No abstract available.
Transcatheter Aortic Valve Replacement

No abstract available.
Transcatheter Aortic Valve Replacement

No abstract available.
Rupture ; Transcatheter Aortic Valve Replacement

No abstract available.
Aortic Valve Insufficiency ; Transcatheter Aortic Valve Replacement

Atrioventricular Block ; Humans ; Transcatheter Aortic Valve Replacement

No abstract available.
Printing, Three-Dimensional* ; Transcatheter Aortic Valve Replacement*

No abstract available.
Aorta, Thoracic ; Transcatheter Aortic Valve Replacement

BACKGROUND

There is ambiguity on antiplatelet therapy for post-transcatheter aortic valve replacement (TAVR) patients for stroke prevention, but dual antiplatelet therapy (DAPT) is routinely started despite lack of data on effectiveness and bleeding safety of DAPT versus single antiplatelet therapy (SAPT). This study aims to determine the effectiveness of DAPT versus SAPT in stroke prevention and assess bleeding safety.

METHODS

A systematic search was done for randomized clinical trials involving DAPT and SAPT in patients who underwent TAVR. The primary outcome was stroke after 1 year of either DAPT and SAPT and life-threatening bleeding. Secondary end points included all-cause mortality. Trials were identified through systematic searches on the following databases (November 2019): Cochrane, MEDLINE, and Google Scholar and ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform. Risk ratio was used for dichotomous outcomes. Heterogeneity among the studies for the meta-analysis was detected using a χ2 test (0.01 level of significance). Risk-of-bias assessment was done.

RESULTS

There is a lower incidence of stroke in patients on DAPT, but with a higher incidence of life-threatening bleeding and major bleeding. There is also a lower incidence of all-cause mortality in SAPT. The statistical power of this meta-analysis is low due to small population size.

CONCLUSION

Single antiplatelet therapy is comparable to DAPT in preventing stroke with the added benefit of a lower incidence of life-threatening and major bleeding and a lower incidence of all-cause mortality.

Hemorrhage ; bleeding ; mortality ; Myocardial Infarction ; Stroke ; Transcatheter Aortic Valve Replacement ; transcatheter aortic valve implantation

OBJECTIVETo evaluate the feasibility and effectiveness of transcatheter aortic valve implantation assisted with snare to fix the delivery system.

METHODSThis study was made in 5 healthy goats. After the abdomen was opened and the abdominal aorta was exposed, a stiff guide wire was advanced into the apex of the left ventricle through abdominal arterial puncture points. The delivery catheter equipped with valved stent was inserted into the descending aorta under fluoroscopy along the stiff guide wire. A minimal thoracic surgery approach was used to access the apex of the heart. A J-type guidewire and 5 F multifunction catheter were placed transapically and across the aortic valve down to the descending aorta. The snare was introduced through the 5 F catheter into the ascending aorta and was controlled to seize the head of stent delivery catheter. Then the delivery catheter was advanced into the left ventricle. The valved stent was positioned in the desired position under aortography and then the balloon was dilated and the valved stent was deployed into the aortic annulus assisted with snare to fix the catheter to prevent stent dispositions. Aortic angiography and echocardiography were performed to evaluate of valve performance post procedure.

RESULTSThe interventional procedure was completed successfully in all 5 goats. The mean aortic annulus diameter was (23.8 ± 2.6) mm, two valved stent of 23 mm diameter and three valved stent of 26 mm in diameter were implanted. The operation duration and X-ray exposure time were (112.3 ± 19.5) min and (16.8 ± 5.2) min, respectively. Immediate observation after procedure showed that the valved stents were in the desired position after implantation by angiography and echocardiography. No moderate to severe aortic regurgitation was observed. All goats were alive at 1 month post procedure.

CONCLUSIONSThe procedure of transcatheter implantation of a balloon-expandable valved stent into the aortic valve position of goats assisted with snare to fix the delivery catheter is feasible and effective. This procedure might be suitable also for patients with noncalcified aortic stenosis.

Animals ; Aorta ; Aortic Valve ; Aortic Valve Insufficiency ; Catheterization ; Echocardiography ; Fluoroscopy ; Goats ; Stents ; Transcatheter Aortic Valve Replacement

Since the first-in-man transcatheter delivery of an aortic valve prosthesis in 2002, the landscape of aortic stenosis therapeutics has shifted dramatically. While initially restricted to non-surgical cases, progressive advances in transcatheter aortic valve replacement and our understanding of its safety and efficacy have expanded its use in intermediate and possibly low surgical risk patients. In this review, we explore the past, present, and future of transcatheter aortic valve replacement.
Aortic Valve ; Aortic Valve Stenosis ; Humans ; Prostheses and Implants ; Transcatheter Aortic Valve Replacement*