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Khalefa BB, Ayyad M, Albandak M, Ayyad A, Yassin MNA, Awad AK. Left versus right ventricular pacing during TAVR and balloon aortic valvuloplasty: A systematic review and meta-analysis. Pacing Clin Electrophysiol 2024. [PMID: 38946136 DOI: 10.1111/pace.15032] [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: 02/06/2024] [Revised: 04/08/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION While right ventricular pacing (RVP) is the conventional temporary pacing modality used for transcatheter aortic valve replacement (TAVR), this approach possesses inherent risks and procedural challenges. We aim to assess and compare the safety and efficacy of left ventricular pacing (LVP) and RVP during TAVR and balloon aortic valvuloplasty (BAV). METHODS Following PRISMA guidelines, a comprehensive literature search was conducted in four databases from inception to December 15th, 2023. We included observational studies and clinical trials comparing LVP with RVP during TAVR and BAV procedures. Primary outcomes included short-term mortality, mortality due to cardiac tamponade, and procedural complications including bleeding, vascular complications, and cardiac tamponade. Secondary outcomes comprised procedure duration and length of hospital stay. RESULTS Five studies involving 830 patients with RVP and 1577 with LVP were included. Short-term mortality was significantly higher in the RVP group (RR 2.32, 95% CI: [1.37-3.93], P = .002), as was the incidence of cardiac tamponade (RR 2.19, 95% CI: [1.11-4.32], P = .02). LVP demonstrated shorter hospital stays (MD = 1.34 d, 95% CI: [0.90, 1.78], P < .001) and reduced procedure duration (MD = 7.75 min, 95% CI: [5.08, 10.41], P < .00001) compared to RVP. New pacemaker implantation was higher in the RVP group (RR 2.23, 95% CI: [1.14, 4.39], P = .02). CONCLUSION LVP during TAVR and BAV emerges a safer alternative to RVP, offering reduced mortality, hospital stays, and procedure durations.
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Affiliation(s)
| | - Mohammed Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Maram Albandak
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Alaa Ayyad
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | | | - Ahmed K Awad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Son BJ, Kim U, Nam JH, Choi KU, Park JI, Son JW. Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement. Tex Heart Inst J 2024; 51:e238215. [PMID: 38680081 PMCID: PMC11075486 DOI: 10.14503/thij-23-8215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Transcatheter aortic valve replacement is quickly becoming the standard of care for patients with severe aortic stenosis thanks to its minimally invasive nature and favorable outcomes. Recently, left ventricular pacing has been proposed as a safer alternative to traditional right heart pacing, which could simplify the transcatheter aortic valve replacement procedure overall, although procedural complications may still occur. This report describes a rare case of left ventricular pacing wire-induced acute severe mitral valve regurgitation during transcatheter aortic valve replacement.
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Affiliation(s)
- Byeng-Ju Son
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Ung Kim
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Jong-Ho Nam
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Kang-Un Choi
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Jong-Il Park
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Jang-Won Son
- Division of Cardiology, College of Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
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Haum M, Steffen J, Sadoni S, Theiss H, Stark K, Estner H, Massberg S, Deseive S, Lackermair K. Pacing Using Cardiac Implantable Electric Device During TAVR: 10-Year Experience of a High-Volume Center. JACC Cardiovasc Interv 2024; 17:1020-1028. [PMID: 38658116 DOI: 10.1016/j.jcin.2024.02.028] [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: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/20/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Transcatheter aortic valve replacement (TAVR) is an effective and safe therapy for severe aortic stenosis. Rapid or fast pacing is required for implantation, which can be performed via a pre-existing cardiac implantable electric device (CIED). However, safety data on CIEDs for pacing in TAVR are missing. OBJECTIVES The aim of this study was to elucidate procedural safety and feasibility of internal pacing with a CIED in TAVR. METHODS Patients undergoing TAVR with a CIED were included in this analysis. Baseline characteristics, procedural details, and complications according to Valve Academic Research Consortium 3 (VARC-3) criteria after TAVR were compared between both groups. RESULTS A total of 486 patients were included. Pacing was performed using a CIED in 150 patients and a transient pacemaker in 336 patients. No differences in technical success according to VARC-3 criteria or procedure duration occurred between the groups. The usage of transient pacers for pacing was associated with a significantly higher bleeding rate (bleeding type ≥2 according to VARC-3-criteria; 2.0% vs 13.1%; P < 0.01). Furthermore, impairment of the CIED appeared in 2.3% of patients after TAVR only in the group in which pacing was performed by a transient pacer, leading to surgical revision of the CIED in 1.3% of all patients when transient pacemakers were used. CONCLUSIONS Internal pacing using a CIED is safe and feasible without differences of procedural time and technical success and might reduce bleeding rates. Furthermore, pacing using a CIED circumvents the risk of lead dislocation. Our data provide an urgent call for the use of a CIED for pacing during a TAVR procedure in general.
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Affiliation(s)
- Magda Haum
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany.
| | - Julius Steffen
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Sebastian Sadoni
- Department of Cardiac Surgery, University Hospital Munich, Ludwig Maximilians University, Munich, Germany
| | - Hans Theiss
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Konstantin Stark
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Heidi Estner
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Steffen Massberg
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany; German Centre for Cardiovascular Research (DZHK), Munich, Germany
| | - Simon Deseive
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany
| | - Korbinian Lackermair
- Department of Medicine I, University Hospital Munich, Ludwig Maximilians University, Munich, Germany
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Regueiro A, Alperi A, Vilalta V, Asmarats L, Baz JA, Nombela-Franco L, Calabuig A, Muñoz-García A, Sabaté M, Moris C, Picard-Deland M, Pelletier-Beaumont E, Rodés-Cabau J. Safety and Efficacy of TAVR With a Pressure Sensor and Pacing Guidewire: SAFE-TAVI Trial. JACC Cardiovasc Interv 2023; 16:3016-3023. [PMID: 37902144 DOI: 10.1016/j.jcin.2023.10.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 10/31/2023]
Abstract
BACKGROUND The SavvyWire (OpSens Inc) is a 0.035-inch preshaped guidewire with dedicated pacing properties and a distal pressure sensor allowing for continuous hemodynamic pressure monitoring. OBJECTIVES This study sought to determine the efficacy and safety of the guidewire during transcatheter aortic valve replacement (TAVR) procedures. METHODS This prospective, multicenter clinical study included patients with severe aortic stenosis undergoing TAVR in 8 European centers. The primary efficacy endpoint was defined as effective left ventricular rapid pacing runs with the guidewire translating into a significant systemic pressure drop (below 60 mm Hg). The safety outcome included the absence of major procedural complications related to the guidewire. RESULTS A total of 121 patients (mean age: 82.2 ± 5.9 years, 50% women) were included in the study, and 119 (98.3%) patients were finally treated with the study device. A balloon-expandable valve was implanted in 45 (37.8%) patients. Predilatation and postdilatation were performed in 89 (74.8%) and 14 (11.8%) patients, respectively. The primary efficacy endpoint was achieved in 116 (98.3%) patients, and the mean aortic systolic arterial pressure achieved during rapid pacing was 46.6 ± 11.3 mm Hg. Hemodynamic assessment with the use of the OptoMonitor 3 (OpSens Inc) without additional catheter exchange was achieved in 117 (99.2%) patients. The safety endpoint was achieved in 117 (99.2%) patients. No procedural mortality, stroke, or ventricular perforation was reported. CONCLUSIONS The use of the guidewire during TAVR procedures appeared to be efficacious and safe. This device could help minimize interventions during the procedure and improve the clinical decision making after transcatheter heart valve deployment. (SavvyWire Efficacy and Safety in Transcatheter Aortic Valve Implantation Procedures [SAFE-TAVI]; NCT05492383).
