Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis

Gotzmann, Michael; Hehen, Tobias; Germing, Alfried; Lindstaedt, Michael; Yazar, Aydan; Laczkovics, Axel; Mumme, A.; Mügge, Andreas; Bojara, Waldemar

doi:10.1136/hrt.2009.180661

Cited by 98 publications

(70 citation statements)

References 23 publications

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“…Also, it can lead to an increased rupture risk and aneurysm dilatation with growing systolic and mean pressure after TAVI and the increase in wall stress. 13,14) Likewise, an aneurysm operation in a patient with severe aortic stenosis presents high-risk. Surgical aneurysm repair had a high-risk because of the very severe aortic stenosis in our case as well.…”

Section: Discussionmentioning

confidence: 99%

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

et al. 2014

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SummaryThe prevalence of aortic stenosis (AS) increases in the elderly. They present high surgical risk due to comorbid factors that increase with age. Transcatheter aortic valve implantation (TAVI) is an effective method in patients who present with severe aortic stenosis with a higher surgical risk or who cannot undergo surgical aortic valve replacement (s-AVR). In our case, the presence of saccular thoracic aortic aneurysm with severe AS, which is a vital co-morbidity, requires the treatment of both. The rise in systolic pressure following the TAVI procedure increases the saccular thoracic aneurysm rupture risk and this is why the timing and method of the two treatments become crucial. In this case, which is as far as we know the first and only report in the literature, both TAVI and endovascular thoracic aortic saccular aneurysm repair were applied simultaneously and successfully to the patient via the same transfemoral route. After 1 month, the patient had good functional capacity and there were no complications in control tomography and echocardiography. In this way, we attempted to emphasize with a multidisciplinary study that the patients be assessed carefully before the procedure, and found that even in patients with common peripheral vascular diseases, a transfemoral route could be used together with the proper methods, and that both procedures could be performed simultaneously. (Int Heart J 2014; 55: 459-462) Key words: Transcatheter aortic valve implantation, TEVAR, Aortic aneurysm T he prevalence of aortic stenosis (AS) has increased with the increase in life expectancy. As a result, severe comorbid factors can occur in advanced ages. The surgical replacement of a stenotic aortic valve (s-AVR) can be performed with low operative mortality rates in the absence of serious comorbid conditions. The patients undergoing s-AVR tend to have greater life expectancy and progress in their symptoms. However, 30% of the patients cannot undergo s-AVR due to left ventricular dysfunction, advanced age, and comorbid conditions. 1,2) Performed for the first time on a patient in 2002, transcatheter aortic valve implantation (TAVI) has become the leading treatment option for high risk and inoperable patient groups. One of the comorbid factors that increases the risk in patients is aortic aneurysm. The rupture risk will be increased with the increase in systolic pressure due to the aortic stenosis being treated. Hence, the timing and method of both treatments are of great importance in our high-risk case which was complicated by a thoracic aortic saccular aneurysm and serious aortic stenosis. In this study, thanks to our unique case in the literature, we managed to show that transfemoral aortic valve implantation and endovascular aneurysm repair could be performed simultaneously and successfully using the same femoral route by evaluating them in a detailed multidisciplinary way. Case ReportAn 83 year-old male patient with a history of coronary artery bypass grafting (CABG) and a permanent pacemaker (VVI-R type) follo...

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Section: Discussionmentioning

confidence: 99%

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

et al. 2014

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“…In most other respects, however, TAVI appears safe and has been associated with important symptomatic benefits, as reflected in the improvement in health-related quality of life reported by the PARTNER investigators (101). Smaller studies have reinforced these findings by reporting improvement in the 6 min walk distance and quality of life scores, while brain natriuretic peptide (BNP) levels decline substantially (102). Add to this the costeffectiveness of TAVI in US and UK analyses, and it seems certain that indications will continue to expand (103,104).…”

Section: Transcatheter Aortic Valve Implantationmentioning

confidence: 82%

Almanac 2012: interventional cardiology

Meier¹

2012

Anadolu Kardiyol Derg

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“…In most other respects, however, TAVI appears safe and has been associated with important symptomatic benefits, as reflected in the improvement in health-related quality of life reported by the PARTNER investigators. 101 Smaller studies have reinforced these findings by reporting improvement in the 6 min walk distance and quality of life scores, while brain natriuretic peptide (BNP) levels decline substantially. 102 Add to this the cost-effectiveness of TAVI in US and UK analyses, and it seems certain that indications will continue to expand.…”

Section: Transcatheter Aortic Valve Implantationmentioning

confidence: 93%

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

Meier¹

2013

Srce i krvni sudovi

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Almanah 2012 serijaPercutaneous coronary intervention versus medical treatment P ercutaneous coronary intervention (PCI) has guide line recommendations for treatment of ST elevation and non-ST elevation myocardial infarction (MI).1 However, its role in stable coronary disease has been the subject of reappraisal following publication of the COURAGE trial, which showed that, in patients receiving optimal medical therapy, PCI does not improve cardiovascular outcomes, while incremental benefits for quality of life disappear by 36 months.2 3 A more recent meta-analysis of eight trials of optimal medical therapy versus PCI involving 7229 patients bears out the COURAGE conclusions by showing no significant differences between the groups with regard to death (9.1% vs 8.9%), non-fatal MI (8.1% vs 8.9%), unplanned revascularisation (30.7% vs 21.4%) and persistent angina (33% vs 29%).4 Drug-eluting stents (DESs) were used in only a minority of these patients and may have reduced the need for further revascularisation while improving symptomatic responses. Nevertheless, the meta-analysis reinforces contemporary guideline advice for optimal medical treatment as the initial treatment for stable angina.5 Whether this will change current practice remains to be seen, but early signs are not encouraging. Thus a US registry analysis of patients undergoing PCI before (n=173416) and after (n=293 795) the COURAGE report showed no change in the proportions receiving optimal medical treatment (43.5% vs 44.7%). 6 PCI versus coronary bypass surgery

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Short-term effects of transcatheter aortic valve implantation on neurohormonal activation, quality of life and 6-minute walk test in severe and symptomatic aortic stenosis

Cited by 98 publications

References 23 publications

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

Simultaneously Successful Transfemoral Aortic Valve Implantation and Endovascular Repair of Thoracic Aortic Saccular Aneurysm

Almanac 2012: interventional cardiology

Almanac 2012: Cardiovascular risk scores: The national society journals present selected research that has driven recent advances in clinical cardiology

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