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Ordoñez S, Chu MWA, Diamantouros P, Valdis M, Chaumont G, Vila RCB, Teefy P, Bagur R. Next-Day Discharge After Transcatheter Aortic Valve Implantation With the ACURATE neo/neo2 Self-Expanding Aortic Bioprosthesis. Am J Cardiol 2024; 227:65-74. [PMID: 38996897 DOI: 10.1016/j.amjcard.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 06/29/2024] [Accepted: 07/08/2024] [Indexed: 07/14/2024]
Abstract
Previous studies have shown the safety of early discharge pathways in selected patients and using selected transcatheter heart valves. Hence, we sought to evaluate the safety of next-day discharge (NDD) in patients who underwent transfemoral transcatheter aortic valve implantation (TF-TAVI) with the ACURATE neo/neo2 (Boston Scientific, Marlborough, Massachusetts) self-expanding aortic bioprosthesis. Patients who underwent TF-TAVI between January 2018 and April 2023 were prospectively included. Patients were stratified into 3 groups according to discharge times within 24 hours (NDD), between 24 and 48 hours, and those discharged >48 hours after TAVI. The primary outcome was the first unplanned readmission at 30 days after TAVI. Log-rank test was used to assess the differences in the outcome of interest between the groups. A total of 368 all-comers were included in this study. According to discharge times, 204 patients followed NDD, 69 patients 24 to 48 hours discharge, and 95 patients >48 hours discharge after TAVI. The mean age was 84 ± 6.3 years and 61% were women, without differences between the groups. The mean Society of Thoracic Surgeons score was lower in those with NDD versus 24 to 48 hours and >48 hours (2.9 ± 1.0, 3.2 ± 1.2, and 3.4 ± 1.4, respectively, p = 0.014). There were no differences between the groups in terms of preprocedural right bundle branch block or pacemaker. The need for new permanent pacemaker implantation was the leading postprocedural complication; it occurred more frequently in the >48 hours group than the 24 to 48 hours, and <24 hours groups (24% vs 8.6% and 2.2%, p <0.001). There were 5 strokes (1.4%) and all of them occurred in the >48 hours group (p = 0.005). At 30 days after discharge, there were no deaths and no differences in all-cause readmissions (9.3% in <24 hours, 8.6% in 24 to 48 hours, and 19% in >48 hours, log-rank p = 0.087). The readmission rates for new permanent pacemaker implantation requirement were 3.3% (n = 6) in NDD, 0% in 24 to 48 hours, and 1.6% (n = 5) in the >48 hours groups (p = 0.27). In conclusion, in unselected patients who underwent TF-TAVI with the ACURATE neo/neo2 self-expanding bioprosthesis, the NDD pathway is feasible and appears to be safe, without an increased risk of death or all-cause rehospitalization through 30 days after hospital discharge.
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Affiliation(s)
- Santiago Ordoñez
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Michael W A Chu
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Pantelis Diamantouros
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Matthew Valdis
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Gloria Chaumont
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | | | - Patrick Teefy
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Rodrigo Bagur
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada.
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2
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Liu Q, Mei J, Zhang H, Zhou W, Qiu K, Zhou Q, Chen Y, Duan W, Zhou C, Tang M, Huang J, Liu H, Liu Q, Chang R, Niu G, Zhang Y, Wu T, Zhang T, Fang W, Wu Y, Gao R. A Novel System for Transcatheter Aortic Valve Implantation: First-in-Man Study. Am J Cardiol 2024; 211:343-349. [PMID: 38141461 DOI: 10.1016/j.amjcard.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 12/25/2023]
Abstract
Transcatheter aortic valve implantation (TAVI) has become a therapeutic treatment for severe symptomatic patients with aortic stenosis. This study aimed to test a novel transcatheter aortic self-expandable bioprosthesis-the ScienCrown system (Lepu Medtech Inc., Beijing, China)-and evaluate the safety of the new device during TAVI. ScienCrown aortic valve implantation was performed on 10 patients. Clinical assessment was performed at baseline, post procedure, and after 1 year. Clinical outcomes and adverse events were assessed according to Valvular Academic Research Consortium-3 criteria. The mean age was 75.30 ± 4.78 years with a mean Society of Thoracic Surgeons score of 4.64 ± 3.23%. Device success was achieved in all patients (80% transfemoral, 20% transapical). After 1 year, there were no deaths, disabling strokes, myocardial infarctions, conversions to surgery, or major procedure-related complications. New pacemaker implantation was required in one patient (10%). ScienCrown implantation resulted in a reduction in mean valve gradient (63.00 ± 18.84 to 9.67 ± 4.97 mm Hg, p <0.001) and an increase in effective orifice area (0.57 ± 0.20 to 2.57 ± 0.59 cm2, p <0.001) at 1 year. Paravalvular leak was absent in 9 patients (90%), and there was a trace in one patient (10%). All patients were in New York Heart Association class I to II at a mean follow-up of 1 year. The experience showed that ScienCrown transcatheter aortic valve system was safely and successfully implanted for treatment of severe symptomatic aortic stenosis. The newer-generation device affords a stable implantation while providing optimal hemodynamic performance.
