Journal articles: 'Transcatheter aortic valve implantation (TAVI)'

1

Esposito, Giovanni, and Anna Franzone. "The TAVI: Transcatheter Aortic Valve Implantation." Cardiologia Ambulatoriale, no. 1 (January 30, 2020): 49–57. http://dx.doi.org/10.17473/1971-6818-2020-1-4.

Full text

Abstract:

L’impianto transcatetere di valvola aortica (Transcatheter Aortic Valve Replacement, TAVI) è una procedura di cardiologia interventistica, introdotta nel 2002, che prevede il posizionamento e l’impianto di una protesi biologica a livello dell’annulus aortico mediante accesso percutaneo, prevalentemente transfemorale. Dopo le prime esperienze cliniche, riservate a pazienti senza altre opzioni terapeutiche, la TAVI si è affermata come alternativa all’intervento chirurgico tradizionale di sostituzione valvolare grazie ad una serie di studi randomizzati che ne hanno dimostrato l’efficacia e la sicurezza in pazienti appartenenti a tutto lo spettro del rischio operatorio (da estremo a basso). L’utilizzo della TAVI è in continua crescita, a livello mondiale, e si assiste ad una progressiva espansione delle sue indicazioni cliniche (stenosi di valvola bicuspide, insufficienza aortica severa). Il presente articolo ha lo scopo di riassumere i recenti progressi nell’ambito del trattamento transcatetere della stenosi valvolare aortica, descrivere le caratteristiche della procedura e analizzare i risultati degli studi che ne hanno favorito la diffusione nella pratica clinica.

APA, Harvard, Vancouver, ISO, and other styles

2

Kleiman, Neal, and Michael J. Reardon. "TAVI: Transcatheter Aortic Valve Implantation." Methodist DeBakey Cardiovascular Journal 7, no. 1 (January 2011): 49–52. http://dx.doi.org/10.14797/mdcj-7-1-49.

Full text

APA, Harvard, Vancouver, ISO, and other styles

3

Kleiman, Neal, and Michael J. Reardon. "TAVI: Transcatheter Aortic Valve Implantation." Methodist DeBakey Cardiovascular Journal 7, no. 1 (January 1, 2011): 49. http://dx.doi.org/10.14797/mdcvj.252.

Full text

APA, Harvard, Vancouver, ISO, and other styles

4

ALUR, İhsan, Bekir Serhat YILDIZ, and Yusuf İzzettin ALİHANOĞLU. "Complications of Transcatheter Aortic Valve Implantatiton (TAVI): Letter to the Editor." Turkiye Klinikleri Cardiovascular Sciences 27, no. 3 (2015): 119–20. http://dx.doi.org/10.5336/cardiosci.2016-50396.

Full text

APA, Harvard, Vancouver, ISO, and other styles

5

Byczkowska, Katarzyna. "Katz Frailty Syndrom has no Predictive Value in Low-Risk Patients Undergoing Transcatheter Aortic Valve Implantation." Clinical Cardiology and Cardiovascular Interventions 04, no. 16 (October 12, 2021): 01–08. http://dx.doi.org/10.31579/2641-0419/227.

Full text

Abstract:

Background: Aortic stenosis is a disease of the elderly people, with multiple comorbidities and often with the frailty syndrome. Therefore, we decided that frailty as a clinical factor requires precise characterization as it is a valuable supplement to the risk stratification in transcatheter aortic Valve implantation (TAVI). Objective: The aim of our study was to evaluate the prognostic value of the Katz frailty scale in patients undergoing TAVI in relation to the risk of mortality assessed with the STS scale. Material and methods: The study included 105 patients with severe aortic stenosis (AS) treated with TAVI at the Department of Invasive Cardiology, Central Clinical Hospital of the Ministry of Interior. In our group, the Katz frailty syndrome confirmed in all patients, and 48% in the advanced stage. Results: Statistical analysis showed a significant difference between survival and Katz frailty score before TAVI. Analysis using Cox's model confirmed a significant prognostic value for the Katz frailty syndrome before TAVI. Patients with moderate to severe frailty on the Katz score (values ≤ 4) had a 13,68 times higher risk of death per year compared to the group with Katz frailty syndrome ≥ 5. Multivariate regression analysis indicated that Katz frailty score and STS score were prognostically significant factors of cardiovascular death in patients undergoing TAVI. Conclusion: The Katz frailty score had a significant prognostic value in the high- and intermediate risk patients. Katz frailty score and STS risk score significantly correlated with the risk of death from cardiovascular causes in frailty patients undergoing TAVI.

APA, Harvard, Vancouver, ISO, and other styles

6

Siontis, George C. M., Pavel Overtchouk, Thomas J. Cahill, Thomas Modine, Bernard Prendergast, Fabien Praz, Thomas Pilgrim, et al. "Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis." European Heart Journal 40, no. 38 (April 23, 2019): 3143–53. http://dx.doi.org/10.1093/eurheartj/ehz275.

Full text

Abstract:

Abstract Aims Owing to new evidence from randomized controlled trials (RCTs) in low-risk patients with severe aortic stenosis, we compared the collective safety and efficacy of transcatheter aortic valve implantation (TAVI) vs. surgical aortic valve replacement (SAVR) across the entire spectrum of surgical risk patients. Methods and results The meta-analysis is registered with PROSPERO (CRD42016037273). We identified RCTs comparing TAVI with SAVR in patients with severe aortic stenosis reporting at different follow-up periods. We extracted trial, patient, intervention, and outcome characteristics following predefined criteria. The primary outcome was all-cause mortality up to 2 years for the main analysis. Seven trials that randomly assigned 8020 participants to TAVI (4014 patients) and SAVR (4006 patients) were included. The combined mean STS score in the TAVI arm was 9.4%, 5.1%, and 2.0% for high-, intermediate-, and low surgical risk trials, respectively. Transcatheter aortic valve implantation was associated with a significant reduction of all-cause mortality compared to SAVR {hazard ratio [HR] 0.88 [95% confidence interval (CI) 0.78–0.99], P = 0.030}; an effect that was consistent across the entire spectrum of surgical risk (P-for-interaction = 0.410) and irrespective of type of transcatheter heart valve (THV) system (P-for-interaction = 0.674). Transcatheter aortic valve implantation resulted in lower risk of strokes [HR 0.81 (95% CI 0.68–0.98), P = 0.028]. Surgical aortic valve replacement was associated with a lower risk of major vascular complications [HR 1.99 (95% CI 1.34–2.93), P = 0.001] and permanent pacemaker implantations [HR 2.27 (95% CI 1.47–3.64), P < 0.001] compared to TAVI. Conclusion Compared with SAVR, TAVI is associated with reduction in all-cause mortality and stroke up to 2 years irrespective of baseline surgical risk and type of THV system.

APA, Harvard, Vancouver, ISO, and other styles

7

Penkalla, Adam, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, and Volkmar Falk. "Transcatheter Aortic Valve Implantation in Nonagenarians." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 11, no. 6 (November 2016): 390–95. http://dx.doi.org/10.1097/imi.0000000000000315.

