Suivi à long terme du TAVI: quelles leçons en 8rer? Dr Claire Boule, 17 Janvier 2015
|
|
- Gwen Bryan
- 5 years ago
- Views:
Transcription
1 Suivi à long terme du TAVI: quelles leçons en 8rer? Dr Claire Boule, 17 Janvier 2015
2 Disclosures Research grants from: SFC, FFC, FRM, Servier Lectures: Novar,s, Daichii Sankyo
3 Follow-up after TAVI Randomized trials Unbiased comparison with other treatments Mid-term follow-up (1 to 3 years) Observational series (registries) Not valid for comparisons No selection bias Longer follow-up
4 Randomized studies Circula(on October 21, 2014
5 Population 358 patients ( ) Variables TAVI n=179 Standard therapy n=179 Age, yr. 83 ± 9 83 ± Male sex 82 (46) 84 (47) 0.92 NYHA func,onal class 0.68 II III IV 14 (8) 165 (92) 11 (6) 168 (94) Atrial fibrilla,on 28/85 (33) 39/80 (49) 0.04 STS score (%) 11 ± 6 12 ± Logis,c EuroSCORE (%) 26 ± ± Frailty 21/116 (18) 33/118 (28) 0.09 Valve area (echocardiography), cm ± ± Mean gradient (Doppler), mmhg 45 ± ± Mean LVEF (%) 54 ± ± MR 3 38/171 (22) 38/165 (23) 0.90 p
6 Population 358 patients ( ) Variables TAVI n=179 Standard therapy n=179 Age, yr. 83 ± 9 83 ± Male sex 82 (46) 84 (47) 0.92 NYHA func,onal class 0.68 II III IV 14 (8) 165 (92) 11 (6) 168 (94) Atrial fibrilla,on 28/85 (33) 39/80 (49) 0.04 STS score (%) 11 ± 6 12 ± Logis,c EuroSCORE (%) 26 ± ± Frailty 21/116 (18) 33/118 (28) 0.09 Valve area (echocardiography), cm ± ± Mean gradient (Doppler), mmhg 45 ± ± Mean LVEF (%) 54 ± ± MR 3 38/171 (22) 38/165 (23) 0.90 p
7 Population 358 patients ( ) Variables TAVI n=179 Standard therapy n=179 Age, yr. 83 ± 9 83 ± Male sex 82 (46) 84 (47) 0.92 NYHA func,onal class 0.68 II III IV 14 (8) 165 (92) 11 (6) 168 (94) Atrial fibrilla,on 28/85 (33) 39/80 (49) 0.04 STS score (%) 11 ± 6 12 ± Logis,c EuroSCORE (%) 26 ± ± Frailty 21/116 (18) 33/118 (28) 0.09 Valve area (echocardiography), cm ± ± Mean gradient (Doppler), mmhg 45 ± ± Mean LVEF (%) 54 ± ± MR 3 38/171 (22) 38/165 (23) 0.90 p
8 Procedures SAPIEN heart valve system Common femoral artery access Under general anaesthesia
9 3-year mortality rate Circula(on October 21, 2014
10 Functional status NYHA class Circula(on October 21, 2014
11 Functional status Circula(on October 21, 2014
12 Randomized studies n engl j med 366;18 nejm.org may 3, 2012
13 Population 699 patients ( ) Variables TAVI N=348 Surgery N=351 Age, yr. 84 ± 7 85 ± Male sex 201 (58) 198 (57) 0.82 NYHA func,onal class II III IV 20 (6) 145 (42) 183 (52) 21 (6) 151 (43) 177 (51) Atrial fibrilla,on 81/199 (41) 75/172 (44) 0.60 STS score (%) 12 ± 3 12 ± Logis,c EuroSCORE (%) 29 ± ± Frailty 46/295 (16) 53/301 (18) 0.58 Valve area (echocardiography), cm ± ± Mean gradient (Doppler), mmhg 43 ± ± Mean LVEF (%) 53 ± ± MR 3 66/337 (20) 71/338 (21) 0.70 p NS
14 Population 699 patients ( ) Variables TAVI N=348 Surgery N=351 Age, yr. 84 ± 7 85 ± Male sex 201 (58) 198 (57) 0.82 NYHA func,onal class II III IV 20 (6) 145 (42) 183 (52) 21 (6) 151 (43) 177 (51) Atrial fibrilla,on 81/199 (41) 75/172 (44) 0.60 STS score (%) 12 ± 3 12 ± Logis,c EuroSCORE (%) 29 ± ± Frailty 46/295 (16) 53/301 (18) 0.58 Valve area (echocardiography), cm ± ± Mean gradient (Doppler), mmhg 43 ± ± Mean LVEF (%) 53 ± ± MR 3 66/337 (20) 71/338 (21) 0.70 p NS
15 Procedures TAVR: 244 pa,ents with transfemoral access 104 with transapical approach SAPIEN Valve Under general aneathesia SAVR: 351 pts
16 All cause mortality n engl j med 366;18 nejm.org may 3, 2012
17 All cause mortality n engl j med 366;18 nejm.org may 3, 2012
18 CoreValve US Pivotal Trial Adams et al. N Engl J Med 2014
19 Study design Adams et al. N Engl J Med 2014
20 Study design Adams et al. N Engl J Med 2014
21 Population 747 patients (Feb 2011-Sept 2012)
22 Procedures CoreValve (self-expandable) Transfemoral (n=323) Subclavian (n=67) Direct Aortic
23 1-year mortality Adams et al. N Engl J Med 2014
24 Indications for TAVI TAVI should only be undertaken with a multidisciplinary heart team including cardiologists and cardiac surgeons and other specialists if necessary. Class I Level C TAVI should only be performed in hospitals with cardiac surgery on-site. I C TAVI is indicated in patients with severe symptomatic AS who are not suitable for AVR as assessed by a heart team and who are likely to gain improvement in their quality of life and to have a life expectancy of more than 1 year after consideration of their comorbidities. TAVI should be considered in high risk patients with severe symptomatic AS who may still be suitable for surgery, but in whom TAVI is favoured by a heart team based on the individual risk profile and anatomic suitability. I IIa B B European Heart Journal 2012 & European Journal of Cardio-Thoracic Surgery 2012
