1
|
Damlin A, Meduri C, Manouras A, Verouhis D, Linder R, Rück A, Settergren M. BASILICA Procedure Prior to Valve-in-Valve TAVR in a Supra-Annular TAV Prosthesis. JACC: Case Reports 2023; 11:101777. [PMID: 37077443 PMCID: PMC10106999 DOI: 10.1016/j.jaccas.2023.101777] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 02/18/2023]
Abstract
An 80-year-old man with a supra-annular transcatheter aortic valve (TAV) prosthesis presented with severe transvalvular aortic regurgitation 18 months after the TAV replacement procedure. The authors report the first ever valve-in-valve procedure using BASILICA (bioprosthetic or native aortic scallop intentional laceration to prevent iatrogenic coronary artery obstruction) in such a supra-annular TAV prosthesis. Minimal paravalvular leakage, normal coronary artery flow, and easy coronary access were seen postimplantation. (Level of Difficulty: Advanced.).
Collapse
|
2
|
Meduri C, Bapat V, Kodali S, Sorajja P, Hamid N, Poon K, Feldt K, Settergren M, Rück A. TCT-471 First-in-Human Study Results With the Novel Anteris DurAVRTM Three-Dimensional Single-Piece TAVR Device. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
3
|
Shaburishvili T, Mehran R, Wilkins G, Wilkins B, Gooley R, Lockwood S, Barker C, Fail P, Meduri C, Feldt K, Solet D, Kriegel J. TCT-342 Early Multi-center Clinical Outcomes of a No-Implant Interatrial Shunt for Heart Failure With Preserved and Reduced Ejection Fraction: Latest Results From the Early Feasibility ALLEVIATE-HF Programs. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
4
|
Udelson JE, Barker CM, Meduri C, Fail PS, Solet D, Kriegel J, Shaburishvili T. SIX MONTH RESULTS FROM FIRST IN HUMAN CLINICAL EXPERIENCE OF A NO-IMPLANT INTERATRIAL SHUNT FOR HEART FAILURE WITH PRESERVED EJECTION FRACTION. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
5
|
Sorajja A, Meduri C, Rück A, Saleh N. TCT-45 Indications and Clinical Outcomes With Surgical Explantation of Chronically Implanted TAVR Prostheses: A Report From the HjärtKIRurgi Registry and SWENTRY TAVR Registry. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
6
|
Palmieri L, Vannucchi S, Lo Noce C, Di Lonardo A, Unim B, Grisetti T, Meduri C, Donfrancesco C. The CUORE project cardiovascular risk assessment in primary care: the ongoing experience in Italy. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Italian National Prevention Plan 2005-08 included 10-year cardiovascular risk assessment (10-CR) for the general population aged 35-69 years using the CUORE Project risk score. GPs were encouraged to perform 10-CR and send data to the Cardiovascular Risk Observatory (CRO).
Aim
To show updated data of the ongoing surveillance system of the 10-CR in the Italian adult population.
Methods
Data were collected using the cuore.exe software, freely downloadable by GPs from the CUORE Project website (www.cuore.iss.it). The CRO provides a web-platform to compare data on 10-CR and risk factors at regional/national level. For persons examined at least twice, variations in risk factors from baseline to follow-up and 95% confidence intervals (C.I.) were calculated using methods for matched pair samples.
Results
Up to February 2019, about 3,500 GPs downloaded cuore.exe; about 300,000 CR assessments on about 140,000 persons were sent to CRO. Mean CR was 3.1% in women (W), 8.5% in men (M); 28% of M, 64% of W were at low risk (CR < 3%); 9.9% of M, 0.4% of W were at high risk (CR ≥ 20%); 26% of M, 16% of W were current smokers; 13% of M, 10% of W were diabetic; 33% of hypertensive M, 35% of hypertensive W were under specific treatment. Among those with at least two risk assessments (31% of the sample), 11% shifted to a lower risk class after one year (14% of M, 7% of W). Systolic blood pressure mean levels decreased by 0.6 mmHg (95%-C.I. 0.3-0.8 mmHg), diastolic blood pressure by 0.5 mmHg (0.2-0.7 mmHg), total cholesterol by 4.1 mg/dl (3.0-5.2 mg/dl), smokers prevalence by 3.1% (2.3%-4.0%); HDL-cholesterol increased in W by 0.3 mg/dl (0.1-0.5 mg/dl).