Full text

Abstract:

Objective In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. Methods Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90–98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23.9 ± 14.21; mean ± SD Society of Thoracic Surgeons mortality score, 24.2 ± 11.4; mean ± SD SYNTAX score, 7.6 ± 9.3; mean ± SD NYHA class, 3.5 ± 0.5; mean ± SD transvalvular gradient, 46.8 ± 17.8 mm Hg; mean ± SD aortic valve area, 0.7 ± 0.2 cm2. Results Intraoperative mortality was 2.5% and 30-day all-cause mortality was 10%. The actuarial survival rates at 1 and 5 years were 58.6% and 30.4%, respectively. Seven patients (17.5%) underwent simultaneous elective TAVI and percutaneous coronary intervention. Three patients (7.5%) were operated on with the use of cardiopulmonary bypass. No conversion to open surgery occurred. In transesophageal echocardiography assessment, no moderate or severe prosthetic aortic valve regurgitation was observed. Four patients (10%) had postoperative acute renal failure stage 3 and needed new dialysis (P = 0.125). Three patients (7.5%) had a disabling stroke. Periprocedural myocardial infarction occurred in one patient (2.5%). Seven patients (17.5%) needed postoperative pacemaker implantation. Male sex and renal insufficiency were found to be predictors of mortality in univariable analysis. Conclusions Transcatheter aortic valve implantation can be performed in nonagenarians despite very high preoperative risk scores and substantial multimorbidity, with acceptable outcomes.

APA, Harvard, Vancouver, ISO, and other styles

8

Vanhaverbeke, Maarten, Ole De Backer, and Christophe Dubois. "Practical Approach to Transcatheter Aortic Valve Implantation and Bioprosthetic Valve Fracture in a Failed Bioprosthetic Surgical Valve." Journal of Interventional Cardiology 2022 (February 15, 2022): 1–9. http://dx.doi.org/10.1155/2022/9899235.

Full text

Abstract:

Bioprosthetic surgical aortic valve failure requiring reintervention is a frequent clinical problem with event rates up to 20% at 10 years after surgery. Transcatheter aortic valve-in-valve implantation (ViV-TAVI) has become a valuable treatment option for these patients, although it requires careful procedural planning. We here describe and illustrate a stepwise approach to plan and perform ViV-TAVI and discuss preprocedural computerized tomography planning, transcatheter heart valve selection, and implantation techniques. Particular attention is paid to coronary artery protection and the possible need for bioprosthetic valve fracture since patients with small surgical aortic bioprostheses are at a risk of high residual gradients after ViV-TAVI. Considering updated clinical data on long-term outcomes following ViV-TAVI, this approach may become the default treatment strategy for patients with a failing surgical aortic bioprosthesis.

APA, Harvard, Vancouver, ISO, and other styles

9

Hayashida, Kentaro. "1. Aortic Valve, 2) Transcatheter Aortic Valve Implantation." Nihon Naika Gakkai Zasshi 105, no. 2 (2016): 215–21. http://dx.doi.org/10.2169/naika.105.215.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Harding, Daniel, Thomas J. Cahill, Simon R. Redwood, and Bernard D. Prendergast. "Infective endocarditis complicating transcatheter aortic valve implantation." Heart 106, no. 7 (January 13, 2020): 493–98. http://dx.doi.org/10.1136/heartjnl-2019-315338.

Full text

Abstract:

Infective endocarditis complicating transcatheter aortic valve implantation (TAVI-IE) is a relatively rare condition with an incidence of 0.2%–3.1% at 1 year post implant. It is frequently caused by Enterococci, Staphylococcus aureus and coagulase negative staphylococci. While the incidence currently appears to be falling, the absolute number of cases is likely to rise substantially as TAVI expands into low risk populations following the publication of the PARTNER 3 and Evolut Low Risk trials. Important risk factors for the development of TAVI-IE include a younger age at implant and significant residual aortic regurgitation. The echocardiographic diagnosis of TAVI-IE can be challenging, and the role of supplementary imaging techniques including multislice computed tomography (MSCT) and positron emission tomography (18FDG PET) is still emerging. Treatment largely parallels that of conventional prosthetic valve endocarditis (PVE), with prolonged intravenous antibiotic therapy and consideration of surgical intervention forming the cornerstones of management. The precise role and timing of cardiac surgery in TAVI-IE is yet to be defined, with a lack of clear evidence to help identify which patients should be offered surgical intervention. Minimising unnecessary healthcare interventions (both during and after TAVI) and utilising appropriate antibiotic prophylaxis may have a role in preventing TAVI-IE, but robust evidence for specific preventative strategies is lacking. Further research is required to better select patients for advanced hybrid imaging, to guide surgical management and to inform prevention in this challenging patient cohort.

APA, Harvard, Vancouver, ISO, and other styles

11

Tovia-Brodie, Oholi, Yoav Michowitz, and Bernard Belhassen. "Use of Electrophysiological Studies in Transcatheter Aortic Valve Implantation." Arrhythmia & Electrophysiology Review 9, no. 1 (June 3, 2020): 20–27. http://dx.doi.org/10.15420/aer.2019.38.3.

Full text

Abstract:

New conduction disturbances requiring permanent pacemaker implantation remain common complications following transcatheter aortic valve implantation (TAVI). It has been suggested that electrophysiological studies could help identify patients who will require permanent pacemaker implantation after TAVI. This article summarises contemporary data on the use of electrophysiological studies in patients undergoing TAVI.

APA, Harvard, Vancouver, ISO, and other styles

12

Yılmaz Ak, Hülya. "Transkateter Aort Kapak İmplantasyonuna (TAVI) Anestezi Yaklaşımı." Kosuyolu Heart Journal 21, no. 1 (April 18, 2018): 91–92. http://dx.doi.org/10.5578/khj.57458.

Full text

APA, Harvard, Vancouver, ISO, and other styles

13

Aktuerk, Dincer, Saeed Mirsadraee, Cesare Quarto, Simon Davies, and Alison Duncan. "Leaflet thrombosis after valve-in-valve transcatheter aortic valve implantation: a case series." European Heart Journal - Case Reports 4, no. 4 (August 1, 2020): 1–6. http://dx.doi.org/10.1093/ehjcr/ytaa221.

Full text

Abstract:

Abstract Background Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) in degenerated surgical aortic valve replacement (SAVR) is an alternative to redo-SAVR. However, reports on leaflet thrombosis following ViV-TAVI are emerging and subclinical thrombosis has gained recent attention. Although the incidence of transcatheter heart valve (THV) thrombosis after TAVI for native aortic valve disease is low, current imaging studies suggest the incidence of subclinical THV thrombosis may be significantly higher. While anticoagulation strategies for THV patients for native aortic stenosis presenting with symptomatic obstructive thrombosis has been described, the optimal management and anticoagulation therapy of patients with THV thrombosis following ViV-TAVI are less evident. Case summary We report a case series of three patients presenting with early and late THV thrombosis after ViV-TAVI. Two patients presented clinically on single antiplatelet therapy and one patient presented with subclinical valve thrombosis whilst taking a non-vitamin K oral anticoagulation agent. Discussion Leaflet thrombosis after ViV-TAVI is an important cause of THV degeneration and may present subclinically. Imaging modalities such as serial transthoracic echocardiograms and multidetector computerized tomography aid diagnosis and guide management. Patient-individualized risk- vs. -benefit prophylactic post-procedural oral anticoagulation may be indicated.

APA, Harvard, Vancouver, ISO, and other styles

14

Lotfi, Shahram, Guido Dohmen, Andreas Götzenich, Marcus Haushofer, Jan Wilhelm Spillner, Rüdiger Autschbach, and Rainer Hoffmann. "Midterm Outcomes after Transcatheter Aortic Valve Implantation." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 9, no. 5 (September 2014): 343–48. http://dx.doi.org/10.1097/imi.0000000000000097.

