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Ferreira-Neto AN, Rodriguez-Gabella T, Guimaraes L, Freitas-Ferraz A, Bernier M, Figueiredo Guimaraes C, Pasian S, Paradis JM, Delarochellière R, Dumont E, Mohammadi S, Kalavrouziotis D, Côté M, Pibarot P, Rodés-Cabau J. Multimodality evaluation of transcatheter structural valve degeneration at long-term follow-up. ACTA ACUST UNITED AC 2021; 74:247-256. [DOI: 10.1016/j.rec.2020.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/20/2020] [Indexed: 11/24/2022]
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Ferreira-Neto AN, Rodriguez-Gabella T, Guimaraes L, Freitas-Ferraz A, Bernier M, Figueiredo Guimaraes C, Pasian S, Paradis JM, Delarochellière R, Dumont E, Mohammadi S, Kalavrouziotis D, Côté M, Pibarot P, Rodés-Cabau J. Evaluación multimodal de la degeneración estructural de válvulas percutáneas en el seguimiento a largo plazo. Rev Esp Cardiol 2021. [DOI: 10.1016/j.recesp.2020.01.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Allen CJ, Patterson T, Chehab O, Cahill T, Prendergast B, Redwood SR. Incidence and outcomes of infective endocarditis following transcatheter aortic valve implantation. Expert Rev Cardiovasc Ther 2020; 18:653-662. [PMID: 33073603 DOI: 10.1080/14779072.2020.1839419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Prosthetic valve infective endocarditis is a feared and potentially catastrophic complication of valvular intervention. Transcatheter aortic valve implantation has transformed the modern management of aortic stenosis and vastly altered the demographics of those patients undergoing valve replacement. AREAS COVERED As a relatively nascent development, what TAVI means for the epidemiology of infective endocarditis, how to identify those patients undergoing the procedure at greatest risk, and how best to prevent and manage the condition remains the subject of fervent research activity. In this review, we appraise relevant contemporary data discussing the incidence, microbiological profiles, associated risk factors and clinical outcomes of infective endocarditis after TAVI. EXPERT OPINION Present outcomes are poor, with exceedingly high in-hospital and long-term mortality. Evidence to support surgical management in this patient group is lacking. Prevention is therefore paramount and a logical focus for future research attention.
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Affiliation(s)
- Christopher J Allen
- King's College London , London, UK.,Department of Cardiology, Guys' and St Thomas NHS Foundation Trust , London, UK
| | - Tiffany Patterson
- King's College London , London, UK.,Department of Cardiology, Guys' and St Thomas NHS Foundation Trust , London, UK
| | - Omar Chehab
- King's College London , London, UK.,Department of Cardiology, Guys' and St Thomas NHS Foundation Trust , London, UK
| | - Thomas Cahill
- Centre for Interventional Vascular Therapy, Columbia University Irving Medical Centre / New York-Presbyterian Hospital , New York, USA.,Oxford Heart Centre, Oxford University Hospitals NHS Trust , Oxford, UK
| | - Bernard Prendergast
- Department of Cardiology, Guys' and St Thomas NHS Foundation Trust , London, UK
| | - Simon R Redwood
- King's College London , London, UK.,Department of Cardiology, Guys' and St Thomas NHS Foundation Trust , London, UK
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Nechwatal RM, Bestehorn K, Leuschner F, Hagendorff A, Guha M, Schlitt A. [Postacute care after transcatheter aortic valve implantation (TAVI)]. Herz 2020; 46:41-47. [PMID: 32313970 DOI: 10.1007/s00059-020-04915-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 07/30/2019] [Accepted: 03/19/2020] [Indexed: 11/26/2022]
Abstract
With increasing age valvular heart disease is among the most frequent diseases of the heart. Relevant valvular disease impairs not only the long-term prognosis but also physical resilience, activities of daily living and the quality of life. In cases of middle to high-grade symptomatic cardiac defects, valve replacement or valve reconstruction is still the surgical procedure of choice; however, in recent years the transcatheter percutaneous aortic valve replacement (TAVI) procedure has become more prominent for the most frequent defect, aortic valve stenosis. This article provides an overview of the aftercare and rehabilitation of patients following a TAVI intervention.
