Edwards Sapien. Medtronic CoreValve. Inoperable FDA approved High risk: in trials. FDA approved
|
|
- Rhoda Day
- 5 years ago
- Views:
Transcription
1 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 State University Wexner Medical Center Leon ME et al. NEJM 2010, Otto CM et al. Circulation 1997 Transcatheter AVR Transcatheter AVR Edwards Sapien Medtronic CoreValve FDA approved Inoperable FDA approved High risk: in trials 1
2 Edwards Sapien TAVR Transcatheter AVR Transfemoral Baloon Expandable Transapical Transfemoral Medtronic CoreValve Direct Aortic Subclavian Direct Aortic CoreValve Deployment Self Expandable The Trials PARTNER TRIAL (EDWARDS SAPIEN) MEDTRONIC US TRIAL INOPERABLE HIGH RISK EXTREME RISK (INOPERABLE) HIGH RISK Medical Management vs TAVR SAVR vs TAVR TAVR SAVR vs TAVR 2
3 PARTNER TRIAL PARTNER TRIAL Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Inoperable Aortic Stenosis TAVR vs. Medical Management Inoperable Aortic Stenosis TAVR vs. Medical Management TAVR: 80% on NYHA class I or II Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. 3
4 Inoperable Aortic Stenosis TAVR vs. Medical Management Inoperable Aortic Stenosis TAVR vs. Medical Management Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Inoperable Aortic Stenosis TAVR vs. Medical Management PARTNER TRIAL Medical management did not change the natural history of aortic stenosis TAVR relieved aortic stenosis TAVR was superior to medical therapy: Decreased all cause mortality Decreased cardiovascular mortality Decreased rate of rehospitalization Improved NYHA functional class Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. 4
5 High Risk Aortic Stenosis TAVR vs. AVR High Risk Aortic Stenosis TAVR vs. AVR 80% on NYHA class I or II Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. High Risk Aortic Stenosis TAVR vs. AVR High Risk Aortic Stenosis TAVR vs. AVR TAVR increased risk of early stroke Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. 5
6 High Risk Aortic Stenosis Paravalvular Aortic Regurgitation Paravalvular Aortic Regurgitation p < p < p < p < N = 277 N = 226 N = 230 N = 172 N = 216 N = 155 N = 145 N = 112 High Risk Aortic Stenosis Paravalvular Aortic Regurgitation High Risk Aortic Stenosis TAVR vs. SAVR TAVR and SAVR effectively relieved AS Mortality was similar up to 2 years NYHA class was similar 30 day stroke rate was higher in TAVR TAVR was associated with PVL Mild moderate and severe PVL resulted in increased mortality Permission to use Partner Trial information and images provided courtesy of Edwards Lifesciences. 6
7 CoreValve Trial Pivotal Trial Design CoreValve US Pivotal Trials Aortic Stenosis Extreme Risk Primary Endpoint All Cause Mortality or Major Stroke CoreValve Iliofemoral Extreme Risk Iliofemoral Access > 18 Fr Sheath Yes No CoreValve Non- Iliofemoral N=487 N=147 High Risk Randomization 1:1 Versus CoreValve SAVR y or Major Stroke All Cause Mortality 9.3% [6.7,12.0] Months Post Procedure P < Performance Goal = 43% 25.5% [21.6,29.4] Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Aortic Stenosis Extreme Risk 1 Year Mortality Aortic Stenosis Extreme Risk Major Stroke Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October
8 Aortic Stenosis Extreme Risk Secondary Endpoints Events* 1 Month 1 Year Any Stroke, % Major, % Minor, % Myocardial Infarction, % Reintervention, % VARC Bleeding, % Life Threatening or Disabling, % Major, % Major Vascular Complications, % Permanent Pacemaker Implant, % Per ACC Guidelines, % * Percentages obtained from Kaplan Meier estimates Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Aortic Stenosis Extreme Risk NYHA Class Survivors 91% 8.8% Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Aortic Stenosis Extreme Risk Echocardiographic Findings Aortic Stenosis Extreme Risk Perivalvular Aortic Regurgitation Paravalvular Regurgitation Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October
9 Aortic Stenosis Extreme Risk Perivalvular Aortic Regurgitation Paravalvular Regurgitation N=46 Aortic Stenosis Extreme Risk Perivalvular Aortic Regurgitation Impact of PVL on Late Mortality Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October CoreValve Extreme Risk TAVR relieved aortic stenosis TAVR reduced mortality and stroke rate at one year Low rate of stroke Pivotal Trial Design CoreValve Mild and moderate PVL was not associated with increased mortality MARCH 2014 Jeffrey J. Popma, MD. CoreValve US Pivotal Trial Extreme Risk Iliofemoral Study Results. Data presented at TCT. San Francisco, California. October
