Bioprosthetic Aortic Valve Replacement in &lt;50 Years Old Patients – Where is the Evidence?

Harky, Amer; Suen, Michael Man Yuen; Wong, Chris Ho Ming; Maaliki, Abdul Rahman; Bashir, Mohamad

doi:10.21470/1678-9741-2018-0374

Cited by 8 publications

(8 citation statements)

References 69 publications

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“…As the use of biologic valve prostheses markedly increased, the incidence of reoperation rose accordingly, with the inherent significant risks of morbidity and mortality. Even considering the emergence of the valve-in-valve procedures, it is not without risk; the reintervention itself currently carries a 7-8% mortality risk [13] .…”

Section: Resultsmentioning

confidence: 99%

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Zilli¹,

Guizilini²,

Rocco³

et al. 2020

Braz J Cardiovasc Surg

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Objective: To analyze the profile and outcomes of patients who underwent valve heart surgery in Brazil, using information retrieved from the Brazilian Registry of Cardiovascular Surgeries in Adults (BYPASS Registry) database.Methods: This is a multicenter cohort study, evaluating 920 patients submitted to heart valve surgery. Demographics and postoperative clinical outcomes were assessed and compared to estimate mortality risk using the European System for Cardiac Operative Risk Evaluation (EuroSCORE).Results: Isolated aortic valve replacement was the most frequently performed surgery (34%), followed by isolated mitral valve replacement (24.9%). Valve repair was performed in 21% of mitral procedures. Minimally invasive access was performed in 1.6% and the most frequent postoperative complications were arrhythmias (22.6%), infections (5.7%), and low-output syndrome (5.1%). Operations covered by the public health system accounted for 80.8% and the hospital mortality rate was 7.3%.Conclusion: The most frequent isolated valve surgery in Brazil is the aortic valve replacement by conventional open access and the rheumatic disease is still the main etiology for valve surgery. The BYPASS Registry has a fundamental role to provide information on the profile of patients with valve heart disease in our country in order to delineate adequate strategies for health promotion and resource allocation for cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Zilli¹,

Guizilini²,

Rocco³

et al. 2020

Braz J Cardiovasc Surg

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“…Several retrospective studies involving national databases around the world should be carried out to get a more thorough representation of the data and understanding of the outcomes. There should be further studies to understand the choice of valve types and approaches treating aortic diseases in this cohort of patients 53‐57 …”

Section: Future Researchmentioning

confidence: 99%

“…There should be further studies to understand the choice of valve types and approaches treating aortic diseases in this cohort of patients. [53][54][55][56][57] The importance of pre-pregnancy counseling is well recognized and should be offered to all women with cardiac conditions.…”

Section: Future Researchmentioning

confidence: 99%

Pregnancy and cardiac interventions: What are the optimal management options?

et al. 2020

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Cardiac disease is the leading cause of maternal mortality in the United Kingdom. Major causes of cardiac death in pregnant women include cardiomyopathies, myocardial infarction, ischemic heart disease, and aortic dissection. Uncorrected congenital heart disease and women who have had corrective or palliative surgery may have complicated pregnancies as well. Some women with significant cardiac disease are unable to meet the increased physiological demands of pregnancy. Of these, those who do not respond to medical treatment may require surgical correction such as coronary artery bypass grafting. The risk of cardiac operations for pregnant women is similar to that for nonpregnant women but the fetal mortality rate remains high. Contributing factors to high fetal mortality rates include timing, urgency of operation, and the fetal/fetoplacental response to cardiopulmonary bypass. The aim of this review is to summarize current evidence in utilizing the different management approaches of cardiac issues during pregnancy.

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“…The decision to use TAVI vs SAVR for aortic valve replacement (AVR) is determined by clinical, anatomical, and technical considerations. Since its introduction in 2002, TAVI has increasingly replaced SAVR, the once considered gold standard treatment, in aortic valve diseases . More recently, trials such as the Placement of Aortic Trans‐Catheter Valve II (PARTNER II) and Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) have further established the use of TAVI in intermediate‐risk patients as well.…”

Section: Introductionmentioning

confidence: 99%

“…Since its introduction in 2002, 5 TAVI has increasingly replaced SAVR, the once considered gold standard treatment, in aortic valve diseases. [6][7][8][9][10] More recently, trials such as the…”

Section: Introductionmentioning

confidence: 99%

TAVI and the future of aortic valve replacement

et al. 2019

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Aortic valve stenosis (AS) is the most common valvular pathology and has traditionally been managed using surgical aortic valve replacement (SAVR). A large proportion of affected patient demographics, however, are unfit to undergo major surgery given underlying comorbidities. Since its introduction in 2002, transcatheter aortic valve implantation (TAVI) has gained popularity and transformed the care available to different-risk group patients with severe symptomatic AS. Specific qualifying criteria and refinement of TAVI techniques are fundamental in determining successful outcomes for intervention. Given the successful applicability in high-risk patients, TAVI has been further developed and trialed in intermediate and low-risk patients. Within intermediate-risk patient groups, TAVI was shown to be noninferior to SAVR evaluating 30-d mortality and secondary endpoints such as the risk of bleeding, development of acute kidney injury, and length of admission. The feasibility of expanding TAVI procedures into low-risk patients is still a controversial topic in the literature. A number of trials have recently been published which demonstrate TAVI as noninferior and even superior over SAVR for primary study endpoints. K E Y W O R D S aortic valve, surgery, TAVI, valve replacement 1 | INTRODUCTION Aortic valve stenosis (AS) is the most common valvular pathology, with between 2% and 4% of patients over the age of 75 years bring affected. 1 For decades, surgical aortic valve replacement (SAVR) has been considered the class I recommendation in the management of AS. 2 However, given that advanced age, frailty, and significant comorbidities are increasingly prevalent in affected patients; more than one-third of high-risk and severe symptomatic AS patients were not considered physiologically fit enough for major surgical intervention. 2,3 This merited the development of TAVI, an intervention suitable for high-risk patients and those deemed unfit for surgery. With a shift in clinical paradigm toward minimally invasive procedures, the development of TAVI has revolutionized clinical outcomes in AS, particularly in those once considered inoperable. 4 The decision to use TAVI vs SAVR for aortic valve replacement (AVR) is determined by clinical, anatomical, and technical considerations. Since its introduction in 2002, 5 TAVI has increasingly replaced SAVR, the once considered gold standard treatment, in aortic valve diseases. 6-10 More recently, trials such as the Placement of Aortic Trans-Catheter Valve II (PARTNER II) and Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) 11,12 have further established the use of TAVI in intermediate-risk patients as well. Given this validation of TAVI within high-and intermediate-risk patients, a need has now developed to evaluate the clinical efficacy of TAVI within low-risk surgical candidates. 13Selective candidate criteria, as well as advances in operative techniques within TAVI, are mainstay contributors to successful outcomes. Fundamentally, there exist both retrogr...

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Bioprosthetic Aortic Valve Replacement in <50 Years Old Patients – Where is the Evidence?

Cited by 8 publications

References 69 publications

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Valve Heart Surgery in Brazil – The BYPASS Registry Analysis

Pregnancy and cardiac interventions: What are the optimal management options?

TAVI and the future of aortic valve replacement

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