Outcomes of Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis

Boskovski, Marko T.; Nguyen, Tom C.; McCabe, James M.; Kaneko, Tsuyoshi

doi:10.1001/jamasurg.2019.4449

Cited by 25 publications

(21 citation statements)

References 59 publications

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“…The rates of post-TAVI permanent pacemaker implantation in patients who received self-expandable transcatheter heart valves remain higher compared to surgical aortic valve replacement [58,74,75]. It might be explained by the extended frame length in the LVOT that comes in direct contact with the portion of the membranous interventricular septum where the conduction system is more superficial [76]. In patients with conduction disturbances post-TAVI, the data on the role of aortic valve calcium score are conflicting, but calcification asymmetry is a relevant variable because it determines higher exertional forces in the central fibrous trigone with temporarily (edema, hematoma) or permanent damage of the conduction system and need of permanent pacemaker implantation.…”

Section: Expert Opinionmentioning

confidence: 99%

How valvular calcification can affect the outcomes of transcatheter aortic valve implantation

Pio

Bax

Delgado

2020

Expert Review of Medical Devices

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Introduction: In transcatheter aortic valve implantation (TAVI), assessment of aortic valve calcification is not as standardized as aortic annulus measurement. Aortic valve calcification is important for stable anchoring of the prosthesis to the aortic annulus. However, excessive aortic valve calcification is related to procedural complications. Areas covered: This review covers the methods to assess aortic valve calcification and the implications of aortic valve calcium burden for TAVI outcomes. We performed a systematic review of the literature in Pubmed and secondary sources. Furthermore, future perspectives on how to integrate aortic valve calcification assessment in the management of patients with aortic stenosis is discussed. Expert opinion: Thorough assessment of the aortic valve and aortic root components including aortic valve calcification is key in the planning of TAVI. Aortic valve calcification load, location and extension are important contributors to paravalvular regurgitation. Asymmetric calcification burden with greater calcification of the left-coronary cusp related to higher need of permanent pacemaker implantation. Patients with moderate and severe left ventricular outflow tract/subannular calcification are more susceptible to aortic annular rupture. Periprocedural dislodgement of calcium form cusps and commissures is one of the main reasons of coronary artery ostial occlusion during transcatheter aortic valve implantation.

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Section: Expert Opinionmentioning

confidence: 99%

How valvular calcification can affect the outcomes of transcatheter aortic valve implantation

Pio

Bax

Delgado

2020

Expert Review of Medical Devices

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“…This enthusiasm is supported by the findings showing overall clinical equivalence between TAVI and surgical aortic valve replacement (SAVR) which necessitates general anaesthesia, extensive surgical trauma, cardiac arrest and cardiopulmonary bypass. TAVI is a disruptive technology and has caused a sea change in cardiovascular Anchoring test concerns an in vitro test evaluating the stability of the valve that was deployed by balloon expansion within the aortic annulus by suspending the heart after valve implantation therapy similar to intracoronary stenting 40 years earlier [10].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The history of transcatheter aortic valve implantation: The role and contribution of an early believer and adopter, the Netherlands

et al. 2020

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“…Building upon developments in materials and procedures, and inspired by breakthrough results of stenting for coronary and endovascular procedures, transcatheter aortic valve implantation (TAVI), also called transcatheter aortic valve replacement (TAVR), was introduced by Alain Cribier almost two decades ago [4][5][6] . The successes of TAVI have been dramatic indeed, as poignantly summarized by the recent US Food and Drug Administration approval of new-generation devices for TAVI even in patients at low surgical risk [7] . However, TAVI continues to be considered and used mostly for elderly patients, given the uncertainty on long-term and very long-term device durability [8] .…”

Section: Introductionmentioning

confidence: 99%

Transcatheter aortic valve implantation in the elderly: an umbrella review

Antonazzo¹,

Biondi‐Zoccai²,

Marullo³

et al. 2020

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Aim: The management of aortic stenosis has seen momentous changes thanks to the introduction of transcatheter aortic valve implantation (TAVI, i.e., transcatheter aortic valve replacement). Indications to TAVI have expanded progressively to intermediate-and low-risk patients, but trends in life expectancy have led to an increase of elderly but fit individuals with aortic stenosis eligible for TAVI. Methods: We reviewed the current evidence base on TAVI in the elderly by conducting an umbrella review (i.e., overview of systematic reviews), based on a formal bibliographic search for systematic reviews on TAVI in elderly patients (≥ 65 years). Key, study, patient, procedural, and outcome data were extracted, and validity formally appraised with the Oxman-Guyatt index. Results: From 71 citations, eight reviews were included (totaling 39 studies and 8579 patients): five systematic reviews, and three meta-analyses. Topics of interest were cognitive function before and after TAVI, predictive role of muscle mass and frailty on post-TAVI outcomes, comparative safety and effectiveness of TAVI, and role of rehabilitation to improve patient outlook after TAVI. Thirty-three additional studies were retrieved by means of snowballing, emphasizing the

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Outcomes of Transcatheter Aortic Valve Replacement in Patients With Severe Aortic Stenosis

Cited by 25 publications

References 59 publications

How valvular calcification can affect the outcomes of transcatheter aortic valve implantation

How valvular calcification can affect the outcomes of transcatheter aortic valve implantation

The history of transcatheter aortic valve implantation: The role and contribution of an early believer and adopter, the Netherlands

Transcatheter aortic valve implantation in the elderly: an umbrella review

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