10 Valve in Valve Ongoing and Upcoming Trials Intermediate Risk High Risk Extreme Risk SURTAVI Trial CoreValve Pivotal Trial Expanded Use CoreValve Pivotal Trial Expanded Use PARTNER II PARTNER A PARTNER B The Structural Heart Disease Team TAVR with Medtronic CoreValve: Femoral Approach Barry George, MD Director Advanced Catheter-Based Therapeutics and Structural Heart Disease Associate Professor Clinical Department of Cardiovascular Medicine The Ohio State University Wexner Medical Center 10
11 CoreValve Delivery Options CoreValve Delivery Options Transfemoral Direct Aortic Transfemoral Direct Aortic Subclavian Subclavian Transfemoral Step by Step Transfemoral Step by Step Vascular Access Valvuloplasty Crossing Aortic Valve Hemodynamic Assessment Vl Valve Vl Valve Vl Valve Positioning Deployment Release Angiographic Assessment Hemodynamic Assessment ECHO Assessment Vascular Access Repair 11
12 Vascular Access Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Contralateral femoral artery placement of 6F sheath. Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Vascular Access Femoral artery cut down (percutaneous) for delivery sheath 5-0 Prolene purse string Needle and guidewire Administer Heparin to achieve ACT>300 s 12
13 Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Angi o 6 French Sheath placement Pigtail placement into descending thoracic aorta Insertion Amplatz Super Stiff guidewire over pigtail catheter Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Vascular Access Femoral artery cut down (percutaneous) for delivery sheath Angi o Arterial dilatation with 12,14 and 18 F dilators over Amplatz Super Stiff guidewire Placement of 18 F sheath 13
14 Vascular Access Contralateral femoral artery placement of 6F sheath. Implant projection Percutaneous arterial access 6F Sheath and pigtail Determination of implantation projection Alignment of all 3 cusps of aortic valve in a single plane. Crossing Aortic Valve angi o NCC Initial Hemodynamic Assessment Pigtail advance to noncoronary sinus 14
15 Crossing the Aortic Valve AL 2 catheter with straight guidewire AP projection Crossing the Aortic Valve Exchange guidewire ROA projection Pigtail placement in LV apex Vide o Initial Hemodynamic Assessment LV and Aortic pressure Placement of stiff guidewire in the LV apex RAO projection Amplatz Super Stiff ST1 (pigtail configuration) vide o 15
16 Aortic balloon valvuloplasty Aortic Valvuloplasty Balloons: Z MED (NuMED Inc) NuCLEUS Ballon (NuMED Inc) True Balloon (Loma Vista Medical) Balloon size: smaller diameter of aortic annulus Pacing rate: bpm Screw-in temporary pacing lead If patient has a PPM,transvenous pacer in the OR. No valvuloplasty in: Low EF patients <30-35% Large plaque-calcifications in the aorta or sinus of Valsalva Valve in valve Aortic balloon valvuloplasty Pacer on Balloon up Ballon down Pacer off CoreValve Implantation angi o 16
17 CoreValve Implantation CoreValve is loaded into the delivery system before the valvuloplasty CoreValve in the delivery capsule Optimal implantation depth 2 to 6 mm Depth of implantation CoreValve insertion and advancement into the aortic root Ao Ao Ao Ao Ao LV c v LV c v c v LV c v c v LV c v LV c v Correct No AI Too deep AI AV block Too shallow AI Pop out Irregular annulus AI Large annulus AI 17
18 CoreValve insertion and advancement into the aortic root CoreValve Deployment Video 0 to 1 CoreValve Deployment Pushing guidewire: CoreValve moves out (toward the aorta) Position adjustments Operator #1: Pulling or pushing delivery catheter Operator #2: Pulling or pushing guidewire 18
19 CoreValve Deployment Node 0 Pulling guidewire: CoreValve moves in (toward ventricle) CoreValve Deployment CoreValve Deployment Node 2 to 3/4 Node 1 Video Final release Video Final release Rapid ventricular pacing 19
20 CoreValve Deployment Final release Nosecone Recapture of the nosecone in the descending aorta and removal of the delivery catheter Video Final release Valve Function Assessment Angiography Valve Function Assessment 20
21 Hemodynamics Valve Function Assessment Valve Function Assessment Hemodynamics Aortic Systolic Pressure Aortic Regurgitation Index Ao Diastolic - LVEDP >0.25 Ao Systolic Aortic Diastolic Pressure Left Ventricular End-diastolic Pressure Aortic Diastolic Pressure >40 mmhg Valve Function Assessment Hemodynamics Valve Function Assessment Echocardiography Aortic Regurgitation Index Ao Diastolic - LVEDP Ao Systolic >0.25 (62-22) 135 =