Conclusions
Data demonstrate that 10-CR assessment can be an effective first step to implement preventive actions in primary care. Individual risk score is a useful tool for GPs to assess CR and promote primary prevention focusing on the adoption of healthy lifestyles. Data can be used to support health policy decision process.
Key messages
The cuore.exe software, freely downloadable from the CUORE Project website-www.cuore.iss.it, allows GPs to assess the CUORE Project risk score, to collect and to send data to the CVD Risk Observatory. 10 year Cardiovascular Risk assessment in the general adult population can be an effective first step to implement preventive actions in primary care.
Collapse
Affiliation(s)
- L Palmieri
- Istituto Superiore di Sanità, Rome, Italy
| | | | - C Lo Noce
- Istituto Superiore di Sanità, Rome, Italy
| | | | - B Unim
- Istituto Superiore di Sanità, Rome, Italy
| | - T Grisetti
- Istituto Superiore di Sanità, Rome, Italy
| | - C Meduri
- Istituto Superiore di Sanità, Rome, Italy
| | | |
Collapse
|
7
|
Agricola E, Asmarats L, Maisano F, Cavalcante JL, Liu S, Milla F, Meduri C, Rodés-Cabau J, Vannan M, Pibarot P. Imaging for Tricuspid Valve Repair and Replacement. JACC Cardiovasc Imaging 2020; 14:61-111. [PMID: 32828782 DOI: 10.1016/j.jcmg.2020.01.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 01/21/2020] [Accepted: 01/29/2020] [Indexed: 12/16/2022]
Abstract
Primary or secondary tricuspid regurgitation (TR) represents an important health care burden and challenge which has often been neglected or undertreated in the past. The expansion and reinforcement of the indications for tricuspid valve (TV) intervention in the 2017 editions of the guidelines as well as the introduction of transcatheter tricuspid valve intervention (TTVI) has considerably increased the attention of the community on the TV and the volume of TV interventions in the past years. Depending on the anatomic target, TTVI can be categorized as the following: 1) direct or indirect tricuspid restrictive annuloplasty; 2) direct (edge-to-edge repair) or indirect (coaptation device) restoration of leaflet coaptation; 3) heterotopic tricuspid valve implantation; and 4) transcatheter tricuspid valve replacement. Multimodality imaging has crucial role for the following: 1) patient selection for TTVI and procedure planning; 2) guiding and monitoring the procedure; and 3) assessing and following over time the results of the procedure. The key points for pre-procedural imaging are: 1) accurate quantitation of TR severity; 2) proper identification of the mechanism(s) responsible for the TR; and 3) quantitation of RV dysfunction and pulmonary arterial hypertension. This imaging work-up is essential to select the right type of intervention for the right patient and TV. Transesophageal echocardiography and fluoroscopy imaging is also key for guiding the TTVI procedures and fusion between these 2 modalities may further enhance the quality of procedure guiding.
Collapse
Affiliation(s)
| | - Lluis Asmarats
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec, Canada
| | | | - João L Cavalcante
- Department of Cardiology, Minneapolis Heart Institute, Minneapolis, Minnesota, USA
| | - Shizhen Liu
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Federico Milla
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Christopher Meduri
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Josep Rodés-Cabau
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec, Canada
| | - Mani Vannan
- Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, Georgia, USA
| | - Philippe Pibarot
- Institut Universitaire de Cardiologie et de Pneumologie de Québec/Québec Heart & Lung Institute, Université Laval, Québec, Canada.