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Affiliation(s)
- Robert Michael Nechwatal
- Rehaklinik Heidelberg-Königstuhl, Fachklinik für Herz‑, Kreislauf‑, Gefäß‑, Lungen- und Bronchialerkrankungen, Kohlhof 6, 69117, Heidelberg, Deutschland.
| | - Kurt Bestehorn
- Institut für Klinische Pharmakologie, TU Dresden, Dresden, Deutschland
| | - Florian Leuschner
- Klinik für Kardiologie, Angiologie und Pneumologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Andreas Hagendorff
- Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - Manju Guha
- Reha-Klinik am Sendesaal, Bremen, Deutschland
| | - Axel Schlitt
- Abteilung für Kardiologie und Diabetologie, Paracelsus-Harz-Klinik Bad Suderode, Quedlinburg, Deutschland
- Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
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Valvo R, Criscione E, Reddavid C, Barbanti M. Early detection of transcatheter heart valve dysfunction. Expert Rev Cardiovasc Ther 2019; 17:863-872. [PMID: 31829050 DOI: 10.1080/14779072.2019.1703673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Transcatheter aortic valve implantation therapy is spreading rapidly, representing the standard of care in inoperable and high-risk patients, and a valid alternative in intermediate- and low-risk patients with severe symptomatic aortic stenosis. In this subset, the development and validation of noninvasive, quantitative, in vivo imaging modality, to monitor possible valve dysfunction is mandatory, in order to plan timely therapeutic interventions before the onset of symptoms.Areas covered: The implantation of transcatheter heart valves (THV) is increasing rapidly. As a consequence, THV dysfunction will become a major cause of cardiovascular morbidity after TAVI. Emergency repeat aortic valve replacement surgery is associated with a high rate of mortality compared with elective repeat surgery. In this context, early detection of THV dysfunction is therefore highly desirable. The review aims to examine the different diagnostic method to early detect THV dysfunction.Expert opinion: Most promising innovations in the diagnosis of early detection of THV dysfunction are evaluated, and the future outlook is explored. Waiting for upcoming evidence about the utility of CT, CMR, and PET on early detection of THV dysfunction, tailoring echocardiogram follow-up based on patients' characteristics is the desirable approach.
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Affiliation(s)
- Roberto Valvo
- A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Enrico Criscione
- A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Claudia Reddavid
- A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
| | - Marco Barbanti
- A.O.U. Policlinico-Vittorio Emanuele, University of Catania, Catania, Italy
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Winter MP, Zbiral M, Kietaibl A, Sulzgruber P, Kastner J, Rosenhek R, Binder T, Lang IM, Goliasch G. Normal values for Doppler echocardiographic assessment of prosthetic valve function after transcatheter aortic valve replacement: a systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging 2019; 19:361-368. [PMID: 28950312 DOI: 10.1093/ehjci/jex212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 08/15/2017] [Indexed: 11/14/2022] Open
Abstract
Transcatheter aortic valve replacement has emerged as valuable treatment modality for patients with severe aortic stenosis and an unacceptable risk/benefit ratio for open heart surgery, but particularities specific to TAVR and a rapidly growing number of available TAVR prosthesis make post-procedural assessment of valve function challenging. Aim of the present analysis was to collect and pool all available data currently in the literature regarding normal doppler values for transcatheter prosthetic heart valves and to provide a comprehensive overview. A PRISMA checklist-guided systematic review and meta-analysis of prospective observational studies or national and device specific registries or randomized clinical trials was conducted. Studies were identified by searching PUBMED, SCOPUS, Cochrane Central Register of Controlled Trials and LILACs from January 2000 to March 2017. Out of 240 abstracts, 155 studies reporting echocardiographic parameter for twelve different valves prosthesis in a total of 27,159 patients were in included in this meta-analysis. The means and standard deviations of peak velocity, peak gradient, mean gradient and effective orifice were extracted and pooled from the included studies. The pooled means and standard deviations for all available TAVR prosthesis were classified according to implanted valve size and time since implantation. The present study firstly describes a pooled analysis of normal values for all available TAVR prosthesis in order to empower treating physicians with a reliable tool to perform follow-up echocardiographic assessment in TAVR patients and to safely identify patients with prostheses dysfunction.
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Affiliation(s)
- Max-Paul Winter
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Martin Zbiral
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Antonia Kietaibl
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Patrick Sulzgruber
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Johannes Kastner
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Raphael Rosenhek
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Thomas Binder
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Irene M Lang
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
| | - Georg Goliasch
- Department of Internal medicine II, Division of cardiology, Medical University of Vienna, Waehringerguertel 18-20, A-1090 Vienna, Austria
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