22 Sheath removal Sheath Removal Access Repair Over stiff guidewire Inject contrast through sheath Contralateral t l pigtail il in the aortic bifurcation Sheath removal Arteriotomy repair If iliac artery rupture: Advance sheath and dilator over stiff guidewire Place Coda aortic occlusion balloon through contralateral pigtail (arterial sheath may need to be exchange) Place coverstent through ipsilateral sheath 22
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 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 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 informationVascular 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 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 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 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 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 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 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 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 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 informationStructural Heart Disease Transcatheter Aortic Valve Replacement (TAVR)
Structural Heart Disease Transcatheter Aortic Valve Replacement (TAVR) Kathleen Harper DO FACC FACP 87 Chief, Cardiology Section VA Maine Healthcare Kathleen.Harper@va.gov Prevalence of Aortic Stenosis
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 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 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 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 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 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 informationTAVR 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 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 information30-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 informationUpdate on Percutaneous Therapies for Structural Heart Disease. William Thomas MD Director of Structural Heart Program Tucson Medical Center
Update on Percutaneous Therapies for Structural Heart Disease William Thomas MD Director of Structural Heart Program Tucson Medical Center NCVH 2014- Tucson Disclosure of Financial Interest Research: Stock
More informationDr. Jean-Claude Laborde
Medtronic CoreValve Experience Alternative Access (Subclavian) and Technology Evolution of the Medtronic CoreValve TAVI System Dr. Jean-Claude Laborde Glenfield Hospital, Leicester, U.K. St George Hospital,
More informationAortic Stenosis and TAVR TARUN NAGRANI, MD INTERVENTIONAL AND ENDOVASCULAR CARDIOLOGIST, SOMC
Aortic Stenosis and TAVR TARUN NAGRANI, MD INTERVENTIONAL AND ENDOVASCULAR CARDIOLOGIST, SOMC No Financial Disclosures Aortic Stenosis AS is an insidious disease with a long latency period followed by
More informationProsthesis-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 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 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 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 informationTrans 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 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 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 informationHow Do I Evaluate a Patient Being Considered for TAVR? Sunday, February 14, :00 11:25 PM 25 min
2016 ASE State of the Art Echocardiography Course Tucson, AZ How Do I Evaluate a Patient Being Considered for TAVR? Sunday, February 14, 2016 11:00 11:25 PM 25 min 1 M U H A M E D S A R I Ć, M D, P H D
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 informationAortic Valve Practice Guidelines: What Has Changed and What You Need to Know
Aortic Valve Practice Guidelines: What Has Changed and What You Need to Know James F. Burke, MD Program Director Cardiovascular Disease Fellowship Lankenau Medical Center Disclosure Dr. Burke has no conflicts
More informationCoreValve Evolut R Technology review and Clinical Results. Paul TL Chiam
CoreValve Evolut R Technology review and Clinical Results Paul TL Chiam MBBS (S pore), MMed, MRCP (UK), FAMS FRCP (Edin), FESC (EU), FACC (USA), FSCAI (USA) Cardiologist Mount Elizabeth Hospital Singapore
More informationPre-procedural CT angiography for Transcatheter Aortic Valve Implantation: What a Radiologist Needs to Know?