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Affiliation(s)
- Qingrong Liu
- Department of Cardiology, Beijing Aerospace General Hospital, Beijing, China; Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ju Mei
- Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Hongliang Zhang
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wenbing Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Kejin Qiu
- Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China
| | - Qing Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Yang Chen
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wei Duan
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Changping Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Min Tang
- Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jianbing Huang
- Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Haixia Liu
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Qingqing Liu
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Rencao Chang
- Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China
| | - Guannan Niu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yuxin Zhang
- Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China
| | - Tao Wu
- Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China
| | - Ting Zhang
- Research and Development Department, Lepu Medical Technology (Beijing) Co., Ltd., Beijing, China
| | - Weiyi Fang
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Hefei, China.
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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McInerney A, Bagur R. Hypoattenuated Leaflet Thickening After Transcatheter Aortic Valve Implantation: The Research Around HALT Does Not Halt. Am J Cardiol 2023; 201:378-381. [PMID: 37468396 DOI: 10.1016/j.amjcard.2023.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Angela McInerney
- Galway University Hospital, National University of Ireland Galway, Galway, Ireland
| | - Rodrigo Bagur
- London Health Sciences Centre, Western University, London, Ontario, Canada.
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Liu Q, Mei J, Zhang H, Zhou W, Qiu K, Zhou Q, Chen Y, Duan W, Zhou C, Tang M, Huang J, Liu H, Liu Q, Chang R, Niu G, Zhang Y, Wu T, Zhang T, Fang W, Wu Y, Gao R. A study of the novel SinoCrown system for transcatheter aortic valve implantation. EUROINTERVENTION 2023; 18:1439-1441. [PMID: 36644962 PMCID: PMC10111132 DOI: 10.4244/eij-d-22-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/24/2022] [Indexed: 01/17/2023]
Affiliation(s)
- Qingrong Liu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Ju Mei
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
- Department of Cardiothoracic Surgery, Xinhua Hospital, affiliated to Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Hongliang Zhang
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Wenbing Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Kejin Qiu
- Lepu Medical Technology (Beijing) Co., Ltd, Beijing, People's Republic of China
| | - Qing Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Yang Chen
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Wei Duan
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Changping Zhou
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Min Tang
- Department of Cardiothoracic Surgery, Xinhua Hospital, affiliated to Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jianbing Huang
- Department of Cardiothoracic Surgery, Xinhua Hospital, affiliated to Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Haixia Liu
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Qingqing Liu
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Rencao Chang
- Lepu Medical Technology (Beijing) Co., Ltd, Beijing, People's Republic of China
| | - Guannan Niu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
| | - Yuxin Zhang
- Lepu Medical Technology (Beijing) Co., Ltd, Beijing, People's Republic of China
| | - Tao Wu
- Lepu Medical Technology (Beijing) Co., Ltd, Beijing, People's Republic of China
| | - Ting Zhang
- Lepu Medical Technology (Beijing) Co., Ltd, Beijing, People's Republic of China
| | - Weiyi Fang
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Yongjian Wu
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
- Department of Cardiology, Hefei High-Tech Cardiovascular Hospital, Anhui Province, People's Republic of China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China
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Bagur R, Chu MWA, Ordoñez S, Valdis M, Gelinas J, Chaumont G, Teefy PJ, Diamantouros P. Single Access for Transfemoral Transcatheter Aortic Valve Implantation With the Acurate neo/neo 2 Self-Expanding Valve. Can J Cardiol 2023; 39:35-37. [PMID: 36328177 DOI: 10.1016/j.cjca.2022.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rodrigo Bagur
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada.