Full text

Abstract:

Objective Transcatheter aortic valve implantation (TAVI) has become a therapeutic option for high-risk or nonoperable patients with severe symptomatic aortic valve stenosis. The best known and most frequently implanted prostheses are the CoreValve and SAPIEN prostheses. We report our experiences and analyze the results of our TAVI program. Methods A total of 357 patients underwent transfemoral (TF) and transapical (TA) TAVI in our center between January 2008 and October 2012. The procedure was performed in 190 patients with CoreValve, in 155 patients with SAPIEN, and in 12 patients with ACURATE TA prostheses. Transfemoral access was used in 190 patients. In 167 patients, TA access was used. The mean age was 80.2 ± 6.4 years. All patients were nonoperable or had a high risk for a conventional aortic valve replacement. The mean logistic EuroSCORE I was 25.92 ± 14.51%. The TF/CoreValve (190 patients) and TA/SAPIEN (155 patients) groups showed significant difference in the patients’ mean age (81.7 ± 6.3 years vs. 79.5 ± 6.6 years, P = 0.002) and in mean logistic EuroSCORE I (22.16 ± 13.05% vs. 31.04 ± 16.40, P < 0.001). Results The overall 30-day mortality (357 patients) was 9.80% (TF, 8.42%; TA, 11.37%); overall 1-year mortality (275 patients), 21.45% (TF, 23.74%; TA, 19.12%); overall 2-year mortality (199 patients), 29.15% (TF, 35.96%; TA, 23.64%); overall 3-year mortality (133 patients), 37.59% (TF, 43.86%; TA, 32.89%); and overall 4-year mortality (38 patients), 39.47% (TF, 45%; TA, 33.33%). The rate of pacemaker implantation after TAVI was significantly higher in the CoreValve group than in the SAPIEN group: 44.74% (85/190 patients) versus 6.45% (10/155 patients), P < 0.001. Stroke rate was higher in the TF-CoreValve group than in the TA-SAPIEN group: 4.21% versus 0.64%, P = 0.045. Conclusions Outcomes after TAVI were, in our population of nonoperable and high-risk patients, encouraging. The differences in midterm outcomes between the TF-CoreValve TAVI and the TA-SAPIEN TAVI were not significant.

APA, Harvard, Vancouver, ISO, and other styles

15

Sakai, Osamu, Katsuhiko Oka, Tomoya Inoue, and Hitoshi Yaku. "Internal Endoconduit Technique during Transcatheter Aortic Valve Implantation." Thoracic and Cardiovascular Surgeon Reports 08, no. 01 (January 2019): e5-e7. http://dx.doi.org/10.1055/s-0038-1676963.

Full text

Abstract:

AbstractThe transfemoral approach is the least invasive transcatheter aortic valve implantation (TAVI) approach, but the diameter of the iliofemoral arteries needs to exceed 5 mm. We report a case of limited access transfemoral TAVI by the “internal endoconduit technique,” which is well known as a safe and effective dilatational technique for thoracic endovascular aortic repair. Subsequently, we could deliver the device without iliac artery injury and we performed transfemoral TAVI.

APA, Harvard, Vancouver, ISO, and other styles

16

Chung, Robin. "Transcatheter Aortic Valve Implantation (TAVI) for Aortic Stenosis." International Cardiovascular Forum Journal 1, no. 2 (April 7, 2015): 62. http://dx.doi.org/10.17987/icfj.v1i2.22.

Full text

Abstract:

Aortic stenosis remains the commonest form of valve disease in modern cardiology. With fifty years’ experience, surgical valve replacement remains the gold standard treatment for survival benefit, durability and symptomatic relief. Percutaneous transcatheter aortic valve replacement has recently gained a credible momentum for inoperable and very high risk patients with severe aortic stenosis. Early and medium term results have demonstrated a proven survival benefit over conservative management, with documented complication rates for stroke, vascular complications and pacemaker implantation. The evidence base for cost effectiveness and long-term results are eagerly anticipated.

APA, Harvard, Vancouver, ISO, and other styles

17

Salaun, Erwan, Marie-Annick Clavel, Josep Rodés-Cabau, and Philippe Pibarot. "Bioprosthetic aortic valve durability in the era of transcatheter aortic valve implantation." Heart 104, no. 16 (May 7, 2018): 1323–32. http://dx.doi.org/10.1136/heartjnl-2017-311582.

Full text

Abstract:

The main limitation of bioprosthetic valves is their limited durability, which exposes the patient to the risk of aortic valve reintervention. Transcatheter aortic valve implantation (TAVI) is considered a reasonable alternative to surgical aortic valve replacement (SAVR) in patients with intermediate or high surgical risk. TAVI is now rapidly expanding towards the lower risk populations. Although the results of midterm durability of the transcatheter bioprostheses are encouraging, their long-term durability remains largely unknown. The objective of this review article is to present the definition, mechanisms, incidence, outcome and management of structural valve deterioration of aortic bioprostheses with specific emphasis on TAVI. The structural valve deterioration can be categorised into three stages: stage 1: morphological abnormalities (fibrocalcific remodelling and tear) of bioprosthesis valve leaflets without hemodynamic valve deterioration; stage 2: morphological abnormalities and moderate hemodynamic deterioration (increase in gradient and/or new onset of transvalvular regurgitation); and stage 3: morphological abnormalities and severe hemodynamic deterioration. Several specifics inherent to the TAVI including valve oversizing, manipulation, delivery, positioning and deployment may cause injuries to the valve leaflets and increase leaflet mechanical stress, which may limit the long-term durability of transcatheter bioprostheses. The selection of the type of aortic valve replacement and bioprosthesis should thus take into account the ratio between the demonstrated durability of the bioprostheses versus the life expectancy of the patient. Pending the publication of robust data on long-term durability of transcatheter bioprostheses, it appears reasonable to select SAVR with a bioprosthesis model that has well-established long-term durability in patients with low surgical risk and long life expectancy.

APA, Harvard, Vancouver, ISO, and other styles

18

Watanabe, Yusuke, and Ken Kozuma. "Transcatheter Aortic Valve Implantation for Patients with Smaller Anatomy." Interventional Cardiology Review 10, no. 3 (2015): 155. http://dx.doi.org/10.15420/icr.2015.10.03.155.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has reached relative maturity for the treatment of severe, symptomatic aortic stenosis (AS). TAVI for patients with smaller anatomy is a challenging procedure due to specific anatomical difficulty and complications including annulus rupture and vascular complications. Prevention of these complications, and the introduction of a newer-generation and lowerprofile TAVI system, will encourage the prevalence of TAVI for patients with smaller anatomy.

APA, Harvard, Vancouver, ISO, and other styles

19

Al-Maisary, Sameer, Mina Farag, Willem Hendrik Te Gussinklo, Jamila Kremer, Sven T. Pleger, Florian Leuschner, Matthias Karck, Gabor Szabo, and Rawa Arif. "Are Sutureless and Rapid-Deployment Aortic Valves a Serious Alternative to TA-TAVI? A Matched-Pairs Analysis." Journal of Clinical Medicine 10, no. 14 (July 12, 2021): 3072. http://dx.doi.org/10.3390/jcm10143072.

