Redo-TAVR Feasibility After SAPIEN 3 Stratified by Implant Depth and Commissural Alignment: A CT Simulation Study DOI
A. Koshy, Gilbert H.L. Tang, Sahil Khera

et al.

Circulation Cardiovascular Interventions, Journal Year: 2024, Volume and Issue: 17(3)

Published: March 1, 2024

BACKGROUND: Redo-transcatheter aortic valve replacement (TAVR) can pin the index transcatheter heart leaflets open leading to sinus sequestration and restricting coronary access. The impact of initial implant depth commissural alignment on redo-TAVR feasibility is unclear. We sought determine access after SAPIEN 3 (S3) TAVR stratified by alignment. METHODS: Consecutive patients with native stenosis were evaluated using multidetector computed tomography. S3 simulations done at depths, sizing per manufacturer recommendation assuming nominal expansion in all cases. Redo-TAVR was deemed unfeasible based valve-to-sinotubular junction distance valve-to-sinus height <2 mm, while neoskirt plane estimated feasibility. RESULTS: Overall, 1900 (mean age, 80.2±8 years; STS-PROM [Society Thoracic Surgeons Predicted Risk Operative Mortality], 3.4%) included. reduced significantly shallower depths (2.3% 80:20 versus 27.5% 100:0, P <0.001). Larger sizes feasibility, but only a 100:0 ( Commissural would render feasible patients, utilization leaflet modification techniques reduce height. Coronary following TAV-in-TAV affected both size. CONCLUSIONS: This study highlights critical depth, alignment, size predicting These findings highlight necessity for individualized preprocedural planning, considering immediate results long-term prospects reintervention as increasingly utilized younger stenosis.

Language: Английский

Sex Differences and Similarities in Valvular Heart Disease DOI Open Access
Jacqueline T. DesJardin,

Joanna Chikwe,

Rebecca T. Hahn

et al.

Circulation Research, Journal Year: 2022, Volume and Issue: 130(4), P. 455 - 473

Published: Feb. 17, 2022

As populations age worldwide, the burden of valvular heart disease has grown exponentially, and so proportion affected women. Although rheumatic valve is declining in high-income countries, degenerative age-related causes are rising. Calcific aortic stenosis mitral regurgitation affect a significant elderly women, particularly those with comorbidities. Women have been underrepresented many landmark studies which form basis for guideline recommendations. consequence, surgical referrals women often delayed, worse postoperative outcomes compared men. described this review, more recent effort to include research clinical trials increased our knowledge about sex-based differences epidemiology, pathophysiology, diagnostic criteria, treatment options, outcomes, prognosis.

Language: Английский

Citations

97
Management of coronary artery disease in patients undergoing transcatheter aortic valve implantation. A clinical consensus statement from the European Association of Percutaneous Cardiovascular Interventions in collaboration with the ESC Working Group on Cardiovascular Surgery DOI Open Access
Giuseppe Tarantini, Gilbert H.L. Tang, Luca Nai Fovino

et al.

EuroIntervention, Journal Year: 2023, Volume and Issue: 19(1), P. 37 - 52

Published: May 1, 2023

Significant coronary artery disease (CAD) is a frequent finding in patients with severe aortic stenosis undergoing transcatheter valve implantation (TAVI), and the management of these two conditions becomes particular importance extension procedure to younger lower-risk patients. Yet, preprocedural diagnostic evaluation indications for treatment significant CAD TAVI candidates remain matter debate. In this clinical consensus statement, group experts from European Association Percutaneous Cardiovascular Interventions (EAPCI) collaboration Society Cardiology (ESC) Working Group on Surgery aims review available evidence topic proposes rationale percutaneous revascularisation treatment. Moreover, it also focuses commissural alignment heart valves re-access after redo-TAVI.

Language: Английский

Citations

91
Mitral valve transcatheter edge-to-edge repair DOI Open Access

Jörg Hausleiter,

Thomas J. Stocker, Marianna Adamo

et al.

EuroIntervention, Journal Year: 2023, Volume and Issue: 18(12), P. 957 - 976

Published: Jan. 1, 2023

Mitral regurgitation (MR) is the most prevalent valvular heart disease and, when left untreated, results in reduced quality of life, failure, and increased mortality. valve transcatheter edge-to-edge repair (M-TEER) has matured considerably as a non-surgical treatment option since its commercial introduction Europe 2008. As result major device interventional improvements, well accumulation experience by cardiologists, M-TEER emerged an important therapeutic strategy for patients with severe symptomatic MR current European American guidelines. Herein, we provide comprehensive up-do-date overview M-TEER. We define preprocedural patient evaluation highlight key aspects decision-making. describe currently available systems summarise evidence both primary mitral (PMR) secondary (SMR). In addition, recommendations selection, intraprocedural imaging guiding, optimisation management recurrent MR. Finally, information on unsolved questions “grey areas”

Language: Английский

Citations

71
Clinical Impact of Standardized TAVR Technique and Care Pathway DOI Creative Commons
Kendra J. Grubb,

Hemal Gada,

Suneet Mittal

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2023, Volume and Issue: 16(5), P. 558 - 570