| | - Michael W A Chu
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Santiago Ordoñez
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Matthew Valdis
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Jill Gelinas
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Gloria Chaumont
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Patrick J Teefy
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Pantelis Diamantouros
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
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Ivanov B, Eghbalzadeh K, Djordjevic I, Zeriouh M, Gerfer S, Gaisendrees C, Sabashnikov A, Rustenbach C, Rahmanian P, Kuhn-Regnier F, Mader N, Adam M, Baldus S, Wahlers T, Kuhn E. Clinical results and 30-day outcomes of self-expanding transcatheter aortic valves: comparative case-matched analysis of CoreValve ® versus ACURATE neo™. Perfusion 2023; 38:115-123. [PMID: 34472999 DOI: 10.1177/02676591211042562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) is associated with excellent results in patients with severe aortic stenosis. In highly calcified aortic anuli with increased risk of annulus rupture and in favor of the supra-annular design, self-expandable prostheses are frequently used. In this regard, we aimed to perform a comparative analysis of clinical and 30-day outcomes after TAVR using the self-expanding CoreValve® Evolut R or ACURATE neo™ prosthesis. METHODS Out of 343 consecutive patients treated with either CoreValve® Evolut R or ACURATE neo™ from January 2014 to December 2017, 76 patients were assigned each per group after 1:1 propensity score matching in regard of preoperative characteristics. Pre- and periprocedural outcomes were retrospectively collected and assessed. Outcomes at 30 days are reported according to the established Valve Academic Research Consortium (VARC-2) criteria. RESULTS Device success and 30-day survival accounted for 93.4% (n = 71), respectively 97.4% (n = 74) in both groups (p = 1.00). No statistically significant differences regarding clinical parameters were observed. The combined safety endpoint at 30 days was comparable (84.2% (n = 64) CoreValve® vs 85.5% (n = 65) ACURATE neo™; p = 0.848). Except a trend toward higher stroke (p = 0.08) and pacemaker (p = 0.07) rate in the CoreValve® group, major vascular complications, incidence of life-threatening or disabling bleeding, and incidence of postoperative acute kidney injury were comparable. Postoperative hemodynamic parameters showed no significant differences between the implanted valves. CONCLUSION Both self-expandable prostheses showed good postoperative hemodynamic performance with a low incidence of severe paravalvular leakage, all- cause mortality, and comparable clinical outcomes.
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Affiliation(s)
- Borko Ivanov
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Kaveh Eghbalzadeh
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Ilija Djordjevic
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Mohamed Zeriouh
- Department of Cardiac Surgery, Campus Kerckhoff, University of Giessen, Bad Nauheim, Germany
| | - Stephen Gerfer
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Christopher Gaisendrees
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Anton Sabashnikov
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Christian Rustenbach
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Parwis Rahmanian
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Ferdinand Kuhn-Regnier
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Navid Mader
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Matti Adam
- Department of Cardiology, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Stephan Baldus
- Department of Cardiology, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Thorsten Wahlers
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
| | - Elmar Kuhn
- Department of Cardiothoracic Surgery, Heart Centre Cologne, University Hospital Cologne, Cologne, Germany
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7
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Peverill W, Chu MWA, Diamantouros P, Bagur R. Transcatheter Balloon-Expandable Valve-in-Valve to Treat Severe Paravalvular Leak Secondary to ACURATE- neo Self-expanding Prosthesis-Annulus Mismatch. CJC Open 2021; 3:1320-1322. [PMID: 34888515 PMCID: PMC8636236 DOI: 10.1016/j.cjco.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/10/2021] [Indexed: 10/28/2022] Open
Abstract
A 75-year-old male with severe symptomatic aortic stenosis underwent transcatheter aortic valve implantation with a Large (27-mm) ACURATE-neo transcatheter aortic valve, complicated by severe paravalvular leak. He developed rapid and progressive worsening heart failure. Reanalysis of the computed tomography images suggested evidence of prosthesis-annulus mismatch. Therefore, a redo transcatheter aortic valve implantation utilizing a 29-mm SAPIEN 3 transcatheter aortic valve was performed. This case illustrates the importance of proper valve sizing to avoid paravalvular leak, and how to safely cross an ACURATE-neo valve to avoid catheter entangling.
