Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and"

Transcription

1 Outcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and Evolut R platforms in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry TM Paul Sorajja, MD, Susheel Kodali, MD, Michael Reardon, MD, Wilson Szeto, MD, Stanley Chetcuti, MD, James Hermiller, Jr, MD, David Adams, MD, Jeffrey J Popma, MD

2 Abstract Background. Transcatheter aortic valve replacement (TAVR) continues to evolve, with rapid adoption of iterative changes for commercial practice. This analysis compared the outcomes of commercial TAVR with the new repositionable Evolut TM R platform to those observed with the CoreValve TM platform in the STS/ACC Transcatheter Valve Therapy (TVT) Registry TM. Methods. Patients in the STS/ACC TVT Registry TM who had TAVR for native aortic stenosis using a 23, 26, or 29 mm Medtronic self-expanding prosthesis (CoreValve TAV or Evolut R TAV) were included in this analysis. Site-reported events for acute, in-hospital, and 30-day outcomes were examined. Results. Between Jan 2014 and April 2016, 9,616 patients underwent TAVR with a Medtronic self-expanding prosthesis in the U.S and were reported in the STS/ACC TVT Registry TM. Compared to patients treated with CoreValve TAV, those who received Evolut R TAV were slightly younger (81.2±8.0 yrs vs. 81.6±8.1 yrs; p=0.02), had lower STS-PROM (8.0±5.4% vs. 8.7±5.3%; p<0.001) and a greater use of ilio-femoral access (91.6% vs. 89.0%; p<0.001). With Evolut R TAV, there was a lower acute need for a second prosthesis [2.2% vs. 4.5%; p<0.001], less device migration (0.2% vs. 0.6%; p=0.01), a lower incidence of moderate or severe paravalvular regurgitation (4.4% vs. 6.2%; p<0.001), and shorter length of hospital stay (median, 4.0 vs. 5.0 days; p<0.001). Overall, patients treated with Evolut R TAV had a greater frequency of acute device success (96.3% vs. 94.9%; p=0.001). At 30-day follow-up, major vascular complications and residual aortic gradients after TAVR were low in both groups [7.7 mmhg vs. 7.3 mmhg; p<0.001], while all-cause mortality and the need for permanent pacemaker was lower for those who received Evolut R. Conclusions. The commercial adoption of TAVR with the Evolut R platform is associated with significant clinical improvements in the acute procedural outcomes for patients undergoing TAVR for aortic stenosis. 2

3 Background Transcatheter aortic valve replacement (TAVR) remains a rapidly evolving therapy. Continued examination of adoption of iterative changes into commercial practice is needed. 3

4 Study Aim To compare the outcomes of commercial TAVR with the new repositionable Evolut R platform to those observed with the CoreValve platform in the STS/ACC Transcatheter Valve Therapy (TVT) Registry TM. 4

5 Methods Between Jan 2014 and April 2016, 9,616 patients underwent commercial TAVR for treatment of native aortic valve stenosis using a 23, 26, or 29 mm Medtronic self-expanding prosthesis. Site-reported events for acute, in-hospital, and 30-day outcomes as reported in the STS/ACC TVT Registry TM were examined. Comparisons of outcome were performed for valve platform (CoreValve TAV or Evolut R TAV) and valve size (23 mm vs. 26 mm vs. 29 mm). Statistical significance was set a priori at p<0.05. Due to the large sample sizes, a statistical difference may be detected even though the difference is not clinically significant. 5

6 Baseline Demographics Demographics CoreValve (N=5806) Evolut R (N=3810) p value Age 1 (years) 81.6 ± ± Body Surface Area (m 2 ) 1.8 ± ± Male 35.1% 37.5% 0.01 STS Score (Risk of Mortality, %) 8.7 ± ± 5.4 < Diabetes Mellitus 36.2% 36.8% 0.53 Creatinine Level >2 mg/dl 7.1% 8.9% History of Hypertension 90.3% 90.7% 0.50 Peripheral Vascular Disease 29.8% 29.4% 0.73 Prior Stroke 12.5% 12.1% 0.52 Prior TIA 10.1% 9.6% 0.45 Cardiac Surgery (Open Heart) 25.7% 23.2% 0.01 Coronary Artery Disease 66.0% 64.3% 0.08 Pre-Existing IPG/ICD 19.1% 19.2% Subjects with age >90 are reported as 90 plus in the database and for calculation are set to 90. Values are presented as mean ± standard deviation or % of patients. 6

