Aortic stenosis (AS), the narrowing of the aortic valve opening which restricts blood flow to the aorta, afflicts nearly 1.5 million people in the United States, with approximately 500,000 of them suffering severe aortic stenosis. While open-heart surgery has historically been the recommended treatment for AS, some patients at high or extreme risk are not considered good candidates. Today, new data demonstrates that for patients at intermediate-risk for open-heart surgery, transcatheter aortic valve replacement (TAVR) with the latest generation of balloon-expandable device - SAPIEN 3 - is superior to surgery, resulting in better patient outcomes. This study, conducted by researchers in the Perelman School of Medicine at the University of Pennsylvania, in partnership with Edwards Lifesciences, the Cardiovascular Research Foundation, and 50 centers across the United States and Canada, was presented today at the American College of Cardiology 65th Annual Scientific Session in Chicago and simultaneously published online in The Lancet.
Researchers find transcatheter aortic valve replacement better for patients with severe aortic stenosis
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Higher volume of TAVR boosts key in-hospital outcomes
The more frequently a hospital performs a minimally invasive technique called transcatheter aortic valve replacement, or TAVR, to replace a damaged aortic heart valve, the better patients fare, on average, immediately after the procedure, researchers reported at the American College of Cardiology's 65th Annual Scientific Session.
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SAPIEN 3 improves outcomes for major endpoints at one year
Intermediate-risk patients who received transcatheter aortic valve replacement, known as TAVR, with the latest-generation valve fared better than patients receiving traditional surgical aortic valve replacement after one year, in a study presented at the American College of Cardiology's 65th Annual Scientific Session.
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Researchers identify a new signaling mechanism implicated in congenital aortic valve disease
Researchers at the Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) have demonstrated the crucial role of the NOTCH signaling pathway in the development of a fundamental heart structure, the heart valves. These valves ensure unidirectional bloodflow with each heartbeat, and open and close millions of times during a person's lifetime. The results, published in Circulation Research, could help to improve the genetic diagnosis and treatment of patients with a bicuspid aortic valve (BAV), a highly prevalent condition (affecting 1-2% of the population) that seriously compromises cardiovascular health.
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Implantation of rapid deployment aortic valve found to be durable, safe, and effective
When replacing a defective aortic valve with a new one, restoring function is the first priority. However, variables such as durability, length of surgery, duration of heart stoppage, size of the surgical incision, postoperative pain, and complications are other important considerations. In a presentation at the 96th AATS Annual Meeting, the results of the TRANSFORM Trial, a large multicenter study evaluating the safety and performance of an investigational rapid deployment aortic valve replacement (RDAVR) system for patients with severe aortic stenosis, was presented. The results show that compared to more conventional methods, this system was associated with excellent one-year survival, reduced the duration of heart stoppage, and was associated with clinically acceptable postoperative complication rates.
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Study identifies aortic valve gradient as key to TAVR outcomes
Patients with a combination of left ventricular dysfunction and low aortic valve gradient, or reduced force of blood flow through the aortic valve, have higher mortality rates and a greater risk of recurrent heart failure after transcatheter aortic valve replacement (TAVR), with low aortic valve gradient the driving force behind their poor outcomes, according to a study published today in the Journal of the American College of Cardiology.
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One-third of patients with low flow aortic stenosis do not improve with transcatheter aortic valve replacement
Aortic stenosis (AS), the narrowing of the aortic valve in the heart which causes restricted blood flow, is one of the most common and serious valve disease problems. For patients with one type of AS - low flow - transcatheter aortic valve replacement (TAVR), a minimally invasive procedure which corrects the damaged aortic valve, is often the best option for restoring the heart's normal pumping function. However, approximately one-third of low flow AS patients treated with TAVR continue to suffer persistent low flow AS even after the procedure, ultimately increasing their risk of death. Now, researchers from the Perelman School of Medicine at the University of Pennsylvania have examined this high-risk patient population to determine the cause of this persistent low flow AS and to evaluate their risk of dying during the year following the procedure. Their findings are detailed in a paper published in the Journal of the American Medical Association - Cardiology.
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One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement
Overall one-year survival was over 85 percent for high-risk or inoperable patients who underwent aortic valve replacement with the SAPIEN 3 trans-catheter aortic valve replacement system, according to a study published in the July 12 issue of the American Heart Association journal Circulation. This survival rate is strikingly higher compared to patient outcomes reported in studies that used older trans-catheter aortic valve replacements (TAVR) systems.
