New findings from the GARY (German Aortic Valve Registry) registry show that intermediate-risk patients with severe aortic stenosis presented significantly higher mortality at 1 year when treated with transcatheter aortic valve replacement (TAVR) rather than with conventional surgery. Results reflect everyday realities, which might include various bias tipping the scales towards one strategy or the...
The introduction of transcatheter aortic valve replacement procedures (TAVR) seems to have increased the number of elderly patients hospitalized with severe aortic stenosis, as well as the number of interventions. However, less than one fifth of patients over 85 are intervened, according to a Canadian registry. Given the significant difference in mortality with TAVR,...
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of high-risk patients with severe aortic stenosis. However, survival after the procedure and severe complications have been assessed in relatively small populations with limited follow-up. This article reports long-term clinical results in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. The FRANCE-2 registry...
In the first PARTNER trial (Placement of Aortic Transcatheter Valves), mortality at one year was 24% for high risk patients and 31% for inoperable patients. A recent report on SAPIEN 3 outcomes at 30 days ─ the last generation balloon expandable valve ─ showed a rather lower adverse events rate. However, additional information at longer...
Courtesy of Dr. Carlos Fava. Body mass index (BMI) has always played an important role in heart surgery. However, there is little evidence on BMI effects on TAVI. This study included 491 patients, which were divided according to BMI into: low (<20 Kg/m2 ) normal (20-24.9 Kg/m2 ) overweight (25-30 Kg/m2 ) obese...
Original Title: One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement in high risk and inoperable patients with severe aortic stenosis. Reference: Herrmann H et al. Circulation. 2016; Epub ahead of print. Data presented at this last TCT annual meeting about the low rate of events at one year in inoperable patients with...
Original Title: Treatment of Symptomatic Severe Aortic Stenosis with a Novel Resheathable Supra-Annular Self-Expanding Transcatheter Aortic Valve System. Reference: Ganesh Manoharan et al. J Am Coll Cardiol Intv. 2015; 8(10):1359-1367. Courtesy of Dr. Agustín Vecchia. Despite the rapid growth and evolution of transcatheter aortic valve replacement devices (TAVR), vascular access complications, paravalvular leak, stroke...
Original Title: Impact of ejection fraction and aortic valve gradient on outcomes of transcatheter aortic valve replacement. Reference: Baron SJ et al. J Am Coll Cardiol. 2016;67:2349-2358. Low aortic valve gradient and left ventricular dysfunction are frequent in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVI) but only low aortic valve...
Original Title: Transcatheter Aortic Valve Implantation Compared With Surgical Aortic Valve Replacement in Low-Risk Patients. Reference: Stefano Rosato et al. Circ Cardiovasc Interv. 2016 May;9(5):e003326. The proved efficacy of transcatheter aortic valve implantation (TAVI) in high risk patients is leading the expansion of its indication for lower risk patients. All the same, compared to the...
Original Title: Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. PARTNER 2A. Reference: Martin B. Leon et al. NEJM April 2, 2016 Courtesy of Dr. Juan A. Terré Studies have shown mortality rates after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in high risk patients are similar (PARTNER 2 – Cohort B). This is...