Full text

Abstract:

Background: Transcatheter aortic valve implantation is a feasible alternative to conventional aortic valve replacement with expanding indication extending to low-risk patients. Sutureless and rapid-deployment aortic valves were developed to decrease procedural risks in conventional treatment. This paired-match analysis aims to compare patients undergoing surgical transcatheter aortic valve implantation to sutureless and rapid-deployment aortic valve implantation. Methods: Retrospective database analysis between 2010 and 2016 revealed 214 patients undergoing transcatheter aortic valve implantation procedures through surgical access (predominantly transapical) and 62 sutureless and rapid-deployment aortic valve procedures including 26 patients in need of concomitant coronary artery bypass surgery. After matching, 52 pairs of patients were included and analyzed. Results: In-hospital death (5.8% vs. 3.8%; p = 0.308) was comparable between transcatheter aortic valve implantation (mean age 77 ± 4.3 years) and sutureless and rapid-deployment aortic valve implantation groups (mean age 75 ± 4.0 years), including 32 females in each group. The logistic EuroSCORE was similar (19 ± 12 vs. 17 ± 10; p = 0.257). Postoperative renal failure (p = 0.087) and cerebrovascular accidents (p = 0.315) were without significant difference. The incidence of complete heart block requiring permanent pacemaker treatment was relatively low for both groups (1.9% vs. 7.7%; p = 0.169) for TAVI and sutureless and rapid-deployment valves respectively. Intraoperative use of blood transfusion was higher in the sutureless and rapid-deployment aortic valve implantation group (0.72 U vs. 1.46 U, p = 0.014). Estimated survival calculated no significant difference between both groups after 6 months (transcatheter aortic valve implantation: 74 ± 8% vs. sutureless and rapid-deployment aortic valve implantation: 92 ± 5%; log rank p = 0.097). Conclusion: Since sutureless and rapid-deployment aortic valve implantation is as safe and effective as transapical transcatheter aortic valve implantation, combining the advantage of standard diseased-valve removal with shorter procedural times, sutureless and rapid-deployment aortic valve replacement may be considered as an alternative for patients with elevated operative risk considered to be in the “gray zone” between transcatheter aortic valve implantation and conventional surgery, especially if concomitant myocardial revascularization is required.

APA, Harvard, Vancouver, ISO, and other styles

20

Mylotte, Darren, Ruben LJ Osnabrugge, Giuseppe Martucci, Ruediger Lange, Arie Pieter Kappetein, and Nicolo Piazza. "Adoption of Transcatheter Aortic Valve Implantation in Western Europe." Interventional Cardiology Review 9, no. 1 (2011): 37. http://dx.doi.org/10.15420/icr.2011.9.1.37.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) is a novel therapeutic option for patients with severe symptomatic aortic stenosis (AS) at excessive or high surgical risk for conventional surgical aortic valve replacement. First commercialised in Europe in 2007, TAVI growth has been exponential among some Western European nations, though recent evidence suggests heterogeneous adoption of this new and expensive therapy. Herein, we review the evidence describing the utilisation of TAVI in Western Europe.

APA, Harvard, Vancouver, ISO, and other styles

21

D'Ancona, Giuseppe, Miralem Pasic, Stephan Dreysse, Thorsten Drews, Semih Buz, Axel Unbehaun, Marian Kukucka, and Roland Hetzer. "Transcatheter Aortic Valve Implantation into a Stentless Prosthetic Valve with a Low Position of the Left Main Coronary Artery." Heart Surgery Forum 15, no. 5 (October 23, 2012): 268. http://dx.doi.org/10.1532/hsf98.20111174.

Full text

Abstract:

Recently during a transcatheter aortic valve implantation (TAVI), we were faced with a problem that seemed to be untreatable by TAVI. It was difficult to decide whether to perform atypical TAVI or to convert to conventional redo aortic valve surgery in an extremely high-risk patient with a degenerated stentless aortic bioprosthesis.

APA, Harvard, Vancouver, ISO, and other styles

22

Russo, Eleonora, Domenico R. Potenza, Michela Casella, Raimondo Massaro, Giulio Russo, Maurizio Braccio, Antonio Dello Russo, and Mauro Cassese. "Rate and Predictors of Permanent Pacemaker Implantation After Transcatheter Aortic Valve Implantation: Current Status." Current Cardiology Reviews 15, no. 3 (May 6, 2019): 205–18. http://dx.doi.org/10.2174/1573403x15666181205105821.

Full text

Abstract:

Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis who are at high surgical risk. Recently, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement in the treatment of intermediate risk patients and greater adoption of this procedure is to be expected in a wider patients population, including younger patients and low surgical risk patients. However since the aortic valve has close spatial proximity to the conduction system, conduction anomalies are frequently observed in TAVI. In this article, we aim to review the key aspects of pathophysiology, current incidence, predictors and clinical association of conduction anomalies following TAVI.

APA, Harvard, Vancouver, ISO, and other styles

23

Kadowaki, Hiroshi, Kazuyuki Yahagi, Yu Horiuchi, and Kengo Tanabe. "Malignant Findings in Candidates for Transcatheter Aortic Valve Implantation." Heart Surgery Forum 23, no. 2 (April 23, 2020): E250—E254. http://dx.doi.org/10.1532/hsf.2699.

Full text

Abstract:

Background: In candidates for transcatheter aortic valve implantation (TAVI), preoperative computed tomography (CT) may detect clinically relevant non-cardiac findings. In particular, when malignant findings are detected, patients may be less likely to undergo the procedure. Additionally, they might require further examinations, which may prolong their time to treatment. We investigated how malignant findings affect candidacy for TAVI. Methods: In this single-center retrospective study, 98 patients with severe aortic stenosis who had undergone preoperative CT between September 2013 and October 2016 were evaluated for malignant findings. Results: Seven patients (7.1%) had malignant findings. 74 of 91 patients who did not have malignant findings underwent TAVI, SAVR, or balloon aortic valvuloplasty (81.3%). All patients who had malignant findings underwent TAVI or SAVR, and they underwent the procedure sooner after CT than the rest of the patients (mean time to TAVI or SAVR: 24.6 ± 16.8 versus 48.5 ± 45.4 days; P = .003). All 5 patients who had malignant findings without metastatic cancer and who underwent TAVI were still alive during the follow-up period (the mean duration of the follow-up period was 22.3 ± 8.8 months). However, 1 patient who had a malignant finding with metastatic cancer died 7 months after CT. Conclusion: Our outcomes indicated that the mean duration before TAVI or SAVR was reduced when malignant findings were detected by CT; and TAVI may be a safe and effective treatment for patients with aortic stenosis and a malignant tumor.

APA, Harvard, Vancouver, ISO, and other styles

24

Kennon, Simon, and Zhan Lim. "Transcatheter Aortic Valve Implantation Without General Anaesthetic." Interventional Cardiology Review 9, no. 2 (2011): 130. http://dx.doi.org/10.15420/icr.2011.9.2.130.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) procedures are increasingly being performed under local anaesthetic, generally with sedation. Operators hope this will reduce mortality, morbidity and length of hospital stay. A general anaesthetic (GA), however, although involving intrinsic risk, permits transoesophageal echocardiogram (TOE) imaging throughout a procedure as well as eliminating patient anxiety, pain and movement. This article reviews the published literature, all single-centre experiences, comparing TAVI procedures performed with and without a GA. Procedures performed without GA are generally shorter with reduced length of stay compared with those performed under GA. There is no evidence of any difference in outcomes.

APA, Harvard, Vancouver, ISO, and other styles

25

Sarwari, Harun, Andreas Schaefer, Markus J. Barten, and Lenard Conradi. "TAVI Using a Self-Expandable Device for Aortic Regurgitation Following LVAD Implantation." Thoracic and Cardiovascular Surgeon Reports 08, no. 01 (January 2019): e33-e36. http://dx.doi.org/10.1055/s-0039-1698412.

Full text

Abstract:

Abstract Background In patients treated by left ventricular assist device (LVAD), aortic regurgitation (AR) may occur. Secondary surgery to correct AR is considered high risk. Case Description We report a case of severe AR following LVAD implantation in a patient who was subsequently treated by transcatheter aortic valve implantation (TAVI) using the latest generation self-expandable transcatheter heart valve (THV) (Boston Scientific Acurate neo, size M [Boston Scientific, Marlborough, Massachusetts, United States]). TAVI followed modified procedural protocol and sizing algorithm. THV implantation without prior balloon aortic valvuloplasty resulted in an adequate valve function without leakage. Conclusion This THV may be particularly well suited for TAVI subsequent to LVAD implantation if modified sizing and deployment considerations are appreciated.