7 Procedural Data Assessment CoreValve (N=5806) Evolut R (N=3810) p value Valve Size Implanted 23 mm 5.4% 3.9% mm 34.3% 35.2% mm 60.3% 60.9% 0.59 Type of Anesthesia < Conscious/Moderate Sedation 12.7% 27.4% General 86.4% 72.1% Combination 0.8% 0.4% Access Site Ilio-femoral 89.2% 91.6% < Subclavian 4.6% 5.4% 0.07 Axillary 1.0% 0.7% 0.09 Direct Aortic 4.6% 1.8% < Other 0.5% 0.4% 0.63 Need for a second prosthesis 1 4.5% 2.2% <0.001 Device 1 Implanted Successfully 98.0% 99.0% <0.001 More than 1 valve used during the same procedure. Device Values are Success presented as mean ± standard deviation or % of patients. 94.9% 96.3%

8 In-Hospital and 30-Day Outcomes CoreValve (N=5806) Evolut R (N=3810) CoreValve (N=5806) Evolut R (N=3810) In-Hospital 30 Day All-cause mortality 3.7% 2.7% Ŧ 5.3% 3.7% Ŧ Any stroke 2.7% 2.6% 3.1% 3.1% Ischemic stroke 2.3% 2.2% 2.6% 2.6% Major vascular complication 1.4% 1.4% 1.5% 1.5% New permanent pacemaker 19.2% 16.6% Ŧ 20.1% 18.3% * Aortic valve reintervention 0.3% 0.2% 0.5% 0.3% Myocardial infarction 0.4% 0.1% Ŧ 0.5% 0.2% * PCI 0.4% 0.1% Ŧ 0.6% 0.2% Ŧ KCCQ N/A N/A 68.7 ± 23.7 (3885) 71.2 ± 23.0 Ŧ (2562) In-hospital: % = Proportion of subjects with events. 30 Days: % = Kaplan-Meier rate. KCCQ: mean ± standard deviation (n). CoreValve vs. Evolut R: *P<0.05; Ŧ P<0.01 8

9 Hospital Stay 9

10 Discharge Status Discharge Location: P<0.001 CoreValve vs. Evolut R 10

11 Hemodynamics Effective Orifice Area (cm 2 ) Baseline Post-procedure CoreValve 0.67 ± 0.25 (5688) 1.90 ± 0.64 (3829) Evolut R 0.68 ± 0.25* (3720) 1.88 ± 0.59 (2685) Data presented as mean ± standard deviation (n). *P<0.05 CoreValve vs. Evolut R. (effective orifice area not collected at 1 month) 11

12 Conclusions The use of Evolut R is associated with significant clinical improvements in acute procedural outcomes for patients undergoing TAVR for aortic stenosis. These improvements include lower procedural mortality, greater use of transfemoral access, shorter hospital stay, and less paravalvular regurgitation. These findings demonstrate that adoption of Evolut R, in the context of continued improvements in TAVR practice, has been of significant clinical benefit for patients with severe, native aortic valve stenosis. 12

13 Acknowledgments This research used data provided by the American College of Cardiology Foundation s National Cardiovascular Data Registry and The Society of Thoracic Surgeons National Database. The views expressed in this presentation represent those of the author(s), and do not necessarily represent the official views of either organization. Learn more about the STS/ACC TVT Registry at Statistical analysis was performed by Sharla Chenoweth, MS, and editorial support with tables and figures provided by Jessica Dries- Devlin, PhD, both of Medtronic 13

14 Disclosures Dr. Sorajja has received consulting and speaking fees from Abbott Vascular; consulting fees from Medtronic, speaking fees from Boston Scientific, and consulting fees from Lake Region; Dr. Kodali discloses financial relationships with Edwards Lifesciences, Thubrikar Aortic Valve Inc, Claret Medical, Meril Lifesciences, and VS Med Tech; Dr. Reardon has received fees from Medtronic for providing educational services; Dr.Szeto reports a financial relationship with MicroInterventional Devices ; Dr Chetcuti reports receiving grant support from Edwards Lifesciences, Boston Scientific, and Medtronic, and proctoring fees from Medtronic; Dr. Hermiller has received fees for educational services from Medtronic; Dr. Adams has received grant support from Medtronic and has royalty agreements through Mount Sinai School of Medicine with Medtronic and with Edwards Lifesciences. Dr. Popma has received grants from Medtronic, Boston Scientific, and Direct Flow Medical, and receives compensation from Boston Scientific for participation in a Medical Advisory Board and serves as a Consultant for Direct Flow Medical receiving consulting fees and equity. 14

Transcatheter 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: 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 information

Le TAVI pour tout le monde?