Pre-procedural CT angiography for Transcatheter Aortic Valve Implantation: What a Radiologist Needs to Know? E O Dwyer, C O Brien, I Murphy, C Shortt, O Buckley Department of Radiology, AMNCH, Dublin,
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 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 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 informationTAVR SPRING 2017 The evolution of TAVR
TAVR SPRING 2017 The evolution of TAVR Matthew Johnson, MD Disclosers None Evolution of the Balloon- Expandable Transcatheter Valves Cribier 2002 SAPIEN 2006 SAPIEN XT 2009 SAPIEN 3 2013 * Sheath compatibility
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 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 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 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 informationEvolving 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 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 informationNew York Valves Patient focused evidence-based approach. New York City: 6 December Antonio Colombo
New York Valves 2018 Patient focused evidence-based approach New York City: 6 December 2018 Antonio Colombo Speaker 7 EMO GVM Centro Cuore Columbus Milan, Italy No conflicts to report Vascular complications
More informationDavid Dexter MD FACS Sentara Vascular Specialists Assistant Professor of Surgery EVMS. Peripheral Complications of TAVR
David Dexter MD FACS Sentara Vascular Specialists Assistant Professor of Surgery EVMS Peripheral Complications of TAVR TAVR Complications Reported Complications Rates range from 8% to 15% Predictors 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 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 informationCurrent 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 informationTranscatheter aortic valve implantation (TAVI): an example of how to organise a TAVI programme
original article Transcatheter aortic valve implantation (TAVI): an example of how to organise a TAVI programme J M ten Berg R Heijmen As the population ages, aortic valve stenosis becomes more prevalent.
More informationTAVR: It s a Career, Not Just a Procedure! Jeffrey A Southard, MD Cardiology May 5, 2012
TAVR: It s a Career, Not Just a Procedure! Jeffrey A Southard, MD Cardiology May 5, 2012 Transcatheter Aortic Valve Replacement T- eam A- pproach to V- alve R- eplacement UCDMC Team Administration Cardiology
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 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 information2/28/2010. 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 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 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 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 informationAffiliation/Financial Relationship Grant/ Research Support: Major Stock Shareholder/Equity Interest: Royalty Income: Ownership/Founder: Salary:
IMPLANTATION OF SAPIEN XT, TRANSFEMORAL TAPED CASE Gerald Yong MBBS (Hons) FRACP FSCAI Interventional Cardiologist Royal Perth Hospital Western Australia TAVI Summit 9 th Aug 2013 Disclosure Statement
More informationTranscatheter 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 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 informationFirst Transfemoral Aortic Valve Implantation In Bulgaria - Crossing The Valve With The Device Is Not Always
ISPUB.COM The Internet Journal of Cardiology Volume 9 Number 2 First Transfemoral Aortic Valve Implantation In Bulgaria - Crossing The Valve With The Device Is Not T D, J P. Citation T D, J P.. First Transfemoral
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 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 information2 Brigham and Women s Hospital, Boston, MA.
Chapter 6: History of Transcatheter Aortic Valve Replacement (TAVR) Bryan Piccirillo, MD 1 ; Pinak B. Shah, MD, FACC 2 1 Brigham and Women s Heart and Vascular Center 2 Brigham and Women s Hospital, Boston,
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 informationPolicy 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 informationIndex. interventional.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Ablation, of mitral leaflets, 80 Accucinch Annuloplasty system, for mitral regurgitation, 79, 94 95 Accutrak delivery system, for CoreValve
More informationTranscatheter Aortic Valve Implantation Using CoreValve by Transaortic Approach
Case Report http://dx.doi.org/10.12997/jla.2013.2.2.85 pissn 2287-2892 eissn 2288-2561 JLA Transcatheter Aortic Valve Implantation Using CoreValve by Transaortic Approach Kyeong-Hyeon Chun 1, Young-Guk
More informationTranscatheter Aortic Valve Replacement (TAVR)
UW MEDICINE PATIENT EDUCATION Transcatheter Aortic Valve Replacement (TAVR) Treatment for aortic stenosis This handout explains when your doctor may advise TAVR to treat aortic stenosis. It includes the
More informationAortic 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 informationTranscatheter 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 informationJonathon Leipsic MD FRCPC FSCCT. Vice Chairman of Radiology University of British Columbia. Disclosures
Jonathon Leipsic MD FRCPC FSCCT Vice Chairman of Radiology University of British Columbia Disclosures Speaker s bureau: GE Healthcare and Edwards LifeSciences Grant Support- CIHR, GE Healthcare Advisory
More informationOutcome 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 informationImage Assistance in TAVI Why CT? Won-Jang Kim, MD, PhD Clinical Assistant Professor of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea
Image Assistance in TAVI Why CT? Won-Jang Kim, MD, PhD Clinical Assistant Professor of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea Major Uses of CT in TAVI Ileofemoral Patient Arterial
More informationNew Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor. Cardiothoracic Radiology
New Cardiovascular Devices and Interventions: Non-Contrast MRI for TAVR Abhishek Chaturvedi Assistant Professor Cardiothoracic Radiology Disclosure I have no disclosure pertinent to this presentation.