APA, Harvard, Vancouver, ISO, and other styles

26

Martins, Ana Margarida, Maria Lurdes Castro, and Isabel Fragata. "Experiência Inicial de um Programa de TAVI: Análise da Decisão Anestésica e sua Evolução." Acta Médica Portuguesa 32, no. 2 (February 28, 2019): 126. http://dx.doi.org/10.20344/amp.10982.

Full text

Abstract:

Introduction: Transcatheter aortic valve implantation is a less invasive option for aortic valve replacement. The number of transcatheter aortic valve implantations under local anesthesia with sedation has been increasing as the team’s experience increases and less invasive accesses are used. The aim of this study is to describe the evolution of the anesthetic technique in patients undergoing transcatheter aortic valve implantation at our center over the years, as which was compared. Material and Methods: Retrospective study in 149 consecutive patients undergoing transcatheter aortic valve implantation in Hospital Santa Marta (January 2010 to December 2016). Data was collected from the periprocedural records of patients. Patients were stratified according to anesthetic technique. Results: From our patients’ sample, 57.0% were female, with median age 82 [58 - 95] years. Most patients underwent general anesthesia (68.5%). In the local anesthesia with sedation group there was a shorter duration of the procedure (120; [60 - 285] vs 155 [30 - 360]) and a lower number of patients requiring administration of vasopressors (61.8% vs 28.3%) – p < 0.05. There were no differences regarding length of hospital stay (9 [4 - 59] vs 10 [3 - 87]), periprocedural complications (66.0% vs 72.5%), readmission rate (4.3% vs 3.9%) or 30-days (2.1% vs 4.9%) and 1-year mortality (6.4% vs 7.8%) – p > 0.05. There was an increasing number of transcatheter aortic valve implantations performed under local anesthesia with sedation over the years.Discussion: The choice of anesthetic technique depends on the patient’s characteristics, experience and preference of the team.Conclusion: Local anesthesia with sedation seems to be associated with similar results as general anesthesia. The increase in the number of transcatheter aortic valve implantations under local anesthesia with sedation seems to follow the trend of lower invasiveness of the procedure.

APA, Harvard, Vancouver, ISO, and other styles

27

Klyshnikov, K. Yu, V. I. Ganyukov, A. V. Batranin, D. V. Nushtaev, and E. A. Ovcharenko. "Simulation of Transcatheter Aortic Valve Implantation Procedure." Mathematical Biology and Bioinformatics 14, no. 1 (May 20, 2019): 204–19. http://dx.doi.org/10.17537/2019.14.204.

Full text

Abstract:

The study is devoted to numerical modeling of transcatheter aortic valve implantation (TAVI) from the position of prognostic value in comparison with clinical data. The finite element method implemented in the Abaqus/CAE software and the reconstruction of three-dimensional models based on the computer microtomography of the CoreValve bioprosthesis of a size of 29 mm and the patient-specific data of functional studies (multispiral tomography) were used in the work. The study included three variations in the modeling of the aortic valve prosthesis procedure, which determine the level of detalization of the numerical experiment. All stages of the TAVI process were reproduced: the crimp of the prosthesis, the movement of the delivery system, the interaction of the guide - guidewire with the elements of the “prosthesis-root” of the aorta system, implantation itself. In silico experiment demonstrated significant quantitative and qualitative agreement with the data of intraoperative fluorography and computed tomography after the TAVI procedure. It is shown that the inclusion of additional elements – the guidewire and catheter of the delivery system into the “aortic root” has a positive effect on the convergence of the data with the clinical results. The analysis of the stress-strain state of the elements interacting in the experiment demonstrated a significant contribution to the analyzed parameters of the prosthetic motion stage along the guidewire as part of the delivery system catheter. Nevertheless, a comparison with the results of the clinical evaluation of the TAVI procedure revealed a number of differences in the response of the model of the bioprosthesis at the later stages of modeling, which requires further researches of a level of detalization. The approach is extremely promising both for practitioners and for research work of prosthetic designers, it can be applied in further R&D tasks.

APA, Harvard, Vancouver, ISO, and other styles

28

Sperlongano, Simona, Francesca Renon, Maurizio Cappelli Bigazzi, Rossella Sperlongano, Giovanni Cimmino, Antonello D’Andrea, and Paolo Golino. "Transcatheter Aortic Valve Implantation: The New Challenges of Cardiac Rehabilitation." Journal of Clinical Medicine 10, no. 4 (February 17, 2021): 810. http://dx.doi.org/10.3390/jcm10040810.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) is an increasingly widespread percutaneous intervention of aortic valve replacement (AVR). The target population for TAVI is mainly composed of elderly, frail patients with severe aortic stenosis (AS), multiple comorbidities, and high perioperative mortality risk for surgical AVR (sAVR). These vulnerable patients could benefit from cardiac rehabilitation (CR) programs after percutaneous intervention. To date, no major guidelines currently recommend CR after TAVI. However, emerging scientific evidence shows that CR in patients undergoing TAVI is safe, and improves exercise tolerance and quality of life. Moreover, preliminary data prove that a CR program after TAVI has the potential to reduce mortality during follow-up, even if randomized clinical trials are needed for confirmation. The present review article provides an overview of all scientific evidence concerning the potential beneficial effects of CR after TAVI, and suggests possible fields of research to improve cardiac care after TAVI.

APA, Harvard, Vancouver, ISO, and other styles

29

Türen, Sevda. "Transcatheter Aortic Valve Implantation (TAVI) and Nursing Care." Journal of Cardiovascular Nursing 5, no. 1 (2014): 1–11. http://dx.doi.org/10.5543/khd.2014.001.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

Soares dos Santos, Augusto Cesar, Maria da Glória Cruvinel Horta, Lélia Maria de Almeida Carvalho, Luíza Rodrigues, Sandra de Oliveira Sapori Avelar, Mariana Fernandes, Luciano Rios Scherrer, Fernando Martin Biscione, and Silvana Marcia Kelles. "PP57 Outcomes On Transcatheter Aortic Valve Implantation." International Journal of Technology Assessment in Health Care 35, S1 (2019): 47–48. http://dx.doi.org/10.1017/s0266462319002101.

Full text

Abstract:

IntroductionSevere aortic stenosis with symptoms or left ventricular dysfunction has commonly a poor prognosis and therefore, aortic valve replacement is usually performed for patients aiming at improving their functional class and survival rate.MethodsThis retrospective study evaluated a convenience sample of patients at high risk for open surgery for the correction of aortic valve dysfunction treated with TAVI from 2013 to 2018. Data from a private healthcare organization in Belo Horizonte, Brazil were used to assess all-cause mortality. Continuous variables were expressed as mean and standard deviation. Cox proportional regression model and Log-Rank test were used to adjust the survival curve.ResultsFifty-two patients were included in the study (mean 83 ± 5.7 years of age, range 67 to 93 years; female 55.8 percent). Patients were characterized by: left ventricular ejection fraction (n = 30; mean 52.9 percent, range 26 to 81 percent); aortic valve area (n = 36; mean 0.68 cm2, range 0.4 to 1.2 cm2); left atrium size (n = 14; range 30 to 61 ml/m2); pulmonary artery pressure (n = 20; mean 53 mmHg, range 31 to 70 mmHg). Death occurred in 19 patients during the follow-up period (mean 8.4 months, range 0 to 60 months). Nine deaths occurred within the first 30 days of follow-up (17.3 percent) and 14 (26.9 percent) in the first year. Stroke occurred in three patients (5.8 percent) in the post-implant period. A pacemaker device was required for nine patients (17.3 percent).ConclusionsTranscatheter aortic valve implantation (TAVI) has become an alternative to surgical aortic valve replacement for patients at high risk for surgery. Real-world studies might result in a better understanding of the local team expertise on TAVI utilization.