Le 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 information

30-Day Outcomes Following Implantation of a Repositionable Self-Expanding Aortic Bioprosthesis: First Report From the FORWARD Study

30-Day Outcomes Following Implantation of a Repositionable Self-Expanding Aortic Bioprosthesis: First Report From the FORWARD Study 30-Day Outcomes Following Implantation of a Repositionable Self-Expanding Aortic Bioprosthesis: First Report From the Study Stephan Windecker Department of Cardiology Bern University Hospital - INSELSPITAL

More information

Debate: 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 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 information

SAPIEN 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 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 information

Vinod H. Thourani, MD, FACC, FACS

Vinod H. Thourani, MD, FACC, FACS Considering SAVR in the TAVR era: Surgical Implications of TAVR Vinod H. Thourani, MD, FACC, FACS Professor of Cardiothoracic Surgery and Medicine Chief of Cardiothoracic Surgery, Emory Hospital Midtown

More information

Tissue vs Mechanical What s the Data??

Tissue vs Mechanical What s the Data?? Biological (Tissue) Valve in a 60 year old patient: Debate Tissue vs Mechanical What s the Data?? Joseph E. Bavaria, MD Immediate-Past President - Society of Thoracic Surgeons (STS) Brooke Roberts-William

More information

Transcatheter Aortic Valve Replacement

Transcatheter 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 information

After 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? 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

Prosthesis-Patient Mismatch in High Risk Patients with Severe Aortic Stenosis in a Randomized Trial of a Self-Expanding Prosthesis

Prosthesis-Patient Mismatch in High Risk Patients with Severe Aortic Stenosis in a Randomized Trial of a Self-Expanding Prosthesis Prosthesis-Patient Mismatch in High Risk Patients with Severe Aortic Stenosis in a Randomized Trial of a Self-Expanding Prosthesis George L. Zorn, III On Behalf of the CoreValve US Clinical Investigators

More information

Outcomes of the Initial Experience with Commercial Transcatheter Mitral Valve Repair in the U.S.

Outcomes of the Initial Experience with Commercial Transcatheter Mitral Valve Repair in the U.S. ACC 2015 LBCT Outcomes of the Initial Experience with Commercial Transcatheter Mitral Valve Repair in the U.S. A report from the STS/ACC TVT Registry Paul Sorajja, MD, Saibal Kar, MD, Amanda Stebbins,

More information

TAVR: Intermediate Risk Patients

TAVR: 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 information

Aortic 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. 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 information

Transcatheter Aortic Valve Replacement with a Repositionable Self-expanding Bioprosthesis in Patients With Severe Aortic Stenosis Suboptimal for

Transcatheter Aortic Valve Replacement with a Repositionable Self-expanding Bioprosthesis in Patients With Severe Aortic Stenosis Suboptimal for Transcatheter Aortic Valve Replacement with a Repositionable Self-expanding Bioprosthesis in Patients With Severe Aortic Stenosis Suboptimal for Surgery: One-Year Results from the Evolut R US Pivotal Study

More information

Indication, Timing, Assessment and Update on TAVI

Indication, 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 information

The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation

The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation The FORMA Early Feasibility Study: 30-Day Outcomes of Transcatheter Tricuspid Valve Therapy in Patients with Severe Secondary Tricuspid Regurgitation Susheel Kodali, MD Director, Structural Heart & Valve

More information

CIPG Transcatheter Aortic Valve Replacement- When Is Less, More?

