Late Clinical Outcomes of Balloon-Expandable Valves in Small Annuli

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2025, Номер 18(4), С. 506 - 517

Опубликована: Фев. 1, 2025

Short-term clinical outcomes after transcatheter aortic valve replacement (TAVR) are similar in individuals with small or large annuli. The longer term impact of prosthesis-patient mismatch (PPM) and mean gradient (MG) post-TAVR these patients remains controversial. aim this study was to investigate 5-year vs Patients from the PARTNER (Placement Aortic Transcatheter Valves) 2 SAPIEN 3 intermediate-risk registry low-risk randomized controlled trial were grouped according (≤430 mm2) (>430 annular size. primary endpoint a composite all-cause death, disabling stroke, heart failure hospitalization. In addition, relationships between both PPM MG analyzed. total, 1,355 included: 476 annuli (376.7 ± 41.9 879 (518.3 58.0 mm2). older (age 79.6 7.1 years 78.7 7.8 years; P = 0.047), more often female (75.0% 16.2%; < 0.0001), had higher baseline Society Thoracic Surgeons scores (4.3% 1.93% 4.0% 1.93%; left ventricular ejection fractions (66.3% 15.82% 59.7% 13.68%; 0.0001). Primary rates at 1 year (7.8% 8.0%; 0.94) 5 (36.3% 35.8%; 0.83). Bioprosthetic infrequent groups (2.9% 2.1%; 0.46). Among patients, for (primary endpoint; 33.6% 34.2%; 0.90). annuli, there no association any severity (P 0.22) 30-day nonlinearity 0.96). Five-year excellent comparable Outcomes not affected by PPM.

Язык: Английский

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Cardiac Surgery 2024 Reviewed

The Thoracic and Cardiovascular Surgeon, Год журнала: 2025, Номер unknown

Опубликована: Март 27, 2025

Abstract For the 11th consecutive time, we systematically reviewed cardio-surgical literature for past year (2024), using PRISMA approach a results-oriented summary. In 2024, discussion on value of randomized and registry evidence increased, triggered by consistent findings in field coronary artery disease (CAD) discrepant results structural heart disease. The 2024 again confirmed excellent long-term outcomes CABG compared with PCI different scenarios, generating further validation advantage reported studies. This has been reflected new guidelines chronic CAD 2024. Two studies indicate novel perspectives CABG, showing that cardiac shockwave therapy improves myocardial function ischemic hearts guided computed tomography is safe feasible. aortic stenosis, an early transcatheter (TAVI) surgical (SAVR) treatment found more support; however, TAVI keep being challenged, this FDA data favor SAVR. failed valves, redo-SAVR showed superior valve-in-valve TAVI. mitral field, short-term noninferiority surgery secondary regurgitation (MR), significant survival benefit registries primary MR. Finally, was associated better medical acute type A intramural hematoma. article summarizes publications perceived as important us. It cannot be complete nor free individual interpretation but provides up-to-date information patient-specific decision-making.

Язык: Английский

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Balloon-versus self-expandable transcatheter aortic valve implantation in small aortic annuli: a meta-analysis of randomized and propensity studies

Cardiovascular Intervention and Therapeutics, Год журнала: 2025, Номер unknown

Опубликована: Фев. 18, 2025

Язык: Английский

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Impact of Small Aortic Annuli on the Performance of Transcatheter Aortic Valve Replacement Bioprostheses: An Updated Meta-analysis of Recent Studies

The American Journal of Cardiology, Год журнала: 2024, Номер 229, С. 1 - 12

Опубликована: Июль 23, 2024

Язык: Английский

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Hemodynamic and clinical outcomes with balloon-expandable valves versus self-expanding valves in patients with small aortic annulus undergoing transcatheter aortic valve replacement: A meta-analysis of randomized controlled trials and propensity score matched studies

IJC Heart & Vasculature, Год журнала: 2024, Номер 55, С. 101542 - 101542

Опубликована: Окт. 28, 2024

Язык: Английский

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Big Picture of TAVR in Small Annuli

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 17(5), С. 693 - 695

Опубликована: Март 1, 2024

Язык: Английский

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Weekly Journal Scan: transcatheter aortic valve implantation in patients with small aortic annulus

European Heart Journal, Год журнала: 2024, Номер 45(28), С. 2476 - 2477

Опубликована: Июнь 1, 2024

Key points• The SMall Annuli Randomized To Evolut or SAPIEN (SMART) Trial is a multi-centre, industry-funded, randomized controlled trial (RCT), aimed at evaluating the clinical outcomes and valve performance of self-expanding supra-annular as compared with balloon-expandable in patients symptomatic severe aortic stenosis small annulus undergoing transcatheter implantation (TAVI). 1 Patients an area 430 mm 2 less (as assessed by multi-detector computed tomography), suitable anatomy for transfemoral TAVI, were 1:1 to receive (Evolut PRO/PRO+/FX; Medtronic) (SAPIEN 3/3 Ultra; Edwards Lifesciences).The sponsor (Medtronic) contributed protocol development was responsible site selection, data monitoring, statistical analyses.• two co-primary endpoints, both which through 12 months, (i) composite death, disabling stroke, rehospitalization heart failure (tested non-inferiority, 8% margin, under assumption that event would occur 16% each group), (ii) bioprosthetic dysfunction superiority), endpoint including haemodynamic structural (defined mean gradient ≥ 20 mmHg); non-structural [defined prosthesis-patient mismatch (i.e.indexed effective orifice < 0.65 cm /m ) least moderate regurgitation]; thrombosis according Valve Academic Research Consortium (VARC)-2 criteria]; endocarditis modified Duke criteria); re-intervention.Secondary endpoints included gradient, area, dysfunction, women (all months), 30 days.• From April 2021 September 2022, total 716 (mean age, 80 years; 87% women; valve, n = 355; 361) treated 83 sites Canada, Europe, Middle East, USA.The Society Thoracic Surgeons Predicted Risk Mortality 3.3%.The (± standard deviation) 382 ± 34 .The prevalence bicuspid 4%.The first occurred 9.4% group 10.6% those [difference -1.2%; 90% confidence interval (CI), -4.9 2.5, P .001for non-inferiority; hazard ratio, 0.90; 95% CI, 0.56-1.43].The second (bioprosthetic months) 41.6% (difference -32.2%; -38.7 -25.6; superiority).• months 8 mmHg vs. 16 group, 1.99 1.50 group.As showed lower 12-month rates (3% 32%), (6% 18%), (10% 43%), days (11% 35%).Both groups low incidence (0.3% 0.3%), (0.6% 2.3%), re-intervention (0.9% 0.6%).The rate permanent pacemaker 12% group.

Язык: Английский

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Reply

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 17(12), С. 1510 - 1510

Опубликована: Июнь 1, 2024

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Numbers vs Patients

КАРДИОЛОГИЯ УЗБЕКИСТАНА, Год журнала: 2024, Номер 17(12), С. 1509 - 1509

Опубликована: Июнь 1, 2024

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Supra-Annular Versus Intra-Annular Self-Expanding Valves in Small Aortic Annulus: A Propensity Score-Matched Study

Structural Heart, Год журнала: 2024, Номер 9(1), С. 100334 - 100334

Опубликована: Июль 8, 2024

Язык: Английский

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