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Transcatheter aortic valve replacement (TAVR) is the standard treatment for severe aortic stenosis, but post-TAVR leaflet thrombus, identified by hypoattenuated leaflet thickening (HALT), poses potential risks like cerebral thromboembolic events. Original article: Choi Y et al. Perivalvular thrombus has also been reported.
The optimal management of concomitant chronic obstructive coronary artery disease (CAD) in transcatheter aortic valve replacement (TAVR) recipients remains a debated topic. While some advocate for pre-TAVR percutaneous coronary intervention, others adopt an expectant approach. Original article: Persits I et al.
Patients with severe aortic stenosis who were treated with either TAVR or surgery had comparable rates of all-cause mortality or disabling stroke at five years, according to research presented during a Late-Breaking Clinical Trial session at ACC.25 25 in Chicago and simultaneously published in JACC.
The Heart Valve Collaboratory has proposed a framework to standardize best practices for using multimodality imaging in transcatheter valve failure (TVF) following transcatheter aortic valve replacement (TAVR), in a State-of-the-Art Review.
What is the 5-year incidence of valve reintervention after self-expanding CoreValve/Evolut transcatheter aortic valve replacement (TAVR) versus surgical aortic valve replacement (SAVR)?
Among patients with aortic regurgitation (AR) undergoing TAVR with the Trilogy valve, the rate of mortality at one year was 8.1%, significantly lower than the prespecified goal of 25% to show noninferiority, according to a study presented during a Late-Breaking Clinical Trial session at ACC.25 25 in Chicago.
The goal of the EARLY TAVR trial was to evaluate transcatheter aortic valve replacement (TAVR) compared with clinical surveillance among patients with asymptomatic severe aortic stenosis (stage C aortic stenosis).
Two studies analyzing data from the STS/ACC TVT Registry exploring out-of-hospital 30-day mortality after mitral transcatheter edge-to-edge repair (TEER) and one-year cause-specific mortality after TAVR were published in JACC: Cardiovascular Interventions on March 19.
What are the national trends in utilization of leadless pacemaker implantation following transcatheter aortic valve replacement (TAVR) and its performance compared with transvenous pacemakers?
While the main PROTECTED TAVR trial found no significant differences in stroke rates when cerebral embolic protection (CEP) was used during TAVR compared with TAVR alone, a post hoc analysis of the trial presented during TCT 2024 and simultaneously published in JAMA Cardiology, suggests there may be potential benefits associated with CEP use based (..)
In light of the growing number of patients undergoing transcatheter aortic valve replacement (TAVR), there is an increasing demand for data regarding the management of failed TAVR procedures, including the possibility of a repeat TAVR intervention. vs. 3.5%, p=0.80) between the redo-TAVR and native-TAVR populations.
A State-of-the-Art review published in JACC: Cardiovascular Interventions covers the epidemiology, clinical implications, risk factors and preventive strategies for new-onset conduction disturbances (CDs) and the need for permanent pacemaker implantation (PPI) after TAVR, which the authors note are a limitation of this therapy.
What are outcomes among patients younger than 65 years who received transcatheter aortic valve replacement (TAVR) using a balloon-expandable valve compared to patients aged 65-80 years?
Despite decreasing rates of permanent pacemaker implantation (PPI) after TAVR, substantial site-level variation persists, suggesting the need for quality improvement initiatives like replicating best practices from high-performing sites and increased guideline-based education, according to a recent study published in JACC: Cardiovascular Interventions. (..)
Does measured or predicted prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) affect all-cause mortality at 2 years?
What is the effect of the time interval between transcatheter aortic valve replacement (TAVR) and noncardiac surgery (NCS) (Δt) on the perioperative risk of major adverse events (MAEs)?
What are the hemodynamic and clinical outcomes after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) among patients with severe aortic stenosis (AS) and a small aortic annulus?
What is the relationship between diffusion-weighted magnetic resonance imaging (DW-MRI) total lesion number (TLN), individual lesion volume (ILV), and total lesion volume (TLV) with clinical stroke outcomes after transcatheter aortic valve replacement (TAVR)?
TAVR was found to bring no increased risks and was associated with substantially decreased rates of death or stroke at one year in low-risk patients, compared with surgical aortic valve replacement (SAVR), according to results from the DEDICATE-DZHK6 study presented during a Late-Breaking Clinical Trial session at ACC.24
Two separate late-breaking clinical trials – EARLY TAVR and EVOLVED – presented at TCT 2024 explore whether early aortic valve intervention improves outcomes in patients with asymptomatic aortic stenosis (AS).
How do mortality and morbidity compare after valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) versus redo surgical aortic valve replacement (SAVR) for intervention for a failed bioprosthetic SAVR?