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Affiliation(s)
- Ander Regueiro
- Clinic Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain.
| | - Alberto Alperi
- Instituto de Investigación Sanitaria del Principado de Asturias, Department of Cardiology, Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Victoria Vilalta
- Heart Institute, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Luis Asmarats
- Cardiology Unit, Interventional Cardiology Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Jose Antonio Baz
- Interventional Cardiology Unit, Hospital Alvaro Cunqueiro, Vigo, Spain
| | - Luis Nombela-Franco
- Cardiovascular Institute, Hospital Clínico San Carlos Instituto de Investigación Sanitaria Hospital Clínico San Carlos, Madrid, Spain
| | - Alvaro Calabuig
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Antonio Muñoz-García
- Hospital Regional Universitario Virgen de la Victoria, Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares, Málaga, Spain
| | - Manel Sabaté
- Clinic Cardiovascular Institute, Hospital Clinic de Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | - Cesar Moris
- Instituto de Investigación Sanitaria del Principado de Asturias, Department of Cardiology, Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | | | - Josep Rodés-Cabau
- Quebec Heart and Lung Institute, Laval University, Quebec City, Canada
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Blusztein D, Raney A, Walsh J, Nazif T, Woods C, Daniels D. Best Practices in Left Ventricular Pacing for Transcatheter Aortic Valve Replacement. STRUCTURAL HEART : THE JOURNAL OF THE HEART TEAM 2023; 7:100213. [PMID: 38046859 PMCID: PMC10692352 DOI: 10.1016/j.shj.2023.100213] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/12/2023] [Accepted: 06/22/2023] [Indexed: 12/05/2023]
Abstract
Transcatheter aortic valve replacement (TAVR) is continually evolving, with a recent emphasis on a "minimalist" approach toward reducing procedural invasiveness, duration, and recovery time. Whereas a better understanding of the relationship between TAVR and new conduction disturbances has led to improved periprocedural management, intraprocedural rapid-pacing techniques have not evolved beyond traditional right ventricular temporary pacing. An alternative strategy utilizing the left ventricular guidewire for rapid pacing has been developed with evidence supporting its safety, effectiveness, and potential reductions in procedure time and cost. This review will outline the current best practices in left ventricular pacing for TAVR, a practical technique that embraces the minimalist approach to TAVR and may be considered for routine use. It aims to explore the current evidence and combine this with expert opinion to offer a strategy for temporary pacing that encourages efficiencies for physicians and patients without compromising periprocedural safety.
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Affiliation(s)
- David Blusztein
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Aidan Raney
- Division of Cardiology, St. Joseph Hospital, Orange, California, USA
| | - Joe Walsh
- Division of Cardiology, St. Alphonsus Health System, Boise, Idaho, USA
| | - Tamim Nazif
- Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Christopher Woods
- Division of Cardiology, California Pacific Medical Center, San Francisco, California, USA
| | - David Daniels
- Division of Cardiology, California Pacific Medical Center, San Francisco, California, USA
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Faurie B, Acheampong A, Abdellaoui M, Dessus I, Monsegu J, Wintzer-Wehekind J. Direct wire pacing during measurement of fractional flow reserve: A randomized proof-of-concept noninferiority crossover trial. Front Cardiovasc Med 2023; 10:1137309. [PMID: 37937287 PMCID: PMC10625906 DOI: 10.3389/fcvm.2023.1137309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/30/2023] [Indexed: 11/09/2023] Open
Abstract
Background Adenosine administration for fractional flow reserve (FFR) measurement may induce heart pauses. Aims To assess the accuracy and tolerability of direct wire pacing (DWP) during measurement of FFR. Methods Adults with at least one intermediate coronary artery stenosis (40%-80%) were consecutively enrolled between June 2021 and February 2022 in this randomized, noninferiority, crossover trial (NCT04970082) carried out in France. DWP was applied (DWP) or not (standard method) through the pressure guidewire used for FFR measurement during adenosine-induced maximal hyperaemia. Subjects were randomly assigned to the allocation sequence (DWP first or standard first). A 2-minute washout period was observed between the two FFR measurements performed for each stenosis. The primary endpoint was the reproducibility of FFR measurements between methods. Results A total of 150 focal lesions, presented by 94 subjects, were randomized (ratio: 1:1). The FFR values obtained with each method were nearly identical (R = 0.98, p = 0.005). The mean FFR difference of 0.00054 (95% confidence interval: 0.004 to 0.003) showed the noninferiority of FFR measurement with DWP vs. that with the standard method. Higher levels of chest discomfort were reported with DWP than with the standard method (0.61 ± 0.84 vs. 1.05 ± 0.89, p < 0.001), and a correlation was observed between the electrical sensations reported with DWP and chest discomfort (p < 0.001). Pauses (n = 20/148 lesions) were observed with the standard method, but did not correlate with chest discomfort (p = 0.21). No pauses were observed with DWP. Conclusions DWP during FFR measurement resulted in accurate and reproducible FFR values, and eliminated the pauses induced by adenosine.
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Affiliation(s)
| | - Angela Acheampong
- Institut Cardiovasculaire de Grenoble, Grenoble, France
- Université Libre de Bruxelles, Bruxelles, Belgium
| | | | - Ilona Dessus
- Institut Cardiovasculaire de Grenoble, Grenoble, France
- Université Grenoble-Alpes, CHU Grenoble-Alpes, Grenoble, France
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Cafaro A, Rizzo F, Fischetti D, Quarta L, Mussardo M, Mandurino-Mirizzi A, Tondo A, Ciccone MM, Iacovelli F, Colonna G. Intracoronary Pacing during "Chimney Technique" in Transcatheter Aortic Valve-in-Valve Implantation: An Alternative Temporary Rapid Ventricular Stimulation? J Cardiovasc Dev Dis 2023; 10:341. [PMID: 37623354 PMCID: PMC10455771 DOI: 10.3390/jcdd10080341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/19/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
Temporary rapid ventricular pacing (TRVP) is required during transcatheter aortic valve implantation (TAVI) in order to reduce cardiac output and to facilitate balloon aortic valvuloplasty, prosthesis deployment, and post-deployment balloon dilation. The two most frequently used TRVP techniques are right endocardial (RE)-TRVP and retrograde left endocardial temporary rapid ventricular pacing (RLE)-TRVP. The first one could be responsible for cardiac tamponade, one of the most serious procedural complications during TAVI, while the second one could often be unsuccessful. Intracoronary (IC)-TRVP through a coronary guidewire has been described as a safe and efficient procedure that could avoid such complications. We describe two clinical cases in which IC-TRVP has been effectively used during valve-in-valve TAVI with coronary protection via the "chimney technique", after unsuccessful RLE-TRVP.