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Affiliation(s)
- William Peverill
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Michael W A Chu
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Pantelis Diamantouros
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Rodrigo Bagur
- Heart Team, London Health Sciences Centre, Western University, London, Ontario, Canada
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8
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Ravaux JM, Di Mauro M, Vernooy K, Kats S, Mariani S, Ronco D, Actis Dato G, Simons J, Hof AWV, Maessen JG, Lorusso R. Permanent pacemaker implantation following transcatheter aortic valve implantation using self-expandable, balloon-expandable, or mechanically expandable devices: a network meta-analysis. Europace 2021; 23:1998-2009. [PMID: 34379760 DOI: 10.1093/europace/euab209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 07/17/2021] [Indexed: 11/13/2022] Open
Abstract
AIMS Permanent pacemaker implantation (PPI) still limits the expansion of indications for transcatheter aortic valve implantation (TAVI). Comparison between different systems remains scarce. We aimed to determine the impact of the device type used on post-TAVI PPI. METHODS AND RESULTS A systematic literature review was performed to identify studies reporting the use of balloon-expandable valve (BEV), self-expandable valve (SEV), and mechanically expandable valve (MEV) and post-TAVI PPI. A network meta-analysis was used to compare TAVI mechanisms (Analysis A) and transcatheter heart valves (Analysis B) with respect to post-TAVI PPI. Analysis A included 40 181 patients with a pooled PPI rate of 19.2% in BEV, 24.7% in SEV, and 34.8% in MEV. Balloon-expandable valve showed lower risk compared to either SEV or MEV and SEV demonstrated lower risk for PPI than MEV. Implantation of BEV was associated with 39% and 62% lower PPI rate with respect to SEV and MEV. Implantation of SEV was associated with 38% lower PPI rate with respect to MEV. Analysis B included 36.143 patients with the lowest pooled PPI rate of 9.6% for Acurate Neo or others, and the highest pooled PPI rate of 34.3% for Lotus. CoreValve, Evolut Portico, and Lotus influenced significantly PPI rate, while Sapien group did not. CONCLUSION Implantation of BEV and also SEV were associated with lower post-TAVI PPI rate, while MEV were associated with higher post-TAVI PPI. Patient tailored-approach including devices characteristics may help to reduce post-TAVI PPI and to allow TAVI to take the leap towards extension of use in younger patients. PROSPERO NUMBER CRD42021238671.
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Affiliation(s)
- Justine M Ravaux
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Michele Di Mauro
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Kevin Vernooy
- Department of Cardiology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Cardiology, Radboud University Medical Center (Radboudumc), Nijmegen, the Netherlands
| | - Suzanne Kats
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Silvia Mariani
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Daniele Ronco
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands.,Department of Medicine and Surgery, Circolo Hospital, University of Insubria, Varese, Italy
| | - Giulia Actis Dato
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Jorik Simons
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands
| | - Arnoud W Van't Hof
- Department of Cardiology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jos G Maessen
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Roberto Lorusso
- Departement of Cardio-Thoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre (MUMC), P. Debyelaan, 25, 6202 AZ Maastricht, The Netherlands.,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
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9
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Teitelbaum M, Kotronias RA, Sposato LA, Bagur R. Cerebral Embolic Protection in TAVI: Friend or Foe. ACTA ACUST UNITED AC 2019; 14:22-25. [PMID: 30858888 PMCID: PMC6406126 DOI: 10.15420/icr.2018.32.2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Cerebrovascular accidents including stroke or transient ischaemic attack are one of the most feared complications after transcatheter aortic valve implantation. Transcatheter aortic valve implantation procedures have been consistently associated with silent ischaemic cerebral embolism as assessed by diffusion-weighted MRI. To reduce the risk of cerebrovascular accidents and silent emboli, cerebral embolic protection devices were developed with the aim of preventing procedural debris reaching the cerebral vasculature. The authors summarise the available data regarding cerebral embolic protection devices and its clinical significance.
