Meta-Analysis of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Low Surgical Risk

Vipparthy, Sharath C; Ravi, Venkatesh; Avula, Sindhu; Kambhatla, Soumyasri; Mahmood, Mobasser; Kabour, Ameer; Ali, Syed Sohail; Barzallo, Marco; Mungee, Sudhir

doi:10.1016/j.amjcard.2019.10.036

Cited by 22 publications

(20 citation statements)

References 31 publications

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“…Successful AVR is generally defined as improvement in left ventricular function after surgery (no decrease in LVEF in patients with preserved ventricular functions), decrease in previously increased left ventricular mass, improved exercise capacity, and increased life span after surgery [Vipparth 2020]. When a prosthetic valve with a small EOA compared with the patient's body size is inserted, high pressure differences may occur in the postoperative period, which may reduce the success of the surgery.…”

Section: ]Discussionmentioning

confidence: 99%

Can Moderate Patient Prosthesis Mismatch Be Tolerated in a Selected Group of Patients with Aortic Valve Replacement?

KAYA

Özgür

Hançer

et al. 2021

HSF

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Introduction: In this study, we aimed to determine the incidence of patient prosthesis mismatch (PPM) and its effects on ejection fraction (EF), gradients, and late survival. Methods: 200 patients who underwent isolated mechanical AVR between March 2013 and May 2016 were retrospectively evaluated based on patient records. Results: 200 patients were included in the study. No PPM was detected in 42 (21%) patients, moderate PPM in 122 (61%), and severe PPM in 36 (18%) patients. A significant decrease was found in all groups in terms of mean valve gradients and LVMI (preoperative LVMI compared with postoperative LVMI at the 12th month) (P < .001). A 30% decrease in mean LVMI in the no PPM and moderate PPM groups and a 20% decrease in the severe PPM group were detected at the 6th month. Conclusion: In our postoperative data, we found that EF was preserved, the transvalvular gradient reduced, and LVMI decreased. There was no difference in mortality rates between the control (no PPM) group and the moderate PPM group. Taking into account our patient groups, we can say that no-to-moderate PPM has no major effect on left ventricular remodeling in patients with preserved left ventricular functions.

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Section: ]Discussionmentioning

confidence: 99%

Can Moderate Patient Prosthesis Mismatch Be Tolerated in a Selected Group of Patients with Aortic Valve Replacement?

KAYA

Özgür

Hançer

et al. 2021

HSF

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Section: Terminologymentioning

confidence: 99%

“…In almost all cases the diagnosis is made by 2D TEE [25]. The peri-annular aortic abscess is a life-threatening condition since it may disrupt the fibrous skeleton and the atrioventricular septum, making the reconstructive procedure very complicated (Figure 3A,B) [26][27][28]. Transcatheter implantation of the aortic valve (TAVI) is now recognized as state-ofthe-art for patients with severe aortic stenosis and high risk for surgery.…”

Section: The Fibrous Component Of Vajmentioning

confidence: 99%

Multimodality Imaging of the Anatomy of the Aortic Root

Paiocchi

Faletra

Ferrari

et al. 2021

JCDD

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The aortic root has long been considered an inert unidirectional conduit between the left ventricle and the ascending aorta. In the classical definition, the aortic valve leaflets (similar to what is perceived for the atrioventricular valves) have also been considered inactive structures, and their motion was thought to be entirely passive—just driven by the fluctuations of ventricular–aortic gradients. It was not until the advent of aortic valve–sparing surgery and of transcatheter aortic valve implantation that the interest on the anatomy of the aortic root again took momentum. These new procedures require a systematic and thorough analysis of the fine anatomical details of the components of the so-called aortic valve apparatus. Although holding and dissecting cadaveric heart specimens remains an excellent method to appreciate the complex “three-dimensional” nature of the aortic root, nowadays, echocardiography, computed tomography, and cardiac magnetic resonance provide excellent images of cardiac anatomy both in two- and three-dimensional format. Indeed, modern imaging techniques depict the aortic root as it is properly situated within the thorax in an attitudinally correct cardiac orientation, showing a sort of “dynamic anatomy”, which admirably joins structure and function. Finally, they are extensively used before, during, and after percutaneous structural heart disease interventions. This review focuses on the anatomy of the aortic root as revealed by non-invasive imaging techniques.

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“…Given these favorable outcomes in intermediate-risk patients, TAVI has also recently been offered to be performed in low-risk patients. Meta-analyses including important randomized controlled trials (RCTs) have suggested that TAVI may be an efficient option for subjects at low surgical risk (7,8). However, the 2020 American College of Cardiology (ACC)/American Heart Association (AHA) Guideline has emphasized that the mean age of patients with low to moderate surgical risk included in RCTs was over 70 ,very few patients were under 65 years of age.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of structural valve deterioration and bioprosthetic valve failure utilizing the new European consensus definition in patients undergoing TAVI with first-generation devices: Outcomes beyond 5 years from a single center in Turkey

Şentürk

Dursun

Colluoglu

et al. 2021

The Anatolian Journal of Cardiology

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Objective: The long-term durability of transcatheter aortic bioprosthetic valves continues to be a major concern. Standardized criteria of the structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) have recently been defined. Limited studies have evaluated the longterm durability of transcatheter aortic valve implantation (TAVI) according to these new definitions. We aim to analyze the durability of TAVI beyond 5 years and to report the frequency of SVD and BVF. Methods: A total of 89 patients who had undergone TAVI and had theoretically completed at least 5 years after the procedure were included. Either a Medtronic CoreValve or an Edwards SAPIEN XT valve were implanted in the patients. New standardized definitions were used to evaluate SVD and BVF. Results: The mean age of the patients was 78.70±6.95 years. SVD occured in 4 (4.5%) patients during 6 years of follow-up. Severe SVD was observed in 2 patients (2.2%), and these patients had the New York Heart Association class II symptoms. Both patients with severe SVD also met the criteria of BVF. Moderate SVD was observed in 2 patients (2.2%), and these patients had no valve-related symptoms. Of the 4 SVD cases, 2 were associated with increased mean transaortic gradients, whereas the remaining 2 cases were associated with intraprosthetic aortic regurgitation. All patients with SVD are still alive, and none of them have required aortic valve reintervention. Conclusion: Although first-generation TAVI devices were used, we determined the low rate of SVD and BVF at the 6-year follow-up. It may be suggested that there is no major concern associated with TAVI even with first-generation devices regarding long-term durability.

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Meta-Analysis of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients With Low Surgical Risk

Cited by 22 publications

References 31 publications

Can Moderate Patient Prosthesis Mismatch Be Tolerated in a Selected Group of Patients with Aortic Valve Replacement?

Can Moderate Patient Prosthesis Mismatch Be Tolerated in a Selected Group of Patients with Aortic Valve Replacement?

Multimodality Imaging of the Anatomy of the Aortic Root

Evaluation of structural valve deterioration and bioprosthetic valve failure utilizing the new European consensus definition in patients undergoing TAVI with first-generation devices: Outcomes beyond 5 years from a single center in Turkey

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