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Affiliation(s)
- Alessandro Cafaro
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Francesco Rizzo
- Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, 70124 Bari, Italy; (M.M.C.); (F.I.)
| | - Dionigi Fischetti
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Luca Quarta
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Marco Mussardo
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Alessandro Mandurino-Mirizzi
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Antonio Tondo
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
| | - Marco Matteo Ciccone
- Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, 70124 Bari, Italy; (M.M.C.); (F.I.)
| | - Fortunato Iacovelli
- Division of University Cardiology, Cardiothoracic Department, Policlinico University Hospital, 70124 Bari, Italy; (M.M.C.); (F.I.)
- Division of Cardiology, “SS. Annunziata” Hospital, 74121 Taranto, Italy
| | - Giuseppe Colonna
- Division of Cardiology, “V. Fazzi” Hospital, 73100 Lecce, Italy; (A.C.); (D.F.); (L.Q.); (M.M.); (A.M.-M.); (A.T.); (G.C.)
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Wintzer-Wehekind J, Lefèvre T, Benamer H, Monsegu J, Tchétché D, Garot P, Honton B, Dumonteil N, Abdellaoui M. A direct wire pacing device for transcatheter heart valve and coronary interventions: a first-in-human, multicentre study of the Electroducer Sleeve. EUROINTERVENTION 2023; 18:1150-1555. [PMID: 36484703 PMCID: PMC9976696 DOI: 10.4244/eij-d-22-00662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/07/2022] [Indexed: 02/19/2023]
Abstract
BACKGROUND Transcatheter aortic valve implantation (TAVI) and complex percutaneous coronary interventions (PCI) may require cardiac pacing during device delivery, generally requiring the insertion of a temporary pacing lead via an additional venous access site. The purpose-built Electroducer Sleeve device provides direct wire pacing without the need for a temporary venous pacemaker. AIMS This study assessed the safety of temporary cardiac pacing using the novel sleeve device during PCI. METHODS This was a multicentre, non-randomised, prospective, first-in-human, single-arm, pilot study. The primary endpoint was analysis of a safety outcome, defined as the occurrence of haematomas or bleeding complications at the device vascular access site. Secondary endpoints included analyses of effectiveness and qualitative outcomes. RESULTS Sixty patients (mean age: 77.9±9.6 years) from 4 centres in France were included: 39 (65%) underwent TAVI, and 21 (35%) underwent PCI. Procedures were performed using the sleeve with access through the radial (32 patients; 53.3%) or femoral arteries (26; 43.3%), or the femoral vein (2; 3.3%). Primary endpoint analysis revealed that 2 patients (3.3%) developed EArly Discharge After Transradial Stenting of CoronarY Arteries Study (EASY) grade I/Bleeding Academic Research Consortium (BARC) type I haematomas at the device access site. As a measure of effectiveness, a haemodynamic effect was observed after each spike delivery in 54 patients (90%). Analyses of other secondary endpoints showed that 2 patients (6.3%) presented asymptomatic radial artery occlusion. No allergies were reported. CONCLUSIONS This first-in-human trial using the Electroducer Sleeve indicated that this novel, purpose-built, temporary pacing device was safe and effective. Larger prospective studies are required to confirm these findings.
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Affiliation(s)
- Jérôme Wintzer-Wehekind
- Institut Cardiovasculaire de Grenoble, Grenoble, France
- Médipôle Lyon-Villeurbanne, Villeurbanne, France
| | - Thierry Lefèvre
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy, France
| | - Hakim Benamer
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy, France
| | - Jacques Monsegu
- Institut Cardiovasculaire de Grenoble, Grenoble, France
- Médipôle Lyon-Villeurbanne, Villeurbanne, France
| | - Didier Tchétché
- Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, Toulouse, France
| | - Philippe Garot
- Institut Cardiovasculaire Paris Sud, Hôpital Privé Jacques Cartier, Massy, France
| | - Benjamin Honton
- Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, Toulouse, France
| | - Nicolas Dumonteil
- Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, Toulouse, France
| | - Mohamed Abdellaoui
- Institut Cardiovasculaire de Grenoble, Grenoble, France
- Médipôle Lyon-Villeurbanne, Villeurbanne, France
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9
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Tagliari AP, Taramasso M. New Practices in Transcatheter Aortic Valve Implantation: How I Do It in 2023. J Clin Med 2023; 12:jcm12041342. [PMID: 36835878 PMCID: PMC9964275 DOI: 10.3390/jcm12041342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/31/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) went through a huge evolution in the last decades. Previously performed under general anesthesia, with transoperative transesophageal echocardiography guidance and using cutdown femoral artery access, the procedure has now evolved into a minimalist approach, with local anesthesia, conscious sedation, and the avoidance of invasive lines becoming the new standards. Here, we discuss the minimalist TAVI approach and how we incorporate it into our current clinical practice.
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Affiliation(s)
- Ana Paula Tagliari
- Cardiovascular Surgery Department, Hospital São Lucas da PUC-RS, Porto Alegre 90619-900, Brazil
- Cardiovascular Surgery Department, Hospital Mãe de Deus, Porto Alegre 90880-0481, Brazil
- Correspondence: ; Tel.: +55-(51)-33205186
| | - Maurizio Taramasso
- HerzZentrum Hirslanden Zurich, Clinic of Cardiac Surgery, 8008 Zurich, Switzerland
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10
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Helmy T, Mina G. Single access TAVR. How "minimalist" do we need to be? Catheter Cardiovasc Interv 2022; 100:233-234. [PMID: 35920372 DOI: 10.1002/ccd.30334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 11/12/2022]
Affiliation(s)
- Tarek Helmy
- Division of Cardiology, Ochsner Louisiana State University Health, Shreveport, Louisiana, USA
| | - George Mina
- Division of Cardiology, Ochsner Louisiana State University Health, Shreveport, Louisiana, USA
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11
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Aroney NP, Patterson T, Kalogeropoulos A, Allen CJ, Hurrell H, Chehab O, Grapsa J, Rajani R, Prendergast B, Redwood S. Clinical outcomes following single access transfemoral transcatheter aortic valve implantation. Catheter Cardiovasc Interv 2022; 100:227-232. [PMID: 35686532 DOI: 10.1002/ccd.30246] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We describe the first experience using calcification of anatomical landmarks to obviate the need for transcatheter aortic valve implantation (TAVI) alignment aortography and secondary TAVI access. BACKGROUND TAVI alignment conventionally involves secondary femoral access for contrast aortography using a second catheter. Secondary femoral access accounts for up to 25% of all vascular complications. Heavily calcified aortic leaflets are often visible fluoroscopically and can act as markers for TAVI alignment. METHODS We considered 100 consecutive patients for transfemoral TAVI. The first group was considered for a conventional dual access technique and the subsequent group was considered for a single access technique. Relevant baseline, and procedural and outcome measures were recorded. RESULTS Baseline characteristics were comparable between groups. Balloon-expandable transcatheter heart valves (THV) were used in all cases. THV implantation was successful in 100% of cases with no procedural or in-hospital mortality. Procedural time and contrast use were lower in the single access group. There were no Valve Academic Research Consortium (VARC)-2 major vascular complications with the single access technique. CONCLUSIONS This is the first study describing the use of calcification of anatomical landmarks to obviate the need for secondary TAVI access. Notable observations included successful device implantation in all cases, no VARC-2 major vascular complications, comparable rates of paravalvular leak and permanent pacemaker requirement, shorter procedural times, and lower contrast use. Single access TAVI is a viable alternative technique to minimize vascular access, contrast use, and procedural duration in experienced centers and with selected patients, allowing successful device implantation and low complication rates while further streamlining TAVI workflow.
