Evolving Indications of Transcatheter Aortic Valve Replacement Compared to Surgical Valve Replacement: A Review of the Current Literature

Shrivastava, Shitij; Shrivastava, Shashwat; Mumtaz, Kahkashan; Mostafa, Jihan A

doi:10.7759/cureus.23364

Cited by 4 publications

(7 citation statements)

References 26 publications

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“…In the United States, TAVR is approved for use in patients regardless of risk strata and has shown non‐inferiority at all risk levels. In high‐risk population, TAVR significantly lowers all‐cause mortality and stroke rates when compared to SAVR 17 . When extensive CAD and severe AS exist concomitantly, treating one but not the other is associated with worse outcomes regardless of sequence of procedures, thus hybrid techniques are recommended 12,13 …”

Section: Discussionmentioning

confidence: 99%

“…Analysis of the TAVR arm of the PARTNER trial revealed severe aortic atherosclerotic disease to be the most common reason (46%) for patients to be considered inoperable due to technical reasons 36 . TAVR carries similar benefits to that of OPCAB—it reduces risk of mortality, bleeding, and transfusion rates, while allowing for shorter hospital stays than SAVR 12 and has been found to carry a lower risk of postoperative stroke in high‐risk patients 17,37 . The choice of access site further dictates the outcomes of the TAVR procedure.…”

Section: Discussionmentioning

confidence: 99%

“…36 TAVR carries similar benefits to that of OPCAB-it reduces risk of mortality, bleeding, and transfusion rates, while allowing for shorter hospital stays than SAVR 12 and has been found to carry a lower risk of postoperative stroke in high-risk patients. 17,37 The choice of access site further dictates the outcomes of the TAVR procedure. The transfemoral approach has been shown to be definitively superior to transapical and transaortic in regard to risk of mortality and stroke.…”

Section: Stroke and Anaortic Techniquementioning

confidence: 99%

“…13,16 Transcatheter aortic valve replacement (TAVR) is noninferior at all patient risk levels and significantly decreases all-cause death and stroke in intermediate and high-risk populations compared with SAVR. 17 Like anaortic OPCAB, the transfemoral approach for TAVR avoids all aortic manipulation. Several authors have previously described concomitant OPCAB and TAVR, [18][19][20][21] however these series have involved aortic manipulation during proximal anastomoses and/ or transaortic delivery of the TAVR.…”

Section: Introductionmentioning

confidence: 99%

“…Anaortic off‐pump coronary artery bypass (OPCAB) is a Class I (EACTS 2018) and IIa (American Heart Association [AHA] 2021) indication for surgical coronary revascularization in patients with a diseased aorta 13,16 . Transcatheter aortic valve replacement (TAVR) is non‐inferior at all patient risk levels and significantly decreases all‐cause death and stroke in intermediate and high‐risk populations compared with SAVR 17 . Like anaortic OPCAB, the transfemoral approach for TAVR avoids all aortic manipulation.…”

Section: Introductionmentioning

confidence: 99%

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Concomitant anaortic OPCAB and transfemoral TAVR for high‐risk patients: A case series

Vallely

Vijayakumar

Whitson

et al. 2022

Journal of Cardiac Surgery

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Background Combined on‐pump coronary artery bypass (ONCAB) and surgical aortic valve replacement (SAVR) is the treatment of choice for concomitant severe aortic stenosis and coronary artery disease not amenable to percutaneous coronary intervention. Extensive aortic calcification and atheromatous disease may prohibit cardiopulmonary bypass and aortic cross‐clamping. In these cases, anaortic off‐pump coronary artery bypass (OPCAB) is a Class I (EACTS 2018) and Class IIA (AHA 2021) indication for surgical coronary revascularization. Transcatheter aortic valve replacement (TAVR) has similar benefits when compared with SAVR for this population (Partner 2 & 3). Herewith we describe a case series of concomitant Anaortic OPCAB and TAVR via the transfemoral approach for patients with coronary artery and valve disease considered too high risk for traditional coronary artery bypass grafting and SAVR due to severe aortic disease. Methods/Results Eight patients underwent anaortic OPCAB and transfemoral TAVR during the same anesthetic in a hybrid operating room. Seven patients with multivessel disease had anaortic OPCAB via a sternotomy using composite grafts, one patient with LAD disease had anaortic OPCAB using a Da Vinci‐assisted MIDCAB approach. All patients then had an Edwards Sapien 3 TAVR placed percutaneously via the common femoral artery. There was no 30 mortality or CVA in the series and all patients were discharged to home or a rehabilitation facility on Day 4–13. Conclusions Combined anaortic OPCAB and transfemoral TAVR is a safe and feasible approach to treating concomitant extensive coronary artery disease and severe aortic stenosis. The aortic no‐touch technique provides benefits in the elderly high‐risk patients by reducing the risk of postoperative myocardial infarction and cerebrovascular stroke.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Stroke and Anaortic Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Concomitant anaortic OPCAB and transfemoral TAVR for high‐risk patients: A case series

Vallely

Vijayakumar

Whitson

et al. 2022

Journal of Cardiac Surgery

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El intervencionismo en cardiopatías congénitas en Chiapas. La historia luego de mil casos realizados

Mijangos-Vázquez,

Hernández-Reyes

2024

ACM

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Antecedentes: Las cardiopatías congénitas son el defecto congénito más común y la primera causa de mortalidad infantil en los países de alto ingreso económico. En estos países, el pronóstico de los pacientes nacidos con estos defectos es excelente, llegando el 90% de ellos hasta la edad adulta. Sin embargo, en los países de mediano o bajo ingreso económico, como el nuestro, el pronóstico es completamente distinto. En el Estado de Chiapas, como resultado del avance del programa de hemodinamia, cada vez más tipos de cardiopatías congénitas son susceptibles de ser tratadas por cateterismo cardiaco. Objetivo: Mostrar la experiencia global actual de la hemodinamia en cardiopatías congénitas en Chiapas después de haber alcanzado los primeros 1000 casos realizados desde el inicio de nuestro programa. Método: A través de un estudio retrospectivo que abarcó de abril de 2016 a junio de 2023 revisamos los expedientes electrónicos del total de pacientes que fueron llevados a cateterismo cardiaco durante ese periodo. Resultados: Se realizaron un total de 1000 procedimientos, 581 en pacientes del sexo femenino, con una mediana de edad de 4 años (1 día a 77 años). Del total de los procedimientos, 115 (11.5%) fueron cateterismos diagnósticos y 885 (88.5%) intervencionistas. Conclusiones: El cateterismo cardiaco en cardiopatías congénitas en el Estado de Chiapas ha desplazado a la cirugía cardiaca en un amplio porcentaje, y los resultados obtenidos son sin duda alentadores, lo cual representa ya una descentralización en la atención de las cardiopatías congénitas en nuestro país.

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Válvula en TAVR: explantación quirúrgica de la válvula aórtica transcatéter

Parra-Salazar,

Vera-Domínguez

2024

Cirugía Cardiaca en México

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Evolving Indications of Transcatheter Aortic Valve Replacement Compared to Surgical Valve Replacement: A Review of the Current Literature

Cited by 4 publications

References 26 publications

Concomitant anaortic OPCAB and transfemoral TAVR for high‐risk patients: A case series

Concomitant anaortic OPCAB and transfemoral TAVR for high‐risk patients: A case series

El intervencionismo en cardiopatías congénitas en Chiapas. La historia luego de mil casos realizados

Válvula en TAVR: explantación quirúrgica de la válvula aórtica transcatéter

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