Cardiology in Review,
Год журнала:
2024,
Номер
unknown
Опубликована: Дек. 4, 2024
Transcatheter
aortic
valve
replacement
has
emerged
as
an
effective
alternative
to
surgery
in
selected
patients
with
stenosis.
It
needs
be
made
clear
which
type
of
better
results
small
annulus.
We
searched
PubMed,
Scopus,
Embase,
Cochrane
Library,
and
Web
Science,
following
the
Preferred
Reporting
Items
for
Systematic
Reviews
Meta-Analyses
statement.
A
total
27
articles
were
included,
including
10,378
[5989
balloon-expanding
(BEV)
4389
self-expanding
(SEV)
groups]
Our
meta-analysis
demonstrated
no
significant
difference
between
SEVs
BEVs
1-year
all-cause
mortality.
There
was
a
statistically
increased
risk
permanent
pacemaker
implantation
(PPI)
within
30
days
ischemic
stroke
at
1
year
[risk
ratio
(RR)
=
1.69,
95%
confidence
interval
(CI)
1.18–2.42,
P
<
0.01,
RR
1.83,
CI
1.03–3.26,
0.04,
respectively].
showed
that
are
favored
over
terms
change
from
baseline
orifice
area
(mean
0.45,
0.19–0.71,
0.01).
Moreover,
after
follow-up,
severe
patient-prosthesis
mismatch
significantly
lower
SEV
group
(RR
0.24,
0.11–0.53,
In
conclusion,
associated
echocardiographic
outcomes
baseline.
Patients
more
likely
develop
require
PPI
but
less
have
mismatch.
The
benefit
larger
balanced
against
higher
rates.
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.
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.
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.