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Early TAVR trial : Too early to call

Dr. S. Venkatesan MD

While the numbers increase, still the debate between SAVR and TAVR is riddled with speculation, skepticism, and absolute confidence. Expected to improve with polymer valves) The latest trial to join the litereture is EARLY TAVR in October 2024 Here is a brief, personal comment about the paper for non-academic consumption.

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New Late-breaking Data from Medtronic Evolut Low Risk Trial Demonstrate Strong Clinical and Cost-effectiveness Benefits of TAVR Platform

DAIC

A cost-effectiveness analysis demonstrates the positive economic value of transcatheter aortic valve replacement (TAVR) using Evolut TAVR compared to surgical aortic valve replacement (SAVR) for low-risk patients. The findings showed a strong economic benefit of Evolut TAVR for low-risk patients from a U.S.

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Transcarotid Versus Surgical Aortic Valve Replacement for the Treatment of Severe Aortic Stenosis

Circulation: Cardiovascular Interventions

Transcarotid transcatheter aortic valve replacement (TC-TAVR) has emerged as an alternative access in suboptimal transfemoral candidates, but no data exist comparing TC-TAVR and SAVR. At 30 days, the SAVR group showed a higher rate of the primary composite outcome compared with the TC-TAVR group (12.6% andP=0.001, respectively).

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Modified percutaneous coronary intervention-derived risk models (PARIS and CREDO-Kyoto integer scoring systems) applied to Japanese transcatheter aortic valve replacement patients

Open Heart

Objective Postprocedural ischaemic and bleeding risks after transcatheter aortic valve replacement (TAVR) remain a major concern. We aimed to assess the accuracy of percutaneous coronary intervention (PCI)-derived models and the performance of a recalibrated model that included variables more applicable to TAVR.

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Rationale and Design of the CREATE Trial: A Multicenter, Randomized Comparison of Continuation or Cessation of Single Antithrombotic Therapy at 1 Year After Transcatheter Aortic Valve Replacement

Journal of the American Heart Association

The primary efficacy end point is the incidence of bleeding events, defined by the VARC3 (Valve Academic Research Consortium3) criteria, at 1year postrandomization. The primary safety end point is a composite of cardiac death, myocardial infarction, and ischemic stroke at 1 year.

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Highlights of ACC 2024

Cardiology Update

SMART 4 ( NCT04722250 ) studied patients with severe aortic stenosis and a small aortic annulus who underwent transcatheter aortic valve replacement (TAVR). A total of 716 patients underwent TAVR with either a self-expanding supraannular valve or a balloon-expandable valve. vs. 6.2%) and stroke (2.9% vs. 4.7%) compared to SAVR.

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