25 Indications for TAVI TAVI should only be undertaken with a multidisciplinary heart team including cardiologists and cardiac surgeons and other specialists if necessary. Class I Level C TAVI should only be performed in hospitals with cardiac surgery on-site. I C TAVI is indicated in patients with severe symptomatic AS who are not suitable for AVR as assessed by a heart team and who are likely to gain improvement in their quality of life and to have a life expectancy of more than 1 year after consideration of their comorbidities. TAVI should be considered in high risk patients with severe symptomatic AS who may still be suitable for surgery, but in whom TAVI is favoured by a heart team based on the individual risk profile and anatomic suitability. I IIa B B European Heart Journal 2012 & European Journal of Cardio-Thoracic Surgery 2012
26 Management of severe AS No LVEF < 50% Severe AS Symptoms Yes No Yes Contraindication for AVR No Physically active No Yes Exercise test Symptoms or fall in blood pressure below baseline Yes No High risk for AVR No Yes Yes Short life expectancy No Yes Presence of risk factors and low/intermediate individual surgical risk TAVI Med Rx No Yes AVR Re-evaluate in 6 months AVR or TAVI European Heart Journal 2012 & European Journal of Cardio-Thoracic Surgery 2012
27 TAVI: long-term follow-up N= Years Follow- up (years) Canadian Registry Toggweiler Bichat
28 Canadian Registry Rodès- cabau et al, JACC 2012
29 Population 339 patients (January June 2009) Variables All N=339 Transfemoral N=162 Transapical N=177 Age, yr. 81 ± 8 83 ± 8 80 ± Male sex 152 (45) 91 (56) 61 (35) < NYHA func,onal class II III - IV 29 (9) 308 (91) Crea,nine clearance 119 ± 83 NS Atrial fibrilla,on 115 (34) 66 (41) 49 (28) Peripheral vascular disease 120 (36) 31 (19) 89 (50) < COPD 100 (30) NS STS score (%) 10 ± 6 9 ± 6 11 ± Frailty 85 (25) NS Severe MR 27 (8) 18 (11) 9 (5) Mean LVEF (%) 55 ± 14 NS p NS Rodès- cabau et al, JACC 2012
30 30-day outcome and follow-up Use of SAPIEN valves Successful procedure 322 (94.9) Complica,ons: Stroke 8 (2.3) Need for permanent pacemaker implanta,on 17 (4.9) Conversion to open heart surgery 6 (1.7) Death 36 (10.6) FU in 99.1% of the study popula,on Mean follow- up of 42 ± 15 months
31 Overall survival at 4 years Rodès- cabau et al, JACC 2012
32 Causes of death
33 Causes of death
34 Predictive factors of late deaths Rodès- cabau et al, JACC 2012
35 Canadian Registry: conclusion Pa,ents with COPD, CKD, frailty, and chronic AF were at higher risk of death within the few years ajer TAVI, sugges,ng that a more careful evalua,on and follow- up of pa,ents with these comorbidi,es might translate into beker mid- to long- term outcomes.
36 5-year follow-up Toggweiler et al, JACC 2013
37 Study design SAPIEN valve Transfemoral in 64 pa,ents (73%) Transapical in 24 pa,ents (27%)
38 Study design SAPIEN valve Transfemoral in 64 pa,ents (73%) Transapical in 24 pa,ents (27%) Toggweiler et al, JACC 2013
39 Population 88 pts (January 2005-March 2007)
40 5-year survival after successful TAVI
41 Predictive factors of late deaths In mul,variable analysis, - chronic obstruc,ve pulmonary disease (HR: 2.17; 95% CI: 1.18, 3.70) - at least moderate paravalvular regurgita,on post- TAVI (HR: 2.98; 95% CI: 1.44, 6.17)
42 Toggweiler et al, JACC 2013 Good long-term valve function At 5 years, 3 pa,ents had moderate prosthe,c valve failure. None of the pa,ents had severe regurgita,on or stenosis, and no pa,ent required reopera,on or reinterven,on due to structural valve failure.
43 6-year follow-up Long- term outcome awer TAVI Claire Boule,, Dominique Himbert, Bernard Iung, Benjamin Alos, Caroline Kerneis, Walid Ghodbane, David Messika- Zeitoun, Eric Brochet, Amir- Ali Fassa, Jean- Pol Depoix, Phalla Ou, Patrick Nataf, Alec Vahanian Boule, et al, Heart 2015, in press
44 Study design prospec8ve single- center registry 141 consecu,ve pa,ents underwent TAVI SAPIEN valve (90%) Transfemoral in 84 pa,ents (68%) Transapical in 37 pa,ents (30%) 18 pa,ents died within 30 days 123 pa,ents in study Boule, et al, Heart 2015, in press
45 Population 123 patients (Oct Dec 2009) Variables n= 123 Age 82 ± 8 Male Sex 69 (56) Lower limb arteri,s 18 (15) Chronic Lung Disease 36 (29) LVEF 50 ± 13 Indexed aor,c valve area 0.4 ± 0.1 Mitral regurgita,on 2/4 21 (17) Atrial fibrilla,on 51 (42) Systolic PAP 47 ± 15 Charlson Comorbidity Index 5 ± 2 STS score 7 ± 5 Euroscore I 22 ± 12 NYHA Class 88% of pa,ents in NYHA class III or IV
46 Follow-up and events FU was complete in 122 pa,ents (99%). Median FU was 3.6 years [ ], and maximum reached 6 years. Events during FU: death, NYHA III or IV, stroke, severe bleeding and cardiac hospitalisa,on according to VARC- 2 criteria. 2 endpoints (1) overall survival (2) event- free survival (VARC- 2 criteria)
47 Events during FU Events Pa8ents N=123 Severe bleeding 9 (7) Stroke 16 (13) Infec,ve endocardi,s 3 (3) Pace- Maker implanta,on 18 (15) Re- hospitaliza,on Cardiac Non- cardiac Death Cardiac Non Cardiac Unknown 96 (78) 42 (44) 54 (56) 77 (63) 25 (33) 44 (57) 8 (10) NYHA III- IV at last FU 40 (33)
48 6-year overall survival rate after successful TAVI
49 Predictive factors of late death Mul,variate analysis Adjusted Hazard Ratio [95% CI] p Lower limb arteritis 2.18 [ ] Charlson comorbidity index (per 1-unit increase) 1.12 [ ] Paraprosthetic AR! 2/4 at day [ ] 0.010!