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Affiliation(s)
- Nicholas P Aroney
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Tiffany Patterson
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Christopher J Allen
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Harriet Hurrell
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Omar Chehab
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Julia Grapsa
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ronak Rajani
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Bioengineering and Imaging Sciences, King's College London, London, UK
| | - Bernard Prendergast
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Simon Redwood
- Cardiovascular Directorate, Guy's and St Thomas' NHS Foundation Trust, London, UK
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12
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Savvoulidis P, Mechery A, Lawton E, Ludman PF, Sharma H, Thompson S, Khalil A, Kalogeropoulos A, Khan S, Nadir AM, Doshi SN. Comparison of left ventricular with right ventricular rapid pacing on tamponade during TAVI. Int J Cardiol 2022; 360:46-52. [PMID: 35597495 DOI: 10.1016/j.ijcard.2022.05.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Small studies have suggested left ventricular (LV) rapid pacing has similar safety and efficacy to conventional right ventricular (RV) rapid pacing in transcatheter aortic valve implantation (TAVI). However, there are limited data on the comparative rates of tamponade. The study compared the rate of cardiac tamponade between LV and RV-pacing during TAVI. METHODS Between 2008 and 2021, 1226 consecutive patients undergoing transfemoral or transaxillary TAVI were included. 470(38.3%) patients had TAVI deployment with RV-pacing and 756(61.7%) with LV-pacing. The primary outcome was the frequency and cause of cardiac tamponade. Secondary outcomes included efficacy, procedure duration and crossover rates. RESULTS There was a trend to less tamponade with LV-pacing, which did not reach statistical significance [11(2.3%) vs 11(1.5%);P = 0.27]. There was no significant difference in the frequency of tamponade due to annular tear [4(0.9%) vs 9(1.2%);P = 0.59] or LV free-wall perforation [1(0.2%) vs 2(0.3%);P = 0.86]. The frequency of tamponade due to RV perforation was significantly lower in the LV-pacing group [0 vs 6(2.3%);P < 0.005)]. Two patients with tamponade due to RV perforation required emergency sternotomy of whom one died. Deployment success was similar (99% vs 99.6%;P=NS). Procedure duration was shorter with LV-pacing (70 vs 80 mins;P < 0.005). Crossover to RV-pacing was low (0.9%). There were no embolizations caused by loss-of-capture in either group. CONCLUSIONS LV-pacing appears equally efficacious and is associated with a lower risk of tamponade due to RV perforation caused by the temporary pacing wire. LV-pacing was not associated with an increased risk of tamponade due to LV free-wall perforation.
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Affiliation(s)
- Panagiotis Savvoulidis
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Anthony Mechery
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Ewa Lawton
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Peter F Ludman
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Harish Sharma
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Sophie Thompson
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | - Arsalan Khalil
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK
| | | | - Sohail Khan
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Adnan M Nadir
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Sagar N Doshi
- Department of Cardiology, Queen Elizabeth University Hospital, Mindelsohn Way, Edgbaston, Birmingham B15 2WB, UK; Institute for Cardiovascular Sciences, College of Medical & Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK..
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13
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Dall'Ara G, Grotti S, Guerrieri G, Compagnone M, Spartà D, Galvani M, Tarantino F. Balloon aortic valvuloplasty: current status and future prospects. Expert Rev Cardiovasc Ther 2022; 20:389-402. [PMID: 35514027 DOI: 10.1080/14779072.2022.2074837] [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] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Balloon aortic valvuloplasty (BAV) improves hemodynamic and clinical status of patients with severe aortic stenosis (AS) for a limited period of 6-12 months. However, there is a high number of procedures performed worldwide and an upward trend over the last decades. AREAS COVERED Epidemiology of AS and the advent of transcatheter aortic valve implantation (TAVI) contribute to the extensive referral of patients. The expansion of recommendations for TAVI has occasionally led to financial reimbursement-related problems that do not exist for BAV. BAV is indicated as a bridge to valve replacement, to decision in complex cases, and to extracardiac surgery. BAV may play a role in preparing for TAVI and optimizing procedural results. The minimalist approach and reduced complication rate make it applicable in fragile patients. EXPERT OPINION In the near future, BAV will continue to be a useful asset in managing patients with AS given the multiple indications, broad applicability, safety profile, low cost, and repeatability. Specific studies are necessary to explore technical solutions, stronger indications, the finest technique, and to standardize the procedural result. Pending the development of potential competitive devices, the role that BAV plays will remain closely intertwined with the one played by TAVI.
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Affiliation(s)
| | - Simone Grotti
- Cardiology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | | | | | - Daniela Spartà
- Cardiology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Marcello Galvani
- Cardiology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy.,Cardiovascular Research Unit, Myriam Zito Sacco Heart Foundation, Forlì, Italy
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14
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Carey J, Buckley A, O'Connor S, Hensey M. The Wattson temporary pacing guidewire for transcatheter heart valve implantation. Future Cardiol 2021; 18:275-283. [PMID: 34875868 DOI: 10.2217/fca-2021-0105] [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: 11/21/2022] Open
Abstract
Transcatheter aortic valve implantation and implantation of other transcatheter heart valves, generally requires insertion of a temporary venous pacemaker. Implantation of a temporary venous pacemaker adds complexity, time and risk to the procedure. Guidewire modification to allow pacing is increasingly popular, however it requires technical expertise and provides unipolar pacing resulting in high thresholds and potential capture loss. The Wattson temporary pacing guidewire is a novel device which offers guidewire support for valve delivery and concomitant bipolar pacing. It may offer a safe and effective solution to guidewire pacing for transcatheter aortic valve implantation and other transcatheter heart valve implantations. Herein, we review the literature surrounding left ventricular guidewire pacing along with the features and clinical data of the Wattson wire.
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Affiliation(s)
- James Carey
- St James's Hospital, James St, Dublin 8, Ireland
| | | | | | - Mark Hensey
- St James's Hospital, James St, Dublin 8, Ireland
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15
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Tamura Y, Tamura Y, Konami Y, Suzuyama H, Horio E, Yamada M, Sassa T, Taguchi E, Horibata Y, Ideta I, Kawamura A, Sakamoto T. Comparison of left ventricular pacing performance among pre-shaped guidewires designed for transfemoral-approach transcatheter aortic valve implantation. Heart Vessels 2021; 37:460-466. [PMID: 34524498 DOI: 10.1007/s00380-021-01938-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/03/2021] [Indexed: 11/30/2022]
Abstract
TAVI is an established therapy for patients with severe aortic stenosis. Rapid or control pacing is necessary for TAVI, and most centers are familiar with right ventricular (RV) pacing. Although there are several reports on the efficacy and safety of LV pacing, they are still few. In addition, LV pacing has not been studied for different LV guidewires. Our aim is to study the effectiveness of left ventricular (LV) pacing and the thresholds of LV guidewires in patients who underwent transcatheter aortic valve implantation (TAVI). We retrospectively analyzed 252 consecutive patients who underwent trans-femoral TAVI (TF-TAVI) with LV pacing in our institute between December 2017 and November 2020. We excluded 48 patients from the total cohort due to TAVI with RV pacing, and the remaining 204 patients were analyzed (52 males, mean age 85 ± 5 years). Among them, 202 patients (99.0%) had successful LV pacing. In the two patients with failed LV pacing, SAFARI2™ Small was used. The CONFIDA™ group (n = 34) showed a significantly lower threshold than the SAFARI2™ group (n = 163) (median 3.0 vs. 5.0 V; P = 1.1 × 10-7). LV pacing with Lunderquist® was successful in all patients (n = 7). LV pacing in TAVI was an effective and safe strategy. CONFIDA™ wire may be particularly well suited for LV pacing in TAVI.