CIPG 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 information

Aortic Stenosis: Open vs TAVR vs Nothing

Aortic 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 information

Edwards Sapien. Medtronic CoreValve. Inoperable FDA approved High risk: in trials. FDA approved

Edwards 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 information

Is TAVR Now Indicated in Even Low Risk Aortic Valve Disease Patients

Is 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 information

Published Manuscripts Based in the STS/ACC TVT Registry

Published Manuscripts Based in the STS/ACC TVT Registry Published Manuscripts Based in the STS/ACC TVT Registry June 2018 Legend Manuscript Status is designated as follows: Abbreviations: Published/Full Citation Provided: Manuscript is in print. In Press: Manuscript

More information

Early Experience of Transcatheter Mitral Valve Replacement Results from the Intrepid Global Pilot Study

Early Experience of Transcatheter Mitral Valve Replacement Results from the Intrepid Global Pilot Study Early Experience of Transcatheter Mitral Valve Replacement Results from the Paul Sorajja, MD for the Investigators Presenter Disclosure Information Within the past 12 months, I or my spouse/partner have

More information

Published Manuscripts Based in the STS/ACC TVT Registry

Published Manuscripts Based in the STS/ACC TVT Registry Published Manuscripts Based in the STS/ACC TVT Registry June 2018 Legend Manuscript Status is designated as follows: Abbreviations: Published/Full Citation Provided: Manuscript is in print. In Press: Manuscript

More information

Medical Policy An independent licensee of the Blue Cross Blue Shield Association

Medical 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 information

Transcatheter aortic valve replacement is considered investigational for all other indications.

Transcatheter 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 information

TAVR today: High Risk, Intermediate Risk Population, and Valve in Valve Therapy

TAVR 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 information

Is 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? 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 information

Transcatheter Aortic-Valve Implantation for Aortic Stenosis

Transcatheter 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 information

TAVR: Review of the Robust Data from Randomized Trials

TAVR: 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 information

Early Experience of Transcatheter Mitral Valve Replacement Results from the Intrepid Global Pilot Study

Early Experience of Transcatheter Mitral Valve Replacement Results from the Intrepid Global Pilot Study Early Experience of Transcatheter Mitral Valve Replacement Results from the Paul Sorajja, MD for the Investigators Presenter Disclosure Information Within the past 12 months, I or my spouse/partner have

More information

Trend and Outcomes of Direct Transcatheter Aortic Valve Replacement from a Single-Center Experience

Trend and Outcomes of Direct Transcatheter Aortic Valve Replacement from a Single-Center Experience Cardiol Ther (2018) 7:191 196 https://doi.org/10.1007/s40119-018-0115-0 BRIEF REPORT Trend and Outcomes of Direct Transcatheter Aortic Valve Replacement from a Single-Center Experience Anthony A. Bavry.

More information

Aortic Stenosis: Background

Aortic 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 information

Evolving and Expanding Indications for TAVR

Evolving and Expanding Indications for TAVR Evolving and Expanding Indications for TAVR Wilson Y. Szeto, MD Associate Professor of Surgery Surgical Director, Transcatheter Cardio-Aortic Therapies Associate Director, Thoracic Aortic Surgery Division

More information

TAVR in Intermediate Risk Populations /Optimizing Systems for TAVR

TAVR 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 information

Igor Palacios, MD Director of Interventional Cardiology Massachusetts General Hospital Professor of Medicine Harvard Medical School

Igor 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 information

TAVR 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 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 information

Transcatheter Aortic-Valve Implantation for Aortic Stenosis

Transcatheter 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 information

Published Manuscripts Based in the STS/ACC TVT Registry

Published Manuscripts Based in the STS/ACC TVT Registry Published Manuscripts Based in the STS/ACC TVT Registry Legend Manuscript Status is designated as follows: Abbreviations: Published/Full Citation Provided: Manuscript is in print. In Press: Manuscript

More information

Current Evidence in TAVI patients using ACURATE and LOTUS valves

Current Evidence in TAVI patients using ACURATE and LOTUS valves Current Evidence in TAVI patients using ACURATE and LOTUS valves Giuseppe Tarantini, MD, PhD, FESC, Professor and Director of Interventional Cardiology University of Padua GISE President Potential conflicts

More information

Clinical and Echocardiographic Outcomes at 30 Days with the SAPIEN 3 TAVR System in Inoperable, High-Risk and Intermediate-Risk AS Patients

Clinical and Echocardiographic Outcomes at 30 Days with the SAPIEN 3 TAVR System in Inoperable, High-Risk and Intermediate-Risk AS Patients Clinical and Echocardiographic Outcomes at 30 Days with the SAPIEN 3 TAVR System in Inoperable, High-Risk and Intermediate-Risk AS Patients Susheel Kodali, MD on behalf of The PARTNER Trial Investigators

More information

In Process, Unpublished STS/ACC TVT Registry Manuscripts

In Process, Unpublished STS/ACC TVT Registry Manuscripts In Process, Unpublished STS/ACC TVT Registry Manuscripts The following pages list current research and publications proposals that have been recently approved, are under analysis, are under manuscript

More information

TAVR-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 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 information

TAVR in 2017 What we know? What to expect?

