Transcatheter aortic valve replacement: Historical perspectives, current evidence, and future directions

Horne, Aaron; Reineck, Elizabeth; Hasan, Rani K.; Resar, Jon R.; Chacko, Matthews

doi:10.1016/j.ahj.2014.07.017

Cited by 19 publications

(11 citation statements)

References 51 publications

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“…Considering both costs and peri-interventional complications of TAVI, we think that patients at such high risk for postinterventional death should at least be considered for conservative, that is, optimal medical, treatment, even though it is well known that patients with severe aortic stenosis have poor prognosis with mortality being as high as 50% 3 years after diagnosis [2]. Considering both costs and peri-interventional complications of TAVI, we think that patients at such high risk for postinterventional death should at least be considered for conservative, that is, optimal medical, treatment, even though it is well known that patients with severe aortic stenosis have poor prognosis with mortality being as high as 50% 3 years after diagnosis [2].…”

Section: Discussionmentioning

confidence: 99%

“…By means of the Youden index, we calculated an optimal cutoff for patients considered for TAVI: Patients above our cut-off showed significantly increased mortality after 1 year, with mortality being as high as 49%. Considering both costs and peri-interventional complications of TAVI, we think that patients at such high risk for postinterventional death should at least be considered for conservative, that is, optimal medical, treatment, even though it is well known that patients with severe aortic stenosis have poor prognosis with mortality being as high as 50% 3 years after diagnosis [2]. To optimize quality of life for those patients, further studies comparing not only mortality but also hospital admission for cardiopulmonary decompensation and NYHA stadiums for TAVI vs. conservative treatment are necessary.…”

Section: Discussionmentioning

confidence: 99%

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Soluble ST2 predicts 1‐year outcome in patients undergoing transcatheter aortic valve implantation

Wernly

Lichtenauer

Jirak

et al. 2017

Eur J Clin Investigation

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Soluble ST2 predicts 1‐year outcome in patients undergoing transcatheter aortic valve implantation

Wernly

Lichtenauer

Jirak

et al. 2017

Eur J Clin Investigation

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“…Under general anesthesia as well as medium, low-temperature cardiopulmonary bypass, 11 surgery was performed through median incision, and then cold blood cardioplegia solution was perfused through the aortic root. For the patients whose aortic valves were not fully closed, direct perfusion after incising left and right coronary arteries or retrograde perfusion through the coronary sinus was employed, during which half of the cardioplegia solution was first given and the other half was given 0.5 h later.…”

Section: Methodsmentioning

confidence: 99%

Success rates and prognosis of heart valvuloplasty and valve replacement performed for elderly patients

Liu¹,

He²,

Shi³

2015

Pak J Med Sci

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Objective:To analyze the success rates and prognosis of heart valvuloplasty and valve replacement for elderly patients, and to provide clinical evidence.Methods:A total of 1240 patients who received heart valve surgeries in our hospital from June 2004 to October 2014 were selected and retrospectively analyzed. They were divided into two groups based on age (60), and those older than 60 (Group B) suffered from rheumatic valvular heart disease and nonrheumatic valvular heart disease including degenerative valve disease. Mitral valve replacement (MVR), tricuspid valve replacement (TVR), aortic valve replacement (AVR), double valve replacement (DVR), mitral valvuloplasty (MVP) and tricuspid valvuloplasty (TVP) were performed by using bioprosthetic and mechanical valves. Before surgery, coronary angiography, coronary artery bypass grafting (CABG), left atrial thrombectomy, left atrial wall folding and radiofrequency ablation were conducted. For the patients younger than 60 (Group A) who had congenital heart disease, rheumatic valvular heart disease and valvular heart disease, MVR, AVR, DVR, MVP, TVP and closed cuspid commissurotomy were performed with bioprosthetic and mechanical valves. The two groups were then monitored.Results:The mortality rates of Group A and Group B were 2.7% (16 cases) and 3.1% (20 cases) respectively. They died mainly of malignant ventricular arrhythmias, multiple organ failure, left ventricular rupture, low cardiac output syndrome, acute renal failure, respiratory failure, upper gastrointestinal bleeding, mechanical valve failure and cerebrovascular accident. The two groups had significantly different application rates of bioprosthetic valve, times of auxiliary ventilation and hospitalization stay lengths (P<0.05), but left ventricular ejection fractions, left ventricular end-diastolic diameters (LVEDDs), mortality rates as well as times of aortic cross-clamping and cardiopulmonary bypass were similar (P>0.05). LVEDD, complicated coronary artery disease, CABG and grade of the New York Heart Association Functional Classification were independent risk factors for postoperative death.Conclusion:When heart valvuloplasty and valve replacement were performed for elderly patients, the success rate and prognosis could only be improved by optimizing preoperative preparation, shortening the times of cardiopulmonary bypass and aortic cross-clamping, and paying particular attention to myocardial protection and postoperative treatment.

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“…Morbidity and mortality rates are considerably high among patients not undergoing valve replacement. Once symptoms occur in these patients, the mortality rate is approximately 50 % over the next 3 years [4]. …”

Section: Introductionmentioning

confidence: 99%

Microparticles in patients undergoing transcatheter aortic valve implantation (TAVI)

et al. 2016

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Degenerative aortic stenosis (AS) is the most frequent form of acquired valvular heart disease. AS is known to entail endothelial dysfunction caused by increased mechanical shear stress leading to elevated circulatory levels of microparticles. Endothelial and platelet microparticles (EMP and PMP) are small vesicles that originate from activated cells and thrombocytes. We sought to evaluate whether transcatheter aortic valve implantation (TAVI) procedure would elicit effects on circulating EMP and PMP. 92 patients undergoing TAVI procedure for severe AS were included in this study. Samples were obtained at each visit before TAVI, 1 week post-procedure and at 1, 3 and after 6 months after TAVI and were evaluated using flow cytometry. A 12 month clinical follow-up was also performed. CD62E+ EMP concentration before TAVI was 21.11 % (±6.6 % SD) and declined to 20.99 % (±6.8 % SD) after 1 week, to 16.63 % (±5.4 % SD, p < 0.0001) after 1 month, to 17.08 % (±4.6 % SD, p < 0.0001) after 3 months and to 15.94 % (±5.4 % SD, p < 0.0001) after 6 months. CD31+/CD42b−, CD31+/Annexin+/− EMP remained unchanged. CD31+/CD41b+ PMP evidenced a slight, but statistically significant increase after TAVI and remained elevated during the entire follow-up. Apart from a procedure-related improvement in echocardiographic parameters, TAVI procedure led also to a decline in CD62E+ EMP. The reduction in pressure gradients with less hemodynamic shear stress seems also to have beneficially affected endothelial homeostasis.Electronic supplementary materialThe online version of this article (doi:10.1007/s00380-016-0885-z) contains supplementary material, which is available to authorized users.

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Transcatheter aortic valve replacement: Historical perspectives, current evidence, and future directions

Cited by 19 publications

References 51 publications

Soluble ST2 predicts 1‐year outcome in patients undergoing transcatheter aortic valve implantation

Soluble ST2 predicts 1‐year outcome in patients undergoing transcatheter aortic valve implantation

Success rates and prognosis of heart valvuloplasty and valve replacement performed for elderly patients

Microparticles in patients undergoing transcatheter aortic valve implantation (TAVI)

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