37 results on '"Landes, Uri"'
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2. A Guide to Transcatheter Aortic Valve Design and Systematic Planning for a Redo-TAV (TAV-in-TAV) Procedure.
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Bapat, Vinayak N., Fukui, Miho, Zaid, Syed, Okada, Atsushi, Jilaihawi, Hasan, Rogers, Toby, Khalique, Omar, Cavalcante, João L., Landes, Uri, Sathananthan, Janarthanan, Tarantini, Giuseppe, Tang, Gilbert H.L., Blackman, Daniel J., De Backer, Ole, Mack, Michael J., and Leon, Martin B.
- Abstract
Transcatheter aortic valve replacement (TAVR) has become more common than surgical aortic valve replacement since 2016, with over 200,000 procedures globally each year. As patients increasingly outlive their TAVR devices, managing these cases is a growing concern. Treatment options include surgical removal of the old TAVR device (transcatheter aortic valve [TAV] explant) or implantation of a new transcatheter aortic valve (redo TAV). Redo TAV is complex because of the unique designs of TAV devices; compatibility issues; and the need for individualized planning based on factors such as implant depth, shape, and coronary artery relationships. This review serves as a comprehensive guide for redo TAV, detailing the design characteristics of TAV devices, device compatibility, standardized terminology, and a structured approach for computed tomography analysis. It aims to facilitate decision making, risk identification, and achieving optimal outcomes in redo TAV procedures. [Display omitted] • Because TAVR has now expanded to patients with longer life expectancies, increasing numbers of patients will present with structural valve deterioration of TAV prostheses. It is important to understand the risks and suitability of patients for repeat implantation of another TAV (redo TAV or TAV-in-TAV). • Unlike valve-in-valve for failed surgical aortic valve replacement because of the complexity of TAV designs, a systematic CT analysis for each combination is necessary to determine suitability with respect to coronary risk, sizing, and injury to the surrounding structures. • Bench testing, prospective clinical studies, and validation of CT algorithms with simulation software will play a critical role in appropriate case selection and improving outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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3. Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI
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Landes, Uri, Morelli, Olga, Danenberg, Haim, Sathananthan, Janarthanan, Backer, Ole De, Sondergaard, Lars, Abdel-Wahab, Mohamed, Yoon, Sung-Han, Makkar, Raj R., Thiele, Holger, Kim, Won-Keun, Hamm, Christian, Guerrero, Mayra, Rodés-Cabau, Josep, Okuno, Taishi, Pilgrim, Thomas, Mangieri, Antonio, Van Mieghem, Nicolas M., Tchétché, Didier, Schoels, Wolfgang H., Barbanti, Marco, Sinning, Jan-Malte, Ielasi, Alfonso, Tarantini, Giuseppe, De Marco, Federico, Finkelstein, Ariel, Sievert, Horst, Andreas, Martin, Latib, Azeem, Godfrey, Rebecca, Hildick-Smith, David, Manevich, Lisa, Kornowski, Ran, Nazif, Tamim M., Leon, Martin B., and Webb, John G.
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- 2022
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4. Transcatheter Aortic Valve Replacement in Failed Transcatheter Bioprosthetic Valves.
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Tarantini, Giuseppe, Sathananthan, Janarthanan, Fabris, Tommaso, Landes, Uri, Bapat, Vinayak N., Khan, Jaffar M., Nai Fovino, Luca, Zaid, Syed, Van Mieghem, Nicolas M., Latib, Azeem, Waksman, Ron, De Backer, Ole, Rogers, Toby, Søndergaard, Lars, and Tang, Gilbert H.L.
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Transcatheter aortic valve replacement (TAVR) is increasingly being performed in younger and lower surgical risk patients. Given the longer life expectancy of these patients, the bioprosthetic valve will eventually fail, and aortic valve reintervention may be necessary. Although currently rare, redo-TAVR will likely increase in the future as younger patients are expected to outlive their transcatheter bioprosthesis. This review provides a contemporary overview of the indications, procedural planning, implantation technique, and outcomes of TAVR in failed transcatheter bioprosthetic aortic valves. [Display omitted] • Redo-TAVR will become more prevalent as TAVR is increasingly performed in younger patients with longer life expectancies. • A multitude of clinical and anatomical factors need to be meticulously evaluated to determine candidacy and the feasibility of redo-TAVR in patients with transcatheter valve failure. • Transcatheter heart valve selection, sizing, and the implantation technique remain under active investigation in redo-TAVR to minimize coronary obstruction risk while preserving access. • Lifetime management of patients with aortic valve disease, including the possibility of redo-TAVR versus TAVR explant, should be part of any heart team discussion. [ABSTRACT FROM AUTHOR]
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- 2022
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5. Outcomes of Redo Transcatheter Aortic Valve Replacement According to the Initial and Subsequent Valve Type.