TAVR 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 information

Valve Disease. Valve Surgery. Total Volume. In 2016, Cleveland Clinic surgeons performed 3039 valve surgeries.

Valve Disease. Valve Surgery. Total Volume. In 2016, Cleveland Clinic surgeons performed 3039 valve surgeries. Valve Surgery Total Volume 1 1 Volume 35 3 5 15 1 5 1 13 1 N = 773 5 79 15 93 1 339 In 1, surgeons performed 339 valve surgeries. surgeons have implanted more than 1, bioprosthetic aortic valves since

More information

Ian T. Meredith AM. MBBS, PhD, FRACP, FCSANZ, FACC, FAPSIC. Monash HEART, Monash Health & Monash University Melbourne, Australia

Ian T. Meredith AM. MBBS, PhD, FRACP, FCSANZ, FACC, FAPSIC. Monash HEART, Monash Health & Monash University Melbourne, Australia Two-Year Outcomes With the Fully Repositionable and Retrievable Lotus Transcatheter Aortic Replacement Valve in 120 High-Risk Surgical Patients With Severe Aortic Stenosis: Results From the REPRISE II

More information

Strokes After TAVR: Perspectives from the US CoreValve Trials

Strokes After TAVR: Perspectives from the US CoreValve Trials Strokes After TAVR: Perspectives from the US CoreValve Trials Jeffrey J. Popma, MD Professor of Medicine Harvard Medical School Director, Interventional Cardiology Clinical Services Beth Israel Deaconess

More information

CoreValve in a Degenerative Surgical Valve

CoreValve in a Degenerative Surgical Valve CoreValve in a Degenerative Surgical Valve Ran Kornowski, MD, FESC, FACC Chairman Department of Cardiology Rabin Medical Center, Petach Tikva, Israel Disclosure Statement of Financial Interest I, Ran Kornowski,

More information

TAVR for low-risk patients in 2017: not so fast.

TAVR 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 information

Vascular complications of embolized core valve

Vascular complications of embolized core valve Vascular complications of embolized core valve Suhail Dohad, MD FACC Director of Endovascular services, Interventional Cardiology Cardiovascular Research Foundation of Southern California, CVMG Director

More information

TAVI limitations for low risk patients

TAVI limitations for low risk patients TAVI limitations for low risk patients Dr. T. Modine / P. Lancellotti MD, PhD, MBA CHRU de Lille, France Potential conflicts of interest Speaker's name: Thomas Modine I have the following potential conflicts

More information

Aortic 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? 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 information

TAVI After PARTNER-2 : The Hamilton Approach

TAVI 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 information

Transcatheter Aortic-Valve Implantation for Aortic Stenosis

Transcatheter 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 information

TAVR for Complex Aortic Valvular Conditions

TAVR for Complex Aortic Valvular Conditions TAVR for Complex Aortic Valvular Conditions Wilson Y. Szeto, MD Professor of Surgery Chief, Cardiovascular Surgery at Penn Presbyterian Surgical Director, Transcatheter Cardio-Aortic Therapies Associate

More information

Incorporating the intermediate risk in Transcatheter Aortic Valve Implantation (TAVI)

Incorporating 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 information

Transcatheter aortic valve implantation for severe aortic valve stenosis with the ACURATE neo2 valve system: 30-day safety and performance outcomes

Transcatheter aortic valve implantation for severe aortic valve stenosis with the ACURATE neo2 valve system: 30-day safety and performance outcomes All cited trademarks are the property of their respective owners. CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings and instructions

More information

Policy Specific Section: March 30, 2012 March 7, 2013

Policy Specific Section: March 30, 2012 March 7, 2013 Medical Policy Transcatheter Aortic Valve Replacement for Aortic Stenosis Type: Medical Necessity and Investigational / Experimental Policy Specific Section: Surgery Original Policy Date: Effective Date:

More information

SOLVE-TAV. Holger Thiele, MD on behalf of the SOLVE-TAVI Investigators

SOLVE-TAV. Holger Thiele, MD on behalf of the SOLVE-TAVI Investigators SOLVE-TAV A 2x2 Randomized Trial of Self-Expandable vs Balloon-Expandable Valves and General vs Local Anesthesia in Patients Undergoing Transcatheter Aortic Valve Implantation Holger Thiele, MD on behalf

