Treatment of Bio-Prosthetic Valve Deterioration Using Transcatheter Techniques
|
|
|
- Laurel Ford
- 5 years ago
- Views:
Transcription
1 Treatment of Bio-Prosthetic Valve Deterioration Using Transcatheter Techniques Pablo Codner, Abid Assali, Hanna Vaknin-Assa, Katia Orvin, Ram Sharony, Leor Perl, Gabriel Greenberg, Marina Kupershmidt, Soraya Taic, Tamir Bental, Yaron Shapira, Alon Barsheshet, Alexander Sagie, Ran Kornowski. Cardiology Department - Rabin Medical Center & Sackler Faculty of Medicine Tel Aviv University - ISRAEL
2 Authors Disclosure Information The authors have no conflicts of interests regarding the content of this presentation.
3 Background Valve-in-Valve Experience Rabin Medical Center IHS Conference 2015 Structural bio-prosthetic valve deterioration may be secondary to leaflet: - Calcification Retraction Endocarditis - Tear / Disruption Entrapment by pannus tissue Thrombus Producing clinically significant regurgitation or stenosis Calcification Tear and disruption Pannus and Retraction Endocarditis Thrombosis 1. Piazza N, Bleiziffer S, Brockmann G, et al. J Am Coll Cardiol Intv. 2011;4(7):
4 Background The standard of care for patients presenting with structural valve deterioration is redo-surgical valve replacement, however many of these patients are high risk surgical candidates. Percutaneous implantation of valves devices has risen as an alternative for the treatment of valve deterioration. 2 The mean survival of patients treated with surgical valve replacement is frequently longer than the durability of their implanted valves; therefore valve deterioration is frequently seen in clinical practice. 2. Dvir D, John Webb, Stephen Brecker, et al. Circulation 2012;126:
5 Aim We aim to report our experience in treating patients with structural bioprosthetic valve deterioration, using the percutaneous implantation of both: the self-expandable and the balloon expandable valve devices.
6 Methods From 2008 to 2015, >400 patients were treated with the percutaneous implantation of a valve device in our institution. This report is focused on our Valve-in Valve experience. All Valve-in-Valve patients (N=39) were rejected from re-do surgery due to high surgical risk, high fragility index, porcelain aorta, chest deformation, etc.
7 Methods Pre-procedure assessment included: Trans-esophageal echocardiography % of cases. Coronary and peripheral angiography % of cases. Gated cardiac CT % of cases. We performed detailed analysis of: 1) The bioprosthetic valve manufacturer characteristics 2) Patient`s operative report.
8 Methods Devices and access routes Aortic valve-in-valve (N=3) Mitral valve-in-valve (N=10) Tricuspid valve-in-valve (N=1) Aortic valve-in-valve (N=2) Aortic valve-in-valve (N=23) * 39 patients treated, 40 valves implanted; one patient was treated with both a mitral and an aortic valve in valve procedure in the same session. 8
9 Aortic Valve in Valve Procedures
10 Results - Aortic Procedures Baseline Characteristics Value N=28 Age (yrs) 80.1 ±4.6 Female 17 (60.7%) Diabetes mellitus type 2 13 (46.4%) Chronic obstructive lung disease 7 (25%) Previous coronary bypass surgery 15 (54%) Mean glomerular filtration rate (ml/min/1.73m 2 ) * 66.2 ± 19.8 New York Heart Association Functional Class III - IV 92.8% Society of Thoracic Surgeons score 8.9 ± 4.4 Mode of failure - Pure aortic stenosis 10 (36%) - Pure aortic regurgitation 8 (28%) - Combined aortic stenosis and regurgitation 10 (36%) Maximal and mean aortic valve gradient (mmhg) Ɨ 68 / 41