APA, Harvard, Vancouver, ISO, and other styles

31

Lauterbach, Michael, Bruno Sontag, and Karl Eugen Hauptmann. "Transcatheter Aortic Valve Implantation in the Hybrid Catheterisation Laboratory – Navigating into the Future." Interventional Cardiology Review 7, no. 1 (2012): 53. http://dx.doi.org/10.15420/icr.2012.7.1.53.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has emerged as a viable treatment option for high-risk patients with symptomatic, senile degenerative aortic stenosis. Since the first TAVI in 2002, the technology has evolved tremendously. With the downsizing of the device delivery catheter profile, vascular access site complications have decreased significantly. Current access routes are transfemoral, subclavian, transapical and transaortic, with most centres preferring a ‘transfemoral-first’ strategy. Other significant complications of TAVI are cerebrovascular events and conduction disturbances with the need for pacemaker implantation. The current TAVI devices with the largest number of implantations and the best evidence are the Medtronic CoreValve™ and the Edwards SAPIEN XT™. Both devices are already in their third generation. Navigation technology, such as the HeartNavigator, has been developed to facilitate the preparation of the procedure and the actual device implantation. The use of hybrid catheterisation labs for performing TAVI is becoming the standard of care due to the significant advantages with regard to safety and hygiene.

APA, Harvard, Vancouver, ISO, and other styles

32

Sousa Uva, Miguel. "Transcatheter aortic valve implantation in low-risk patients: is it too early?" Heart 105, Suppl 2 (March 2019): s51—s56. http://dx.doi.org/10.1136/heartjnl-2018-314248.

Full text

Abstract:

The median age of patients treated by transcatheter aortic valve implantation (TAVI) is falling across Europe, and low-risk patients with severe aortic stenosis (AS) represent 80% of patients with severe AS undergoing surgical aortic valve replacement (SAVR). There are few data for TAVI in low-risk patients, but there are four ongoing randomised trials of SAVR versus TAVI. The key issues relate to pacemaker implantation rates and the associated potential longer term deleterious effects, and the need to minimise vascular complications and paravalvular leak. Valve leaflet thrombosis and paucity of data on valve durability remain a concern. Given the higher incidence of bicuspid aortic valves in younger patients, outcomes of TAVI in this setting need clarification and are discussed.

APA, Harvard, Vancouver, ISO, and other styles

33

Stelzmueller, Marie-Elisabeth, Robert Zilberszac, Nikolaus Heinrich, Bruno Mora, Guenther Laufer, and Wilfried Wisser. "Concomitant Transapical Transcatheter Aortic Valve Implantation and Transapical Mitral Valve Repair With NeoChord Implantation." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 14, no. 6 (September 16, 2019): 564–68. http://dx.doi.org/10.1177/1556984519871905.

Full text

Abstract:

One-third of the patients with severe symptomatic aortic valve stenosis (sAS) present with hemodynamic relevant mitral valve insufficiency (rMI). In patients who undergo conventional surgery, the rMI never would be left untreated; however, in cases of transcatheter aortic valve implantation (TAVI), the impact of rMI is often overlooked and left untreated. The combination of transapical TAVI (TA-TAVI) and NeoChord implantation represents a novel, promising therapeutic option for high-risk-surgery patients with sAS and rMI due to a prolapsed or flailed leaflet. This case report describes 2 patients (1 male, 1 female; mean age 82 years) who underwent TA-TAVI and concomitant NeoChord implantation at our institute. Both presented with sAS and rMI due to a prolapse of the P2 segment of the mitral valve. At first, the TA-TAVI was implanted under angio-guidance, followed by three-dimensional echo-guided implantation of the NeoChords, through the same approach, which was slightly posterior and lateral to the apex. TA-TAVI using an Edwards Sapien 3 (26 mm, n = 1 and 29 mm, n = 1) and NeoChord implantation (2 in the first and 3 in the second patient) was successful in both cases. Post-intervention discharge echo indicated no paravalvular or central insufficiency after the procedure and only a trace of mitral valve insufficiency. TA-TAVI and concomitant NeoChord implantation is a feasible and promising treatment option for high-risk patients with rMI. Despite its technical demands, in experienced hands, it is a safe procedure for those not well suited for surgical intervention.

APA, Harvard, Vancouver, ISO, and other styles

34

Wijesinghe, Namal, Fabian Nietlispach, Ronen Gurvitch, Edgar Tay, David A. Wood, Josep Rodés-Cabau, James L. Velianou, et al. "TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) IN BICUSPID AORTIC STENOSIS." Journal of the American College of Cardiology 55, no. 10 (March 2010): A148.E1386. http://dx.doi.org/10.1016/s0735-1097(10)61387-3.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Tan, B. Y. Q., N. J. Ngiam, S. Sunny, W. Y. Kong, and V. K. Sharma. "Transcatheter aortic valve implantation (TAVI) for severe aortic incompetence." QJM: An International Journal of Medicine 111, no. 2 (October 23, 2017): 135–36. http://dx.doi.org/10.1093/qjmed/hcx202.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Tanaka, Shuhei, Teruhiko Imamura, Ryuichi Ushijima, Mitsuo Sobajima, Nobuyuki Fukuda, Hiroshi Ueno, Tadakazu Hirai, and Koichiro Kinugawa. "Improvement in Vascular Endothelial Function following Transcatheter Aortic Valve Implantation." Medicina 57, no. 10 (September 24, 2021): 1008. http://dx.doi.org/10.3390/medicina57101008.

Full text

Abstract:

Background and objectives: Endothelial dysfunction is associated with exercise intolerance and adverse cardiovascular events. Transcatheter aortic valve implantation (TAVI) is applied to treat elderly patients with severe aortic stenosis, but less is known about the impact of TAVI on endothelial dysfunction, which can be assessed by measuring flow-mediated vasodilation (FMD). In this parameter, a low value indicates impaired endothelial function. Materials and Methods: Vascular endothelial function was evaluated by FMD of the brachial artery just before and one week after TAVI. Factors associated with the normalization of FMD and their prognostic impact were investigated. Results: Fifty-one patients who underwent TAVI procedure (median 86 years old, 12 men) were included. FMD improved significantly from baseline to one week following TAVI (from 5.3% [3.7%, 6.7%] to 6.3% [4.7%, 8.1%], p < 0.001). Among 33 patients with baseline low FMD (≤6.0%), FMD normalized up to >6.0% following TAVI in 15 patients. Baseline higher cardiac index was independently associated with normalization of FMD following TAVI (odds ratio 11.8, 95% confidence interval 1.12–124; p < 0.04). Conclusions: Endothelial dysfunction improved following TAVI in many patients with severe aortic stenosis. The implication of this finding is the next concern.

APA, Harvard, Vancouver, ISO, and other styles

37

Walther, Thomas, Helge Möllmann, Johannes Blumenstein, and Jörg Kempfert. "Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis – Overcoming the Challenges." Interventional Cardiology Review 6, no. 2 (2011): 165. http://dx.doi.org/10.15420/icr.2011.6.2.165.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has evolved as one of the most important innovations in cardiovascular medicine during the past five years. By means of transfemoral (TF) and transapical (TA) AVI elderly and high-risk patients with symptomatic aortic stenosis (AS) are being routinely treated using a minimally invasive approach. Some challenges have to be overcome to obtain perfect results: patient screening and eventual selection is important, conduct of the procedures by an experienced and interdisciplinary heart team is ideal and intense post-operative therapy is required for the patients. Currently available devices, the Corevalve™ (CV, Medtronic Inc.) and SAPIEN™ (ES, Edwards Inc.) prostheses, which are Conformité Européenne (CE) Mark approved for TF (CV and ES) and TA (ES) implantations, are first-generation prostheses. Future developments will focus on reduction of potential paravalvular leakage as well as improved features during valve implantation, most importantly repositioning and retrievability. TAVI has already gained an important position for the treatment of elderly high-risk patients with AS.

