Mitral Valve Surgery: Lessons from New York State
|
|
- Edgar Shelton
- 5 years ago
- Views:
Transcription
1 Mitral Valve Surgery: Lessons from New York State Joanna Chikwe, MD Professor of Cardiovascular Surgery Icahn School of Medicine at Mount Sinai Chairman & Program Director Department of Cardiovascular Surgery Mount Sinai St Luke s
2 2
3 Disclosures Icahn School of Medicine at Mount Sinai receives royalties from Edwards Lifesciences and Medtronic for Dr. David Adams involvement in developing two mitral valve repair rings and one tricuspid valve repair ring. Dr. David Adams is the National Co-Principal Investigator of the CoreValve United States Pivotal Trial, which is supported by Medtronic. None of the sponsoring organizations had any role in the design and conduct of the study. None of the other authors have any conflicts of interest to disclose.. 3
4 Background In non-elderly patients undergoing mitral valve replacement, the optimal prosthesis type is controversial. 1,2 Current guidelines recommend either mechanical or bioprosthetic valves in patients under 70 years of age, 3,4 and state that the balance of risks favors mechanical valves in patients <60 years. 3 1 Kaneko, Cohn & Aranki, Circulation Suri & Schaff, Circulation Nishimura, Otto, & Bonow et al, JACC Vahanian, Alfieri, & Andreotti et al, Eur Heart J
5 Current evidence base Study Setting Age range Patients Survival Oxenham et al Heart, 2003 Randomized AVR: 211 MVR: 261 Both: 61 Mech (overall): 25.0% Bio (overall): 22.6% (p=0.39) at 20 years Hammermeister et al JACC, 2000 Randomized AVR: 394 MVR: 181 Mech (MVR): 19% Bio (MVR): 21% (p=0.30) at 15 years Kaneko et al JTCVS, 2014 Cohort <65 MVR: 250 Mech: 62.6% Bio: 40.4% (p<0.004) 5
6 Research question In non-elderly patients undergoing mitral valve replacement: Is there a survival difference between prosthesis types? If not, does the balance of complications such as stroke, reoperation, or major bleeding favor one prosthesis type over the other? Statewide planning and research cooperative Syststem(SPARCS) Mandatory All admissions, all visits to the emergency room, all ambulatory visits Administrative 6
7 Methodology Inclusion criteria Primary mitral valve replacement (n=5340) Age Exclusion criteria Out-of-state residents (7.0%, n=) Prior replacement of any valve (7.8%) Concomitant valve replacement (21.9%) Concomitant aortic/pulmonary valve repair (1.1%) Concomitant CABG (33.4%) Concomitant thoracic aortic surgery (1.2%) 7
8 Trend in mitral prosthesis choice Bioprosthetic Mechanical prosthetic Year 8
9 Patient characteristics Co-morbidity Bioprosthetic (n=664) Mechanical (n=664) Male 42% 42% 0.7 Age Endocarditis 3% 4% 0.46 Bleeding disorder 7% 8% 0.52 Hypertension 56% 58% 0.28 Diabetes 21% 24% 0.68 Coronary artery disease 39% 39% 0.11 Peripheral vascular disease 3% 5% 0.43 Cerebrovascular disease 8% 9% 0.63 Congestive heart failure 57% 60% 0.28 Atrial fibrillation 46% 44% 0.35 COPD 21% 23% 0.47 Chronic kidney disease 9% 10% 0.43 Liver disease 7% 9% 0.18 Cancer 4% 4% 0.89 P value 9
10 30-day outcomes Complication Bioprosthetic (n=664) Mechanical (n=664) P value Mortality 5% 4% 0.12 Stroke 2% 2% 0.85 Atrial fibrillation 13% 10% 0.13 Acute kidney injury 4% 4% 0.67 Respiratory failure 21% 16% Readmission 22% 20%
11 Results: survival 59.9% 57.5% 11
12 Results: reoperation 11.1% 5.0% 12
13 Results: major bleeding 14.9% 9.0% 13
14 Results: stroke 14.0% 6.8% 14
15 Summary of findings We did not observe a survival difference between mechanical and bioprosthetic mitral valves in propensity matched patients aged 50 to 69 years. The 15-year cumulative incidence of stroke and major bleeding were both significantly higher in the mechanical group The 15-year cumulative incidence of reoperation was lower in the mechanical prosthesis group 15
16 Conclusions The main trade-off is between reoperation and stroke: patients with mechanical valves had a lower risk of reoperation but a greater risk of stroke. These findings support the expanded use of bioprosthetic valves in younger patients undergoing mitral valve replacement. 16