11 Results - Aortic Procedures Nr. Age (yrs) Gender Surgical valve brand name Percutaneous device Years from surgery 1 81 Male Toronto SPV 29mm CoreValve 29mm 14.5 Transfemoral 2 87 Female Mitroflow 21mm CoreValve 26mm 14.7 Transaxilary 3 86 Male Carpentier Edwards porcine 23mm CoreValve 26mm 13.9 Transaxilary 4 88 Female Mitroflow 21mm CoreValve 26mm 17.3 Transfemoral 5 88 Female Mitroflow 21mm CoreValve 26mm 8.8 Transfemoral 6 82 Male Mitroflow 23mm CoreValve 26mm 8.0 Transfemoral 7 86 Male Toronto SPV 23mm CoreValve 26mm 16.4 Transfemoral 8 83 Male Hancock II 27mm Edwards Sapien 29mm 10.6 Transapical 9 78 Male Toronto SPV 25mm CoreValve 26mm 16.7 Transaxilary Female Mitoflow 19mm CoreValve 23mm 10.0 Transfemoral Female Mitoflow 19mm CoreValve 23mm 10.1 Transfemoral Male Mosaic 23mm CoreValve 26mm 11.2 Transfemoral Female Mitroflow 19mm CoreValve 23mm 6.3 Transfemoral Female Mitroflow 21mm CoreValve 23mm 5.3 Transfemoral Female Mitroflow 19mm CoreValve 23mm 15.5 Transfemoral Male Mosaic 23mm CoreValve 26mm 16.7 Transfemoral Female Mitroflow 19mm CoreValve 23mm 11.7 Transfemoral Female Mitroflow 19mm CoreValve 23mm 4.9 Transfemoral Male Magna 23mm CoreValve 26mm 7.0 Transfemoral Male Mosaic 25mm CoreValve 26mm 11.1 Transfemoral Female Carpentier Edwards SPV 23mm CoreValve 26mm 2.0 Transfemoral 22* 82 Male Carpentier Edwards porcine 25mm (aortic) Edwards Sapien (aortic) 26mm 16.3 Transapical Female Perimount 21mm CoreValve Evolut 23mm 11 Transfemoral Female Carpentier Edwards SPV 26mm CoreValve Evolut 26mm 10 Transfemoral Male Perimount 21mm CoreValve 26mm 11 Transfemoral Female Mitroflow 19mm CoreValve 23mm 9 Transfemoral Female Mitroflow 19mm CoreValve 23mm 9 Transfemoral Female Mitroflow 19mm CoreValve 23mm 10 Transfemoral % 19 29mm 13 Access
12 Results - Aortic Procedures Procedural characteristics and outcomes valve-in-valve aortic position N=28 General anesthesia 18 (64%) Balloon pre-dilatation 1 (3.5%) Tamponade 0% Coronary obstruction 0% Valve snaring 1 (3.5%) Two valves 1 (3.5%) Valve success 27 (96.4%) In hospital mortality 0% In hospital CVA 0% Need for pacemaker implantation 0% Mean length of hospitalization 4.2 ± month max / mean trans-aortic valve gradient (mmhg) 24.4 ± 16.4 / 15.7 ± 11.1 NYHA I/II (1year follow up) 100% 1 month death / 1 year death 0 (%) / 1 (3.5%) Mean follow up (years) 1.6 ± 1.1
13 Aortic Procedures CoreValve Evolut 23mm in Perimount 21mm
14 Mitral Valve in Valve Procedures
15 Results - Mitral Procedures Baseline Characteristics Value N=10 Age (yrs) 73.6 ± 15 Female 6 (60%) Diabetes mellitus type 2 2 (20%) Previous coronary bypass surgery 5 (50%) Mean glomerular filtration rate (ml/min/1.73m 2 ) * 67.2 ± 26.1 New York Heart Association Functional Class III 7 (70%) Society of Thoracic Surgeons score 7.7 ± 4.1 Mean time from valve surgery (yrs) 12.6 ± 3.4 Mode of failure - Pure mitral regurgitation 10 (100%) Mean vena contracta (cm) 0.62 ± 0.9 Proximal isovelocity surface area radius (cm) 0.8 ± 0.3 Effective regurgitant orifice area (cm 2 ) 0.34 ± 0.6
