Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis in High-Risk Patients Using the Second- and Current Third-Generation Self-Expanding CoreValve Prosthesis

Grube, Eberhard; Schuler, Gerhard; Buellesfeld, Lutz; Gerckens, Ulrich; Linke, Axel; Wenaweser, Peter; Sauren, Barthel; Mohr, Friedrich–Wilhelm; Walther, Thomas; Zickmann, B.; Iversen, Stein; Felderhoff, Thomas; Cartier, Raymond; Bonan, Raoul

doi:10.1016/j.jacc.2007.04.047

Cited by 884 publications

(426 citation statements)

References 19 publications

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“…The devices used int hi sst ud yan dth eT A V Rp r o c e d ur eh av ebe e np r eviously described (12)(13)(14).T h eb a l l o o n -e x p a n d a b l e valve used in this trial (Edwards SAPIEN XT; Edwards Lifesciences, Irvine, California) is a cylindrical cobalt-chromium stent into which 3 leaflets made of bovine pericardium are mounted, whereas the self- STUDY ENDPOINTS. The pre-specified primary endpoint of the CHOICE trial was "device success," as defined by the first Valve Academic Research Consortium (VARC) consensus document (15) and has been previously reported (12).A l lp a t i e n t sw e r e followed-up for at least 1 year and had clinical visits and echocardiographic evaluations at 6 months and 1 year.…”

Section: Methodsmentioning

confidence: 99%

1-Year Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves

Abdel‐Wahab

Neumann

Mehilli³

et al. 2015

Journal of the American College of Cardiology

142

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Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. 1-Year Outcomes After

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Section: Methodsmentioning

confidence: 99%

1-Year Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves

Abdel‐Wahab

Neumann

Mehilli³

et al. 2015

Journal of the American College of Cardiology

142

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“…Atualmente cerca de 25 mil pacientes já foram tratados com esse dispositivo no mundo e a experiência acumulada com o emprego dessas biopróteses em pacientes com contraindicação ou com alto risco cirúrgico indica que os resultados são bastante promissores. [7][8][9][10][11][12] Recentemente, iniciou-se a experiência com o sistema CoreValve TM no Brasil, 13,14 que motivou a criação de um registro nacional para aferir os resultados do implante percutâneo de biopróteses aórticas em nosso meio.…”

Section: Key-wordsunclassified

“…Nesse grupo, a abordagem por cateter tem elevada chance de sucesso e pode oferecer mortalidade inferior àquela esperada com o tratamento cirúrgico. 7,[10][11][12]15 O risco cirúrgico pode ser estimado por diversos escores. Os mais empregados são o EuroSCORE 16 e o STS 17 , validados em centros europeus e americanos, respectivamente.…”

Section: Seleção De Pacientesunclassified

Racional e desenho do registro brasileiro de implante de bioprótese aórtica por cateter

Júnior¹,

Siqueira²,

Sarmento‐Leite³

et al. 2011

Rev. Bras. Cardiol. Invasiva

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RESUMOIntrodução: A substituição cirúrgica da valva aórtica é o tratamento de eleição para pacientes com estenose aórtica acentuada. Entretanto, o risco cirúrgico aumenta expressivamente com o avançar da idade e com a associação de comorbidades. Recentemente, iniciou-se a experiência com o implante por cateter de biopróteses aórticas no Brasil. Justifica-se, portanto, a criação de um registro nacional para conhecimento dos resultados desse tipo de procedimento em nosso meio. Descrevemos o racional e o desenho do Registro Brasileiro de Implante de Bioprótese Aórtica por Cateter. Métodos: Trata-se de um registro multicêntrico, prospectivo, que incluirá 200 pacientes portadores de estenose valvar aórtica sintomática de alto risco cirúrgico submetidos a implante por cateter de bioprótese valvular aórtica em centros brasileiros. O desfecho primário do estudo é a mortalidade por qualquer causa aos 30 dias, 12 meses e 24 meses. Os desfechos secundários avaliados incluem, entre outros: 1) sucesso técnico do implante da bioprótese; 2) mortalidade cardiovascular aos 30 dias, 12 meses e 24 meses; 3) desfecho combinado de segurança aos 30 dias; e 4) desfecho combinado de eficácia aos 12 meses e 24 meses. Conclusões: A análise dos resultados desse registro ABSTRACT Rationale and Design of the Brazilian TranscatheterAortic Valve Implantation Registry