50 Events during FU Events Pa8ents N=123 Severe bleeding 9 Stroke 16 (13) Infec,ve endocardi,s 3 (3) Pace- Maker implanta,on 18 (15) Re- hospitaliza,on Cardiac Non- cardiac Death Cardiac Non Cardiac Unknown 96 (78) 42 (44) 54 (56) 77 (63) 25 (33) 44 (57) 8 (10) NYHA III- IV at last FU 40 (33)
51 Events during FU Events Pa8ents N=123 Severe bleeding 9 Stroke 16 (13) Infec,ve endocardi,s 3 (3) Pace- Maker implanta,on 18 (15) Re- hospitaliza,on Cardiac Non- cardiac 96 (78) 42 (44) 54 (56) CoreValve prosthesis (HR 95% CI 4.0 [ ] p=0.016) Death Cardiac Non Cardiac Unknown 77 (63) 25 (33) 44 (57) 8 (10) NYHA III- IV at last FU 40 (33)
52 Events during FU Events Pa8ents N=123 Severe bleeding 9 Stroke 16 (13) Infec,ve endocardi,s 3 (3) Pace- Maker implanta,on 18 (15) Re- hospitaliza,on Cardiac Non- cardiac Death Cardiac Non Cardiac Unknown 96 (78) 42 (44) 54 (56) 77 (63) 25 (33) 44 (57) 8 (10) NYHA III- IV at last FU 40 (33)
53 Stroke Boule, et al, Heart 2015, in press
54 Stroke Older age (HR 95% CI 1.2 [ ] p=0.003) Previous cerebrovascular accident (HR 95% CI 3.8 [ ] p=0.03) Higher crea,nine level (HR 95% CI 1.01 [ ] p=0.0001).
55 Event-free survival (VARC-2 Criteria) In mul,variate analysis, 2 predictors of late events: higher Charlson Comorbidity Index (p=0.01), and post- procedure PAR 2/4 (p=0.01)
56 Functional status The rate of good late func,onal results (survival in NYHA class I or II) was 32 ± 5% at 5 years Boule, et al, Heart 2015, in press
57 Quality of life EQ- 5D ques8onnaire and visual analogical scale of QoL in the 45 survivors Best state 76% had no problem with self- care 50% had no difficul,es in performing their usual ac,vi,es 50% were pain free 33% of pa,ents could walk easily 50% were neither anxious nor depressed. 64 ± 12 Worse state
58 Long-term survival Con,nuous akri,on of results More than half of deaths are related to non- cardiac causes N= Follow- up (years) Non cardiac death (%) Canadian Registry Toggweiler Bichat
59 Long-term FU after TAVI: which lessons? N= Follow- up (years) Predic8ve factors of late mortality Canadian Registry AF COPD crea,nin clearance Frailty Toggweiler 88 5 COPD AR post- TAVI Bichat Charlson Index Lower limb arteri,s AR post- TAVI Impact of : Comorbidi,es Post- TAVI AR
60 Weight of comorbidities ALL 179 Causes of death (30 days to 1 Year) Cardiac 45 (25.1%) Non Cardiac 88 (49.2%) Unknown 46 (25.7%) in the Source Registry 1038 patients (TAVI Heart Failure 28 (62.2%) Pulmonary*** 21 (23.9%) Sudden Death 18 (39.1%) using Sapien valve) Half of deaths were of non-cardiac cause Myocardial Infarc,on 6 (13.3%) Endocardi,s 3 (6.7%) Renal Failure 11 (12.5%) Cancer 10 (11.4%) Unknown 18 (39.1%) Other 10 (21.7%) (Thomas et al. Other* 8 (17.8%) Stroke 9 (10.2%) Circulation 2011;124:425-33) Gastrointes,nal 5 (5.6%) Other** 32 (36.4%)
61 Weight of comorbidities ALL 179 Causes of death (30 days to 1 Year) Cardiac 45 (25.1%) Non Cardiac 88 (49.2%) Unknown 46 (25.7%) in the Source Registry 1038 patients (TAVI Heart Failure 28 (62.2%) Pulmonary*** 21 (23.9%) Sudden Death 18 (39.1%) using Sapien valve) Half of deaths were of non-cardiac cause Myocardial Infarc,on 6 (13.3%) Endocardi,s 3 (6.7%) Renal Failure 11 (12.5%) Cancer 10 (11.4%) Unknown 18 (39.1%) Other 10 (21.7%) (Thomas et al. Other* 8 (17.8%) Stroke 9 (10.2%) Circulation 2011;124:425-33) Gastrointes,nal 5 (5.6%) Other** 32 (36.4%)
62 Weight of comorbidities Mortality accorging to the STS score PARTNER B, 2014
63 Weight of comorbidities Mortality accorging to the Logistic ES Moat et al, JACC Vol. 58, No. 20, 2011
64 Weight of comorbidities The Charlson Comorbidity Index Non- modifiable factor but shoud be given par,cular considera,on in the analysis by the Heart Team Charlson Index > 5 associated with poor late prognosis ajer TAVI
65 Weight of comorbidities: Frailty 5- year follow- up 6- year follow- up No evalua,on of frailty 4- year follow- up = Frailty was defined as a syndrome of decreased reserve and resistance to stressors, resul,ng from mul,ple declines across mul,ple physiologic systems leading to vulnerability to adverse outcomes. No systema8c tests were performed for the evalua8on of frailty
66 Frailty Prevalence in patients undergoing TAVI 25% in a multicentre Canadian series of 339 patients (Rodés-Cabau et al. J Am Coll Cardiol 2010;55: ) 17% in the TAVI German Registry (697 patients) (Zahn et al. Eur Heart J 2011, 32: ) 23% in the Partner B Cohort (358 patients) (Leon et al. N Engl J Med 2010;363: ) Impact of indices of functional performance / frailty - Indice de Katz - IADL
67 Impact of paravalvular leak Paraprosthe,c AR is the only post- procedural factor related to late survival in different long- term studies. But nega,ve impact for mild or moderate PAR?
68 Impact of paravalvular leak n engl j med 366;18 nejm.org may 3, 2012
69 Impact of paravalvular leak n engl j med 366;18 nejm.org may 3, 2012
70 Impact of paravalvular leak Toggweiler et al, JACC 2013
71 Impact of paravalvular leak PAR 2 is associated with poor late prognosis ajer TAVI
72 Impact of paravalvular leak
73 Conclusion (I) Due to randomized studies, in patients with severe symptomatic aortic stenosis who are at high risk for surgery - TAVI is now the reference treatment when surgery is contraindicated - When surgery is not contraindicated, TAVI is a valid alternative Longer follow- up in observa,onal studies provide encouraging informa,on on survival in pa,ents discharged alive ajer TAVI, and a sustained improvement in func,onal status. Sustained good valve func,on.