APA, Harvard, Vancouver, ISO, and other styles

38

Fanning, Jonathon P., David G. Platts, Darren L. Walters, and John F. Fraser. "Transcatheter aortic valve implantation (TAVI): Valve design and evolution." International Journal of Cardiology 168, no. 3 (October 2013): 1822–31. http://dx.doi.org/10.1016/j.ijcard.2013.07.117.

Full text

APA, Harvard, Vancouver, ISO, and other styles

39

Pagnesi, Matteo, Luca Baldetti, Paolo Del Sole, Antonio Mangieri, Marco B. Ancona, Damiano Regazzoli, Nicola Buzzatti, Francesco Giannini, Antonio Colombo, and Azeem Latib. "Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite?" Interventional Cardiology Review 12, no. 02 (2017): 116. http://dx.doi.org/10.15420/icr.2017:17:2.

Full text

Abstract:

Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications. Several real-world retrospective studies and one small randomised study have shown that direct TAVI (with both self-expanding and balloon-expandable prostheses) is feasible, safe and associated with outcomes similar to standard TAVI with pre-implantation balloon aortic valvuloplasty. In the absence of high-quality, robust evidence, the current review aims to discuss the advantages and disadvantages of omitting predilatation prior to TAVI.

APA, Harvard, Vancouver, ISO, and other styles

40

Kinthala, Sudhakar, Poovendran Saththasivam, Abistanand Ankam, and Sudhakar Sattur. "Embolization of aortic valve leaflet during valve-in-valve transcatheter aortic valve implantation: a case report." European Heart Journal - Case Reports 4, no. 1 (February 1, 2020): 1–5. http://dx.doi.org/10.1093/ehjcr/ytaa010.

Full text

Abstract:

Abstract Background Aortic stenosis (AS) is one of the most common valvular disorders worldwide. An increasing number of transcatheter aortic valve implantation (TAVI) procedures are being performed yearly for managing AS. This, along with the occurrence of common complications, makes timely diagnosis essential to manage rare complications and improve patient outcomes. Case summary We present a case of a 77-year-old Caucasian male with severe AS with a dysfunctional bioprosthetic valve following previous surgical valve replacement. During valve-in-valve TAVI, we noted bioprosthetic valve leaflet avulsion and embolization causing a major vascular occlusion that resulted in vascular insufficiency of the left lower extremity. This condition was managed successfully via immediate diagnosis using transoesophageal echocardiogram, angiogram, and vascular surgical intervention for retrieving the embolized valve to re-establish circulation. Discussion To our knowledge, this is the first case of aortic valve leaflet embolization during TAVI resulting in significant vascular insufficiency. Vascular complications are common during TAVI. However, not all vascular complications are the same. Our case highlights an embolic vascular complication from an avulsed prosthetic material during a challenging valve-in-valve TAVI procedure.

APA, Harvard, Vancouver, ISO, and other styles

41

Hanson, Ivan D., Pratik K. Dalal, Brian M. Renard, George S. Hanzel, and Alessandro Vivacqua. "Emergency Valve-in-Valve Transcatheter Aortic Valve Implantation for the Treatment of Acute Stentless Bioprosthetic Aortic Insufficiency and Cardiogenic Shock." Case Reports in Cardiology 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/6872748.

Full text

Abstract:

Bioprosthetic aortic valve degeneration may present as acute, severe aortic regurgitation and cardiogenic shock. Such patients may be unsuitable for emergency valve replacement surgery due to excessive risk of operative mortality but could be treatable with transfemoral valve-in-valve transcatheter aortic valve implantation (TAVI). There is a paucity of data regarding the feasibility of valve-in-valve TAVI in patients presenting with cardiogenic shock due to acute aortic insufficiency from stentless bioprosthetic valve degeneration. We present one such case, highlighting the unique aspects of valve-in-valve TAVI for this challenging patient subset.

APA, Harvard, Vancouver, ISO, and other styles

42

Sawaya, Fadi J., and Lars Søndergaard. "Expert Opinion: Will PARTNER 2 Change My Practice?" Interventional Cardiology Review 12, no. 02 (2017): 126. http://dx.doi.org/10.15420/icr.2016:29:2.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has become an established and increasingly-used technique to treat patients with severe aortic valve stenosis (AS) over the past decade. The clinical outcomes obtained with TAVI have been found to be equivalent to surgical aortic valve replacement (SAVR) in patients with a high-risk profile. Following the Placement of Aortic Transcatheter Valves (PARTNER) 1 trial, which demonstrated the utility of TAVI in inoperable and high-risk groups, the PARTNER 2 trial was implemented. PARTNER 2 reflects the current TAVI practice in Europe, confirms that transfemoral access is related to superior outcomes compared to SAVR in a selected population and demonstrates improved results with new-generation devices.

APA, Harvard, Vancouver, ISO, and other styles

43

Lai, Ka Sing Paris, Nathan Herrmann, Mahwesh Saleem, and Krista L. Lanctôt. "Cognitive Outcomes following Transcatheter Aortic Valve Implantation: A Systematic Review." Cardiovascular Psychiatry and Neurology 2015 (February 15, 2015): 1–8. http://dx.doi.org/10.1155/2015/209569.

Full text

Abstract:

Severe aortic stenosis is the most common valvular heart disease in the elderly in the Western world and contributes to a large proportion of all deaths over the age of 70. Severe aortic stenosis is conventionally treated with surgical aortic valve replacement; however, the less invasive transcatheter aortic valve implantation (TAVI) is suggested for those at high surgical risk. While TAVI has been associated with improved survival and favourable outcomes, there is a higher incidence of cerebral microembolisms in TAVI patients. This finding is of concern given mechanistic links with cognitive decline, a symptom highly prevalent in those with cardiovascular disease. This paper reviews the literature assessing the possible link between TAVI and cognitive changes. Studies to date have shown that global cognition improves or remains unchanged over 3 months following TAVI while individual cognitive domains remain preserved over time. However, the association between TAVI and cognition remains unclear due to methodological limitations. Furthermore, while these studies have largely focused on memory, cognitive impairment in this population may be predominantly of vascular origin. Therefore, cognitive assessment focusing on domains important in vascular cognitive impairment, such as executive dysfunction, may be more helpful in elucidating the association between TAVI and cognition in the long term.

APA, Harvard, Vancouver, ISO, and other styles

44

Ciardetti, Niccolò, Francesca Ciatti, Giulia Nardi, Francesca Maria Di Muro, Pierluigi Demola, Edoardo Sottili, Miroslava Stolcova, et al. "Advancements in Transcatheter Aortic Valve Implantation: A Focused Update." Medicina 57, no. 7 (July 14, 2021): 711. http://dx.doi.org/10.3390/medicina57070711.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has become the leading technique for aortic valve replacement in symptomatic patients with severe aortic stenosis with conventional surgical aortic valve replacement (SAVR) now limited to patients younger than 65–75 years due to a combination of unsuitable anatomies (calcified raphae in bicuspid valves, coexistent aneurysm of the ascending aorta) and concerns on the absence of long-term data on TAVI durability. This incredible rise is linked to technological evolutions combined with increased operator experience, which led to procedural refinements and, accordingly, to better outcomes. The article describes the main and newest technical improvements, allowing an extension of the indications (valve-in-valve procedures, intravascular lithotripsy for severely calcified iliac vessels), and a reduction of complications (stroke, pacemaker implantation, aortic regurgitation).