16 Results - Mitral Procedures Nr. Age (yrs) Gende r Surgical valve brand name Percutaneous device Years from surgery Access 1 51 Female Carpentier Edwards porcine 27mm Edwards Sapien 26mm 13.0 Transapical 2 80 Female Carpentier Edwards SAV 25mm Edwards Sapien 26mm 9.3 Transapical 3 81 Female Carpentier Edwards SAV 27mm Edwards Sapien 26mm 10.8 Transapical 4 63 Female Magna 25mm Edwards Sapien 26mm 3.9 Transapical 5 87 Male Carpentier Edwards SAV 31mm Edwards Sapien 29mm 10.2 Transapical 6 80 Female Hancock II 27mm Edwards Sapien 26mm 10.5 Transapical 7 77 Male Carpentier Edwards SAV 27mm Edwards Sapien 26mm 11.4 Transapical 8 46 Female Hancock II 29mm Edwards Sapien 29mm 8.6 Transapical 9 89 Male Carpentier Edwards SAV 31mm Edwards Sapien 29mm 16.3 Transapical 10* 82 Male Carpentier Edwards Porcine 27mm Edwards Sapien 29mm 16.3 Transapical %
17 Results - Mitral Procedures Procedural characteristics and outcomes valve-in-valve mitral position Value General anesthesia 10 (100%) Tamponade 0 (0%) Two valves 0 (%) Valve success 10 (100%) In hospital mortality 1 (10%) Mean length of hospitalization (days) 6.6 ± month mitral regurgitation grade > 1 0% (0%) 1 month / 1 year NYHA I or II 100% 1 month death / 1 year death 1 (10%) / 2(20%) 1 month cerebrovascular accident 0 (0%) Mean follow up (years) 1.7 ± 1.2
18 Combined Aortic and Mitral Trans-apical Valve-in-Valve procedure Aortic Valve-in-Valve Edwards Sapien XT 26mm in CE Porcine 25mm Mitral Valve-in-Valve Edwards Sapien XT 29mm in CE Porcine 27mm Optimal Final Positioning of Both Valves
19 The Tricuspid Valve in Valve Procedures
20 Results The Tricuspid Procedure The case of a 78-year-old female patient with overwhelming right sided heart failure, 35 years after combined mitral and tricuspid valve replacement, was discussed in our heart team meeting. At TEE the tricuspid bioprosthesis - Hancock 31mm, Medtronic, MN, USAshowed elevated valve gradients 26/16 mmhg, thickened prosthetic valve leaflets and mild regurgitation.
21 Conclusion In our experience, the Valve-in-Valve procedure for the treatment of failed mitral, aortic and tricuspid bio-prosthetic valves, using multiple access techniques and available devices, was correlated with: Significant symptomatic improvement. Very low peri procedural morbidity. Very low mortality rates. This therapeutic modality should be considered as an alternative to redo-surgery in patients with structural bio-prosthetic valve deterioration. Whether valve-in-valve offers a prognostic advantage over redo-valve surgery should be assessed in a prospective randomized trial. 21
22 Thank You
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,
TAVI 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,
Hemodynamics Benefit of Supra-Annular Design in Failed Bio-Prosthetic Valves
Hemodynamics Benefit of Supra-Annular Design in Failed Bio-Prosthetic Valves Speaker's name: I have the following potential conflicts of interest to report: Proctorship for Medtronic Agenda Failure modes
Valve Replacement without a Scalpel Transcatheter Aortic Valve Replacement (TAVR) Charles T. Klodell, M.D.
Valve Replacement without a Scalpel Transcatheter Aortic Valve Replacement (TAVR) Charles T. Klodell, M.D. Professor, Thoracic and Cardiovascular Surgery University of Florida klodell@surgery.ufl.edu Disclosures
2/15/2018 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
Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel
TAVI CON Extension to medium and low risk patients? Friedrich Eckstein University Hospital Basel Extension to medium and low risk patients? In octogenerians already reality in most of the swiss clinics!?
