Transcatheter versus surgical aortic valve replacement in patients with non-high surgical risk severe aortic stenosis: A systematic review

Enezate, Tariq; Kumar, Arun; Fadel, Mazen Abu; Patel, Mitul S.; Dadah, Ashraf Al; Omran, Jad

doi:10.1016/j.carrev.2017.02.009

Cited by 6 publications

(3 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ORIGInAL PAPER low-and medium-risk patients [6]. The most dangerous life-threatening TAVR complications include acute kidney failure, myocardial infarction and vascular complications requiring transfusions of red blood cells [7]. However, the enthusiasm for the transcatheter method in low-and medium-risk patients was damped by the PARTnER II study results [8].…”

Section: General Anaesthesia or Sedation For Percutaneous Aortic Valve Implantation? The Questionnaire Results And Authors' Experiencementioning

confidence: 99%

General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience

Kucewicz‐Czech

Machej

Kiermasz

et al. 2020

kitp

View full text Add to dashboard Cite

Introduction Over the last two decades transcatheter aortic valve replacement (TAVR) has been approved for clinical use. The anaesthetic choice for this procedure is evolving. General anaesthesia was the predominant anaesthetic technique. Growing experience and advances in technology and economic considerations have led to an increasing interest in performing TAVR under monitored sedation. Aim The assessment of monitored sedation, called cooperative sedation, involves pharmacologically mediated suppression of consciousness and preservation of verbal contact in response to stimulation as a safe method of anaesthesia for TAVR. Material and methods Sixty out of 63 TAVR patients with femoral access received monitored sedation. Dexmedetomidine was administered in most of such cases (46 patients). A questionnaire was also carried out by staff involved in performing TAVR procedures, with more than 5 years of experience in it, concerning the method of anaesthesia and perioperative care. Results Conversion to general anaesthesia was required in 10% of patients (6 cases), only one as a patient-related complication (hypercarbia). The questionnaire carried out showed that anaesthesia and postoperative care after TAVR are underestimated. Conclusions The preliminary results regarding anaesthetic management in TAVR procedures demonstrate that monitored sedation is safe, provided that contraindications are observed.

show abstract

Section: General Anaesthesia or Sedation For Percutaneous Aortic Valve Implantation? The Questionnaire Results And Authors' Experiencementioning

confidence: 99%

General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience

Kucewicz‐Czech

Machej

Kiermasz

et al. 2020

kitp

View full text Add to dashboard Cite

show abstract

“…Hence, AVR remains the definitive treatment for severe symptomatic AS [6]. Before the advent of transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation, in 2002, the standard treatment for severe AS was surgical aortic valve replacement (SAVR) [7]. With the development of TAVR, the choice of treatment now depends primarily on surgical risk.…”

Section: Introductionmentioning

confidence: 99%

Aortic Stenosis and Aortic Valve Replacement among Patients with Chronic Kidney Disease: A Narrative Review

Rivera

Jesselyn

et al. 2023

Cardiorenal Med

View full text Add to dashboard Cite

Background: Aortic stenosis (AS) can present with dyspnea, angina, syncope, and palpitations and this presents a diagnostic challenge as chronic kidney disease (CKD) and other commonly found comorbid conditions may present similarly. While medical optimization is an important aspect in management, aortic valve replacement (AVR) by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR) is the definitive treatment. Patients with concomitant CKD and AS require special consideration as it is known that CKD is associated with progression of AS and poor long-term outcomes. Aims and objectives: To summarize and review current existing literature on patients with both CKD and AS regarding disease progression, dialysis method, surgical intervention, and post operative outcomes. Conclusion: The incidence of aortic stenosis increases with age but has also been independently associated with chronic kidney disease and furthermore with hemodialysis. Regular dialysis with hemodialysis vs. peritoneal dialysis and female gender have been associated with progression of AS. Management of aortic stenosis is multidisciplinary and requires planning and interventions by the “Heart-Kidney Team” to decrease risk of further inducing kidney injury among high-risk population. Both TAVR and SAVR are effective interventions for patients with severe symptomatic AS, but TAVR has been associated with better short-term renal and cardiovascular outcomes. Implications for practice: Special consideration must be taken in patients with both CKD and AS. The choice of whether to undergo hemodialysis (HD) vs. peritoneal dialysis (PD) among patients with CKD is multifactorial but studies have shown benefit regarding AS progression among those who undergo PD. The choice regarding AVR approach is likewise the same. TAVR has been associated with decreased complications among CKD patients, but the decision is multifactorial and requires a comprehensive discussion with the Heart-Kidney Team as many other factors play a role in the decision including preference, prognosis, and other risk factors.

show abstract

“…Transcatheter aortic valve replacement (TAVR) is a revolutionary, relatively new catheter-based technique for treating patients with severe aortic stenosis who are at high risk for a surgical aortic valve replacement [ 1 ]. In addition, recent studies have also suggested the potential use of TAVR for patients at intermediate [ 2 , 3 ] and low risk [ 4 ], as well as for a subset of patients whose aortic stenosis was more technically challenging to repair surgically [ 5 , 6 ]. Although TAVR is considered less invasive than surgical repair, patients undergoing TAVR usually have more comorbidities [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

The association between renal recovery after acute kidney injury and long-term mortality after transcatheter aortic valve replacement

et al. 2017

View full text Add to dashboard Cite

BackgroundThis study aimed to examine the association between renal recovery status at hospital discharge after acute kidney injury (AKI) and long-term mortality following transcatheter aortic valve replacement (TAVR).MethodsWe screened all adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary referral medical center from January 1, 2008, through June 30, 2014. An AKI was defined as an increase in serum creatinine level of 0.3 mg/dL or a relative increase of 50% from baseline. Renal outcome at the time of discharge was evaluated by comparing the discharge serum creatinine level to the baseline level. Complete renal recovery was defined as no AKI at discharge, whereas partial renal recovery was defined as AKI without a need for renal replacement therapy at discharge. No renal recovery was defined as a need for renal replacement therapy at discharge.ResultsThe study included 374 patients. Ninty-eight (26%) patients developed AKI during hospitalization: 55 (56%) had complete recovery; 39 (40%), partial recovery; and 4 (4%), no recovery. AKI development was significantly associated with increased risk of 2-year mortality (hazard ratio [HR], 2.20 [95% CI, 1.37–3.49]). For patients with AKI, the 2-year mortality rate for complete recovery was 34%; for partial recovery, 43%; and for no recovery, 75%; compared with 20% for patients without AKI (P < .001). In adjusted analysis, complete recovery (HR, 1.87 [95% CI, 1.03–3.23]); partial recovery (HR, 2.65 [95% CI, 1.40–4.71]) and no recovery (HR, 10.95 [95% CI, 2.59–31.49]) after AKI vs no AKI were significantly associated with increased risk of 2-year mortality.ConclusionThe mortality rate increased for all patients with AKI undergoing TAVR. A reverse correlation existed for progressively higher risk of death and the extent of AKI recovery.

show abstract

Transcatheter versus surgical aortic valve replacement in patients with non-high surgical risk severe aortic stenosis: A systematic review

Cited by 6 publications

References 24 publications

General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience

General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience

Aortic Stenosis and Aortic Valve Replacement among Patients with Chronic Kidney Disease: A Narrative Review

The association between renal recovery after acute kidney injury and long-term mortality after transcatheter aortic valve replacement

Contact Info

Product

Resources

About