More information

Transcatheter procedures of the future; expanding the treatment options for patients with severe aortic stenosis

Transcatheter procedures of the future; expanding the treatment options for patients with severe aortic stenosis Transcatheter procedures of the future; expanding the treatment options for patients with severe aortic stenosis John Webb MD Director interventional cardiology, St Paul s Hospital McLeod Professor of

More information

An 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. 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 information

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

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 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 information

Transcatheter 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 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 information

Aortic Stenosis Background and Breakthroughs in Treatment: TAVR Update

Aortic Stenosis Background and Breakthroughs in Treatment: TAVR Update Aortic Stenosis Background and Breakthroughs in Treatment: TAVR Update Howard J Broder MD Interventional Cardiology DaVita Medical Group/ Healthcare Partners Cardiology Disclosures for Howard J Broder

More information

Sentinel Dual Filter Device: Technology Overview and Status of the CLEAN-TAVI Randomized Trial. Martin B. Leon, MD

Sentinel Dual Filter Device: Technology Overview and Status of the CLEAN-TAVI Randomized Trial. Martin B. Leon, MD 8 mins Sentinel Dual Filter Device: Technology Overview and Status of the CLEAN-TAVI Randomized Trial Martin B. Leon, MD Columbia University Medical Center Cardiovascular Research Foundation New York City

More information

Trans Catheter Aortic Valve Replacement

Trans Catheter Aortic Valve Replacement Trans Catheter Aortic Valve Replacement Satish K Surabhi, MD,FACC,FSCAI Medical Director, Cardiac Cath Labs AnMed Health Heart and Vascular Care No financial conflict of interest related to this talk Will

More information

TAVR in 2020: What is Next!!!!

TAVR in 2020: What is Next!!!! TAVR in 2020: What is Next!!!! Vinod H. Thourani, MD Professor of Surgery Chairman, Department of Cardiac Surgery Medstar Heart and Vascular Institute Washington Hospital Center Washington, DC Disclosures

More information

Appropriate Use of TAVR - now and in the future. A Surgeon s Perspective. Neil Moat Royal Brompton Hospital, London, UK

Appropriate Use of TAVR - now and in the future. A Surgeon s Perspective. Neil Moat Royal Brompton Hospital, London, UK Appropriate Use of TAVR - now and in the future A Surgeon s Perspective Neil Moat Royal Brompton Hospital, London, UK Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner

More information

TAVI: 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 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 information

CARDIOLOGY GRAND ROUNDS

CARDIOLOGY GRAND ROUNDS CARDIOLOGY GRAND ROUNDS Presentation: Mitral Disease Speakers: Robert S. Farivar, MD, PhD Chief, Cardiothoracic Surgery, Abbott Northwestern Hospital Chairman, Allina Cardiothoracic; Minneapolis Heart

More information

Minimalist Transcatheter Aortic Valve Replacement (MA-TAVR)

Minimalist Transcatheter Aortic Valve Replacement (MA-TAVR) Minimalist Transcatheter Aortic Valve Replacement (MA-TAVR) Jensen HA, Condado JF, Devireddy C, Binongo JN, Leshnower BG, Babaliaros V, Sarin EL, Lerakis S, Guyton RA, Stewart JP, Syed AQ, Mavromatis K,

More information

Transcatheter aortic valve implantation for aortic stenosis

Transcatheter 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 information

Predictors, incidence and outcomes of patients undergoing transcatheter aortic valve implantation complicated by stroke

Predictors, incidence and outcomes of patients undergoing transcatheter aortic valve implantation complicated by stroke Predictors, incidence and outcomes of patients undergoing transcatheter aortic valve implantation complicated by stroke From the CENTER-Collaboration Wieneke Vlastra, MD Heart Center, Amsterdam UMC, University

More information

Valve Disease. Valve Surgery. In 2015, Cleveland Clinic surgeons performed 2943 valve surgeries.