| |
Collapse
|
8
|
Reginauld S, Liu S, Mobasseri S, Sayegh H, Rajagopal V, Meduri C, Kauten J, Vannan M. TCT-211 Static and Dynamic 3D TEE Automated Aortic Root Modeling Are Both Accurate and Useful to Size the Aortic Annulus in Patients Undergoing TAVR: Comparison to CT. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
9
|
Vemulapalli S, Meduri C, Kerr M, Roberts G, Prillinger J, McCarthy P. COMORBIDITIES AND OUTCOMES IN PATIENTS WITH NON-RHEUMATIC TRICUSPID VALVE DISEASE. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)32625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Meduri C, Hahn R, Davidson C, Lim S, Nazif T, Ricciardi M, vivek rajagopal, Ailawadi G, Vannan M, Thomas J, Kodali S. TCT-74 SCOUT Study: Trialign results at 30 days from combined US and EU cohort for the treatment of functional TR. J Am Coll Cardiol 2018. [DOI: 10.1016/j.jacc.2018.08.1166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
11
|
Yehya A, Rajagopal V, Meduri C, Kauten J, Brown M, Dean L, Webster J, Krishnamoorthy A, Hrobowski T, Dean D. TAVR is an Effective and Durable Treatment Modality for Symptomatic Aortic Insufficiency in LVAD Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
12
|
Reardon M, Meduri C, Makkar R, Bajwa T, Linke A, Kereiakes D, Waksman R, Thourani VH, Yakubov SJ, Pederson W, Rutkin B, Wang J, Allocco D, Meredith I, Feldman T, Kleiman N. OUTCOMES AND SOCIETY OF THORACIC SURGEONS RISK SCORE: A SUBANALYSIS OF THE REPRISE III RANDOMIZED CLINICAL TRIAL. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31958-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
13
|
Meduri C, Davidson C, Lim S, Nazif T, Ricciardi M, Rajagopal V, Ailawadi G, Vannan M, Thomas J, Fowler D, Rich S, Kodali SK, Hahn RT. 30 DAY RESULTS OF THE SCOUT I STUDY IN PATIENTS WITH SEVERE TRICUSPID REGURGITATION (TR). J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
14
|
Kereiakes D, Meduri C, Makkar R, Linke A, Babaliaros V, Stoler R, Mishkel G, Rizik DG, Iyer V, Schindler J, Allocco D, Meredith I, Reardon M, Feldman T. PACEMAKER DEPENDENCY FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION: A SUBANALYSIS OF THE REPRISE III RANDOMIZED CONTROLLED CLINICAL TRIAL. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
15
|
Feldman TE, Reardon MJ, Rajagopal V, Makkar RR, Bajwa TK, Kleiman NS, Linke A, Kereiakes DJ, Waksman R, Thourani VH, Stoler RC, Mishkel GJ, Rizik DG, Iyer VS, Gleason TG, Tchétché D, Rovin JD, Buchbinder M, Meredith IT, Götberg M, Bjursten H, Meduri C, Salinger MH, Allocco DJ, Dawkins KD. Effect of Mechanically Expanded vs Self-Expanding Transcatheter Aortic Valve Replacement on Mortality and Major Adverse Clinical Events in High-Risk Patients With Aortic Stenosis: The REPRISE III Randomized Clinical Trial. JAMA 2018; 319:27-37. [PMID: 29297076 PMCID: PMC5833545 DOI: 10.1001/jama.2017.19132] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. OBJECTIVE To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. DESIGN, SETTING, AND PARTICIPANTS The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017. INTERVENTIONS Participants were randomized in a 2:1 ratio to receive either an MEV (n = 607) or an SEV (n = 305). MAIN OUTCOMES AND MEASURES The primary safety end point was the 30-day composite of all-cause mortality, stroke, life-threatening or major bleeding, stage 2/3 acute kidney injury, and major vascular complications tested for noninferiority (margin, 10.5%). The primary effectiveness end point was the 1-year composite of all-cause mortality, disabling stroke, and moderate or greater paravalvular leak tested for noninferiority (margin, 9.5%). If noninferiority criteria were met, the secondary end point of 1-year moderate or greater paravalvular leak was tested for superiority in the full analysis data set. RESULTS Among 912 randomized