17 Strengths & limitations Large sample size All levels of care represented from tertiary referral centers to community hospitals Important clinical endpoints Accuracy of coding Unable to determine when patients were hospitalized outside of New York State Absence of potential confounding variables e.g. etiology of valve disease, extent of coronary artery disease, and ventricular dysfunction Lack of operative detail 17
18 NYS work in progress Validating method of reliably identifying degenerative and ischemic patients Combining SPARCS data with clinical datasets such as New York State report cards: Additional validation of dataset Better information on LV function, valve dysfunction and precise distribution of coronary artery disease More detailed operative Long-term outcomes of repair versus replacement in ischemic mitral valve disease Long-term outcomes of isolated CABG versus concomitant mitral surgery in patients with ischemic MR undergoing CABG Impact of surgeon experience on degenerative mitral valve repair rates and durability Impact of atrial fibrillation on long-term outcomes after mitral valve surgery 18
19 Thank you David H. Adams MD Yuting Chiang MSc, MD Natalia Egorova PhD Annetine Gellijns MD Shinobu Itagaki MD Alan Moskowitz MD Nana Toyoda MD 19
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 informationMechanical 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
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 informationExpanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated?
Expanding Relevance of Aortic Valve Repair Is Earlier Operation Indicated? RM Suri, V Sharma, JA Dearani, HM Burkhart, RC Daly, LD Joyce, HV Schaff Division of Cardiovascular Surgery, Mayo Clinic, Rochester,
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 informationThe Changing Epidemiology of Valvular Heart Disease: Implications for Interventional Treatment Alternatives. Martin B. Leon, MD
The Changing Epidemiology of Valvular Heart Disease: Implications for Interventional Treatment Alternatives Martin B. Leon, MD Columbia University Medical Center Cardiovascular Research Foundation New
More informationHani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz
Hani K. Najm MD, Msc, FRCSC FACC, FESC President Saudi Society for Cardiac Surgeons Associate Professor of Cardiothoracic Surgery King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia Decision process for
More informationThe Journal of Thoracic and Cardiovascular Surgery
Accepted Manuscript The mid-life crisis of the meta-analysis Joanna Chikwe, MD, FRCS, Aaron Weiss, MD PII: S0022-5223(18)33158-1 DOI: https://doi.org/10.1016/j.jtcvs.2018.11.045 Reference: YMTC 13805 To
More informationKinsing Ko, Thom de Kroon, Najim Kaoui, Bart van Putte, Nabil Saouti. St. Antonius Hospital, Nieuwegein, The Netherlands
Minimal Invasive Mitral Valve Surgery After Previous Sternotomy Without Aortic Clamping: Short- and Long Term Results of a Single Surgeon Single Institution Kinsing Ko, Thom de Kroon, Najim Kaoui, Bart
More informationCatheter-based mitral valve repair MitraClip System
Percutaneous Mitral Valve Repair: Results of the EVEREST II Trial William A. Gray MD Director of Endovascular Services Associate Professor of Clinical Medicine Columbia University Medical Center The Cardiovascular
More informationOutline 9/17/2016. Advances in Percutaneous Mitral Valve Repair and Replacement. Scope of the Problem and Guidelines
Advances in Percutaneous Mitral Valve Repair and Replacement Scott M Lilly MD PhD, Interventional Cardiology The Ohio State University Contemporary Multidisciplinary Cardiovascular Conference Orlando,
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 informationTissue 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 informationManagement of Difficult Aortic Root, Old and New solutions
Management of Difficult Aortic Root, Old and New solutions Hani K. Najm MD, Msc, FRCSC,, FACC, FESC Chairman, Pediatric and Congenital Heart Surgery Cleveland Clinic Conflict of Interest None Difficult
More informationHani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia.