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Affiliation(s)
- Yudai Tamura
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan.,Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yuichi Tamura
- Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Yutaka Konami
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Hiroto Suzuyama
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Eiji Horio
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Masahiro Yamada
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Toshiharu Sassa
- Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Eiji Taguchi
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Yoko Horibata
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Ichiro Ideta
- Division of Cardiovascular Surgery, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan
| | - Akio Kawamura
- Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Japan
| | - Tomohiro Sakamoto
- Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, 5-3-1 Chikami Minami-ku, Kumamoto, 861-4193, Japan.
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Cockburn J, Arunothayaraj S, Gannaway A, Alsanjari O, Parker J, Trivedi U, Hildick-Smith D. Balloon seal separation leading to SAPIEN 3 transcatheter heart valve deployment failure: Complications and management. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021; 40S:144-147. [PMID: 34344585 DOI: 10.1016/j.carrev.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 11/03/2022]
Abstract
We present two cases of failure of balloon inflation secondary to balloon separation from the delivery catheter when implanting the SAPIEN 3 transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA). Although very uncommon, this is a potentially disastrous complication of transcatheter intervention. Case 1 highlights the complexity of the problem when it occurs and subsequent complications. Case 2 highlights how to manage this issue successfully.
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Affiliation(s)
- James Cockburn
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
| | - Sandeep Arunothayaraj
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom.
| | - Alex Gannaway
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
| | - Osama Alsanjari
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
| | - Jessica Parker
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
| | - Uday Trivedi
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
| | - David Hildick-Smith
- Sussex Cardiac Centre, University Hospitals Sussex NHS Trust, Brighton BN2 5DE, United Kingdom
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17
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Liang Y, Dhoble A, Pakanati A, Zhao Y, Kork F, Ruan W, Markham T, Smalling R, Balan P, Estrera A, Nguyen TC, Gregoric I, Kar B, Eltzschig H. Catastrophic Cardiac Events during Transcatheter Aortic Valve Replacement. Can J Cardiol 2021; 37:1522-1529. [PMID: 33992736 DOI: 10.1016/j.cjca.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/03/2021] [Accepted: 05/05/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Perioperative complications of transcatheter aortic valve replacement (TAVR) are decreasing but can be catastrophic when they occur. Systematic reports of the nature of these events are lacking in the contemporary era. Our study aimed to report the incidence, outcomes, and perioperative management of catastrophic cardiac events in patients undergoing TAVR and to propose a working strategy to address these complications. METHODS This is a retrospective cohort study of patients who developed catastrophic cardiac events during or immediately after TAVR between 2015 and 2019 at a single academic center. RESULTS Of 2102 patients who underwent TAVR, 51 (2.5%) developed catastrophic cardiac events. The causes included cardiac perforation and tamponade (n=19, 37.3%), acute left ventricular failure (n=10, 19.6%), coronary artery obstruction (n=10, 19.6%), aortic root disruption (7, 13.7%), and device embolization (n=5, 9.8%). Twenty-four patients (47.0%) with catastrophic cardiac events required stabilization by either intra-aortic balloon counter-pulsation or extracorporeal membrane oxygenation. The in-hospital mortality rate increased by 11.7-fold for patients with catastrophic cardiac events compared to those without (25.5% vs 2.0%, p<0.001). Patients who developed aortic root disruption had the highest mortality rate (42.8%) compared with the others. The incidence of catastrophic cardiac events remained stable over a 5-year period, but the associated mortality decreased from 38.5% in 2015 to 9.1% in 2019. CONCLUSIONS Catastrophic cardiac events during TAVR are rare, but they account for a dramatic increase in perioperative mortality. Early recognition and development of a standardized perioperative team approach can help manage patients experiencing these complications.
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Affiliation(s)
| | | | | | | | - Felix Kork
- Department of Anesthesiology, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | | | | | | | | | - Anthony Estrera
- Department of Cardiac Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School/Memorial Hermann Heart and Vascular Institute, Houston, TX, USA
| | - Tom C Nguyen
- Department of Cardiac Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School/Memorial Hermann Heart and Vascular Institute, Houston, TX, USA
| | - Igor Gregoric
- Department of Advanced Cardiopulmonary Therapies and Transplantation
| | - Biswajit Kar
- Department of Advanced Cardiopulmonary Therapies and Transplantation
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18
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Abstract
Bradyarrhythmias represent a common pathology in the intensive care unit (ICU) with etiologies of varying severity. Treatment has often been focused on correcting underlying causes and may require pacing for urgent hemodynamic support. In recent years, there has been interest in physiologic pacing modalities which avoid the dyssynchrony from right ventricular (RV) only pacing. Cardiac resynchronization therapy (CRT) through biventricular pacing is a well-established device-based electrical therapy in patients with wide QRS and heart failure. Recently, it has been shown that biventricular pacing may also be pursued for hemodynamic rescue in the ICU setting. Efforts to re-engage the conduction system with His bundle pacing or further downstream have also emerged as alternative means to deliver resynchronization, with early applications in the ICU now being reported. The goal of the review is to examine bradyarrhythmia causes and management in the ICU as well as investigate new approaches in physiologic pacing and their potential roles in critically ill patients.
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Affiliation(s)
- Jonathan Lattell
- Center for Arrhythmia Care
- Heart and Vascular Institute, University of Chicago Pritzker School of Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Gaurav A Upadhyay
- Center for Arrhythmia Care
- Heart and Vascular Institute, University of Chicago Pritzker School of Medicine, The University of Chicago Medicine, Chicago, IL, USA
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19
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Tumscitz C, Di Cesare A, Balducelli M, Piva T, Santarelli A, Saia F, Tarantino F, Preti G, Picchi A, Rolfo C, Attisano T, Colonna G, De Iaco G, Parodi G, Di Marco M, Cerrato E, Pierini S, Fileti L, Cavazza C, Dall'Ara G, Govoni B, Mantovani G, Serenelli M, Penzo C, Tebaldi M, Campo G, Biscaglia S. Safety, efficacy and impact on frailty of mini-invasive radial balloon aortic valvuloplasty. Heart 2021; 107:874-880. [PMID: 33627400 DOI: 10.1136/heartjnl-2020-318548] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The study was designed to: (1) confirm safety and feasibility of mini-invasive radial balloon aortic valvuloplasty (BAV); (2) assess its impact in terms of quality of life and frailty; and (3) evaluate whether changes in frailty after BAV are associated with death in patients undergoing transcatheter aortic valve implantation (TAVI). METHODS 330 patients undergoing BAV in 16 Italian centres were prospectively included. The primary endpoint was the occurrence of major and minor Valve Academic Research Consortium (VARC)-2 bleeding. Secondary endpoints were scales of quality of life, frailty, evaluated at baseline and 30 days, and their relationship with the occurrence of all-cause death. RESULTS BAV was performed by radial access in 314 (95%) patients. No VARC-2 major and six (1.8%) VARC-2 minor bleedings occurred in the study population. Quality of life, as well as frailty status, significantly improved 30 days after BAV. At 1 year, patients undergoing TAVI with baseline essential frailty toolset (EFT) <3 or achieving an EFT <3 after BAV had a comparable occurrence of all-cause death (15% vs 19%, p=0.58). On the contrary, patients with EFT ≥3 at 30 days despite BAV showed the worst prognosis (all-cause death: 40% vs 15% and 19%, p=0.006 and p=0.05, respectively). CONCLUSIONS Mini-invasive radial BAV is safe, feasible and associated with a low rate of vascular complications. Patients improving EFT 30 days after BAV showed a favourable outcome after TAVI. TRIAL REGISTRATION NUMBER NCT03087552.
