Pathways Towards Lean TAVR

Wiechen, Maarten P. van; Ooms, Joris F.; Hokken, Thijmen W.; Ronde-Tillmans, Marjo J. De; Goudzwaard, Jeannette A.; Daemen, Joost; Jaegere, Peter P. de; Mattace‐Raso, Francesco; Mieghem, Nicolas Van

doi:10.1080/24748706.2020.1765056

Cited by 3 publications

(7 citation statements)

References 31 publications

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“…All the proposed recommendations are integrated into a contemporary lean TAVI clinical pathway. 44 , 45 …”

Section: Proposed Sex‐oriented Tavi Managementmentioning

confidence: 99%

“… 77 The use of the dicrotic notch index to assess for paravalvular leak avoiding left ventricle measurements is currently under investigation. 44 …”

Section: Proposed Sex‐oriented Tavi Managementmentioning

confidence: 99%

“…Contemporary TAVI programs have to streamline postprocedural care and discharge policy, with no distinction between sexes. 44 , 45 However, in light of the greater simplification of the TAVI procedure and shortened length of hospital stays, specific attention should be paid to the risk of complications as well as to a tailored pharmacotherapy in female patients.…”

Section: Postprocedural Managementmentioning

confidence: 99%

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Sex‐Specific Considerations in Degenerative Aortic Stenosis for Female‐Tailored Transfemoral Aortic Valve Implantation Management

Masiero

Paradies

Franzone³

et al. 2022

JAHA

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The impact of sex on pathophysiological processes, clinical presentation, treatment options, as well as outcomes of degenerative aortic stenosis remain poorly understood. Female patients are well represented in transfemoral aortic valve implantation (TAVI) trials and appear to derive favorable outcomes with TAVI. However, higher incidences of major bleeding, vascular complications, and stroke have been reported in women following TAVI. The anatomical characteristics and pathophysiological features of aortic stenosis in women might guide a tailored planning of the percutaneous approach. We highlight whether a sex‐based TAVI management strategy might impact on clinical outcomes. This review aimed to evaluate the impact of sex from diagnosis to treatment of degenerative aortic stenosis, discussing the latest evidence on epidemiology, pathophysiology, clinical presentation, therapeutic options, and outcomes. Furthermore, we focused on technical sex‐oriented considerations in TAVI including the preprocedural screening, device selection, implantation strategy, and postprocedural management.

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“…All the proposed recommendations are integrated into a contemporary lean TAVI clinical pathway. 44 , 45 …”

Section: Proposed Sex‐oriented Tavi Managementmentioning

confidence: 99%

“… 77 The use of the dicrotic notch index to assess for paravalvular leak avoiding left ventricle measurements is currently under investigation. 44 …”

Section: Proposed Sex‐oriented Tavi Managementmentioning

confidence: 99%

Section: Postprocedural Managementmentioning

confidence: 99%

See 1 more Smart Citation

Sex‐Specific Considerations in Degenerative Aortic Stenosis for Female‐Tailored Transfemoral Aortic Valve Implantation Management

Masiero

Paradies

Franzone³

et al. 2022

JAHA

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“…It was the stepping stone for further simplification of TAVI to a minimalist approach mimicking PCI [17]. Moreover, TF-TAVI is now possible via a two-arterial access only (femoral artery for valve delivery and pacing over the wire, contralateral femoral or radial for pig-tale guidance) [18]. In case of TAVI for failed bioprosthesis, single access (femoral) suffices as the radiopaque structures of the bioprosthesis can be used as reference for valve deployment.…”

Section: Tavi In the Netherlandsmentioning

confidence: 99%

“…5). In conjunction with the experience gained and improved catheter and valve Total number of publications (n) per year are subdivided by the journal Impact Factor (2019) using the following categories: ≥15, 10-15 and 0-10 technology, a program of early discharge was instituted [18][19][20][21]. The Netherlands also played an important role in the adoption and evaluation of the use of cerebral protection devices for the prevention of perioperative stroke [22].…”

Section: Tavi In the Netherlandsmentioning

confidence: 99%

The history of transcatheter aortic valve implantation: The role and contribution of an early believer and adopter, the Netherlands

et al. 2020

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Outcomes of Transcatheter Aortic Valve Replacement in the United Arab Emirates: Real-world, Single-centre Experience from an Emerging Programme

Edris¹,

Manla²,

Badarin³

et al. 2023

Interv Cardiol

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Background: Data on outcomes of transcatheter aortic valve replacement (TAVR) in the Middle East, particularly in the United Arab Emirates (UAE), are limited. Whether centres with a low volume of patients requiring the procedure can achieve similar outcomes as those reported in pivotal clinical trials remains unclear. This study evaluates procedural outcomes of patients undergoing TAVR in a newly established programme in the UAE. Methods: Procedural outcomes of consecutive patients who underwent transfemoral TAVR at a single centre in the UAE between January 2016 and November 2021 were compared with those at centres in the lowest quartile (Q1) of procedural volume in the Transcatheter Valve Therapy Registry, which covers centres in the US. Results: Among the 183 patients included in the study, the median age was 76 years (interquartile range [IQR] 71–82), and 42.1% of patients were women, with a median Society of Thoracic Surgeons predicted risk of mortality score of 4.6 (IQR 2.9–7.5). Most of the patients (93.3%) received a balloon expandable valve. All-cause death within 30 days, stroke and major vascular complications occurred in 0.6%, 0.6% and 2.2% of patients, respectively, compared with 3.1%, 2.2% and 4% in patients treated at Q1 hospitals. Conclusion: Patients undergoing transfemoral TAVR at an emerging centre in the Middle East had favourable outcomes compared with those performed at Q1 hospitals in the US. These findings suggest that careful patient selection for TAVR is critical and may help optimise patient outcomes, especially when procedural volumes are low.

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Pathways Towards Lean TAVR

Cited by 3 publications

References 31 publications

Sex‐Specific Considerations in Degenerative Aortic Stenosis for Female‐Tailored Transfemoral Aortic Valve Implantation Management

Sex‐Specific Considerations in Degenerative Aortic Stenosis for Female‐Tailored Transfemoral Aortic Valve Implantation Management

The history of transcatheter aortic valve implantation: The role and contribution of an early believer and adopter, the Netherlands

Outcomes of Transcatheter Aortic Valve Replacement in the United Arab Emirates: Real-world, Single-centre Experience from an Emerging Programme

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