Hani K. Najm MD, Msc, FRCSC, FRCS (Glasgow), FACC, FESC President of Saudi Heart Association King Abdulaziz Cardiac Centre Riyadh, Saudi Arabia. Decision process for Management of any valve Timing Feasibility
More informationEarly 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 informationBioprosthetic 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
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 informationOPCAB IS NOT BETTER THAN CONVENTIONAL CABG
OPCAB IS NOT BETTER THAN CONVENTIONAL CABG Harold L. Lazar, M.D. Harold L. Lazar, M.D. Professor of Cardiothoracic Surgery Boston Medical Center and the Boston University School of Medicine Boston, MA
More information16 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
More informationMechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement
Original Article or Prostheses for Aortic-Valve and Mitral-Valve Replacement Andrew B. Goldstone, M.D., Ph.D., Peter Chiu, M.D., Michael Baiocchi, Ph.D., Bharathi Lingala, Ph.D., William L. Patrick, M.D.,
More informationValve 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 informationOptions for my no option Patients Treating Heart Conditions Via a Tiny Catheter
Options for my no option Patients Treating Heart Conditions Via a Tiny Catheter Nirat Beohar, MD Associate Professor of Medicine Director Cardiac Catheterization Laboratory, Medical Director Structural
More informationReconstruction of the Aortic Valve and Root A Practical approach Why and when to repair the aortic valve. Diana Aicher. September 16 th - 18 th 2015
Reconstruction of the Aortic Valve and Root A Practical approach Why and when to repair the aortic valve Diana Aicher September 16 th - 18 th 2015 Why repair the aortic valve? Aortic Valve Replacement
More informationSotirios N. Prapas, M.D., Ph.D, F.E.C.T.S.
CORONARY ARTERY REVASCULARIZATION WITH MILD AORTIC STENOSIS: STRATEGIES OF TREATMENT 9 th ANNUAL MEETING OF THE EAB SOCIETY, Pravets, Bulgaria, 2012 Sotirios N. Prapas, M.D., Ph.D, F.E.C.T.S. Director
More informationCIPG Transcatheter Aortic Valve Replacement- When Is Less, More?
CIPG 2013 Transcatheter Aortic Valve Replacement- When Is Less, More? James D. Rossen, M.D. Professor of Medicine and Neurosurgery Director, Cardiac Catheterization Laboratory and Interventional Cardiology
More informationUpdate on Oral Anticoagulation for Mechanical Heart Valves
Update on Oral Anticoagulation for Mechanical Heart Valves Douglas C. Anderson, Pharm.D., D.Ph. Professor and Chair Dept. of Pharmacy Practice Cedarville University School of Pharmacy OHIO SOCIETY OF HEALTH-SYSTEM
More informationAppropriate 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 informationCerebral Embolic Protection In Patients Undergoing Surgical Aortic Valve Replacement (SAVR)
Cerebral Embolic Protection In Patients Undergoing Surgical Aortic Valve Replacement (SAVR) Michael Mack, MD, Michael Acker, MD, Steve Messe, MD For the Cardiothoracic Surgical Trials Network (CTSN) American
More informationIndication, Timing, Assessment and Update on TAVI
Indication, Timing, Assessment and Update on TAVI Swedish Heart and Vascular Institute Ming Zhang MD PhD Interventional Cardiology Structure Heart Disease Conflict of Interest None Starr- Edwards Mechanical
More informationSpotlight on valvular heart disease guidelines. Prosthetic heart valves. Bernard Iung Bichat Hospital, Paris Diderot University Paris, France
Spotlight on valvular heart disease guidelines. Prosthetic heart valves. Bernard Iung Bichat Hospital, Paris Diderot University Paris, France Faculty disclosure First name - last name I disclose the following
More informationDISCLOSURE. 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
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Goldstone AB, Chiu P, Baiocchi M, et al. Mechanical or biologic
More informationEarly and One-year Outcomes of Aortic Root Surgery in Marfan Syndrome Patients
Early and One-year Outcomes of Aortic Root Surgery in Marfan Syndrome Patients A Prospective, Multi-Center, Comparative Study Joseph S. Coselli, Irina V. Volguina, Scott A. LeMaire, Thoralf M. Sundt, Elizabeth