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Affiliation(s)
- Carlo Tumscitz
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
| | - Annamaria Di Cesare
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
| | - Marco Balducelli
- Cardiovascular Department, Azienda Unità Sanitaria Locale della Romagna, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Tommaso Piva
- Cardiology Unit, Ospedali Riuniti Umberto I - GM Lancisi, Ancona, Italy
| | | | - Francesco Saia
- Cardiology Unit, Cardio-Thoracic-Vascular Department, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | | | - Gerlando Preti
- Cardiac Unit, Aulss 2 Marca Trevigiana, Ospedale civile, Conegliano Veneto (TV), Italy
| | - Andrea Picchi
- Cardiovascular Department, Azienda USL Toscana SudEst, Misericordia Hospital, Grosseto, Italy
| | - Cristina Rolfo
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli (TO), Italy
| | - Tiziana Attisano
- Interventional Cardiology Unit, Heart Department, AOU S.Giovanni di Dio e Ruggi D'Aragona (SA), Salerno, Italy
| | | | - Giuseppe De Iaco
- Interventional Cardiology, AO Cardinal G Panico, Tricase (LE), Italy
| | - Guido Parodi
- Clinica Cardiologica, Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy
| | | | - Enrico Cerrato
- Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli (TO), Italy
| | - Simona Pierini
- Cardiovascular Department, ASST Nord Milano - Bassini Hospital, Cinisello Balsamo (MI), Italy, Cinisello Balsamo, Italy
| | - Luca Fileti
- Cardiovascular Department, Azienda Unità Sanitaria Locale della Romagna, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | | | - Benedetta Govoni
- Department of Medical Sciences, Ferrara University, Ferrara, Italy
| | | | - Matteo Serenelli
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
| | - Carlo Penzo
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
| | - Matteo Tebaldi
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
| | - Gianluca Campo
- Department of Medical Sciences, Cardiology Unit, Azienda Ospedaliera Universitaria di Ferrara, Cona (FE), Italy
| | - Simone Biscaglia
- Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Cona, Emilia-Romagna, Italy
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20
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Acurate Neo Implantation to Treat Degenerative Regurgitation of Surgical Bioprostheses. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 28S:105-108. [PMID: 32981854 DOI: 10.1016/j.carrev.2020.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 09/01/2020] [Accepted: 09/14/2020] [Indexed: 11/21/2022]
Abstract
Valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) provides a safe and effective treatment option for failing surgical aortic bioprostheses. Self-expanding supra-annular valves offer optimal haemodynamics for this clinical application. The Acurate Neo transcatheter heart valve (THV) offers further unique advantages with stabilisation arches to assist with alignment, upper crowns to restrain bioprosthetic valve leaflets, rapid final opening coaxial to the left ventricular outflow tract and an open design that optimises future coronary access. We report our procedural technique and experience using the Acurate Neo THV in four VIV-TAVR implantations for patients aged between 70 and 81 yrs. All patients presented with severe symptomatic valvular aortic regurgitation (AR), one of whom was in cardiogenic shock. The patients had malfunctioning surgical bioprostheses (stented n = 3; stentless n = 1) ranging in size from 21 to 25 mm. The Acurate Neo THV was successfully implanted in all patients without any complications, residual AR, coronary compromise or need for permanent pacing. Length of stay was 2 to 7 days. Follow-up to 12 months revealed no adverse events. The Acurate Neo THV is an attractive self-expanding option for patients with AR due to degeneration of a surgical aortic valve bioprosthesis.
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21
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Kirtchuk D, Williams T, Cockburn J, Hildick-Smith D. Transcatheter Aortic Valve Implantation in Patients With Symptomatic Severe Aortic Regurgitation Using the Self-Expanding Acurate neo Valve. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2020; 21:14-17. [PMID: 32675001 DOI: 10.1016/j.carrev.2020.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This case series describes use of the Acurate Neo transcatheter aortic valve in patients with symptomatic severe native aortic regurgitation (AR). TAVI is not currently mentioned in either the European Society of Cardiology or American College of Cardiology guidance for management of severe symptomatic AR. There are no randomised trials comparing the outcomes of patients with pure severe AR treated with a TAVI valve vs surgical aortic valve replacement (sAVR). METHOD We present a case series of four patients with isolated AR treated using the Acurate Neo valve (Boston Scientific). Each case had been turned down for sAVR but deemed suitable for TAVI after review at the structural heart multi-disciplinary team meeting. TAVI implantation was successful in each case with reduction or resolution of their AR and improved cardiac haemodynamics. RESULTS Three of the patients had significant symptomatic improvement, one had limited symptomatic improvement despite resolution of her AR on aortogram post TAVI. CONCLUSION Our case series adds to the growing literature that TAVI is a viable option for patients with pure AR but further long-term follow-up is required to assess the longevity and robustness of the valves.
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22
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May A, Collins N, Jackson N, Fitzgerald J, Boyle A, Bhagwandeen R. Pacing Over the Guidewire in Cardiac Structural Intervention: A Practical Guide. Heart Lung Circ 2020; 29:e265-e268. [PMID: 32718903 DOI: 10.1016/j.hlc.2020.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/01/2020] [Indexed: 11/17/2022]
Abstract
Left ventricular access for aortic valve intervention provides the opportunity to deliver rapid pacing over the guidewire for device positioning and deployment. Temporary pacing delivered via the left ventricle can obviate the need for venous access and has been shown to be a safe alternative to temporary right ventricular pacing. The technique requires some basic knowledge and experience in temporary cardiac pacing. We outline safe practical steps and common pitfalls in using this technique.
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Affiliation(s)
- Austin May
- John Hunter Hospital, Newcastle, NSW, Australia.