74 Conclusion (II) Predic,ve factors of late results underline the need for careful assessment of comorbidi,es and confirm the main impact of paraprosthe,c AR on long- term results. Poten,al Improvements?: Use of Charlson Index Use of systema,c tests for the evalua,on of frailty Use of post- dilata,on? New genera,on prosthesis to limit PAR
75 Merci de votre aken,on
Measuring the risk in valve patients Lessons learnt from the TAVI story? Bernard Iung Bichat Hospital, Paris, France
Measuring the risk in valve patients Lessons learnt from the TAVI story? Bernard Iung Bichat Hospital, Paris, France Faculty disclosure Bernard Iung I disclose the following financial relationships: Consultant
More informationPercutaneous Treatment of Valvular Heart Diseases: Lessons and Perspectives. Bernard Iung Bichat Hospital, Paris
Percutaneous Treatment of Valvular Heart Diseases: Lessons and Perspectives Bernard Iung Bichat Hospital, Paris Euro Heart Survey on Valvular Diseases 3547 Patients with Native Valve Disease n= 1250 1000
More informationTranscatheter Aortic Valve Implantation. SSVQ November 23, 2012 Centre Mont-Royal 15:40
Transcatheter Aortic Valve Implantation SSVQ November 23, 2012 Centre Mont-Royal 15:40 Nicolo Piazza MD, PhD, FRCPC, FESC, FACC McGill University Health Center German Heart Center Munich 1 First-in-Human
More informationRANDOMISED TRIALS TAVI WITH SAVR STEPHAN WINDECKER AORTIC VALVE DISEASE COMPARING
AORTIC VALVE DISEASE RANDOMISED TRIALS COMPARING TAVI WITH SAVR STEPHAN WINDECKER DEPARTMENT OF CARDIOLOGY SWISS CARDIOVASCULAR CENTER AND CLINICAL TRIALS UNIT BERN BERN UNIVERSITY HOSPITAL, SWITZERLAND
More informationTranscatheter aortic valve implantation and pre-procedural risk assesment
Transcatheter aortic valve implantation and pre-procedural risk assesment Alec Vahanian,FESC, FRCP(Edin.) Bichat Hospital University Paris VII, Paris, France Disclosures Relationship with companies who
More informationFive-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe Aortic Stenosis: The PARTNER Trial
Five-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe Aortic Stenosis: The PARTNER Trial Samir R. Kapadia, MD On behalf of The PARTNER Trial Investigators
More informationFRANCE 2 : FRench Aor$c Na$onal Corevalve
: FRench Aor$c Na$onal Corevalve and Edwards Registry Mar$ne Gilard, MD University of Brest, France On behalf of the scien/fic commi2ee and the inves/gators M Laskar, P Donzeau- Gouge, K Chevreul, H Eltchaninoff,
More informationLe TAVI pour tout le monde?
Le TAVI pour tout le monde? Thierry Lefèvre Institut Cardiovasculaire Paris Sud, Massy Disclosure Statement of Financial Interest I currently have, or have had over the last two years, an affiliation or
More informationTranscatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data
Transcatheter Aortic Valve Replacement: Current and Future Devices: How do They Work, Eligibility, Review of Data Echo Florida 2013 Jonathan J. Passeri, M.D. Co-Director, Heart Valve Program Director,
More informationIncorporating the intermediate risk in Transcatheter Aortic Valve Implantation (TAVI)
Incorporating the intermediate risk in Transcatheter Aortic Valve Implantation (TAVI) Larry S. Dean, MD, MSCAI Past President SCAI Professor of Medicine and Surgery University of Washington School of Medicine
More informationThe Role of TAVI in high-risk and normal-risk Patients
The Role of TAVI in high-risk and normal-risk Patients Joachim Schofer Hamburg University Cardiovascular Center and Department for percutaneous treatment of structural heart disease Albertinen Heart Center
More informationValvular Intervention
Valvular Intervention Outline Introduction Aortic Stenosis Mitral Regurgitation Conclusion Calcific Aortic Stenosis Deformed Eccentric Calcified Nodular Rigid HOSTILE TARGET difficult to displace prone
More informationTAVI: Nouveaux Horizons
TAVI: Nouveaux Horizons EUAPI580i 432HQ14NP02353 Institut de Cardiologie de la Pitié-Salpêtrière jean-philippe.collet@psl.aphp.fr www.action-coeur.org Objectifs Les recommandations Le TAVI en chiffre La
More informationValve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection
More informationLOW RISK TAVR. WHAT THE FUTURE HOLDS
LOW RISK TAVR. WHAT THE FUTURE HOLDS Michael J. Reardon, M.D. Professor of Cardiothoracic Surgery Allison Family Distinguish Chair of Cardiovascular Research Houston Methodist DeBakey Heart & Vascular
More informationResults of Transfemoral Transcatheter Aortic Valve Implantation
Results of Transfemoral Transcatheter Aortic Valve Implantation Saudi Heart Association, February 21-24 Rüdiger Lange, MD, PhD Nicolo Piazza, MD, FRCPC, FESC German Heart Center, Munich, Germany Division
More informationA new option for the Diagnosis and Management of Valvular Heart Disease. Oregon Comprehensive Valve Center
A new option for the Diagnosis and Management of Valvular Heart Disease Oregon Comprehensive Valve Center I have no disclosures Oregon Comprehensive Valve Center Weekly multidisciplinary case conferences
More informationPeri-operative results and complications in 15,964 transcatheter aortic valve implantations from the German Aortic valve RegistrY (GARY)
Peri-operative results and complications in 15,964 transcatheter aortic valve implantations from the German Aortic valve RegistrY (GARY) Thomas Walther, Christian W. Hamm, Gerhard Schuler, Alexander Berkowitsch,
More informationCIPG Transcatheter Aortic Valve Replacement- When Is Less, More?
CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology
More information2/15/2018 DISCLOSURES OBJECTIVES. Consultant for BioSense Webster, a J&J Co. Aortic stenosis background. Short history of TAVR
TRANSCATHETER AORTIC VALVE REPLACEMENT IN 2018: IS IT NOW THE STANDARD OF CARE? 22 ND ANNUAL COASTAL CARDIAC & VASCULAR CONFERENCE FEBRUARY 17, 2018 R. David Anderson, MD, MS, FACC, FSCAI Professor of
More informationAS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO
AS with reduced LV ejection fraction: Contractile reserve should be systematically assessed: PRO Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Potential conflicts of interest
More informationAortic Valve Controversies Beyond risk assessment: TAVI for Everybody
Aortic Valve Controversies Beyond risk assessment: TAVI for Everybody Anna Sonia Petronio, MD, FESC Head of Cardiac Catheteriza8on Lab Cardiothoracic and Vascular Department University of Pisa, Italy 1.
More informationTAVR in 2017 What we know? What to expect?
Journal of Geriatric Cardiology (2018) 15: 55 60 2018 JGC All rights reserved; www.jgc301.com Perspective Open Access TAVR in 2017 What we know? What to expect? Panagiota Kourkoveli 1,*, Konstantinos Spargias
More informationAortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV?
Aortic Stenosis: Interventional Choice for a 70-year old- SAVR, TAVR or BAV? Interventional Choice for a 90-year old- SAVR, TAVR or BAV? Samin K Sharma, MD, FACC, FSCAI Director Clinical & Interventional
More information3 years after introduction of TAVI in QEH. Michael KY Lee On Behalf of QEH TAVI Heart Team Queen Elizabeth Hospital Hong Kong
3 years after introduction of TAVI in QEH Michael KY Lee On Behalf of QEH TAVI Heart Team Queen Elizabeth Hospital Hong Kong HA Convention 2014 Introduction Aortic Stenosis most common valvular heart disease
More informationAortic Stenosis: Background
Transcatheter Aortic Valve Replacement in Low Surgical Risk Patients Barry George, MD The Ohio State University Structural Heart Disease Course May 19 th, 2017 Aortic Stenosis: Background Severe Symptomatic
More informationAortic Stenosis in the Elderly: Difficulties for the Clinician. Are Symptoms Due to Aortic Stenosis?
Aortic Stenosis in the Elderly: Difficulties for the Clinician Are Symptoms Due to Aortic Stenosis? Raphael Rosenhek Department of Cardiology Medical University of Vienna No disclosure European Society
More informationIs TAVR Now Indicated in Even Low Risk Aortic Valve Disease Patients
Is TAVR Now Indicated in Even Low Risk Aortic Valve Disease Patients Saibal Kar, MD, FACC, FAHA, FSCAI Director of Interventional Cardiac Research Cedars Sinai Heart Institute, Los Angeles, CA Potential
More informationStrokes After TAVR Reasons for Declining Frequency
Strokes After TAVR Reasons for Declining Frequency Samir Kapadia, MD Professor of Medicine Director, Cardiac Catheterization Laboratory Cleveland Clinic Disclosure NONE Second Generation Valves Newer
More informationDebate: SAVR for Low-Risk Patients in 2017 is Obsolete AVR vs TAVI
Debate: SAVR for Low-Risk Patients in 2017 is Obsolete AVR vs TAVI Joseph E. Bavaria, MD Roberts-Measey Professor of Surgery Vice Chair, Division of Cardiovascular Surgery University of Pennsylvania Immediate
More informationIs TAVI ready for prime time in: - Intermediate risk patients? - Low risk patients?
Is TAVI ready for prime time in: - Intermediate risk patients? - Low risk patients? Didier TCHETCHE, MD. Clinique PASTEUR, Toulouse, France, Conflicts of interest: -Consultant for Edwards LifeSciences
More informationTAVR IN INTERMEDIATE-RISK PATIENTS
TAVR IN INTERMEDIATE-RISK PATIENTS K. Lampropoulos MD, PhD, FESC, MEAPCI Interventional Cardiologist Evangelismos General Hospital The Burden of Valve Disease Prevalence Survival NATURAL HISTORY OF AS
More informationManagement of significant asymptomatic aortic stenosis. Alec Vahanian Bichat Hospital University Paris VII Paris, France
Management of significant asymptomatic aortic stenosis. Alec Vahanian Bichat Hospital University Paris VII Paris, France Background Aortic stenosis (AS) is the most frequent valve disease among referred
More informationTAVI: The Real Deal? Marc Pelletier, MD Head, Department of Cardiac Surgery New Brunswick Heart Centre
TAVI: The Real Deal? Marc Pelletier, MD Head, Department of Cardiac Surgery New Brunswick Heart Centre Disclosure St. Jude Medical: Consultant and Proctor Edwards Lifesciences: Proctor Medtronic: Research
More informationTranscatheter Aortic Valve Replacement
Transcatheter Aortic Valve Replacement Jesse Jorgensen, MD Medical Director, Cardiac Catheterization Laboratory Greenville Health System Greenville, South Carolina, USA January 30, 2016 Aortic Stenosis
More informationBernard De Bruyne, MD, PhD Cardiovascular Center Aalst OLV-Clinic Aalst, Belgium
Medium Term Survival and Functional Status in Patients with Severe Aortic Stenosis Treated by Transcatheter Aortic Valvular Implantation in the PARTNER EU Trial Bernard De Bruyne, MD, PhD Cardiovascular
More informationTranscatheter Aortic Valve Replacement with a Self-Expanding Prosthesis or Surgical Aortic Valve Replacement in Intermediate-Risk Patients:
Transcatheter Aortic Valve Replacement with a Self-Expanding Prosthesis or Surgical Aortic Valve Replacement in Intermediate-Risk Patients: 1-Year Results from the SURTAVI Clinical Trial Nicolas M. Van
More informationIndication, Timing, Assessment and Update on TAVI
Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical
More informationTAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central
TAVR-Update Andrzej Boguszewski MD, FACC, FSCAI Vice Chairman, Cardiology Mid-Michigan Health Associate Professor Michigan State University, Central Michigan University 1 Disclosure Chiesi Pharma- Consultant
More informationAortic Stenosis: Open vs TAVR vs Nothing
Aortic Stenosis: Open vs TAVR vs Nothing Wilson Y. Szeto, MD Associate Professor of Surgery Surgical Director, Transcatheter Cardio-Aortic Therapies Associate Director, Thoracic Aortic Surgery Division
More informationTranscatheter Aortic Valve Implantation (TAVI)
Transcatheter Aortic Valve Implantation (TAVI) QEH Registry A Multidisciplinary Team Approach Michael KY Lee 1, LK Chan 1, KC Chan 1, KT Chan 1, SF Chui 1, HS Ma 1, CY Wong 1, CS Chiang 1, P Li 1, CB Lam
More informationInterventional procedures guidance Published: 26 July 2017 nice.org.uk/guidance/ipg586
Transcatheter aortic valve implantation for aortic stenosis Interventional procedures guidance Published: 26 July 17 nice.org.uk/guidance/ipg586 Your responsibility This guidance represents the view of
More informationMedical Policy An independent licensee of the Blue Cross Blue Shield Association
Transcatheter Aortic Valve Implantation for Aortic Stenosis Page 1 of 37 Medical Policy An independent licensee of the Blue Cross Blue Shield Association Title: Transcatheter Aortic Valve Implantation
More informationTAVI After PARTNER-2 : The Hamilton Approach
TAVI After PARTNER-2 : The Hamilton Approach James L. Velianou MD FRCPC Interventional Cardiology Hamilton General Hospital St Catharines General Hospital Associate Professor of Medicine McMaster University
More informationTAVR in patients with. End-Stage CKD or in Renal Replacement Therapy:
TAVR in patients with End-Stage CKD or in Renal Replacement Therapy: Special Considerations and Prevention of early Valve Failure Antonios Chalapas, MD, PhD, FESC THV & Hygeia Hospital Heart Team Athens,
More informationTAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair?