More informationThe Journal of Thoracic and Cardiovascular Surgery
Accepted Manuscript Judgement Day: Should You Add Atrial Fibrillation Ablation? Dr. Patrick M. McCarthy, MD PII: S0022-5223(18)32917-9 DOI: https://doi.org/10.1016/j.jtcvs.2018.11.004 Reference: YMTC 13719
More informationOutcomes in the Commercial Use of Self-expanding Prostheses in Transcatheter Aortic Valve Replacement: A Comparison of the Medtronic CoreValve and
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
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 informationNext Generation Therapies: Aortic, Mitral and Beyond
Next Generation Therapies: Aortic, Mitral and Beyond Scott M Lilly, MD PhD Medical (Interventional) Director, Structural Heart Program Heart Summit, Lima OH August 26 th, 2017 Next Generation Therapies:
More informationValve 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 informationValvular Heart Disease and Adult Congenital Intervention. A Pichard, MD. Director Cath Labs, Washington Hospital Center. Georgetown University.
Valvular Heart Disease and Adult Congenital Intervention. A Pichard, MD Director Cath Labs, Washington Hospital Center. ProfessorofMedicine (Cardiology), Georgetown University. Conflict of Interest Proctor
More informationAlthough mitral valve replacement (MVR) is no longer the surgical
Surgery for Acquired Cardiovascular Disease Ruel et al Late incidence and predictors of persistent or recurrent heart failure in patients with mitral prosthetic valves Marc Ruel, MD, MPH a,b Fraser D.
More informationSURGICAL ABLATION OF ATRIAL FIBRILLATION DURING MITRAL VALVE SURGERY THE CARDIOTHORACIC SURGICAL TRIALS NETWORK
SURGICAL ABLATION OF ATRIAL FIBRILLATION DURING MITRAL VALVE SURGERY THE CARDIOTHORACIC SURGICAL TRIALS NETWORK Marc Gillinov, M.D. For the CTSN Investigators ACC Late Breaking Clinical Trials March 16,
More informationCardiac Valve/Structural Therapies
Property of Dr. Chad Rammohan Cardiac Valve/Structural Therapies Chad Rammohan, MD FACC Medical Director, El Camino Hospital Cardiac Catheterization Lab Director, Interventional and Structural Cardiology,
More informationValve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal
Valve Disease in Patients With Heart Failure TAVI or Surgery? Miguel Sousa Uva Hospital Cruz Vermelha Lisbon, Portugal I have nothing to disclose. Wide Spectrum Stable vs Decompensated NYHA II IV? Ejection
More informationAppropriate 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 informationParis, 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 informationChronic Primary Mitral Regurgitation
Chronic Primary Mitral Regurgitation The Case For Early Surgical Intervention William K. Freeman, MD, FACC, FASE DISCLOSURES Relevant Financial Relationship(s) None Off Label Usage None Watchful Waiting......
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 informationTAVR 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
More informationClinical Practice Guidelines and the Under Treatment of Concomitant AF Vinay Badhwar, MD
Clinical Practice Guidelines and the Under Treatment of Concomitant AF Vinay Badhwar, MD Gordon F. Murray Professor and Chairman Department of Cardiovascular & Thoracic Surgery WVU Heart and Vascular Institute
More informationQuality Outcomes Mitral Valve Repair
Quality Outcomes Mitral Valve Repair Moving Beyond Reoperation Rakesh M. Suri, D.Phil. Professor of Surgery 2015 MFMER 3431548-1 Disclosure Mayo Clinic Division of Cardiovascular Surgery Research funding
More informationThe Role of TAVI in high-risk and normal-risk Patients
The Role of TAVI in high-risk and normal-risk Patients Joachim Schofer Hamburg University Cardiovascular Center and Department for percutaneous treatment of structural heart disease Albertinen Heart Center
More informationProf. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM
The Patient with Aortic Stenosis and Mitral Regurgitation Prof. Patrizio LANCELLOTTI, MD, PhD Heart Valve Clinic, University of Liège, CHU Sart Tilman, Liège, BELGIUM Aortic Stenosis + Mitral Regurgitation?