Valve Disease. Valve Surgery. In 2015, Cleveland Clinic surgeons performed 2943 valve surgeries. Valve Surgery 11 15 Volume 3 1 11 1 13 1 N = 1 773 5 79 15 93 In 15, surgeons performed 93 valve surgeries. surgeons have implanted more than 1,5 bioprosthetic aortic valves since the 199s, with excellent

More information

2/28/2010. Speakers s name: Paul Chiam. I have the following potential conflicts of interest to report: NONE. Antegrade transvenous transseptal route

2/28/2010. Speakers s name: Paul Chiam. I have the following potential conflicts of interest to report: NONE. Antegrade transvenous transseptal route Transcatheter Aortic Valve Implantation Asian perspective Speakers s name: Paul Chiam Paul TL Chiam MBBS, MRCP, FACC I have the following potential conflicts of interest to report: NONE Consultant National

More information

Progress In Transcatheter Aortic Valve Implantation

Progress In Transcatheter Aortic Valve Implantation Progress In Transcatheter Aortic Valve Implantation Gerald Yong MBBS (Hons) FRACP FSCAI Interventional Cardiologist Royal Perth Hospital Western Australia 4 th APCASH 8 th Sept 2013 Disclosure Statement

More information

LOW RISK TAVR. WHAT THE FUTURE HOLDS

LOW 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 information

In Process, Unpublished STS/ACC TVT Registry Manuscripts

In Process, Unpublished STS/ACC TVT Registry Manuscripts In Process, Unpublished STS/ACC TVT Registry Manuscripts The following pages list current research and publications proposals that have been recently approved, are under analysis, are under manuscript

More information

Interventional procedures guidance Published: 26 July 2017 nice.org.uk/guidance/ipg586

Interventional 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 information

Incidence, Predictors, and Outcomes of Prosthesis-Patient Mismatch in 62,125 TAVR Patients. An STS/ACC TVT Registry Report

Incidence, Predictors, and Outcomes of Prosthesis-Patient Mismatch in 62,125 TAVR Patients. An STS/ACC TVT Registry Report Incidence, Predictors, and Outcomes of Prosthesis-Patient Mismatch in 62,125 TAVR Patients An STS/ACC TVT Registry Report Howard C. Herrmann, MD University of Pennsylvania Philadelphia Howard C. Herrmann

More information

TAVI and TAVR: Radical and Revolutionary: The Newest Insights for the CV Community and a Panel Discussion

TAVI and TAVR: Radical and Revolutionary: The Newest Insights for the CV Community and a Panel Discussion TAVI and TAVR: Radical and Revolutionary: The Newest Insights for the CV Community and a Panel Discussion Moderator: Joseph E. Bavaria, MD Roberts-Measey Professor of Surgery Vice Chair, Division of Cardiovascular

More information

Transcatheter heart valve thrombosis

Transcatheter heart valve thrombosis Transcatheter heart valve thrombosis Jeroen J Bax Dept Cardiology Leiden, The Netherlands New York, 2017 The department of Cardiology of the Leiden University Medical center received research grants from

More information

The SAPIEN 3 TAVI Advantage

The SAPIEN 3 TAVI Advantage Edwards SAPIEN 3 Valve The SAPIEN 3 TAVI Advantage... The SAPIEN 3 TAVI Advantage The clear choice for your patients and your TAVI program Advanced valve and system designed to simplify procedures Consistent

More information

Paris, August 28 th Gian Paolo Ussia on behalf of the CoreValve Italian Registry Investigators

Paris, August 28 th Gian Paolo Ussia on behalf of the CoreValve Italian Registry Investigators Paris, August 28 th 2011 Is TAVI the definitive treatment in high risk patients? Impact Of Coronary Artery Disease In Elderly Patients Undergoing TAVI: Insight The Italian CoreValve Registry Gian Paolo

More information

1-YEAR OUTCOMES FROM JOHN WEBB, MD

1-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 information

Successful Transfemoral Edwards Sapien Aortic. Valve Implantation in a Patient with Previous. Mitral Valve Replacement

Successful Transfemoral Edwards Sapien Aortic. Valve Implantation in a Patient with Previous. Mitral Valve Replacement Advanced Studies in Medical Sciences, Vol. 2, 2014, no. 1, 37-45 HIKARI Ltd, www.m-hikari.com http://dx.doi.org/10.12988/asms.2014.31213 Successful Transfemoral Edwards Sapien Aortic Valve Implantation

More information

22/06/2017. Oxford City. Transcatheter aortic valve replacement 2017 guidelines. 1. First time I have heard about it. 2.

22/06/2017. 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 information

Appropriate Patient Selection or Healthcare Rationing? Lessons from Surgical Aortic Valve Replacement in The PARTNER I Trial Wilson Y.