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Affiliation(s)
| | - Rafail A Kotronias
- Oxford University Clinical Academic Graduate School, University of Oxford Oxford, UK.,Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust Oxford, UK.,Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele Stoke-on-Trent, UK
| | - Luciano A Sposato
- Department of Clinical Neurological Sciences, Stroke, Dementia & Heart Disease Laboratory London, Ontario, Canada
| | - Rodrigo Bagur
- London Health Sciences Centre London, Ontario, Canada.,Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele Stoke-on-Trent, UK.,Department of Epidemiology and Biostatistics, Western University London, Ontario, Canada
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10
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Choudhury T, Solomonica A, Bagur R. The Evolut R and Evolut PRO transcatheter aortic valve systems. Expert Rev Med Devices 2018; 16:3-9. [PMID: 30518281 DOI: 10.1080/17434440.2019.1557045] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Transcatheter aortic valves have evolved over the last 15 years. Second- and third- generation devices have considerably improved, and a range of newer devices have also been introduced with the aim of decreasing the incidence of paravalvular leak, reducing the need for permanent pacemaker implantation and minimizing procedure- and device-related complications. Areas covered: In this review, we highlight the special features of the latest generation of self-expanding Evolut PRO (Medtronic, Minneapolis, Minnesota) transcatheter aortic valve system. A detailed literature search on the Medtronic Evolut R and Evolut PRO transcatheter aortic valves was undertaken using Ovid, PubMed and Web of Science. Expert commentary: In a single, small study, the Evolut PRO has shown significant improvement over the Evolut R in terms of reduced paravalvular leak and pacemaker implantation. Larger scaled studies are needed to ascertain the performance of the Evolut PRO.
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Affiliation(s)
| | | | - Rodrigo Bagur
- a London Health Sciences Centre , London , Ontario , Canada.,b Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences , University of Keele , Stoke-on-Trent , UK
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Solomonica A, Choudhury T, Bagur R. Newer-generation of Edwards transcatheter aortic valve systems: SAPIEN 3, Centera, and SAPIEN 3 Ultra. Expert Rev Med Devices 2018; 16:81-87. [DOI: 10.1080/17434440.2019.1555465] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | | | - Rodrigo Bagur
- London Health Sciences Centre, London, Canada
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
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12
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Bagur R. Unmet issues in transcatheter aortic valve implantation. J Thorac Dis 2018; 10:S3557-S3359. [PMID: 30505534 DOI: 10.21037/jtd.2018.10.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rodrigo Bagur
- London Health Sciences Centre, London, Ontario, Canada.,Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
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13
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Kotronias RA, Teitelbaum M, Bagur R. Pre-implantation balloon-aortic valvuloplasty before transcatheter aortic valve implantation: is this still needed? J Thorac Dis 2018; 10:S3599-S3603. [PMID: 30505541 DOI: 10.21037/jtd.2018.06.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Balloon aortic valvuloplasty (BAV) has historically been recommended prior to transcatheter aortic valve implantation (TAVI). Pre-implantation BAV (pBAV) creates fractures at the level of calcified leaflets, thereby facilitating delivery of the transcatheter valve system across the diseased aortic valve and, enhances prosthesis implantation and expansion within the calcified aortic valve annulus. New device designs, lower profile delivery systems and increasing operator experience have enabled direct-TAVI (without pBAV), and its appeal amongst TAVI operators enhanced the dissemination of a direct TAVI approach across many centres. In this review, we discuss contemporary evidence that inform the debate on the need for routine pBAV for TAVI candidates and present a framework that may assist operators in selecting patients for pBAV.