TAVI- Is Stroke Risk the Achilles Heel of Percutaneous Aortic Valve Repair? Elaine E. Tseng, MD and Marlene Grenon, MD Department of Surgery Divisions of Adult Cardiothoracic and Vascular and Endovascular
More informationIgor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of Medicine Harvard Medical School
Aortic Stenosis: Current State of Percutaneous Therapies, Emerging Technologies and Future Directions Igor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of
More informationPost-TAVI Cerebral Embolisms and Potential Protection Means
Post-TAVI Cerebral Embolisms and Potential Protection Means Josep Rodés-Cabau, MD Quebec Heart & Lung Institute, Laval University Quebec City, Quebec, Canada EBR Marseille, May 2012 Conflict of Interest
More informationTranscatheter Aortic-Valve Implantation for Aortic Stenosis
Transcatheter Aortic-Valve Implantation for Aortic Stenosis Policy Number: 7.01.132 Last Review: 6/2018 Origination: 2/2012 Next Review: 2/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC)
More informationAlec Vahanian,FESC, FRCP (Edin.) Bichat Hospital University Paris VII, Paris, France
Future Percutaneous Therapies for Mitral Valve Disease (Mitraclip,percutaneous annuloplasty and transcatheter valve implantation) Will they reach the TAVI s success? Alec Vahanian,FESC, FRCP (Edin.) Bichat
More informationTAVI in Korea, How to Avoid Conduction
TAVI in Korea, How to Avoid Conduction Disturbance after CoreValve Seung-Jung Park, MD, PhD Professor of Medicine, University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul,
More information1-YEAR OUTCOMES FROM JOHN WEBB, MD
1-YEAR OUTCOMES FROM JOHN WEBB, MD ON BEHALF OF THE SAPIEN 3 INVESTIGATORS UNIVERSITY OF BRITISH COLUMBIA VANCOUVER, CANADA Potential conflicts of interest Speaker's name: John Webb I have the following
More informationThe Transcatheter Aortic Valve Replacement (TAVR)Program at Southcoast Health. Adam J. Saltzman, MD Cardiovascular Care Center
The Transcatheter Aortic Valve Replacement (TAVR)Program at Southcoast Health Adam J. Saltzman, MD Cardiovascular Care Center Southcoast Health Disclosures Edwards Lifesciences: speaking honorarium Outline
More informationTAVR today: High Risk, Intermediate Risk Population, and Valve in Valve Therapy
TAVR today: High Risk, Intermediate Risk Population, and Valve in Valve Therapy Alan Zajarias, MD FACC Structural Interventional Fellowship Director Associate Professor Medicine Cardiovascular Division
More informationTranscatheter Aortic-Valve Implantation for Aortic Stenosis
Transcatheter Aortic-Valve Implantation for Aortic Stenosis Policy Number: 7.01.132 Last Review: 2/2019 Origination: 2/2012 Next Review: 2/2020 Policy Blue Cross and Blue Shield of Kansas City (Blue KC)
More informationSAPIEN 3: Evaluation of a Balloon- Expandable Transcatheter Aortic Valve in High-Risk and Inoperable Patients With Aortic Stenosis One-Year Outcomes
SAPIEN 3: Evaluation of a Balloon- Expandable Transcatheter Aortic Valve in High-Risk and Inoperable Patients With Aortic Stenosis One-Year Outcomes Howard C. Herrmann, MD on behalf of The PARTNER II Trial
More informationNeal Kleiman, MD Houston Methodist DeBakey Heart and Vascular Institute
Neal Kleiman, MD Houston Methodist DeBakey Heart and Vascular Institute Despite a 33 fold growth in the first five years, there is still tremendous variability among penetration in different countries
More informationAortic valve implantation using the femoral and apical access: a single center experience.
Aortic valve implantation using the femoral and apical access: a single center experience. R. Hoffmann, K. Brehmer, R. Koos, R. Autschbach, N. Marx, G. Dohmen Rainer Hoffmann, University Aachen, Germany
More informationEstablishing the New Standard of Care for Inoperable Aortic Stenosis THE PARTNER TRIAL COHORT B RESULTS
Establishing the New Standard of Care for Inoperable Aortic Stenosis THE PARTNER TRIAL COHORT B RESULTS E D W A R D S T R A N S C A T H E T E R H E A R T V A L V E P R O G R A M T H E P A R T N E R T R
More informationAn Update on the Edwards TAVR Results. Zvonimir Krajcer, MD Director, Peripheral Intervention Texas Heart Institute at St.
An Update on the Edwards TAVR Results Zvonimir Krajcer, MD Director, Peripheral Intervention Texas Heart Institute at St. Luke s Hospital Disclosures On the speaker s bureau for Endologix, TriVascular,
More informationTranscatheter aortic valve replacement is considered investigational for all other indications.
