Current Key Issues in Transcatheter Aortic Valve Replacement Undergoing a Paradigm Shift

Hwang, Ingyu; Hayashida, Kentaro; Kim, Hyo Soo

doi:10.1253/circj.cj-19-0096

Cited by 7 publications

(6 citation statements)

References 51 publications

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“…Furthermore, indications for TAVI instead of open valve replacement have expanded to encompass patients classified as intermediate risk for open surgery, with recent calls for the low risk cohort to be considered as well. 2 The authors' rate of major vascular complications (3.38%) compares favourably with early studies and with the more recent PARTNER 2 trial, which reported a 7.9% incidence of major VCs at 30 days. 3 They attribute these excellent results to their multidisciplinary approach and the involvement of vascular surgeons in planning intervention, though the specific role played or how this altered management is not examined in their analysis.…”

supporting

confidence: 60%

TAVI and the Vascular Surgeon

Manning

2019

European Journal of Vascular and Endovascular Surgery

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supporting

confidence: 60%

TAVI and the Vascular Surgeon

Manning

2019

European Journal of Vascular and Endovascular Surgery

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“…With the increasing popularity and success of TAVR for the treatment of symptomatic aortic valve stenosis, 5 , 6 , 7 off-label uses of TAVR for the treatment of other valvular diseases such as native aortic valve regurgitation (NAVR) are becoming more common. 5 In fact, TAVR for NAVR showed adequate results in high-risk patients 8 and the Trilogy Valve System (JenaValve Technology) was approved for the treatment of severe NAVR in Europe, 9 although the use of the latter was contraindicated in our patient because of the dilated ascending aorta.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Aortic Valve Replacement in a Patient With Criss-Cross Heart

Lewin

Praet²,

Nersesian³

et al. 2022

JACC: Case Reports

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“…Although new PPM insertion post TAVR has not been definitely showed to impact short term mortality it seems to have unfavorable effects on left ventricular function (15)(16)(17) with the need for pacing increasing the risk of heart failure and late-mortality (18). The higher risk of PPM at implantation with TAVR in low-intermediate risk patients is an important finding especially as TAVR indication if expanded to younger, lower risk populations who are more likely to have a higher life expectancy, highlighting the need for longer-term follow-up in this population.…”

Section: Discussionmentioning

confidence: 99%

Comparison of surgical versus transcatheter aortic valve replacement for patients with aortic stenosis at low-intermediate risk

Khan¹,

Kayani²,

Manan³

et al. 2020

Cardiovasc Diagn Ther

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Background: To compare safety and efficacy of transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) in patients at low-intermediate risk, given the paucity of robust data. Methods:We performed an aggregate data meta-analysis of 7 randomized controlled trials (RCTs) and 6,778 patients comparing TAVR with SAVR for aortic stenosis (AS) in low-intermediate risk patients (Society of Thoracic Surgeons risk-score ≤8%) using the random-effects model. Primary outcome was allcause mortality at 30-day, 1-year and 2-year of follow-up. Secondary outcomes included cardiac-mortality, stroke, acute kidney injury (AKI), atrial fibrillation (AF), permanent pacemaker (PPM) implantation, majorbleeding, moderate-severe paravalvular regurgitation (PVR) and rehospitalization.Results: All-cause mortality, cardiac-mortality and stroke were comparable between the two groups. AF was higher with SAVR at 30-day [odds ratio (OR) 0.17, 95% confidence intervals (CI): 0.12-0.24] thorough to 2-year (OR 0.34, 95% CI: 0.21-0.55), while PPM implantation was higher with TAVR (30-day: OR 3.31, 95% CI: 1.64-6.66, 2-year: OR 3.17, 95% CI: 1.02-9.86). Moderate-severe PVR was more prevalent with TAVR at all follow-ups. On inter-group comparison, patients in the low-risk group had an even lower risk of AF, but a higher risk of PPM implantation as compared to the patients in the intermediate-risk group undergoing TAVR.Conclusions: Compared to SAVR, TAVR had comparable all-cause mortality and stroke, lower-risk of AF, but was associated with a higher risk of PPM implantation and moderate-severe PVR in low-intermediaterisk patients. Thus, highlighting the need for longer-term follow-up before robust inferences are drawn.

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Current Key Issues in Transcatheter Aortic Valve Replacement Undergoing a Paradigm Shift

Cited by 7 publications

References 51 publications

TAVI and the Vascular Surgeon

TAVI and the Vascular Surgeon

Transcatheter Aortic Valve Replacement in a Patient With Criss-Cross Heart

Comparison of surgical versus transcatheter aortic valve replacement for patients with aortic stenosis at low-intermediate risk

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