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Affiliation(s)
- Rafail A Kotronias
- Oxford University Clinical Academic Graduate School, University of Oxford, Oxford, UK.,Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
| | - Michael Teitelbaum
- London Health Sciences Centre, Western University, London, Ontario, Canada
| | - Rodrigo Bagur
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK.,London Health Sciences Centre, Western University, London, Ontario, Canada
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Choudhury T, Solomonica A, Bagur R. The ACURATE neo transcatheter aortic valve system. Expert Rev Med Devices 2018; 15:693-699. [DOI: 10.1080/17434440.2018.1526675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | - Rodrigo Bagur
- London Health Sciences Centre, London, Canada
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
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15
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Auffret V, Puri R, Urena M, Chamandi C, Rodriguez-Gabella T, Philippon F, Rodés-Cabau J. Conduction Disturbances After Transcatheter Aortic Valve Replacement. Circulation 2017; 136:1049-1069. [DOI: 10.1161/circulationaha.117.028352] [Citation(s) in RCA: 302] [Impact Index Per Article: 43.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Transcatheter aortic valve replacement (TAVR) has become a well-accepted option for treating patients with aortic stenosis at intermediate to high or prohibitive surgical risk. TAVR-related conduction disturbances, mainly new-onset left bundle-branch block and advanced atrioventricular block requiring permanent pacemaker implantation, remain the most common complication of this procedure. Furthermore, improvements in TAVR technology, akin to the increasing experience of operators/centers, have translated to a major reduction in periprocedural complications, yet the incidence of conduction disturbances has remained relatively high, with perhaps an increasing trend over time. Several factors have been associated with a heightened risk of conduction disturbances and permanent pacemaker implantation after TAVR, with prior right bundle-branch block and transcatheter valve type and implantation depth being the most commonly reported. New-onset left bundle-branch block and the need for permanent pacemaker implantation may have a significant detrimental association with patients’ prognosis. Consequently, strategies intended to reduce the risk and to improve the management of such complications are of paramount importance, particularly in an era when TAVR expansion toward treating lower-risk patients is considered inevitable. In this article, we review the available evidence on the incidence, predictive factors, and clinical association of conduction disturbances after TAVR and propose a strategy for the management of these complications.
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Affiliation(s)
- Vincent Auffret
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - Rishi Puri
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - Marina Urena
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - Chekrallah Chamandi
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - Tania Rodriguez-Gabella
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - François Philippon
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
| | - Josep Rodés-Cabau
- From University Hospital Pontchaillou, Cardiology and Vascular Disease Department, CIC-IT 804, Rennes 1 University, Signal and Image Processing Laboratory (LTSI), INSERM U1099, France (V.A.); Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (V.A., R.P., C.C., T.R.-G., F.P., J.R.,-C.); and Bichat-Claude Bernard University Hospital, Paris, France (M.U.)
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Bagur R, Choudhury T, Mamas MA. Transcatheter aortic valve implantation with the repositionable and fully retrievable Lotus Valve System TM. J Thorac Dis 2017; 9:2798-2803. [PMID: 29221243 DOI: 10.21037/jtd.2017.08.78] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Rodrigo Bagur
- Division of Cardiology, London Health Sciences Centre, Departments of Medicine and Epidemiology & Biostatistics, Western University, London, Ontario, Canada.,Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
| | - Tawfiq Choudhury
- Division of Cardiology, London Health Sciences Centre, Departments of Medicine and Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Stoke-on-Trent, UK
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Bagur R, Pestrichella V, Montesanti R, Alemanni R, Cassese M. Transfemoral transcatheter ACURATE-neo™ aortic valve replacement in a patient with a previous mechanical mitral valve. J Card Surg 2017; 32:358-360. [PMID: 28544015 DOI: 10.1111/jocs.13153] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Transcatheter aortic valve replacement (TAVR) in the presence of a mechanical mitral valve (MMV) prosthesis is challenging due to the stiff mitral cage in the boundaries of the aorto-mitral curtain. We describe the technique for TAVR using the ACURATE-neo™ aortic bioprosthesis in a patient with a MMV prosthesis.
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Affiliation(s)
- Rodrigo Bagur
- Interventional Cardiology, Division of Cardiology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Keele Cardiovascular Research Group, Institute of Applied Clinical Science and Centre for Prognosis Research, Keele University, Stoke-on-Trent, UK
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