Appropriate Patient Selection or Healthcare Rationing? Lessons from Surgical Aortic Valve Replacement in The PARTNER I Trial Wilson Y. Appropriate Patient Selection or Healthcare Rationing? Lessons from Surgical Aortic Valve Replacement in The PARTNER I Trial Wilson Y. Szeto, MD on behalf of The PARTNER Trial Investigators and The PARTNER

More information

3 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 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 information

Is 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 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 information

Disclosures. LGH TAVR: Presentation Outline 2/2/2016. Updates in Transcatheter Aortic Valve Replacement (TAVR) and the LGH Experience

Disclosures. LGH TAVR: Presentation Outline 2/2/2016. Updates in Transcatheter Aortic Valve Replacement (TAVR) and the LGH Experience Updates in Transcatheter Aortic Valve Replacement (TAVR) and the LGH Experience The LGH TAVR Program James E. Harvey, MD, MSc Medical Director, Structural Heart Intervention The Heart Group of Lancaster

More information

Embolic Protection Devices for Transcatheter Aortic Valve Replacement

Embolic Protection Devices for Transcatheter Aortic Valve Replacement Embolic Protection Devices for Transcatheter Aortic Valve Replacement James M. McCabe, MD Medical Director, Cardiac Cath Lab University of Washington Seattle, WA Disclosures Proctoring and honoraria for

More information

Aortic Stenosis. TAVR available devices Ioannis Iakovou, MD, PhD

Aortic Stenosis. TAVR available devices Ioannis Iakovou, MD, PhD Aortic Stenosis. TAVR available devices Ioannis Iakovou, MD, PhD Interventional Cardiology Onassis Cardiac Surgery Center Athens, Greece TAVI in 2018: Landscape TAVI is a Breakthrough Technology Dramatic

More information

TAVI EN INSUFICIENCIA AORTICA

TAVI EN INSUFICIENCIA AORTICA TAVI EN INSUFICIENCIA AORTICA Cesar Moris Profesor Cardiología Director Departamento del Corazón Hospital Universitario Central de Asturias Universidad de Oviedo OVIEDO -- ESPAÑA CONFLICTO DE INTERESES

More information

Transcatheter Heart Valve Procedures

Transcatheter Heart Valve Procedures Medical Coverage Policy Transcatheter Heart Valve Procedures Table of Contents Coverage Policy... 1 Overview... 2 General Background... 2 Coding/Billing Information... 27 References... 29 Effective Date...11/15/2017

More information

Transcatheter Aortic-Valve Implantation for Aortic Stenosis

Transcatheter 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 05/26/2017

More information

Transcatheter Aortic Valve Replacement with Evolut-R

Transcatheter Aortic Valve Replacement with Evolut-R Transcatheter Aortic Valve Replacement with Evolut-R Department of Transcatheter Heart Valves and 2 nd Cardiothoracic Surgery Clinic K. Spargias, M.Chrissoheris, A.Halapas, I. Nikolaou, S.Pattakos Disclosures

More information

Update on the CoreValve Experience

Update on the CoreValve Experience TCT Asia Pacific April 22-24, 2009 Update on the CoreValve Experience Eberhard Grube HELIOS Klinikum, Germany Instituto Dante Pazzanese de Cardiología, São Paulo, Brazil Stanford University, Palo Alto,

More information

One Year Outcomes from the STS/ACC Transcatheter Valve Therapy (TVT) Registry

One Year Outcomes from the STS/ACC Transcatheter Valve Therapy (TVT) Registry One Year Outcomes from the STS/ACC Transcatheter Valve Therapy (TVT) Registry David R. Holmes, Jr., J. Matthew Brennan, John S. Rumsfeld, David Dai, Fred Edwards, John Carroll, David Shahian, Fred Grover,

More information

Outcome of Next-Generation Transcatheter Valves in Small Aortic Annuli: A Multicenter Propensity-Matched Comparison

Outcome of Next-Generation Transcatheter Valves in Small Aortic Annuli: A Multicenter Propensity-Matched Comparison Outcome of Next-Generation Transcatheter Valves in Small Aortic Annuli: A Multicenter Propensity-Matched Comparison Mauri, V. et al.: Circ Cardiovasc Interv. 2017;10:e005013 All trademarks are the property

More information

Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients?

Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients? Really Less-Invasive Trans-apical Beating Heart Mitral Valve Repair: Which Patients? David H. Adams, MD Cardiac Surgeon-in-Chief Mount Sinai Health System Marie Josée and Henry R. Kravis Professor and

More information