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Landes, Uri, Richter, Ilan, Danenberg, Haim, Kornowski, Ran, Sathananthan, Janarthanan, De Backer, Ole, Søndergaard, Lars, Abdel-Wahab, Mohamed, Yoon, Sung-Han, Makkar, Raj R., Thiele, Holger, Kim, Won-Keun, Hamm, Christian, Buzzatti, Nicola, Montorfano, Matteo, Ludwig, Sebastian, Schofer, Niklas, Voigtlaender, Lisa, Guerrero, Mayra, and El Sabbagh, Abdallah
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As transcatheter aortic valve (TAV) replacement is increasingly used in patients with longer life expectancy, a sizable proportion will require redo TAV replacement (TAVR). The unique configuration of balloon-expandable TAV (bTAV) vs a self-expanding TAV (sTAV) potentially affects TAV-in-TAV outcome. The purpose of this study was to better inform prosthesis selection, TAV-in-TAV outcomes were assessed according to the type of initial and subsequent TAV. Patients from the Redo-TAVR registry were analyzed using propensity weighting according to their initial valve type (bTAV [n = 115] vs sTAV [n = 106]) and subsequent valve type (bTAV [n = 130] vs sTAV [n = 91]). Patients with failed bTAVs presented later (vs sTAV) (4.9 ± 2.1 years vs 3.7 ± 2.3 years; P < 0.001), with smaller effective orifice area (1.0 ± 0.7 cm
2 vs 1.3 ± 0.8 cm2 ; P = 0.018) and less frequent dominant regurgitation (16.2% vs 47.3%; P < 0.001). Mortality at 30 days was 2.3% (TAV-in-bTAV) vs 0% (TAV-in-sTAV) (P = 0.499) and 1.7% (bTAV-in-TAV) vs 1.0% (sTAV-in-TAV) (P = 0.612); procedural safety was 72.6% (TAV-in-bTAV) vs 71.2% (TAV-in-sTAV) (P = 0.817) and 73.2% (bTAV-in-TAV) vs 76.5% (sTAV-in-TAV) (P = 0.590). Device success was similar according to initial valve type but higher with subsequent sTAV vs bTAV (77.2% vs 64.3%; P = 0.045), primarily because of lower residual gradients (10.3 mm Hg [8.9-11.7 mm Hg] vs 15.2 mm Hg [13.2-17.1 mm Hg]; P < 0.001). Residual regurgitation (moderate or greater) was similar after bTAV-in-TAV and sTAV-in-TAV (5.7%) and nominally higher after TAV-in-bTAV (9.1%) vs TAV-in-sTAV (4.4%) (P = 0.176). In selected patients, no association was observed between TAV type and redo TAVR safety or mortality, yet subsequent sTAV was associated with higher device success because of lower redo gradients. These findings are preliminary, and more data are needed to guide valve choice for redo TAVR. [Display omitted] [ABSTRACT FROM AUTHOR]- Published
- 2022
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6. Coronary Access Following Redo TAVR: Impact of THV Design, Implant Technique, and Cell Misalignment.
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Meier, David, Akodad, Mariama, Landes, Uri, Barlow, Aaron M., Chatfield, Andrew G., Lai, Althea, Tzimas, Georgios, Tang, Gilbert H.L., Puehler, Thomas, Lutter, Georg, Leipsic, Jonathon A., Søndergaard, Lars, Wood, David A., Webb, John G., Sellers, Stephanie L., and Sathananthan, Janarthanan
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The implications and potential challenges of coronary access after redo transcatheter aortic valve replacement (TAVR) are unknown. The authors sought to evaluate the impact of different transcatheter heart valve (THV) designs, neoskirt height, implant technique, and cell misalignment on coronary access after redo TAVR. Different THV designs (Sapien 3 [Edwards Lifesciences LLC], Evolut Pro [Medtronic], ACURATE neo [Boston Scientific Corporation], and Portico [Abbott Structural Heart]) and sizes were implanted inside Sapien XT (Edwards Lifesciences LLC) and Evolut R (Medtronic) THVs, which were modeled as the "failed" THVs, at different implant depths. Valve combinations underwent micro–computed tomography to determine the neoskirt height and dimensions of the lowest accessible cell for potential coronary access. This was compared with dimensions of 6-F/7-F/8-F coronary guiding catheters. Redo TAVR combinations resulted in a wide range of neoskirt heights (15.4-31.6 mm) and a variable diameter of the lowest accessible cell (1.9-21.8 mm). An ACURATE neo implanted in a Sapien XT resulted in the largest accessible cells, whereas a Portico implanted in a Sapien XT resulted in the lowest neoskirt heights. The smallest accessible cell was observed in the Evolut Pro–in–Evolut R configuration with higher neoskirt heights. Redo TAVR in a tall frame valve with supra-annular leaflets caused a taller neoskirt height. In Evolut-in-Evolut combinations, misalignment of the cells of the 2 THVs reduced the cell area by 30% to 50% compared with an aligned configuration. This study demonstrates that different redo TAVR combinations are not equivalent in terms of future coronary access. Redo TAVR using a tall frame valve in a failed tall frame valve and misaligned cells may lead to potentially challenging coronary access. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2022
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7. Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement: Insights From the AMTRAC Registry.