More informationOverview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan
Overview of Surgical Approach to Mitral Valve Disease : Why Repair? Steven F. Bolling, MD Cardiac Surgery University of Michigan Degenerative MR is not Functional MR 2o - Functional MR : Ventricular Problem!!
More informationDoes Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement?
Original Article Does Patient-Prosthesis Mismatch Affect Long-term Results after Mitral Valve Replacement? Hiroaki Sakamoto, MD, PhD, and Yasunori Watanabe, MD, PhD Background: Recently, some articles
More informationLate secondary TR after left sided heart disease correction: is it predictibale and preventable
Late secondary TR after left sided heart disease correction: is it predictibale and preventable Gilles D. Dreyfus Professor of Cardiothoracic surgery Nath J, et al. JACC 2004 PREDICT Incidence of secondary
More informationMitral valve replacement in patients under 65 years of age: mechanical or biological valves?
REVIEW C URRENT OPINION Mitral valve replacement in patients under 65 years of age: mechanical or biological valves? David C. Reineke, Paul Philipp Heinisch, Bernhard Winkler, Lars Englberger, and Thierry
More informationCLINICAL 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
More informationExtension 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!?
More informationTAVR in 2017 What we know? What to expect?
Journal of Geriatric Cardiology (2018) 15: 55 60 2018 JGC All rights reserved; www.jgc301.com Perspective Open Access TAVR in 2017 What we know? What to expect? Panagiota Kourkoveli 1,*, Konstantinos Spargias
More informationThe 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 informationMitral Valve Repair Does Hospital Volume Matter? Juan P. Umaña, M.D. Chief Medical Officer FCI Institute of Cardiology Bogotá Colombia
Mitral Valve Repair Does Hospital Volume Matter? Juan P. Umaña, M.D. Chief Medical Officer FCI Institute of Cardiology Bogotá Colombia Disclosures Edwards Lifesciences Consultant Abbott Mitraclip Royalties
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 informationCover 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
More information2017 Update to the AHA/ACC Guideline for Management of Mitral Valve Disease
2017 Update to the AHA/ACC Guideline for Management of Mitral Valve Disease Patrick T. O Gara, MD BWH Heart and Vascular Center Professor of Medicine, Harvard Medical School Disclosures NHLBI CTSN Co-chair
More informationAnticoagulation Therapy and Valve Surgery. Dr Pau Kiew Kong Consultant Cardiothoracic Surgeon
Anticoagulation Therapy and Valve Surgery Dr Pau Kiew Kong Consultant Cardiothoracic Surgeon Outline of lecture 1. Type of Valve Surgery 2. Anticoagulation requirements 3. Mechanical (Metallic) prosthetic
More informationPercutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat
Percutaneous Mitral Valve Repair: What Can We Treat and What Should We Treat Innovative Procedures, Devices & State of the Art Care for Arrhythmias, Heart Failure & Structural Heart Disease October 8-10,
More informationAlec Vahanian,FESC, FRCP (Edin.) Bichat Hospital University Paris VII, Paris, France