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“…A self-expanding prosthetic valve can be deployed percutaneously via a retrograde approach in approximately 84-93% of patients. When successfully implanted, it increases aortic valve area, reduces transvalvular gradients, and improves New York Heart Association functional class, but major adverse cardiac events occurred in as many as 32% of patients at short term follow-up, which included death in 20% [10][11][12]. The largest trial to date which included 86 patients reported a procedural mortality of 6%, a 30-day mortality of 12%, and a cumulative incidence of death, stroke, and myocardial infarction of 22% [12].…”

Section: Discussionmentioning

confidence: 99%

“…When successfully implanted, it increases aortic valve area, reduces transvalvular gradients, and improves New York Heart Association functional class, but major adverse cardiac events occurred in as many as 32% of patients at short term follow-up, which included death in 20% [10][11][12]. The largest trial to date which included 86 patients reported a procedural mortality of 6%, a 30-day mortality of 12%, and a cumulative incidence of death, stroke, and myocardial infarction of 22% [12]. Percutaneous AVR is also limited by bleeding (24%) and paravalular leakage (48%) and might be less successful in the setting of a bicuspid aortic valve [13].…”

Section: Discussionmentioning

confidence: 99%

Palliative Combined Percutaneous Balloon Aortic Valvuloplasty and Unprotected Left Main Stenting in End Stage Renal Disease

Dorfman¹,

Aqel²

2009

CCR

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Abstract:With the aging population and high prevalence of atherosclerosis, an increasing number of patients presenting with heart failure and angina are found to have severe coronary artery disease and severe valvular disease. These patients tend to have multiple co-morbidities such as end stage renal disease and are considered high-risk for surgery. In patients with severe coronary artery disease, severe aortic stenosis, and heart failure with depressed left ventricular systolic function, the options are limited as they are not usually offered surgery, but palliative percutaneous high-risk procedures might be a viable alternative.Though long term results after balloon aortic valvuolpasty are not promising, there is a role for these procedures in highrisk inoperable patients for either palliation or as a bridge to surgery. Unprotected left main percutaneous interventions are also feasible with low complication rates. This review provides mounting evidence that it is reasonable to perform combined palliative balloon aortic valvuolpasty and high-risk coronary artery stenting in certain inoperable patients. An illustrative case is presented that extends the findings of the current literature and demonstrates that combined balloon aortic valvuolpasty and left main stenting could be a safe and effective alternative in the setting of heart failure, left ventricular dysfunction, and end stage renal disease.Keywords: Aortic stenosis, critical left main disease, percutaneous balloon aortic valvuoplasty, unprotected left main stenting, palliative high risk percutaneous interventions. CASE REPORTA 56 year-old African American female with end stage renal disease on hemodialysis was admitted for worsening dsypnea and exertional chest pain. Her shortness of breath had begun 1-2 years ago but had progressed rapidly over the past few months. Presently she has dyspnea on exertion with minimal activity, severe orthopnea, paroxysmal nocturnal dyspnea, and marked peripheral edema and was considered to be in New York Heart Association class IV heart failure.Past medical history was notable for congestive heart failure with preserved left ventricular (LV) function, end stage renal disease on hemodialysis, systemic arterial hypertension, and diabetes type 2. On admission the patient was on a beta blocker, ace inhibitor, non-dihydropyridine calcium channel blocker, hydralazine, a statin, and aspirin.She was afebrile with a heart rate of 94 beats/min, blood pressure 148/75 mm Hg, and a respiratory rate 28 breaths/min with 94% oxygen saturation on room air. Her exam was otherwise notable for jugular venous pressure at about 13 cm H 2 0, delayed carotid upstrokes, and bibasilar crackles. Cardiac exam was notable for a normal S1 and a soft P2, a focal, non-displaced point of maximal impulse with no lifts, heaves, or thrills, and a III/VI systolic ejection murmur that peaked late in systole and was audible at the Transthoracic echocardiography revealed a LV ejection fraction of 35%, preserved right ventricular function, mild mitral regurgit...

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Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis in High-Risk Patients Using the Second- and Current Third-Generation Self-Expanding CoreValve Prosthesis

Abstract: Treatment of severe aortic valve stenosis in high-risk patients with percutaneous implantation of the CoreValve prosthesis is feasible and associated with a lower mortality rate than predicted by risk algorithms.

Cited by 884 publications

References 19 publications

1-Year Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves

1-Year Outcomes After Transcatheter Aortic Valve Replacement With Balloon-Expandable Versus Self-Expandable Valves

Racional e desenho do registro brasileiro de implante de bioprótese aórtica por cateter

Palliative Combined Percutaneous Balloon Aortic Valvuloplasty and Unprotected Left Main Stenting in End Stage Renal Disease

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