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Device reduces risk of brain injury after heart valve replacement
Among patients with severe aortic stenosis (narrowing of the aortic valve) undergoing transcatheter aortic valve implantation, the use of a cerebral protection device (a filter that captures debris [tissue and plaque] dislodged during the procedure) reduced the number and volume of brain lesions, according to a study appearing in the August 9 issue of JAMA.
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Review IDs predictors of post-TAVR cerebrovascular events
(HealthDay)—For patients undergoing transcatheter aortic valve replacement (TAVR), predictors of cerebrovascular events (CVEs) include female sex, chronic kidney disease, new-onset atrial fibrillation, and enrollment date, according to a review published in the Aug. 16 issue of the Journal of the American College of Cardiology.
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Novel heart valve replacement offers hope for thousands with rheumatic heart disease
Cape Town, South Africa 9 Sept 2016: A novel heart valve replacement method is revealed today that offers hope for the thousands of patients with rheumatic heart disease who need the procedure each year. The research is being presented at the SA Heart Congress 2016.
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Risk factors and clinical outcomes of infective endocarditis after transcatheter aortic valve replacement
Among patients undergoing transcatheter aortic valve replacement, younger age, male sex, history of diabetes mellitus, and moderate to severe residual aortic regurgitation were significantly associated with an increased risk of infective endocarditis, and patients who developed endocarditis had high rates of in-hospital mortality and 2-year mortality, according to a study appearing in the September 13 issue of JAMA.
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New method for performing aortic valve replacement proves successful in high risk patients
Researchers at the National Institutes of Health (NIH) have developed a new, less invasive way to perform transcatheter aortic valve replacement (TAVR), a procedure widely used to treat aortic valve stenosis, a lethal heart condition. The new approach, called transcaval access, will make TAVR more available to high risk patients, especially women, whose femoral arteries are too small or diseased to withstand the standard procedure. The Journal of the American College of Cardiology published the findings.
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Results of PARTNER II QUALITY OF LIFE study presented
Patients with severe aortic stenosis (AS) at intermediate surgical risk, and who are treated with transcatheter aortic valve replacement (TAVR) had improved health status at one month compared with surgical aortic valve replacement (SAVR) but two-year quality of life outcomes were similar. Prior studies have shown that TAVR results in an early quality of life (QoL) benefit in patients at high surgical risk; however, the effect of TAVR versus. SAVR on QoL in intermediate risk patients was unknown prior to this study.
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Researchers create exact 3-D models of patients' heart valves to assist cardiologists
Tens of thousands of patients each year are diagnosed with heart valve disease, with many in need of lifesaving surgery to treat the condition.
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Women fare better than men one year after valve replacement
Women with significant aortic valve disease who undergo transcatheter aortic valve replacement (TAVR) are considered higher risk than men in some respects. However, their survival rate one year after having had the procedure is higher than men, according to a study published today in the Journal of the American College of Cardiology.
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Recs provided for transcatheter aortic valve replacement
(HealthDay)—In a clinical expert consensus report published online Jan. 4 in the Journal of the American College of Cardiology, a series of practice point-of-care checklists help provide guidance on the use of transcatheter aortic valve replacement (TAVR).
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STS: SAVR still excellent option for intermediate-risk seniors
(HealthDay)—For intermediate-risk elderly patients, surgical aortic valve replacement (SAVR) remains a safe and effective way to treat aortic stenosis, according to a study presented at the annual meeting of the Society of Thoracic Surgeons, held from Jan. 21 to 25 in Houston.
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Furosemide plus matched hydration cuts contrast-induced AKI
(HealthDay)—For high-risk patients undergoing percutaneous coronary intervention or transcatheter aortic valve replacement, furosemide with matched hydration via the RenalGuard system may reduce the incidence of contrast-induced acute kidney injury (CI-AKI), according to a meta-analysis published in the Feb. 27 issue of JACC: Cardiovascular Interventions.
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Less invasive procedure may benefit certain heart valve patients
New recommendations clarify which patients who have malfunctioning heart valves may benefit from artificial valves replaced through a minimally invasive procedure; clarify the need for antibiotics for some patients prior to a dental procedure; and expand the age range for choosing tissue valve replacement.
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