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23
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Williams T, Hildick-Smith DJR. Balloon aortic valvuloplasty: indications, patient eligibility, technique and contemporary outcomes. Heart 2020; 106:1102-1110. [PMID: 32444499 DOI: 10.1136/heartjnl-2019-315904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Kleczynski P, Dziewierz A, Socha S, Rakowski T, Daniec M, Zawislak B, Arif S, Wojtasik-Bakalarz J, Dudek D, Rzeszutko L. Direct Rapid Left Ventricular Wire Pacing during Balloon Aortic Valvuloplasty. J Clin Med 2020; 9:jcm9041017. [PMID: 32260289 PMCID: PMC7230545 DOI: 10.3390/jcm9041017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Rapid ventricular pacing is mandatory for optimal balloon positioning during aortic valvuloplasty (BAV) in patients with severe aortic stenosis. We aimed to assess the safety and efficacy of direct left ventricular (LV) guidewire pacing in comparison with regular pacing induced by temporary pacemaker (PM) placement in the right ventricle. Methods: Direct rapid LV pacing was provided with a 0.035″ guidewire. Baseline clinical characteristics, echocardiographic and procedural data, as well as complication rates, were compared between the two groups. Results: A total of 202 patients undergoing BAV were enrolled (49.5% with direct LV guidewire pacing). The pacing success rate was 100%. In the direct LV guidewire pacing group, we found a lower radiation dose, shorter fluoroscopy and overall procedural time (0.16 vs. 0.28 Gy, p = 0.02; 5.4 vs. 10.3 min, p = 0.01; 17 vs. 25 min, p = 0.01; respectively). In addition, the complication rate was lower in that group (cardiac tamponades, vascular access site complications, blood transfusions rate, and in-hospital mortality: 0% vs. 3.9%; 4.0% vs. 15.7%; 2.0% vs. 12.7%; 2.0% vs. 9.8%, p = 0.01 for all, respectively). Conclusions: Direct rapid LV guidewire pacing is a simple, safe and effective option for BAV with a reduced complication rate compared to a temporary PM placed in the right ventricle.
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Affiliation(s)
- Pawel Kleczynski
- Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Pradnicka 80 Street, 31-202 Krakow, Poland
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
- Correspondence:
| | - Artur Dziewierz
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Sylwia Socha
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Tomasz Rakowski
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Marzena Daniec
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Barbara Zawislak
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
- Intensive Cardiac Care Unit, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland
| | - Saleh Arif
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Joanna Wojtasik-Bakalarz
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
| | - Dariusz Dudek
- 2nd Department of Cardiology, Jagiellonian University Medical College, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (A.D.); (T.R.); (B.Z.); (D.D.)
| | - Lukasz Rzeszutko
- Department of Cardiology and Cardiovascular Interventions, University Hospital, Jakubowskiego 2 Street, 30-688 Krakow, Poland; (S.S.); (M.D.); (S.A.); (J.W.-B.); (L.R.)
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25
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Hensey M, Sathananthan J, Alkhodair A, Landes U, Wood DA, Daniels D, Webb JG. Single‐center prospective study examining use of the Wattson temporary pacing guidewire for transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2020; 96:968-971. [DOI: 10.1002/ccd.28832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 02/25/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Mark Hensey
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
| | - Janarthanan Sathananthan
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
| | - Abdullah Alkhodair
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
| | - Uri Landes
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
| | - David A. Wood
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
| | - David Daniels
- Department of Interventional Cardiology Sutter Health San Francisco California USA
| | - John G. Webb
- Centre for Heart Valve Innovation St Paul's Hospital, University of British Columbia Vancouver Canada
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26
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Dall'Ara G, Tumscitz C, Grotti S, Santarelli A, Balducelli M, Tarantino F, Saia F. Contemporary balloon aortic valvuloplasty: Changing indications and refined technique. Catheter Cardiovasc Interv 2020; 97:E1033-E1042. [PMID: 32096927 DOI: 10.1002/ccd.28807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/25/2020] [Accepted: 02/10/2020] [Indexed: 12/19/2022]
Abstract
Even if un to improve long-term prognosis, balloon aortic valvuloplasty (BAV) may be useful in selected patients with symptomatic severe aortic stenosis either as a bridge to surgical or transcatheter valve replacement (aortic valve replacement [AVR] or transcatheter aortic valve implantation [TAVI]) or as a triage strategy for patients with uncertain indications. International guidelines recommend BAV as: a "bridge" to AVR/TAVI, a "trial" in patients with undetermined symptoms, or a "bridge-to-decision" in case of comorbidities. However, in clinical practice, BAV is also used as a palliative measure to improve hemodynamics and quality of life in many patients who are excluded from AVR/TAVI. Finally, BAV is often performed during TAVI to facilitate prosthesis delivery, optimize frame expansion, or for bioprosthetic valve fracture in selected valve-in-valve procedures. Technical innovations, which allow for a mini-invasive approach via transradial access and pacing delivered through the wire, have led to a decrease in complications over time. This review focuses on contemporary BAV with a specific emphasis on new indications, innovative techniques, and specific complex patient subgroups.
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Affiliation(s)
| | - Carlo Tumscitz
- Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Cona, Italy
| | - Simone Grotti
- Cardiology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | | | - Marco Balducelli
- Cardiology Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
| | | | - Francesco Saia
- Cardiology Unit, Policlinico S.Orsola-Malpighi University Hospital, Bologna, Italy
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27
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Burzotta F, Aurigemma C, Romagnoli E, Shoeib O, Russo G, Zambrano A, Verdirosi D, Leone AM, Bruno P, Trani C. A less‐invasive totally‐endovascular (LITE) technique for trans‐femoral transcatheter aortic valve replacement. Catheter Cardiovasc Interv 2020; 96:459-470. [DOI: 10.1002/ccd.28697] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/20/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Francesco Burzotta
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Cristina Aurigemma
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Enrico Romagnoli
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Osama Shoeib
- Cardiology Department Tanta University Tanta Egypt
| | - Giulio Russo
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Aniello Zambrano
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Diana Verdirosi
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Antonio Maria Leone
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Piergiorgio Bruno
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
| | - Carlo Trani
- Institute of Cardiology, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore Rome Italy
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28
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Rougé A, Abdellaoui M, Monségu J, Faurie B. Transcoronary Rapid Pacing Solving a Complex Retrograde Chronic Total Occlusion Procedure. JACC Case Rep 2019; 1:832-837. [PMID: 34316941 PMCID: PMC8289134 DOI: 10.1016/j.jaccas.2019.10.033] [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: 09/20/2019] [Revised: 10/22/2019] [Accepted: 10/29/2019] [Indexed: 12/01/2022]
Abstract
We report a case of revascularization of the right coronary artery via the epicardial collateral, for which we used transcoronary rapid pacing to obtain cardiac standstill while puncturing the distal chronic total occlusion (CTO) cap. To our knowledge, this is the first case in which this technique has been used in CTO. (Level of Difficulty: Advanced.)