APA, Harvard, Vancouver, ISO, and other styles

45

Currie, Maria E., A. Jonathan McLeod, John T. Moore, Michael W. A. Chu, Rajni Patel, Bob Kiaii, and Terry M. Peters. "Augmented Reality System for Ultrasound Guidance of Transcatheter Aortic Valve Implantation." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 11, no. 1 (January 2016): 31–39. http://dx.doi.org/10.1097/imi.0000000000000235.

Full text

Abstract:

Objective Transcatheter aortic valve implantation (TAVI) relies on fluoroscopy and nephrotoxic contrast medium for valve deployment. We propose an alternative guidance system using augmented reality (AR) and transesophageal echocardiography (TEE) to guide TAVI deployment. The goals of this study were to determine how consistently the aortic valve annulus is defined from TEE using different aortic valve landmarks and to compare AR guidance with fluoroscopic guidance of TAVI deployment in an aortic root model. Methods Magnetic tracking sensors were integrated into the TAVI catheter and TEE probe, allowing these tools to be displayed in an AR environment. Variability in identifying aortic valve commissures and cuspal nadirs was assessed using TEE aortic root images. To compare AR guidance of TAVI deployment with fluoroscopic guidance, a TAVI stent was deployed 10 times in the aortic root model using each of the two guidance systems. Results Commissures and nadirs were both investigated as features for defining the valve annulus in the AR guidance system. The commissures were identified more consistently than the nadirs, with intraobserver variability of 2.2 and 3.8 mm, respectively, and interobserver variability of 3.3 and 4.7 mm, respectively. The precision of TAVI deployment using fluoroscopic guidance was 3.4 mm, whereas the precision of AR guidance was 2.9 mm, and its overall accuracy was 3.4 mm. This indicates that both have similar performance. Conclusions Aortic valve commissures can be identified more reliably than cuspal nadirs from TEE. The AR guidance system achieved similar deployment accuracy to that of fluoroscopy while eliminating the use and consequences of nephrotoxic contrast and radiation.

APA, Harvard, Vancouver, ISO, and other styles

46

Ducrocq, Grégory, Dominique Himbert, Eric Brochet, and Alec Vahanian. "Transcatheter Valve Implantation for Patients with Aortic Stenosis." Interventional Cardiology Review 4, no. 1 (2009): 34. http://dx.doi.org/10.15420/icr.2009.4.1.34.

Full text

Abstract:

Seven years after the first-in-man transcatheter aortic valve implantation (TAVI) for the treatment of aortic stenosis, it remains a dynamic field of research and development. Evidence from 8,000 patients treated worldwide suggests that TAVI is feasible and provides haemodynamic and clinical improvement for up to three years in patients at high risk or with contraindications to surgery. Pending questions mainly concern safety and long-term durability. Today these techniques are targeted at high-risk patients, but they may be extended to lower-risk groups in the future if their initial promise holds true after careful evaluation.

APA, Harvard, Vancouver, ISO, and other styles

47

Nakashima, Makoto, and Yusuke Watanabe. "Transcatheter Aortic Valve Implantation in Small Anatomy: Patient Selection and Technical Challenges." Interventional Cardiology Review 13, no. 2 (2018): 1. http://dx.doi.org/10.15420/icr.2017:28:1.

Full text

Abstract:

Transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis. Although this technique has reached relative maturity, further optimisation of patient selection and device implantation is essential to improve prognosis. Smaller body size is a predictor of a challenging TAVI procedure due to specific anatomical difficulty and adverse events including annulus rupture, acute coronary obstruction and vascular complications. A newer generation, lower profile TAVI system is useful for patients with smaller anatomy. Moreover, TAVI is superior to surgical aortic valve replacement in patients with a narrowing annulus because this treatement has a low incidence of prosthesis�patient mismatch.

APA, Harvard, Vancouver, ISO, and other styles

48

Brtko, Miroslav. "Infective endocarditis in transcatheter aortic valve implantation." Intervenční a akutní kardiologie 19, no. 1 (June 1, 2020): 55–59. http://dx.doi.org/10.36290/kar.2019.053.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Nijenhuis, Vincent J., Naoual Bennaghmouch, Jan-Peter van Kuijk, Davide Capodanno, and Jurriën M. ten Berg. "Antithrombotic treatment in patients undergoing transcatheter aortic valve implantation (TAVI)." Thrombosis and Haemostasis 113, no. 04 (July 2015): 674–85. http://dx.doi.org/10.1160/th14-10-0821.

Full text

Abstract:

SummaryTranscatheter aortic valve implantation (TAVI) is an established treatment option for symptomatic patients with severe aortic valvular disease who are not suitable for conventional surgical aortic valve replacement. Despite improving experience and techniques, ischaemic and bleeding complications after TAVI remain prevalent and impair survival in this generally old and comorbid-rich population. Due to changing aetiology of complications over time, antiplatelet and anticoagulant therapy after TAVI should be carefully balanced. Empirically, a dual antiplatelet strategy is generally used after TAVI for patients without an indication for oral anticoagulation (OAC; e. g. atrial fibrillation, mechanical mitral valve prosthesis), including aspirin and a thienopyridine. For patients on OAC, a combination of OAC and aspirin or thienopyridine is generally used. This review shows that current registries are unfit to directly compare antithrombotic regimens. Small exploring studies suggest that additional clopidogrel after TAVI only affects bleeding and not ischemic complications. However, these studies are lack in quality in terms of Cochrane criteria. Currently, three randomised controlled trials are recruiting to gather more knowledge about the effects of clopidogrel after TAVI.

APA, Harvard, Vancouver, ISO, and other styles

50

Lárusdóttir, Katrín Júníana, Hjalti Guðmundsson, Árni Johnsen, Martin Ingi Sigurðsson, Tómas Guðbjartsson, and Ingibjörg Jóna Guðmundsdóttir. "Indications and outcomes of TAVI (transcatheter aortic valve implantation) in Iceland." Læknablaðið 107, no. 03 (March 3, 2021): 123–29. http://dx.doi.org/10.17992/lbl.2021.03.625.

Full text

Abstract:

INTRODUCTION: Surgical aortic valve replacement (SAVR) has been the standard of treatment for aortic stenosis but transcatheter aortic valve implantation (TAVI) is increasingly used as treatment in Iceland and elsewhere. Our objective was to assess the outcome of TAVI in Iceland, focusing on indications, complications and survival. MATERIAL AND METHODS: This retrospective study included all TAVI-procedures performed in Iceland between January 2012 and July 2020. Patient characteristics, outcome and complications were registered, and overall survival compared to an age and sex matched Icelandic reference-population. The mean follow-up was 2.4 years. RESULTS: Altogether 189 TAVI procedures (mean age 83±6 years, 41.8% females), were performed, all with a self-expandable valve. Most patients (81.5%) had symptoms of severe heart failure (NYHA-class III-IV) and median EuroSCORE-II was 4.9 (range: 0.9-32). Echocardiography pre-TAVI showed a mean aortic-valve area of 0.67 cm2 and max aortic-valve gradient of 78 mmHg. One out of four patients (26.5%) needed permanent pacemaker implantation following TAVI. Other complications were mostly vascular-related (13.8%) but cardiac tamponade stroke was detected in 3.2 and 2.6% of cases, respectively and severe paravalvular aortic valve regurgitation in 0.5% cases. Thirty-day mortality was 1.6% (n=3) with one-year survival of 93.5% (95% CI: 89.8-97.3), but long-term survival of TAVI-patients was similar to the matched reference population (p=0.23). CONCLUSIONS: The outcome of TAVI-procedures in Iceland is good, especially regarding 30-day mortality and long-term survival that was comparable to a reference population, but incidence of major complications was also low.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Transcatheter aortic valve implantation (TAVI)'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles