.040) compared with tricuspid aortic valves (TAVs). ...
The Edwards SAPIEN 3 and SAPIEN 3 Ultra Transcatheter Heart Valve system is indicated for relief of aortic stenosis in patients with symptomatic heart disease due to severe native calcific aortic stenosis who are judged by a Heart Team, including a cardiac surgeon, to be appropriate for the transcatheter heart valve replacement therapy.. The Edwards SAPIEN 3 and SAPIEN 3 Ultra Transcatheter Heart Valve system is indicated for patients with symptomatic heart disease due to failing (stenosed, insufficient, or combined) of a surgical or transcatheter bioprosthetic aortic valve or surgical bioprosthetic mitral valve who are judged by a heart team, including a cardiac surgeon, to be at high or greater risk for open surgical therapy (i.e., predicted risk of surgical mortality ≥ 8% at 30 days, based on the Society of Thoracic Surgeons (STS) risk score and other clinical co-morbidities unmeasured by the STS risk calculator).. Contraindications (Who should not use): ...
Despite the promising short-term results of the PARTNER trials,7 31 long-term outcomes after TAVR remain an ongoing concern. For instance, 2 to 5 year follow-up analysis of the PARTNER 2 trial31 demonstrated a higher incidence of all-cause mortality in the TAVR cohort. Many have postulated that the underlying reasons may include the increased likelihood of structural valve degeneration and paravalvular leakage associated with TAVR. Consistent with this hypothesis, the TAVR cohort in the PARTNER 2 trial had a greater need for repeat intervention and valve-in-valve TAVR. Unfortunately, the PARTNER trials did not separately compare TAVR with miAVR (as the surgical arm was inclusive of all approaches); therefore, leaving an important gap in the literature.. In our pooled analysis, the 30-day all-cause mortality did not differ significantly between both groups; however, midterm mortality was significantly higher in the TAVR cohort. It should be noted that none of the included studies independently ...
0008]The three major factors to preserve the function of the aortic valve include maintaining the appropriate diameter of the sinotubular junction and the aortic annulus, and state of the leaflets per se. Only when the functions of these three factors are optimally recovered, the aortic valve function can be successfully restored. Existing methods to repair the aortic valve havent met these requirements entirely. For example, resuspension of the aortic valve leaflets inside an artificial vascular conduit has been suggested as an effective method of repairing ascending aortic aneurysm due to Marfan syndrome with morphologically normal aortic leaflets (David T. E. `Aortic valve repair in patients with Marfan syndrome and ascending aorta aneurysms due to degenerative disease` J. Card. Surg. 1994; 9(2 Suppl):182-7). However, this method is applicable only to limited situations. One drawback is that the sinus portion in the proximal aortic root has to be removed. Furthermore, this method may lead to ...
Causes and Effects of Aortic Valve Disease - Some causes of aortic valve disease include calcium buildup, wear and tear or a misshapen valve. Learn the other causes of aortic valve disease.
The Edwards SAPIEN 3 THV System and Edwards SAPIEN 3 Ultra THV System were previously approved for the treatment of severe aortic stenosis (a narrowing of the aortic valve that restricts blood flow to aorta, the bodys main artery) in patients at intermediate and greater risk for surgical therapy.
Objective: As the veteran population ages, the incidence of clinically significant aortic stenosis (AS) is increasing and aortic stenosis has become a veterans health issue. This analysis focused on using serum Brain Natriuretic Peptide (BNP) levels as an adjunct to aid decision making for early aortic valve replacement (AVR) in veterans with severe AS to reduce hospital admission rates. Methods: We retrospectively reviewed the charts of patients referred to the heart valve clinic at the Washington DC, Veterans Affairs Medical Center (VAMC) Heart Center between 2004 and 2015 who were diagnosed with severe AS. We identified veterans who had a BNP drawn in addition to traditional echocardiography during their diagnostic workup. This cohort was then stratified based on their serum BNP levels and whether they received medical therapy or aortic valve replacement. The primary endpoint of interest was admission to a VAMC for valvular heart failure. Results: Univariate analysis of BNP quartile and operative
Implantation was successful in 30 of 31 cases (aortic annulus diameter 24.7 ± 1.5 mm); THV dislodgement necessitated valve-in-valve implantation in one patient. Post-procedural aortic regurgitation was none/trace in 28 of 31 and mild in 3 of 31 patients. During follow-up, two patients underwent valvular reinterventions (surgical aortic valve replacement for endocarditis, valve-in-valve implantation for increasing paravalvular regurgitation). All-cause mortality was 12.9% and 19.3% at 30 days and 6 months, respectively. In the remaining patients, a significant improvement in New York Heart Association class was observed and persisted up to 6 months after TAVI.. ...
Minimally invasive surgery is associated with a faster postoperative recovery because of reduced postoperative pain and improved respiratory function, especially in elderly patients. We began using a minimally invasive approach ismall parasternal incision jfor isolated aortic valve replacement iMICS AVR jfrom January 2011. Between January 2011 and February 2012, 32 patients underwent MICS AVR surgery. The mean age was 73 years irange 57-85 years j;69% were women. MICS AVR was performed through a skin incision of 6.5 }0.5cm along the third intercostal space. Cardiopulmonary bypass was established through the right femoral artery and vein. The patients were cooled to 28 , the aorta was crossclamped with a flex clamp, and antegrade cardioplegic solution was given into the aortic root or selectively into the coronary ostia. The aortic valve procedure was performed in a standard fashion. If the distance to the aortic valve was too far, we used surgical instruments for minimally invasive surgery. ...