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Outcome after transvascular transcatheter aortic valve implantation in 2016.

ABSTRACT: We analysed the number of procedures, complications, and in-hospital mortality rates of all patients undergoing transvascular transcatheter aortic valve implantation (TV-TAVI) in comparison to isolated surgical aortic valve replacement (iSAVR) from 2014 to 2016 in Germany.All aortic valve procedures performed in Germany are mandatorily registered in a quality control program. More than 15 000 TV-TAVI procedures were performed in 2016 in Germany. Especially the number of post-procedural complications declined within the last few years, including new pacemaker implantations (2015: 12.6% vs. 2016: 11.4%, P?=?0.002) and vascular complications (2015: 8.5% vs. 2016: 7.1%; P?

SUBMITTER: Gaede L

PROVIDER: S-EPMC5837346 | biostudies-other | 2018 Feb

REPOSITORIES: biostudies-other

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Outcome after transvascular transcatheter aortic valve implantation in 2016.

Gaede Luise L Blumenstein Johannes J Liebetrau Christoph C Dörr Oliver O Kim Won-Keun WK Nef Holger H Husser Oliver O Elsässer Albrecht A Hamm Christian W CW Möllmann Helge H

European heart journal 20180201 8

<h4>Aims</h4>We analysed the number of procedures, complications, and in-hospital mortality rates of all patients undergoing transvascular transcatheter aortic valve implantation (TV-TAVI) in comparison to isolated surgical aortic valve replacement (iSAVR) from 2014 to 2016 in Germany.<h4>Methods and results</h4>All aortic valve procedures performed in Germany are mandatorily registered in a quality control program. More than 15 000 TV-TAVI procedures were performed in 2016 in Germany. Especiall ...[more]

PMID: 29228149

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| S-EPMC6879149 | biostudies-literature

Outcomes of Redo Transcatheter Aortic Valve Implantation for Structural Valve Degeneration of Transcatheter Aortic Valve.

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| S-EPMC7890286 | biostudies-literature

Transcatheter aortic valve implantation in Asia.

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Repeated transcatheter aortic valve implantation for the treatment of a degenerated transcatheter aortic valve implantation valve (valve-in-valve technique): a case report.

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| S-EPMC8183662 | biostudies-literature

Antithrombotic Therapy After Transcatheter Aortic Valve Implantation.

Project description:The development of transcatheter aortic valve implantation has represented one of the greatest advances in the cardiology field in recent years and has changed clinical practice for patients with aortic stenosis. Despite the continuous improvement in operators' experience and techniques, and the development of new generation devices, thromboembolic and bleeding complications after transcatheter aortic valve implantation remain frequent, and are a major concern due to their negative impact on prognosis in this vulnerable population. In addition, the optimal antithrombotic regimen in this scenario is not known, and current recommendations are mostly empirical and not evidence based. The present review aims to provide an overview of the current status of knowledge, including relevant on-going randomised trials, on antithrombotic treatment strategies after transcatheter aortic valve implantation.

| S-EPMC7066806 | biostudies-literature

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation.

Project description:OBJECTIVE:Valve-in-valve procedures using transcatheter aortic valves are increasingly performed to treat degenerated bioprosthetic surgical aortic valves because they are less invasive than redo aortic valve replacement. The objective of this study is to quantify the changes in aortic sinus blood flow dynamics before and after a valve-in-valve procedure to gain insight into mechanisms for clinical and subclinical thrombosis of leaflets. METHODS:A detailed description of the sinus hemodynamics for valve-in-valve implantation was performed in vitro. A Medtronic Hancock II (Medtronic Inc, Minneapolis, Minn) porcine bioprosthesis was modeled as a surgical aortic valve, and Medtronic CoreValve and Edwards Sapien (Edwards Lifesciences, Irvine, Calif) valves were used as the transcatheter aortic valves. High-resolution particle image velocimetry was used to compare the flow patterns from these 2 valves within both the left coronary and noncoronary sinuses in vitro. RESULTS:Velocity and vorticity within the surgical valve sinuses reached peak values of 0.7 m/s and 1000 s-1, with a 70% decrease in peak fluid shear stress near the aortic side of the leaflet in the noncoronary sinus. With the introduction of transcatheter aortic valves, peak velocity and vorticity were reduced to approximately 0.4 m/s and 550 s-1 and 0.58 m/s and 653 s-1 without coronary flow and 0.60 m/s and 631 s-1 and 0.81 m/s and 669 s-1 with coronary flow for the CoreValve and Sapien valve-in-valve implantations, respectively. Peak shear stress was approximately 38% higher along the aortic side of the coronary versus noncoronary transcatheter aortic valve leaflet. CONCLUSIONS:Decreased flow and shear stress in valve-in-valve procedures indicate a higher risk of leaflet thrombosis secondary to flow stasis, perhaps more so in the noncoronary sinus.

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Project description: Not available

| S-EPMC8078441 | biostudies-literature

Does transcatheter aortic valve implantation mean the end of surgical aortic valve replacement?

Project description:Although the results of the early TAVI experience are promising, longer-term follow-up is necessary before the procedure can be extended to lowerrisk patients. Many issues are not yet resolved, including the long-term effects of paravalvular leaks (which occur in most TAVI patients), the true stroke rate in TAVI patients (which is probably in the range of 5% to 6%), and the need for permanent pacemaker implantation (which ranges from 5% to 40% in TAVI patients, depending upon the device used). As the procedure is extended into the lower-risk population, these issues will assume greater import than they have in the population currently in treatment—very elderly, high-risk patients with limited life expectancy. As in the coronary-revascularization paradigm of percutaneous coronary intervention versus coronary artery bypass grafting, there will be increasing adoption of the transcatheter approach. Just as the rumors of the demise of surgical bypass were premature, conventional AVR will continue to be the predominant technique for the treatment of aortic stenosis during at least the next decade. Although the percentage of patients treated by a transcatheter approach will continue to increase, regulatory and reimbursement factors are likely to be the primary determinants of the rate of adoption.

| S-EPMC3014148 | biostudies-other

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