Future Percutaneous Therapies for Mitral Valve Disease (Mitraclip,percutaneous annuloplasty and transcatheter valve implantation) Will they reach the TAVI s success? Alec Vahanian,FESC, FRCP (Edin.) Bichat
More informationMichigan Society of Echocardiography 30 th Year Jubilee
Michigan Society of Echocardiography 30 th Year Jubilee Stress Echocardiography in Valvular Heart Disease Moving Beyond CAD Karthik Ananthasubramaniam, MD FRCP (Glas) FACC FASE FASNC Associate Professor
More informationThe operative mortality rate after redo valvular operations
Clinical Outcomes of Redo Valvular Operations: A 20-Year Experience Naoto Fukunaga, MD, Yukikatsu Okada, MD, Yasunobu Konishi, MD, Takashi Murashita, MD, Mitsuru Yuzaki, MD, Yu Shomura, MD, Hiroshi Fujiwara,
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 informationVery Long-Term Survival Implications of Heart Valve Replacement With Tissue Versus Mechanical Prostheses in Adults <60 Years of Age
Very Long-Term Survival Implications of Heart Valve Replacement With Versus Prostheses in Adults
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 informationOutcomes of Surgical Aortic Valve Replacement in Moderate Risk Patients: Implications for Determination of Equipoise in the Transcatheter Era
Outcomes of Surgical Aortic Valve Replacement in Moderate Risk Patients: Implications for Determination of Equipoise in the Transcatheter Era Sebastian A. Iturra, Rakesh M. Suri, Kevin L. Greason, John
More informationOutcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease
Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease TIRONE E. DAVID, MD ; SEMIN THORAC CARDIOVASC SURG 19:116-120c 2007 ELSEVIER INC. PRESENTED BY INTERN 許士盟 Mitral valve
More informationSurgical AF Ablation : Lesion Sets and Energy Sources. What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan
Surgical AF Ablation : Lesion Sets and Energy Sources What are the data? Steven F Bolling, MD Cardiac Surgery University of Michigan Disclosures Consultant/Advisory Board: Abbott, Edwards Lifesciences
More information2017 Cardiovascular Symposium CARDIAC SURGERY UPDATE: SMALLER INCISIONS AND LESS COUMADIN DAVID L. SAINT, MD
2017 Cardiovascular Symposium CARDIAC SURGERY UPDATE: SMALLER INCISIONS AND LESS COUMADIN DAVID L. SAINT, MD David L Saint M.D. Tallahassee Memorial Hospital Southern Medical Group Division of Cardiothoracic
More informationSupplementary Online Content
Supplementary Online Content Toyoda N, Chikwe J, Itagaki S, Gelijns AC, Adams DH, Egorova N. Trends in infective endocarditis in California and New York State, 1998-2013. JAMA. doi:10.1001/jama.2017.4287
More informationMitral Regurgitation
Mitral Regurgitation Focus on Percutaneous Repair Steven J. Yakubov, MD FACC FSCAI System Chief, Structural Heart Diseaese, OhioHealth John H. McConnell Chair of Advanced Structural Heart Disease Medical
More informationDecreasing Mortality for Aortic and Mitral Valve Surgery In Northern New England
ORIGINAL ARTICLES: CARDIOVASCULAR Decreasing Mortality for Aortic and Mitral Valve Surgery In Northern New England Nancy J. O. Birkmeyer, PhD, Charles A. S. Marrin, MBBS, Jeremy R. Morton, MD, Bruce J.