patients (mean age, 82.8 [SD, 7.3] years; 463 [51%] women; predicted risk of mortality, 6.8%), 874 (96%) were evaluable at 1 year. The primary safety composite end point at 30 days occurred in 20.3% of MEV patients and 17.2% of SEV patients (difference, 3.1%; Farrington-Manning 97.5% CI, -∞ to 8.3%; P = .003 for noninferiority). At 1 year, the primary effectiveness composite end point occurred in 15.4% with the MEV and 25.5% with the SEV (difference, -10.1%; Farrington-Manning 97.5% CI, -∞ to -4.4%; P<.001 for noninferiority). The 1-year rates of moderate or severe paravalvular leak were 0.9% for the MEV and 6.8% for the SEV (difference, -6.1%; 95% CI, -9.6% to -2.6%; P < .001). The superiority analysis for primary effectiveness was statistically significant (difference, -10.2%; 95% CI, -16.3% to -4.0%; P < .001). The MEV had higher rates of new pacemaker implants (35.5% vs 19.6%; P < .001) and valve thrombosis (1.5% vs 0%) but lower rates of repeat procedures (0.2% vs 2.0%), valve-in-valve deployments (0% vs 3.7%), and valve malpositioning (0% vs 2.7%). CONCLUSIONS AND RELEVANCE Among high-risk patients with aortic stenosis, use of the MEV compared with the SEV did not result in inferior outcomes for the primary safety end point or the primary effectiveness end point. These findings suggest that the MEV may be a useful addition for TAVR in high-risk patients. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02202434.
Collapse
Affiliation(s)
- Ted E Feldman
- Evanston Hospital Cardiology Division, Northshore University Health System, Evanston, Illinois
| | - Michael J Reardon
- Department of Cardiovascular Surgery, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | | | - Raj R Makkar
- Cedars-Sinai Heart Institute, Los Angeles, California
| | | | - Neal S Kleiman
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas
| | - Axel Linke
- University of Leipzig, Heart Center and Leipzig Heart Institute, Leipzig, Germany
| | - Dean J Kereiakes
- Christ Hospital Heart and Vascular Center/Lindner Research Center, Cincinnati, Ohio
| | | | | | | | | | - David G Rizik
- HonorHealth and the Scottsdale-Lincoln Health Network, Scottsdale, Arizona
| | - Vijay S Iyer
- University at Buffalo/Gates Vascular Institute, Buffalo, New York
| | - Thomas G Gleason
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Joshua D Rovin
- Morton Plant Mease Healthcare System, Clearwater, Florida
| | - Maurice Buchbinder
- Foundation for Cardiovascular Medicine, Stanford University, Stanford, California
| | | | - Matthias Götberg
- Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden
| | - Henrik Bjursten
- Department of Cardiothoracic Surgery, Clinical Sciences, Lund University, Skåne University University Hospital, Lund, Sweden
| | | | - Michael H Salinger
- Evanston Hospital Cardiology Division, Northshore University Health System, Evanston, Illinois
| | | | | |
Collapse
|
16
|
Bapat V, Rajagopal V, Meduri C, Farivar RS, Walton A, Duffy SJ, Gooley R, Almeida A, Reardon MJ, Kleiman NS, Spargias K, Pattakos S, Ng MK, Wilson M, Adams DH, Leon M, Mack MJ, Chenoweth S, Sorajja P. Early Experience With New Transcatheter Mitral Valve Replacement. J Am Coll Cardiol 2017; 71:12-21. [PMID: 29102689 DOI: 10.1016/j.jacc.2017.10.061] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 10/24/2017] [Accepted: 10/24/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Transcatheter mitral valve replacement (TMVR) is a potential therapy for patients with symptomatic, severe mitral regurgitation (MR). The feasibility of this therapy remains to be defined. OBJECTIVES The authors report their early experience with TMVR using a new valve system. METHODS The valve is a self-expanding, nitinol valve with bovine pericardial leaflets that is placed using a transapical delivery system. Patients