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
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
Bioprosthetic Mitral Valve Dysfunction: Innovation and Evolution of a New Therapeutic Technique
Bioprosthetic Mitral Valve Dysfunction: Innovation and Evolution of a New Therapeutic Technique Charanjit S. Rihal MD MBA Professor and Chair Division of Cardiovascular Diseases Mayo Clinic DISCLOSURES
Magdalena Erlebach 1, Michael Wottke 1, Marcus-André Deutsch 1, Markus Krane 1, Nicolo Piazza 2, Ruediger Lange 1, Sabine Bleiziffer 1
Original Article on TAVI Redo aortic valve surgery versus transcatheter valve-in-valve implantation for failing surgical bioprosthetic valves: consecutive patients in a single-center setting Magdalena
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
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,
Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute
Mechanical vs. Bioprosthetic Aortic Valve Replacement: Time to Reconsider? Christian Shults, MD Cardiac Surgeon, Medstar Heart and Vascular Institute Assistant Professor, Georgetown School of Medicine
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
Catheter-Based Valve-Implantations Using CoreValve and Edwards-Sapien Devices Kornowski, Ran
S2 Catheter-Based Valve-Implantations Using CoreValve and Edwards-Sapien Devices Kornowski, Ran 1 ; Dvir, Danny 1 ; Assali, Abid 1 ; Porat, Eyal 2 ; Shapira, Yaron 1 ; Vaknin-Assa, Hana 1 ; Koren, Arnon
Percutaneous 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
TAVI- 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
TAVR for Valve-In-Valve. Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology
TAVR for Valve-In-Valve Brian O Neill Assistant Professor of Medicine Department of Medicine, Section of Cardiology Temple Hearth and Vascular Institute Disclosures: Consultant: Cardiac Assist TAVR for
Late failure of transcatheter heart valves: An open question
Late failure of transcatheter heart valves: An open question A comparison with surgically implanted bioprosthetic heart valves. A. Rashid The Cardiothoracic Centre Liverpool, UK. Conflict of Interest Statement
Alec 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
DISCLOSURE. Mitral ViV: why? Mitral Valve- in- Valve: Procedural Image Guidance with TEE, a Must Have or Nice to Have? UW Medicine NONE.
Mitral Valve- in- Valve: Procedural Image Guidance with TEE, a Must Have or Nice to Have? G. Burkhard Mackensen, MD, PhD, FASE Professor & Chief, Division of Cardiothoracic Anesthesia, Department of Anesthesiology
TSDA Boot Camp September 13-16, Introduction to Aortic Valve Surgery. George L. Hicks, Jr., MD
TSDA Boot Camp September 13-16, 2018 Introduction to Aortic Valve Surgery George L. Hicks, Jr., MD Aortic Valve Pathology and Treatment Valvular Aortic Stenosis in Adults Average Course (Post mortem data)
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
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
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
Stainless Steel. Cobalt-chromium
Sapien is better than Corevalve! Raj R. Makkar, MD Associate Director, Cedars-Sinai Heart Institute Associate Professor, UCLA School of Medicine, Los Angeles Eberhard Grube: Pioneer in the field of TAVR
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,
Interventional 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
TAVR: 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
Transcatheter 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
Transcatheter valve-in-valve implantation for degenerated surgical bioprostheses
Review Article Transcatheter valve-in-valve implantation for degenerated surgical bioprostheses Dale J. Murdoch, John G. Webb Centre for Heart Valve Innovation, St. Paul s Hospital, Vancouver, Canada Contributions:
Hardware in the Chest - From VADs to Valves
Hardware in the Chest - From VADs to Valves Cristina Fuss, MD Purpose Recognize the device Indication and function Cristina Fuss, MD Department of Diagnostic Radiology FROM VADS TO VALVES Implanting technique
Comments restricted to Sapien and Corevalve 9/12/2016. Disclosures: Core Lab contracts with Edwards Lifesciences, Middlepeak, Medtronic
Para-ValvularRegurgitation post TAVR: Predict, Prevent, Quantitate, Manage Linda D. Gillam, MD, MPH, FACC, FASE Chair, Department of Cardiovascular Medicine Morristown Medical Center/Atlantic Health System
Transcatheter Aortic Valve Implantation Present Status and Perspectives
Transcatheter Aortic Valve Implantation Present Status and Perspectives Angioplasty Summit TCTAP 2010 Alain Cribier, MD University of Rouen, France Transcatheter Aortic Valve Implantation has entered the
A 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
Transcatheter 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
How 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
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
Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia
Transcatheter Transapical Aortic Valve Implantation Prince Sultan Cardiac Center Experience Riyadh, Saudi Arabia Ahmed Elwatidy, MD,PhD, FRCS S Kassab, MD,S Ahmari, MD, H Amri, MD, H Ismail, MD, A Calafiori,
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,
Australia 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
Aortic Valve Stenosis and TAVR: Putting it all together.