Published: March 1, 2023

Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual regurgitation (AR) new permanent pacemaker implantation (PPI) rates remain variable because of a lack uniform periprocedural management implantation.The Optimize PRO study evaluates performance procedural using an "optimized" TAVR care pathway the cusp overlap technique (COT) in patients receiving Evolut PRO/PRO+ (Medtronic) self-expanding valves.Optimize PRO, nonrandomized, prospective, postmarket conducted United States, Canada, Europe, Middle East, Australia, is enrolling with severe symptomatic stenosis no pre-existing pacemaker. Sites follow standardized pathway, including early discharge conduction disturbance algorithm, transfemoral deployment COT.A total 400 attempted implants from States Canada comprised main cohort this second interim analysis. The mean age was 78.7 ± 6.6 years, Society Thoracic Surgeons predictive risk mortality 3.0 2.4. median length stay 1 day. There were instances moderate or AR at discharge. At 30 days, all-cause stroke 3.8%, 0.8%, disabling 0.7%, hospital readmission 10.1%, cardiovascular rehospitalization 6.1%. PPI rate 9.8%, 5.8% 4-step COT compliance. In multivariable model, right bundle branch block depth implant increased PPI, whereas lowered 30-day PPI.The use resulted favorable low days while facilitating reproducible across various sites operators. (Optimize PRO; NCT04091048).

Language: Английский

Citations

57
Comparison of different percutaneous revascularisation timing strategies in patients undergoing transcatheter aortic valve implantation DOI
Tobias Rheude, Giuliano Costa, Flavio Ribichini

et al.

EuroIntervention, Journal Year: 2023, Volume and Issue: 19(7), P. 589 - 599

Published: Sept. 1, 2023

The optimal timing to perform percutaneous coronary interventions (PCI) in transcatheter aortic valve implantation (TAVI) patients remains unknown.

Language: Английский

Citations

44
Valvular heart disease: from mechanisms to management DOI
Fabien Praz, Friedhelm Beyersdorf, Kristina H. Haugaa

et al.

The Lancet, Journal Year: 2024, Volume and Issue: 403(10436), P. 1576 - 1589

Published: March 27, 2024

Language: Английский

Citations

26
Early outcomes of the novel Myval THV series compared to SAPIEN THV series and Evolut THV series in individuals with severe aortic stenosis DOI
Niels van Royen, Ignacio J. Amat‐Santos, Martin Hudec

et al.

EuroIntervention, Journal Year: 2025, Volume and Issue: 21(2), P. e105 - e118

Published: Jan. 1, 2025

There are limited head-to-head randomised trials comparing the performance of different transcatheter heart valves (THVs).

Language: Английский

Citations

4
Timing and Outcomes of PCI in Conjunction With TAVR With Balloon-Expandable Valves DOI Creative Commons
Abhijeet Dhoble, Talha Ahmed, Raymond G. McKay

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2025, Volume and Issue: 18(2), P. 244 - 254

Published: Jan. 1, 2025

Language: Английский

Citations

3
Transcatheter Aortic Valve Replacement With the Latest-Iteration Self-Expanding or Balloon-Expandable Valves DOI Creative Commons
Giuliano Costa, Francesco Saia, Thomas Pilgrim

et al.

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Journal Year: 2022, Volume and Issue: 15(23), P. 2398 - 2407

Published: Sept. 16, 2022

Language: Английский

Citations

46
Peripheral intravascular lithotripsy for transcatheter aortic valve implantation: a multicentre observational study DOI
Giulia Nardi, Ole De Backer, Francesco Saia

et al.

EuroIntervention, Journal Year: 2022, Volume and Issue: 17(17), P. e1397 - e1406

Published: March 31, 2022

The presence of severe calcific atherosclerosis at the iliofemoral axis may preclude transcatheter aortic valve implantation (TAVI) by transfemoral (TF) approach. Intravascular lithotripsy (IVL) is a novel technology that fractures intimal/medial calcium and increases vessel compliance allowing TF TAVI in selected patients with peripheral artery disease (PAD).The aim this study was to report on safety efficacy IVL-assisted an all-comers population.Clinical, imaging procedural data all consecutive treated six high-volume European centres (2018-2020) were collected prospective, real-world, multicentre registry.IVL-assisted performed 108 patients, increasing from 2.4% 6.5% 2018 2020, respectively. target lesion most often localised common and/or external iliac (93.5% cases; average TL-MLD 4.6±0.9 mm 318 degrees arc). Transfemoral delivery successful 100% final success 98.2% (two conversions cardiac open surgery for annular rupture migration). Complications IVL-treated segments consisted 1 perforation 3 major dissections requiring stent (2 covered stents 2 BMS). Access-site-related complications included bleedings. Three in-hospital deaths recorded (2.8%, failed surgical conversion after rupture, arrest initial valvuloplasty, late hyperkalaemia renal dysfunction).IVL-assisted proved be safe effective approach, which helps expand indications PAD. However, these continue have higher-than-average incidence periprocedural complications.

Language: Английский

Citations

39