Among patients undergoing transcatheter aortic valve replacement (TAVR) with a balloon-expandable valve (BEV), what are the 3-year clinical outcomes associated with a small (20 mm) compared to a larger (≥23 mm) device, and is there a relationship between the discharge echocardiographic (echo) mean gradient (MG) and measured or predicted thresholds (..)
Patients with moderate or severe tricuspid regurgitation (TR) prior to undergoing TAVR or mitral transcatheter edge-to-edge repair (TEER), when compared to patients with no or mild TR, were associated with worse health status and clinical outcomes, according to a study published in JACC: Cardiovascular Interventions.
What are the contemporary characteristics, trends, and outcomes of intravascular lithotripsy (IVL)-assisted transfemoral (TF) transcatheter aortic valve replacement (TAVR) in the United States?
The supra-annular self-expanding Evolut PRO/PRO+/FX TAVR device was found to be superior for valve function and noninferior for clinical outcomes at one year compared to the balloon-expandable SAPIEN 3/3 Ultra TAVR device, according to the results of the SMART trial, presented during a Late-Breaking Clinical Trial Session at ACC.24
Self-expanding valves (SEVs) are associated with less prosthesis-patient mismatch (PPM) in East Asian patients with small aortic annuli (SAA) undergoing TAVR, compared with balloon-expandable valves (BEVs).
Is there a relationship between site-level volumes and outcomes for transcatheter aortic valve replacement (TAVR) and mitral transcatheter edge-to-edge repair (MTEER)?
In women with symptomatic, severe aortic stenosis (AS), TAVR with the balloon-expandable valve was superior to surgical aortic valve replacement in terms of the composite rate of death, stroke and rehospitalization at one-year follow-up, according to a pooled analysis of patient-level data from RHEIA and PARTNER 3 trials presented at TCT 2024.
Transcatheter aortic valve replacement (TAVR) is a relatively new treatment method for aortic stenosis (AS) and has been demonstrated to be suitable for patients with varying risk levels.
Subclinical leaflet thrombosis (SLT) has raised concerns about the long-term durability and outcomes of transcatheter aortic valve replacement (TAVR). Clinical valve thrombosis (CVT) is a rare complication after TAVR with an incidence of 0.62.8%
What are the rates of a permanent pacemaker (PPM) implantation, the predictors of needing a PPM, and long-term clinical outcomes of the third-generation balloon-expandable SAPIEN 3 (S3) transcatheter heart valve (THV)?
Widely recognized for pioneering innovative concepts and techniques in TAVR, Tang has set contemporary standards in the field. His research centers on the comprehensive management of patients post-TAVR, transcatheter mitral and tricuspid valve interventions, and advanced imaging techniques in structural heart disease.
Patients younger than 65 years who received balloon-expandable valve TAVR for severe aortic stenosis during the low-surgical risk era were more likely to have comorbidities and exhibited higher rates of death and readmission at one year vs. patients aged 65 to 80 years, according to a study presented at TCT 2024 and simultaneously published in JAMA (..)
The goal of the ALIGN-AR trial was to evaluate the efficacy and safety of the JenaValve Trilogy transcatheter heart valve in patients with symptomatic, greater-than-moderate native aortic regurgitation who were deemed high risk for surgery by heart teams.
The presence of cardiac amyloidosis negatively affects the outcome of patients with aortic stenosis, these patients undergo transcatheter aortic valve replacement (TAVR) with increasing frequency and have a significantly higher overall mortality rate than patients with aortic stenosis alone.
The following are key points to remember from a state-of-the-art guide to transcatheter aortic valve (TAV) design and systematic planning for a redo-TAV (TAV-in-TAV) procedure.
Risk-adjusted 30-day mortality after TAVR increased modestly from January 2019 to March 2022 in the U.S., according to an observational cohort study published in JAMA Cardiology. Exploratory analyses were unable to find any site-related, patient-related or process-related factors that explain these findings.
He then explores the prognostic ability of diffusion-weighted brain MRI lesions after TAVR. Eagle looks at the kidney and cardiovascular effectiveness of SGLT2 inhibitors versus GLP-1 receptor agonists in type 2 diabetes.
In this week’s View, Dr. Eagle looks at post-capillary pulmonary hypertension in heart failure and the revised European guideline definition. He then explores obesity in adolescents and its impact on our societal health.
In this week's View, Dr. Eagle looks at secular trends of incidence and outcomes in severe aortic stenosis. He then examines titration of medications after acute heart failure.
The EARLY TAVR trial results demonstrate that early transcatheter aortic valve implantation in patients with asymptomatic severe aortic stenosis is superior to clinical surveillance in significantly reducing the composite primary outcome of death, stroke, or unplanned hospitalization for cardiovascular causes.
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