Aortic Valve Stenosis and TAVR: Putting it all together. Maria L. Held, MSN CNS Valve Clinic Coordinator at The Cleveland Clinic Alliance of Cardiovascular Professionals April 14 th, 2018 Brief Anatomy
This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and
This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution
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
TRANSAPICAL AORTIC VALVE REPAIR
TRANSAPICAL AORTIC VALVE REPAIR Mauro ROMANO M.D. Department of Cardio-Vascular Surgery Institut Cardiovasculaire Paris Sud Institut Hospitalier Jacques Cartier MASSY FRANCE romano.mauro@orange.fr Treatment
Percutaneous Therapy for Calcific Mitral Valve Disease
31 st Annual State of the Art Echocardiography San Diego, CA February 18, 2018 5:00 5:15 PM 15 min Percutaneous Therapy for Calcific Mitral Valve Disease Muhamed Sarić MD, PhD, MPA Director of Noninvasive
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
Percutaneous Aortic Valve Implantation. Core-Valve and Cribier-Edwards Update
Percutaneous Aortic Valve Implantation. Core-Valve and Cribier-Edwards Update T. Lefèvre Natural History of Aortic Stenosois 100 Latent period Survival (%) 80 60 40 20 Symptoms Average Age Death 0 40 50
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
Cover Page. The handle holds various files of this Leiden University dissertation
Cover Page The handle http://hdl.handle.net/1887/28521 holds various files of this Leiden University dissertation Author: Katsanos, Spyridon Title: Outcomes of transcatheter aortic valve implantation Issue
Transcatheter 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
Transcatheter CoreValve valve-in-valve implantation in a stentless porcine aortic valve for severe aortic regurgitation
CASE REPORT Transcatheter CoreValve valve-in-valve implantation in a stentless porcine aortic valve for severe aortic regurgitation Celina M. Yong, Maurice Buchbinder & John C. Giacomini Stanford University/VA
New 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.
Dr.ssa Loredana Iannetta. Centro Cardiologico Monzino
Dr.ssa Loredana Iannetta Centro Cardiologico Monzino Bicuspid aortic valve BAV is the most common congenital cardiac anomaly. Estimated incidence is 2% in general population. 4:1 male predominance. Frequency
TAVI IN BICUSPID AOV AND VALVE-IN-VALVE
TAVI IN BICUSPID AOV AND VALVE-IN-VALVE Petros S. Dardas, MD, FESC St Lukes Hospital Thessaloniki, GREECE 6o ΣΥΝΕΔΡΙΟ ΔΙΑΚΑΘΕΤΗΡΙΑΚΗΣ ΘΕΡΑΠΕΙΑΣ ΚΑΡΔΙΑΚΩΝ ΒΑΛΒΙΔΟΠΑΘΕΙΩΝ ΑΘΗΝΑ 2017 BICUSPID AOV Surgical
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
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
I will not discuss off label use or investigational use in my presentation.
I will not discuss off label use or investigational use in my presentation. Surgical valves Design and Durability Testing Potential Concerns Real Practice 1952-1962 1963-1966 1967-1969 1969-1977 1977-1984
Update 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
Disclosures. ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech
Disclosures ESC Munich 2012 Bernard Iung, MD Consultancy: Abbott Boehringer Ingelheim Bayer Servier Valtech Speaker s fee Edwards Lifesciences Sanofi-Aventis Decision Making in Patients with Multivalvular
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,
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
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
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
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
Are Heart Valve Referral Centers Feasible in Latin America?
Are Heart Valve Referral Centers Feasible in Latin America? Vadim Kotowicz, MD Chief of Cardiovascular Surgery Department Italian Hospital of Buenos Aires Disclosure Medtronic inc. Consultanting Johnson
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
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
Andrzej Ochala, MD Medical University of Silesia, Katowice, Poland
Andrzej Ochala, MD Medical University of Silesia, Katowice, Poland Bicuspid aortic valve o Most common congenital heart disease in adults (1% - 2%) o AS is the most common complication of BAV o Patophysiology
Edwards 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
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
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of transcatheter valvein-valve implantation for aortic bioprosthetic valve dysfunction
The St. Jude Medical Biocor Bioprosthesis
The St. Jude Medical Biocor Bioprosthesis Clinical Evidence of Long-term Durability Long-term Biocor Experience A Review and Comparative Assessment Long-term Biocor Stented Tissue Valve Studies Twenty-year
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
Transcatheter 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
16 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900
CLINICAL COMMUNIQUé 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 69 The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 69, was introduced into clinical
Conflicts 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
How to manage device embolization?