with symptomatic MR who were deemed high or extreme risk by the local heart teams were enrolled in a global pilot study at 14 sites (United States, Australia, and Europe). RESULTS Fifty consecutively enrolled patients (mean age: 73 ± 9 years; 58.0% men; 84% secondary MR) underwent TMVR with the valve. The mean Society for Thoracic Surgery score was 6.4 ± 5.5%; 86% of patients were New York Heart Association functional class III or IV, and the mean left ventricular ejection fraction was 43 ± 12%. Device implant was successful in 48 patients with a median deployment time of 14 min (interquartile range: 12 to 17 min). The 30-day mortality was 14%, with no disabling strokes, or repeat interventions. Median follow-up was 173 days (interquartile range: 54 to 342 days). At latest follow-up, echocardiography confirmed mild or no residual MR in all patients who received implants. Improvements in symptom class (79% in New York Heart Association functional class I or II at follow-up; p < 0.0001 vs. baseline) and Minnesota Heart Failure Questionnaire scores (56.2 ± 26.8 vs. 31.7 ± 22.1; p = 0.011) were observed. CONCLUSIONS TMVR with the valve was feasible in a study group at high or extreme risk for conventional mitral valve replacement. These results inform trial design of TMVR in lower-risk patients with severe mitral valve regurgitation (Evaluation of the Safety and Performance of the Twelve Intrepid Transcatheter Mitral Valve Replacement System in High Risk Patients with Severe, Symptomatic Mitral Regurgitation - The Twelve Intrepid TMVR Pilot Study; NCT02322840).
Collapse
Affiliation(s)
- Vinayak Bapat
- St. Thomas' Hospital, London, United Kingdom; New York Presbyterian/Columbia University Medical Center, New York, New York
| | | | | | | | - Antony Walton
- Cardiology Department, The Alfred, Melbourne, Australia
| | | | | | | | - Michael J Reardon
- Houston Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas
| | - Neal S Kleiman
- Houston Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas
| | | | | | - Martin K Ng
- Royal Prince Alfred Hospital, Sydney, Australia
| | | | | | - Martin Leon
- New York Presbyterian/Columbia University Medical Center, New York, New York
| | | | | | - Paul Sorajja
- Abbott Northwestern Hospital, Minneapolis, Minnesota.
| |
Collapse
|
17
|
Baron S, Li H, Magnuson E, Arnold S, Meduri C, Makkar R, Bajwa T, Linke A, Kereiakes D, Waksman R, Thourani V, Meredith I, Allocco D, Reardon MJ, Feldman T, Cohen D. TCT-782 Effect of a Mechanical-Expanding vs. Self-Expanding Transcatheter Valve Prosthesis on Health Status in Patients with Severe Aortic Stenosis at High Surgical Risk: Results from the REPRISE III Trial. J Am Coll Cardiol 2017. [DOI: 10.1016/j.jacc.2017.09.667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Meduri C, Kauten J, Vannan M, Rajagopal V. First report of a simultaneous transcatheter mitral valve-in-valve and aortic valve replacement in a left ventricular assist device patient. Catheter Cardiovasc Interv 2017; 90:526-529. [PMID: 28295972 DOI: 10.1002/ccd.26983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 01/22/2017] [Indexed: 12/20/2022]
Abstract
Transcatheter aortic valve replacement is standard of care for patients with severe aortic stenosis at high risk for surgical aortic valve replacement. Although not intended for treatment of primary aortic insufficiency, several transcatheter aortic valve prostheses have been used to treat patients with severe aortic insufficiency (AI), including patients with left ventricular assist devices (LVAD), in whom significant AI is not uncommon. Similarly, transcatheter valve replacements have been used for valve-in-valve treatment, in the pulmonary, aortic, and mitral positions, either via a retrograde femoral approach or antegrade transseptal approach (mitral valve-in-valve). In this case report, we report an LVAD patient with severe aortic insufficiency and severe bioprosthetic mitral prosthetic stenosis, in whom we successfully performed transfemoral aortic valve replacement and transfemoral mitral valve-in-valve replacement via a transseptal approach. © 2017 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Christopher Meduri