More informationConflict of Interests
Introduction to Interventional Echocardiography Roberto M Lang, MD Tomtec Conflict of Interests Research Grants Philips Medical Imaging Research Grants Speakers bureau Advisory bureau 1 Structural Heart
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 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 05/26/2017
More informationHow to manage TAVI related vascular complications. Paul TL Chiam MBBS, FRCP, FESC, FACC, FSCAI
How to manage TAVI related vascular complications Paul TL Chiam MBBS, FRCP, FESC, FACC, FSCAI Definition VARC-2 consensus statement Complications caused by: Wire Catheter Anything related to vascular access
More informationTAVI complication. Possible aetiology and how to manage
TAVI complication. Possible aetiology and how to manage Dr Sanjeevan Pasupati Waikato Hospital, Hamilton, New Zealand Operators: Dr Sanjeevan Pasupati, Mr Nand Kejriwal, Mr Adam Elgamel Valve Positioning
More informationTAVI: Transapical Procedures
Cardiology Update Davos TAVI: Transapical Procedures Volkmar Falk, MD University Hospital Zürich TA-AVI: antegrade, simple, safe The front door approach! Transapical TAVI Technical advantages of TA approach
More informationAPOLLO TMVR Trial Update: Case Presentation
APOLLO TMVR Trial Update: Case Presentation Anelechi Anyanwu, MD, MSc, FRCS-CTh Professor and Vice-Chairman Department of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai New York, NY Disclosure
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 informationNouvelles indications/ Nouvelles valves
Nouvelles indications/ Nouvelles valves Sadra Lotus Valve system Boston Scientific A. Tirouvanziam Institut Thorax Nantes SH-31314-AC Sept 2012 Slide 1 of 53 SH-31314-AC Sept 2012 Slide 2 of 53 Building
More informationTranscatheter 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 informationTAVR: Echo Measurements Pre, Post And Intra Procedure
2017 ASE Florida, Orlando, FL October 10, 2017 8:00 8:25 AM 25 min TAVR: Echo Measurements Pre, Post And Intra Procedure Muhamed Sarić MD, PhD, MPA Director of Noninvasive Cardiology Echo Lab Associate
More informationTranscatheter Aortic Valve Implantation Management of risks and complications
Transcatheter Aortic Valve Implantation Management of risks and complications TAVI Summit, Seoul, Korea, Spetember 3rd, 2011 Alain Cribier University of Rouen, France Complications of TAVI Depending on
More informationFor the SURTAVI Investigators
Neurological complications after transcatheter aortic valve implantation with a self-expanding bioprosthesis or surgical aortic valve replacement in patients at intermediate-risk for surgery A. Pieter
More informationAlternate Vascular Access for TAVR. Gian Paolo Ussia Campus Bio-medico University, Rome Italy
Alternate Vascular Access for TAVR Gian Paolo Ussia Campus Bio-medico University, Rome Italy g.ussia@unicampus.it REQUIRED Gian Paolo Ussia I have no relevant financial relationships Transcatheter Valves
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 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 (AS) remains the most common
Sapien Valve: Past, Present, and Future A look at how the Sapien family of valves continues to evolve to treat a range of patients seeking transcatheter aortic valve replacement. BY RAVINDER SINGH RAO,
More informationTAVI 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 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 informationConflicts of interests
Update in Interventional Cardiology for the Internist Transcatheter valve therapies Dr Vaikom S Mahadevan Director of Structural and Adult Congenital Interventions William W Parmley Endowed Chair in Cardiology
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 informationTRANSCATHETER HEART VALVE PROCEDURES
UnitedHealthcare Commercial Medical Policy TRANSCATHETER HEART VALVE PROCEDURES Policy Number: 2017T0557M Effective Date: November 1, 2017 Table of Contents Page INSTRUCTIONS FOR USE... 1 BENEFIT CONSIDERATIONS...
More information