How to manage device embolization? Swiss Fellow Course Interventional Cardiology Amir-Ali Fassa Hôpital de La Tour Meyrin, Geneva Coronary interventions: Definitions Stent loss: stent dislodgment from
VALVULOPATIE: NUOVE SOLUZIONI.
VALVULOPATIE: NUOVE SOLUZIONI www.fisiokinesiterapia.biz Nkomo, Lancet 2006 ELDERLY POPULATION PROJECTION IN USA 65-84 Years Old 85 and Older 77,2 Millions of people 34,8 4,3 30,5 53,8 6,8 47 14,3 62,9
TAVR 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
Conflicts 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
Transcatheter 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
Bioprosthetic Valve Fracture for Optimizing Results of Valve-in-Valve TAVR
Bioprosthetic Valve Fracture for Optimizing Results of Valve-in-Valve TAVR David J. Cohen, M.D., M.Sc. Director, Cardiovascular Research Saint-Luke s Mid America Heart Institute Professor of Medicine University
CLINICAL COMMUNIQUE 16 YEAR RESULTS
CLINICAL COMMUNIQUE 6 YEAR RESULTS Carpentier-Edwards PERIMOUNT Mitral Pericardial Bioprosthesis, Model 6900 Introduction The Carpentier-Edwards PERIMOUNT Mitral Pericardial Valve, Model 6900, was introduced
42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim
42yr Old Male with Severe AR Mild LV dysfunction s/p TOF -AV Replacement(tissue valve) or AoV plasty- Kyung-Hwan Kim Current Guideline for AR s/p TOF Surgery is reasonable in adults with prior repair of
DICE Session. The endocarditis team. Bernard Iung Bichat Hospital, Paris Diderot University Paris, France
DICE Session. The endocarditis team Bernard Iung Bichat Hospital, Paris Diderot University Paris, France Faculty disclosure First name - last name I disclose the following financial relationships: Consultant
TMVR Transcatheter Valve-in-Valve: Technical Considerations
TMVR Transcatheter Valve-in-Valve: Technical Considerations JOHN C. MESSENGER, MD, FACC, FSCAI PROFESSOR OF MEDICINE DIRECTOR, CARDIAC CATHETERIZATION LABS UNIVERSITY OF COLORADO SCHOOL OF MEDICINE Disclosures:
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
Transcatheter Mitral Valve Replacement How Close Are We?
Transcatheter Mitral Valve Replacement How Close Are We? Gregory Pavlides, MD, PhD, FACC, FESC Professor of Medicine Miscia Chair of Interventional Cardiology Director, Cardiac Catheterization Laboratories,
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
Transcatheter Aortic Valve Implantation for Failing Surgical Aortic Bioprosthetic Valve
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 4, NO. 7, 2011 2011 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION ISSN 1936-8798/$36.00 PUBLISHED BY ELSEVIER INC. DOI: 10.1016/j.jcin.2011.05.007 Clinical Research
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
Imaging 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,
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
Reverse left atrium and left ventricle remodeling after aortic valve interventions
Reverse left atrium and left ventricle remodeling after aortic valve interventions Alexandra Gonçalves, Cristina Gavina, Carlos Almeria, Pedro Marcos-Alberca, Gisela Feltes, Rosanna Hernández-Antolín,
Repair or Replacement
Surgical intervention post MitraClip Device: Repair or Replacement Saudi Heart Association, February 21-24 Rüdiger Lange, MD, PhD Nicolo Piazza, MD, FRCPC, FESC German Heart Center, Munich, Germany Division
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
Transcather Pulmonary Valve Replacement Using The Melody Valve: Indications, Techniques, Outcomes
Transcather Pulmonary Valve Replacement Using The Melody Valve: Indications, Techniques, Outcomes Matthew J. Gillespie MD The Children s Hospital of Philadelphia SCAI Fall Fellows Course 2014 December
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
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