- Piedmont Heart Institute and Marcus Heart Valve Center, Atlanta, Georgia
| | - James Kauten
- Piedmont Heart Institute and Marcus Heart Valve Center, Atlanta, Georgia
| | - Mani Vannan
- Piedmont Heart Institute and Marcus Heart Valve Center, Atlanta, Georgia
| | - Vivek Rajagopal
- Piedmont Heart Institute and Marcus Heart Valve Center, Atlanta, Georgia
| |
Collapse
|
19
|
Donfrancesco C, Palmieri L, Lo Noce C, Di Lonardo A, Vannucchi S, Meduri C, Vanuzzo D, Giampaoli S. P5325Eating behaviours of hypertensive, diabetics, hypercholesterolemic, and obese in the Italian adult population: the Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey-OEC/HES results. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C. Donfrancesco
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - L. Palmieri
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - C. Lo Noce
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - A. Di Lonardo
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - S. Vannucchi
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - C. Meduri
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - D. Vanuzzo
- ANMCO Foundation For Your Heart, Florence, Italy
| | - S. Giampaoli
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | | |
Collapse
|
20
|
Palmieri L, Donfrancesco C, Lo Noce C, Vannucchi S, Di Lonardo A, Meduri C, Vanuzzo D, Giampaoli S. P6251Multi-morbidity in the Italian adult population: The Osservatorio Epidemiologico Cardiovascolare/Health Examination Survey (OEC/HES) 2008-2012. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L. Palmieri
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - C. Donfrancesco
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - C. Lo Noce
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - S. Vannucchi
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - A. Di Lonardo
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - C. Meduri
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | - D. Vanuzzo
- ANMCO Foundation For Your Heart, Florence, Italy
| | - S. Giampaoli
- Superior Institute of Health, Department of Cardiovascular, Dysmetabolic and Aging-associated Diseases, Rome, Italy
| | | |
Collapse
|
21
|
Yehya A, Rajagopal V, Meduri C, Kauten J, Brown M, Dean L, Krishnamoorthy A, Hrobowski T, McCants K, Dean D. TAVR for Treating Progressive Symptomatic Aortic Insufficiency in LVAD Patients. J Card Fail 2017. [DOI: 10.1016/j.cardfail.2017.07.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
22
|
Qian Z, Wang K, Chang YH, Zhang C, Wang B, Rajagopal V, Meduri C, Kauten J, Polsani V, Zhou X, Martin R, Houle H, Vannan M, Mansi T. 3-D PRINTING OF BIOLOGICAL TISSUE-MIMICKING AORTIC ROOT USING A NOVEL META-MATERIAL TECHNIQUE: POTENTIAL CLINICAL APPLICATIONS. J Am Coll Cardiol 2016. [DOI: 10.1016/s0735-1097(16)30008-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
23
|