Medical Policy Original Policy Date: March 30, 2012 Effective Date: July 1, 2018 Section: 7.0 Surgery Page: Page 1 of 33 Policy Statement Transcatheter aortic valve replacement with an U.S. Food and Drug
More informationTranscatheter aortic valve implantation for aortic stenosis
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Transcatheter aortic valve implantation for aortic stenosis Aortic stenosis occurs when the aortic valve
More informationTAVI PROGRAM CHANGING THE EDMONTON LANDSCAPE...
TAVI PROGRAM CHANGING THE EDMONTON LANDSCAPE... Benjamin Tyrrell MD, FRCPC Co-Director TAVI Program Northern Alberta CK HUI Heart Centre NOV 29, 2014 Disclosures None related to this talk Objectives Brief
More informationPARTNER 2A & SAPIEN 3: TAVI for intermediate risk patients
O P E N A C C E S S Department of Cardiology, Aswan Heart Centre *Email: ahmed.elguindy@aswanheartcentre.com Lessons from the trials PARTNER 2A & SAPIEN 3: TAVI for intermediate risk patients Ahmed ElGuindy*
More informationImaging in TAVI. Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013
Imaging in TAVI Jeroen J Bax Dept of Cardiology Leiden Univ Medical Center The Netherlands Davos, feb 2013 Research grants: Medtronic, Biotronik, Boston Scientific, St Jude, BMS imaging, GE Healthcare,
More informationTranscatheter Aortic Valve Implantation (TAVI) - 5 important lessons learnt from HK experiences Michael KY Lee
Transcatheter Aortic Valve Implantation (TAVI) - 5 important lessons learnt from HK experiences Michael KY Lee Queen Elizabeth Hospital, Hong Kong President, HKSTENT APCASH 2013 SJ Park TAVI Summit 2013
More informationEdwards Sapien. Medtronic CoreValve. Inoperable FDA approved High risk: in trials. FDA approved
Transcatheter Aortic Valve Replacement Symptomatic Aortic Stenosis Asymptomatic Juan Crestanello, MD Interim Director, Division of Cardiac Surgery Associate Professor Division of Cardiac Surgery The Ohio
More informationTAVR: Intermediate Risk Patients
TAVR: Intermediate Risk Patients Oscar A. Mendiz.MD.FACC.FSCAI Director Cardiology & Cardiovascular Institute (ICyCC) Chief Interventional Cardiology Department Board of Directors Hospital & Favaloro University
More informationSurgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea
Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Contents Decision making in surgical AVR in old age Clinical results of AVR with tissue valve Impact of 19mm
More informationTAVR: Review of the Robust Data from Randomized Trials
TAVR: Review of the Robust Data from Randomized Trials Nicholas J. Ruggiero II, MD,FACP, FACC, FSCAI, FSVM, FCPP Director, Structural Heart Disease and Non-Coronary Interventions Director, Jefferson Heart
More informationCase Presentations TAVR: The Good Bad and The Ugly
Case Presentations TAVR: The Good Bad and The Ugly Vincent J. Pompili, MD, FACC, FSCAI Professor of Internal Medicine Director of Interventional Cardiovascular Medicine and Cardiac Catheterization Laboratories
More informationTranscatheter Aortic Valve Replacement TAVR
Transcatheter Aortic Valve Replacement TAVR Paul Gordon, MD Associate Prof of Medicine, Brown University Director, Cardiac Catheterization Laboratory The Miriam Hospital Disclosures: none 100 Symptomatic
More informationMulticentre clinical study evaluating a novel resheatable self-expanding transcatheter aortic valve system
Multicentre clinical study evaluating a novel resheatable self-expanding transcatheter aortic valve system Preliminary Results: Acute and 1-year Outcomes Ganesh Manoharan, MBBCh, MD, FRCP Consultant Cardiologist
More informationSevere left ventricular dysfunction and valvular heart disease: should we operate?
Severe left ventricular dysfunction and valvular heart disease: should we operate? Laurie SOULAT DUFOUR Hôpital Saint Antoine Service de cardiologie Pr A. COHEN JESFC 16 janvier 2016 Disclosure : No conflict
More information22/06/2017. Oxford City. Transcatheter aortic valve replacement 2017 guidelines. 1. First time I have heard about it. 2.
Oxford City Transcatheter aortic valve replacement 2017 guidelines Monday 19 th June Jim Newton Oxford Oxford University Hospitals NHS FT How familiar are you with TAVR? 1. First time I have heard about
More informationFacteurs prédic.fs de mauvais pronos.c à court terme après TAVI
Facteurs prédic.fs de mauvais pronos.c à court terme après TAVI Auffret V., Bedossa M., Donal E., Boulmier D., Laurent M., Mabo P., Verhoye JP., Beneux X., Sost G. et Le Breton H. GRCI 29/11/12 Leon MB
More informationAssessment and Preparation of Patients with TAVI. Rob Tanzola Associate Professor, Queen s University
Assessment and Preparation of Patients with TAVI Rob Tanzola Associate Professor, Queen s University My patient has aortic stenosis and needs non-cardiac surgery Should (s)he get a TAVI? Rob Tanzola Associate
More informationAustralia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes
Australia and New Zealand Source Registry Edwards Sapien Aortic Valve 30 day Outcomes A/ Professor Darren Walters On behalf of the ANZ Source Investigators Director of Cardiology Brisbane, Australia ANZ
More informationPercutaneous aortic valve replacement should NOT be preferred therapy for aortic stenosis
Percutaneous aortic valve replacement should NOT be preferred therapy for aortic stenosis James Bartholomew McClurken, MD FACC, FCCP, FACS, FESC Professor & Vice-Chair of Surgery, Temple University Hosp.,
More informationTranscatheter Therapies For Aortic Valve Disease. March 2017 Brian Whisenant MD
Transcatheter Therapies For Aortic Valve Disease March 2017 Brian Whisenant MD Introduction I got into this field to protect my turf. I must say, I have come full circle... - Kent W. Jones I got into this
More informationDisclosures 4/16/2018. What s New in Valvularand Structural Heart Disease. None relevant to the presentation
What s New in Valvularand Structural Heart Disease Ryan C. Shelstad, MD Surgical Enthusiast, Valvular and Structural Heart Disease Bryan Heart Cardiothoracic Surgery Disclosures None relevant to the presentation
More informationResearch Grant from Servier
Disclosures ESC Paris 2011 Claire Bouleti, MD Research Grant from Servier Long-term impact of repeat Percutaneous Mitral Commissurotomy on the need for surgery in mitral stenosis. Insight from a series
More informationLow Gradient Severe? AS
Low Gradient Severe? AS Philippe Pibarot, DVM, PhD, FACC, FAHA, FESC, FASE Canada Research Chair in Valvular Heart Diseases Institut Universitaire de Cardiologie et de Pneumologie de Québec / Québec Heart
More informationEstablishing a New Path Forward for Patients With Severe Symptomatic Aortic Stenosis THE PARTNER TRIAL CLINICAL RESULTS
Establishing a New Path Forward for Patients With Severe Symptomatic Aortic Stenosis THE PARTNER TRIAL CLINICAL RESULTS E D W A R D S T R A N S C A T H E T E R H E A R T V A L V E P R O G R A M T h e Pa
More informationPERCUTANEOUS STRUCTURAL UPDATES TAVR WATCHMAN(LEFT ATRIAL APPENDAGE OCCLUDERS) MITRACLIP PARAVALVULAR LEAK REPAIRS ASD/PFO CLOSURES VALVULOPLASTIES
PERCUTANEOUS STRUCTURAL UPDATES TAVR WATCHMAN(LEFT ATRIAL APPENDAGE OCCLUDERS) MITRACLIP PARAVALVULAR LEAK REPAIRS ASD/PFO CLOSURES VALVULOPLASTIES Dr.Vinny K.Ram No disclosures TAVR 1 Lesson number 1:
More informationTAVI in Rabin Medical Center -
Long-Term Outcomes of 560 Consecutive Patients treated with TAVI and Propensity Score Matched- Analysis of Early Versus New Generation Valves Amos Levi, MD, Uri Landes, MD, Abid R Assali, MD, Katia Orvin,
More informationEdwards Transcatheter AVR: Have the Outcomes Changed after CE Approval?
