Minimalistic Contrast-Zero Aortic Valve-in-Valve Replacement Using the Novel Hydra Transcatheter Valve in a Patient with Severe Chronic Kidney Disease

Ielasi, Alfonso; Buono, Andrea; Briguglia, Daniele; Uccello, Giuseppe; Pellicano, Mariano; Medda, Massimo; Tespili, Maurizio

doi:10.1016/j.carrev.2022.08.020

Cited by 2 publications

(1 citation statement)

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“…This risk is exacerbated in elderly patients, who often have impaired renal function and multiple comorbidities. Strategies to mitigate this risk include using the minimum necessary contrast volume, using ultra-low or zero-contrast techniques, and ensuring adequate hydration and renal protection before, during, and after the procedure [ 19 ]. In addition, delaying PCI after TAVR may reduce cumulative contrast exposure and allow for better preservation of renal function, making it a potentially safer approach for treating patients with concomitant CAD and severe AR.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Coronary Intervention before or after Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Involving 1531 Patients

Caminiti,

Ielasi,

Vetta

et al. 2024

JCM

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Background: The optimal timing to perform percutaneous coronary interventions (PCIs) in patients undergoing transcatheter aortic valve replacement (TAVR) is not well established. In this meta-analysis, we aimed to compare the outcomes of patients undergoing PCI before versus after TAVR. Methods: A comprehensive literature search was performed including Medline, Embase, and Cochrane electronic databases up to 5 April 2024 for studies that compared PCI before and after TAVR reporting at least one clinical outcome of interest (PROSPERO ID: CRD42023470417). The analyzed outcomes were mortality, stroke, and myocardial infarction (MI) at follow-up. Results: A total of 3 studies involving 1531 patients (pre-TAVR PCI n = 1240; post-TAVR PCI n = 291) were included in this meta-analysis following our inclusion criteria. Mortality was higher in the pre-TAVR PCI group (OR: 2.48; 95% CI: 1.19–5.20; p = 0.02). No differences were found between PCI before and after TAVR for the risk of stroke (OR: 3.58; 95% CI: 0.70–18.15; p = 0.12) and MI (OR: 0.66; 95% CI: 0.30–1.42; p = 0.29). Conclusions: This meta-analysis showed in patients with stable CAD undergoing TAVR that PCI after TAVR is associated with lower mortality compared with PCI before TAVR.

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Section: Discussionmentioning

confidence: 99%