Pinto DS, Kohli P, Fan W, Kirtane AJ, Kociol RD, Meduri C, Deliargyris EN, Prats J, Reynolds MR, Stone GW, Michael Gibson C. Bivalirudin is associated with improved clinical and economic outcomes in heart failure patients undergoing percutaneous coronary intervention: Results from an observational database. Catheter Cardiovasc Interv 2015; 87:363-73. [PMID: 26011467 DOI: 10.1002/ccd.26023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/18/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Outcomes with bivalirudin compare favorably with heparin ± GPIIb/IIIa receptor inhibition (heparin ± GPI) during percutaneous coronary intervention (PCI). Patients with congestive heart failure (CHF) have increased risk for complications. The objective was to investigate clinical and economic outcomes for bivalirudin ± GPI vs. heparin ± GPI among PCI patients with CHF. METHODS Using the Premier Hospital Database, PCI patients with CHF were stratified by anticoagulant: bivalirudin, bivalirudin ± GPI, heparin and heparin ± GPI. The probability of receiving bivalirudin ± GPI was estimated using individual and hospital variables. Using propensity scores, each bivalirudin ± GPI patient was matched to a heparin ± GPI patient. The primary outcome was in-hospital death. Bleeding rates, transfusion, length of stay and in-hospital cost were ascertained. RESULTS Overall, 116,313 patients at 315 hospitals received bivalirudin (n = 45,559) bivalirudin + GPI (n = 8,115), heparin (n = 27,972) or heparin + GPI (n = 34,667). Patients had STEMI (21.2%), NSTEMI (29.1%), unstable angina (16.6%), stable angina (5.7%) or other ischemic heart disease (24.2%). Of these, 79.1% of bivalirudin patients matched, resulting in 84,948 analyzed patients. Compared with heparin ± GPI patients, bivalirudin ± GPI patients had fewer deaths (3.3% vs. 3.9%; p < 0.0001), less clinically apparent bleeding (10.2% vs. 11.4%; p < 0.0001), clinically apparent bleeding with transfusion (2.7% vs. 3.2%, p <0.0001), and transfusion (8.5% vs. 9.8%, p < 0.0001). Patients receiving bivalirudin had shorter length of stay (6.3 vs. 6.8 days; p < 0.0001) and lower in-hospital cost (mean $26,706 vs. $27,166 [median $19,414 vs. $19,798]; p < 0.0001). In conclusion, this is the largest retrospective analysis of PCI patients with CHF and demonstrates bivalirudin ± GPI compared with heparin ± GPI is associated with lower inpatient rates of death, bleeding, and cost.
Collapse
Affiliation(s)
- Duane S Pinto
- Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Payal Kohli
- Cardiology Division, University of California, San Francisco
| | - Weihong Fan
- The Medicines Company, Parsippany, New Jersey
| | - Ajay J Kirtane
- Columbia University Medical Center/New York Presbyterian Hospital and Cardiovascular Research Foundation, New York, New York
| | - Robert D Kociol
- Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Christopher Meduri
- Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | | | - Jayne Prats
- The Medicines Company, Parsippany, New Jersey
| | - Matthew R Reynolds
- Lahey Clinic, Burlington, MA and Harvard Clinical Research Institute, Boston, Massachusetts
| | - Gregg W Stone
- Columbia University Medical Center/New York Presbyterian Hospital and Cardiovascular Research Foundation, New York, New York
| | - C Michael Gibson
- Cardiology Division, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
24
|
Potter BJ, Meduri C, Genereux P, Osnabrugge RL, Rajagopal V, Rassi A, Wood D, Kappetein A, Cohen D. REDUCING THE COST OF TAVR: AN EVALUATION OF THE IMPACT OF PERMANENT PACEMAKER RATE ON THE COST OF TRANSCATHETER AORTIC VALVE REPLACEMENT FROM THE HOSPITAL PERSPECTIVE. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
25
|
Meduri C, Potter B. PUTTING DECISION MODELING TO WORK FOR TAVR CENTERS: AN APP-BASED DECISION AID DESIGNED TO IMPROVE THE FINANCIAL VIABILITY OF TAVR PROGRAMS THROUGH OPTIMIZED DISCHARGE PLANNING. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61671-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
26
|
Meduri C, Reynolds M, Rassi A, Burke D, Popma J. COST–EFFECTIVENESS OF SURGICAL AORTIC VALVE REPLACEMENT VERSUS TRANSCATHETER AORTIC VALVE REPLACEMENT IN HIGH–RISK PATIENTS USING REAL–WORLD REGISTRY DATA. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)61866-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|