Edwards Transcatheter AVR: Have the Outcomes Changed after CE Approval? Update from PARTNER EU and SOURCE Registries T. Lefèvre Disclosure Statement Cardiologist Interventional cardiologist 1 st PABV in
More informationIs Stroke Frequency Declining?
Is Stroke Frequency Declining? Etiologic Factors Clinical, Anatomic, Technique-related, and Device-specific Samir Kapadia, MD Professor of Medicine Section head, Interventional Cardiology Director, Cardiac
More informationComplications after TAVI: VARC Definitions, Frequency and Management Considerations Patrick W. Serruys, Nicolo Piazza,
Complications after TAVI: VARC Definitions, Frequency and Management Considerations Patrick W. Serruys, Nicolo Piazza, Nicolas M. Van Mieghem, Yoshinobu Onuma, Martin B. Leon TCT-AP 2011 April 27 th, 2011
More informationInterventional procedures guidance Published: 26 September 2014 nice.org.uk/guidance/ipg504
Transcatheter valve-in-valve e implantation for aortic bioprosthetic valve dysfunction Interventional procedures guidance Published: 26 September 2014 nice.org.uk/guidance/ipg504 Your responsibility This
More informationTranscatheter Aortic-Valve Implantation for Aortic Stenosis
Transcatheter Aortic-Valve Implantation for Aortic Stenosis Policy Number: Original Effective Date: MM.06.019 10/01/2012 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 07/27/2018
More informationIs TAVR the treatment of choice for high risk diabetic patients with aortic stenosis? Insights from the FRANCE2 Registry
Is TAVR the treatment of choice for high risk diabetic patients with aortic stenosis? Insights from the FRANCE2 Registry E Van Belle, E Teiger, F Juthier, A Vincentelli, B Iung, H Eltchaninoff, J Fajadet,
More informationTAVR in Intermediate Risk Populations /Optimizing Systems for TAVR
TAVR in Intermediate Risk Populations /Optimizing Systems for TAVR Saibal Kar, MD, FACC, FAHA, FSCAI Professor of Medicine Director of Interventional Cardiac Research Smidt Heart Institute, Cedars-Sinai
More informationTAVR for low-risk patients in 2017: not so fast.
TAVR for low-risk patients in 2017: not so fast. Enrico Ferrari, MD, FETCS Cardiac Surgery Department Cardiocentro Ticino Foundation Lugano, Switzerland Conflicts of Interest Consultant and proctor for
More informationTAVR 2018: TAVR has high clinical efficacy according to baseline patient risk! ii. Con
TAVR 2018: TAVR has high clinical efficacy according to baseline patient risk! ii. Con Dimitrios C. Angouras, MD, FETCS Associate Professor of Cardiac Surgery National and Kapodistrian University of Athens,
More informationTranscatheter Valve Replacement: Current State in 2017
Transcatheter Valve Replacement: Current State in 2017 Marc A. Sintek MD Assistant Professor of Medicine Interventional Cardiology Cardiovascular Division Washington University in St. Louis Missouri ACP
More informationSevere Aortic Valve Disease: TAVR in Four Ages and Four Etiologies Age 25 y/o Congenital, 50 y/o Bicuspid, 75 y/o Rheumatic, 100 y/o Degenerative
Severe Aortic Valve Disease: TAVR in Four Ages and Four Etiologies Age 25 y/o Congenital, 50 y/o Bicuspid, 75 y/o Rheumatic, 100 y/o Degenerative Samin K. Sharma, MD, FACC, FSCAI Director Clinical & Interventional
More informationTHE PERCUTANEOUS MANAGEMENT OF VALVULAR HEART DISEASE DR JOHN RAWLINS CONSULTANT INTERVENTIONAL CARDIOLOGIST UNIVERSITY HOSPITAL SOUTHAMPTON
THE PERCUTANEOUS MANAGEMENT OF VALVULAR HEART DISEASE DR JOHN RAWLINS CONSULTANT INTERVENTIONAL CARDIOLOGIST UNIVERSITY HOSPITAL SOUTHAMPTON INTRODUCTION History of heart valve intervention Current indications
More informationIstanbul Course of Interventional Cardiology Istanbul, June 11, 2011
Istanbul Course of Interventional Cardiology Istanbul, June 11, 2011 Within the past 12 months, the presenter or their spouse/partner have had a financial interest/arrangement or affiliation with the organization(s)
More informationAfter PARTNER 2A/S3i and SURTAVI: What is the Role of Surgery in Intermediate-Risk AS Patients?
After PARTNER 2A/S3i and SURTAVI: What is the Role of Surgery in Intermediate-Risk AS Patients? Vinod H. Thourani, MD Professor of Surgery and Medicine Emory University Disclosure Statement of Financial
More information