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29
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Malik IS, Demir OM, Pabari P, Sutaria N, Chukwuemeka A, Gopalan D, Hadjiloizou N, Sen S, Mikhail GW, Ruparelia N. Double Utility of a Buddy Wire in Transseptal Transcatheter Mitral Intervention. JACC Cardiovasc Interv 2019; 12:2555-2557. [DOI: 10.1016/j.jcin.2019.08.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/09/2019] [Accepted: 08/20/2019] [Indexed: 10/25/2022]
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30
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Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2019; 12:2449-2459. [DOI: 10.1016/j.jcin.2019.09.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 11/17/2022]
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31
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Kotronias RA, Scarsini R, De Maria GL, Rajasundaram S, Sayeed R, Krasopoulos G, Grebenik C, Keiralla A, Newton JD, Banning AP, Kharbanda RK. Ultrasound guided vascular access site management and left ventricular pacing are associated with improved outcomes in contemporary transcatheter aortic valve replacement: Insights from the OxTAVI registry. Catheter Cardiovasc Interv 2019; 96:432-439. [DOI: 10.1002/ccd.28578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/22/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Rafail A. Kotronias
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
- Department of Cardiovascular Medicine University of Oxford Oxford UK
| | - Roberto Scarsini
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
- Department of Medicine, Division of Cardiology University of Verona Verona Italy
| | | | | | - Rana Sayeed
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
| | | | | | - Amar Keiralla
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
| | - James D. Newton
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
| | - Adrian P. Banning
- Oxford Heart Centre Oxford University Hospitals, NHS Trust Oxford UK
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32
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Rajkumar CA, Cook C, Shalhoub J, Chukwuemeka A, Jaffer U, Hadjiloizou N, Sen S, Ruparelia N, Mikhail G, Malik IS. Facilitating right-sided axillary artery access for transcatheter aortic valve replacement using the Edwards Sapien 3 and ultra valves: Technical considerations. Catheter Cardiovasc Interv 2019; 96:E747-E754. [PMID: 31631520 DOI: 10.1002/ccd.28558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/01/2019] [Accepted: 10/07/2019] [Indexed: 11/08/2022]
Abstract
Trans-Axillary Transcatheter Aortic Valve Replacement (TAVR) has become established as the safest arterial approach when femoral arterial anatomy is unfavorable. Although a left sided axillary approach is generally preferred, patient specific factors may require use of the right axillary artery. In this case series we describe procedural modifications that are required to overcome the challenge of restricted space in the ascending aorta for in situ valve preparation of balloon-expandable valve systems when a right sided trans-Axillary approach is taken. These steps permit implantation of both the Edwards LifeSciences Sapien 3 and Ultra prostheses via the right trans-Axillary approach, allowing patients a greater range of valve options when this arterial route is required for TAVR.
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Affiliation(s)
- Christopher A Rajkumar
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.,National Heart and Lung institute, Imperial College London, Hammersmith Hospital, London, UK
| | - Christopher Cook
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.,National Heart and Lung institute, Imperial College London, Hammersmith Hospital, London, UK
| | - Joseph Shalhoub
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | | | - Usman Jaffer
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | | | - Sayan Sen
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.,National Heart and Lung institute, Imperial College London, Hammersmith Hospital, London, UK
| | - Neil Ruparelia
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Ghada Mikhail
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Iqbal S Malik
- Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
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33
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Ooms JF, van Wiechen M, Ziviello F, Kroon H, Ren B, Daemen J, De Jaegere P, Van Mieghem NM. Single-access balloon aortic valvuloplasty – an overview of contemporary technical improvements. EUROINTERVENTION 2019; 15:e766-e770. [DOI: 10.4244/eij-d-19-00074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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34
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Scarsini R, De Maria GL, Joseph J, Fan L, Cahill TJ, Kotronias RA, Burzotta F, Newton JD, Kharbanda R, Prendergast B, Ribichini F, Banning AP. Impact of Complications During Transfemoral Transcatheter Aortic Valve Replacement: How Can They Be Avoided and Managed? J Am Heart Assoc 2019; 8:e013801. [PMID: 31522627 PMCID: PMC6818016 DOI: 10.1161/jaha.119.013801] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Roberto Scarsini
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom.,Division of Cardiology Department of Medicine University of Verona Italy
| | - Giovanni L De Maria
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | - Jubin Joseph
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom.,Guy's and St.Thomas' Hospitals NHS Foundation Trust London United Kingdom
| | - Lampson Fan
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | - Thomas J Cahill
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | - Rafail A Kotronias
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom.,Department of Cardiovascular Medicine University of Oxford United Kingdom
| | | | - James D Newton
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | - Rajesh Kharbanda
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
| | | | - Flavio Ribichini
- Division of Cardiology Department of Medicine University of Verona Italy
| | - Adrian P Banning
- Oxford Heart Centre Oxford University Hospitals NHS Foundation Trust Oxford United Kingdom
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35
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Scarsini R, Kotronias RA, De Maria GL, Rajasundaram S, Cahill TJ, Brown R, Newton JD, Banning AP, Kharbanda RK. Routine Left Ventricular Pacing for Patients Undergoing Transcatheter Aortic Valve Replacement. STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM 2019. [DOI: 10.1080/24748706.2019.1649771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Roberto Scarsini
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
- Department of Medicine, Division of Cardiology, University of Verona, Verona, Italy
| | - Rafail A. Kotronias
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
- Department of Cardiovascular Medicine, University of Oxford, Oxford, UK
| | | | | | - Thomas J. Cahill
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Robin Brown
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - James D. Newton
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
| | - Adrian P. Banning
- Oxford Heart Centre, Oxford University Hospitals, NHS Trust, Oxford, UK
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36
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Hensey M, Daniels D, Wood D, Webb JG. Early experience with a purpose-designed temporary pacing guidewire for transcatheter valve implantation. EUROINTERVENTION 2019; 15:e508-e509. [DOI: 10.4244/eij-d-19-00138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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37
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Díaz de la Llera LS, Cubero Gómez JM, Casquero Domínguez S, Fernández Quero M, Villa Gil-Ortega M, Guisado Rasco A. Estimulación ventricular izquierda a través de la guía del implante percutáneo de válvula aórtica. Rev Esp Cardiol 2018. [DOI: 10.1016/j.recesp.2017.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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38
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Modified balloon aortic valvuloplasty in fragile symptomatic patients unsuitable for both surgical and percutaneous valve replacement. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 19:444-447. [DOI: 10.1016/j.carrev.2017.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 10/14/2017] [Accepted: 10/16/2017] [Indexed: 11/19/2022]
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39
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Díaz de la Llera LS, Cubero Gómez JM, Casquero Domínguez S, Fernández Quero M, Villa Gil-Ortega M, Guisado Rasco A. Guidewire-driven Left Ventricular Pacing During Transcatheter Aortic Valve Implantation. ACTA ACUST UNITED AC 2017; 71:869-871. [PMID: 28941981 DOI: 10.1016/j.rec.2017.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 06/22/2017] [Indexed: 10/18/2022]
Affiliation(s)
| | - José María Cubero Gómez
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Sara Casquero Domínguez
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
| | - Mónica Fernández Quero
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Manuel Villa Gil-Ortega
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Agustín Guisado Rasco
- Unidad de Hemodinámica y Cardiología Intervencionista, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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40
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Verma A, Verma S, Al-Omran M, Rutka JT. Editorial. To pace or not to pace: that is the question. J Neurosurg 2017; 128:1737-1740. [PMID: 28820307 DOI: 10.3171/2017.1.jns162923] [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)
| | | | | | - James T Rutka
- 3Division of Neurosurgery, Department of Surgery, University of Toronto, Ontario, Canada
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41
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Tumscitz C, Campo G, Tebaldi M, Gallo F, Pirani L, Biscaglia S. Safety and Feasibility of Transradial Mini-Invasive Balloon Aortic Valvuloplasty. JACC Cardiovasc Interv 2017; 10:1375-1377. [DOI: 10.1016/j.jcin.2017.05.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 04/27/2017] [Accepted: 05/04/2017] [Indexed: 11/29/2022]
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