More informationPercutaneous Management of Severe AS in Octagenarians. Phillip Matsis FRACP FCSANZ Interventional Cardiologist Wakefield Heart Centre Wellington
Percutaneous Management of Severe AS in Octagenarians Phillip Matsis FRACP FCSANZ Interventional Cardiologist Wakefield Heart Centre Wellington May 2017 Outline Aetiology of AS Natural History of AS Assessment
More informationBiatrial Maze or PVI to Ablate Afib? Marc Gillinov, MD
Biatrial Maze or PVI to Ablate Afib? Marc Gillinov, MD Disclosures Consultant/Speaker AtriCure Medtronic CryoLife Edwards Abbott Research Funding Abbott Equity Interest Clear Catheter Cleveland Clinic
More informationAntithrombotic therapy for patients with congenital heart disease. George Giannakoulas, MD, PhD AHEPA University Hospital Thessaloniki
Antithrombotic therapy for patients with congenital heart disease George Giannakoulas, MD, PhD AHEPA University Hospital Thessaloniki Disclosures Educational fees from Astra Zeneca, GSK Research fees from
More informationSteven F Bolling Professor of Cardiac Surgery University of Michigan
Optimal Treatment of Functional MR Steven F Bolling Professor of Cardiac Surgery University of Michigan Functional MR Functional MR in Ischemia Badhwar, Bolling, chapter in: Advances in Heart Failure,
More informationWhat is the Role of Surgical Repair in 2012
What is the Role of Surgical Repair in 2012 The Long-Term Results of Surgery Raphael Rosenhek Department of Cardiology Medical University of Vienna European Society of Cardiology 2012 Munich, August 27th
More informationThe risk-benefit ratio of mitral valve operation is
Degenerative Mitral Regurgitation: When Should We Operate? Malcolm J. R. Dalrymple-Hay, PhD, Mark Bryant, Richard A. Jones, MRCP, Stephen M. Langley, FRCS, Steven A. Livesey, FRCS, and James L. Monro,
More informationSurgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea
Surgical AVR: Are there any contraindications? Pyowon Park Samsung Medical Center Seoul, Korea Contents Decision making in surgical AVR in old age Clinical results of AVR with tissue valve Impact of 19mm
More informationTAVI 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 information1198 MINAKATA K et al. Circ J 2017; 81: ORIGINAL ARTICLE doi: /circj.CJ
1198 MINAKATA K et al. Circ J 2017; 81: 1198 1206 ORIGINAL ARTICLE doi: 10.1253/circj.CJ-17-0154 Valvular Heart Disease Comparison of the Long-Term Outcomes of Mechanical and Bioprosthetic Aortic Valves
More informationEarly 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 informationMechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation
Mechanical Tricuspid Valve Replacement Is Not Superior in Patients Younger Than 65 Years Who Need Long-Term Anticoagulation Ho Young Hwang, MD, PhD, Kyung-Hwan Kim, MD, PhD, Ki-Bong Kim, MD, PhD, and Hyuk
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 informationIn 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 informationI have financial relationships to disclose Honoraria from: Edwards
I have financial relationships to disclose Honoraria from: Edwards Mitral Valve Annuloplasty in Ischemic Mitral regurgitation Jean François Avierinos Hôpital Timone Marseille August 28, 2012 Ischemic MR
More information-The Living Aortic Valve- Repair or Else? Ismail El-Hamamsy, MD PhD
-The Living Aortic Valve- Repair or Else? Ismail El-Hamamsy, MD PhD Associate Professor Director, Aortic Surgery Division of Cardiac Surgery Montreal Heart Institute Université de Montreal PhD Thesis Imperial
More informationA Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision
A Surgeon s Perspective Guidelines for the Management of Patients with Valvular Heart Disease Adapted from the 2006 ACC/AHA Guideline Revision Prof. Pino Fundarò, MD Niguarda Hospital Milan, Italy Introduction
More informationSupplementary Online Content
1 Supplementary Online Content Friedman DJ, Piccini JP, Wang T, et al. Association between left atrial appendage occlusion and readmission for thromboembolism among patients with atrial fibrillation undergoing
More informationLess Invasive Reoperations for Aortic and Mitral Valve Disease. Peter Bent Brigham Hospital 1913
Shapiro CV Center 2008 Peter Bent Brigham Hospital 1913 Lawrence H. Cohn, MD, Professor of Cardiac Surgery, HMS Division of Cardiac Surgery, BWH, Boston, MA 70% of US valve patients select bioprosthetic
More informationCarpentier-Edwards Pericardial Valve in the Aortic Position: 25-Years Experience
SURGERY: The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/ home. To take the CME activity related to this article, you must have either an STS member
More informationIs Stroke Frequency Declining?
Is Stroke Frequency Declining? Etiologic Factors Clinical, Anatomic, Technique-related, and Device-specific Samir Kapadia, MD Professor of Medicine Section head, Interventional Cardiology Director, Cardiac
More information