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Witberg, Guy, Landes, Uri, Talmor-Barkan, Yeela, Richter, Ilan, Barbanti, Marco, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., Islas, Fabian, Marroquin, Luis, Sedaghat, Alexander, Sugiura, Atsushi, Masiero, Giulia, Armario, Xavier, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra, Fernández-Vázquez, Felipe, Baz, Jose A., and Steblovnik, Klemen
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Data on outcomes of transcatheter aortic valve replacement (TAVR) using balloon-expandable valves (BEVs) or self-expandable valves (SEVs) as well as the impact of center valve preference on these outcomes are limited. The aim of this study was to compare outcomes of TAVR procedures using third-generation BEVs and SEVs stratified by center valve preference. In a multicenter registry (n = 17), 13 centers exhibited valve preference (66.6%-90% of volume) and were included. Outcomes were compared between BEVs and SEVs stratified by center valve preference. In total, 7,528 TAVR procedures (3,854 with SEVs and 3,674 with BEVs) were included. The mean age was 81 years, and the mean Society of Thoracic Surgeons score was 5.2. Baseline characteristics were similar between BEVs and SEVs. Need for pacemaker implantation was higher with SEVs at BEV- and SEV-dominant centers (17.8% vs 9.3% [ P < 0.001] and 12.7% vs 10.0% [ P = 0.036], respectively; HR: 1.51; P for interaction = 0.021), risk for cerebrovascular accident was higher with SEVs at BEV-dominant but not SEV-dominant centers (3.6% vs 1.1% [ P < 0.001] and 2.2% vs 1.4% [ P = 0.162]; HR: 2.08; P for interaction < 0.01). Aortic regurgitation greater than mild was more frequent with SEVs at BEV-dominant centers and similar with BEVs regardless of center dominance (5.2% vs 2.8% [ P < 0.001] and 3.4% vs 3.7% [ P = 0.504], respectively). Two-year mortality was higher with SEVs at BEV-dominant centers but not at SEV-dominant centers (21.9% vs 16.9% [ P = 0.021] and 16.8% vs 16.5% [ P = 0.642], respectively; HR: 1.20; P for interaction = 0.032). Periprocedural outcomes, aortic regurgitation greater than mild, and 2-year mortality are worse when TAVR is performed using SEVs at BEV-dominant centers. Outcomes are similar regardless of valve type at SEV-dominant centers. The present results stress the need to account for this factor when comparing BEV and SEV outcomes. (The Aortic+Mitral Transcatheter [AMTRAC] Valve Registry; NCT04031274) [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2022
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8. Balloon-Expandable Valve for Treatment of Evolut Valve Failure: Implications on Neoskirt Height and Leaflet Overhang.
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Akodad, Mariama, Sellers, Stephanie, Landes, Uri, Meier, David, Tang, Gilbert H.L., Gada, Hemal, Rogers, Toby, Caskey, Michael, Rutkin, Bruce, Puri, Rishi, Rovin, Joshua, Leipsic, Jonathon, Sondergaard, Lars, Grubb, Kendra J., Gleason, Patrick, Garde, Kshitija, Tadros, Hatem, Teodoru, Sebastian, Wood, David A., and Webb, John G.
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This study sought to determine the degree of Evolut (Medtronic) leaflet pinning, diameter expansion, leaflet overhang, and performance at different implant depths of the balloon-expandable Sapien 3 (S3, Edwards Lifesciences LLC) transcatheter heart valve (THV) within the Evolut THV. Preservation of coronary access and flow is a major factor when considering the treatment of failed Evolut THVs. An in vitro study was performed with 20-, 23-, 26-, and 29-mm S3 THVs deployed within 23-, 26-, 29-, and 34-mm Evolut R THVs, respectively. The S3 outflow was positioned at various depths at node 4, 5, and 6 of the Evolut R. Neoskirt height, leaflet overhang, performance, and Evolut R valve housing diameter expansion were assessed under physiological conditions as per ISO 5840-3 standard. The neoskirt height for the Evolut R was shorter when the S3 outflow was positioned at node 4 compared with node 6 (node 4 height for 23 mm = 16.3 mm, 26 mm = 17.1 mm, 29 mm = 18.3 mm, and 34 mm = 19.9 mm vs node 6 height for 23 mm = 23.9 mm, 26 mm = 23.4 mm, 29 mm = 24.7 mm, and 34 mm = 27 mm Evolut R). All configurations exhibited acceptable hydrodynamic performance irrespective of the degree of leaflet overhang, except the 29-mm S3 implanted in 34-mm Evolut R at node 4 (regurgitant fraction >20%). The valve housing radius of the index Evolut R increased when the S3 was implanted, with the increase ranging from 0 to 2.5 mm. Placement of the S3 at a lower implant position within an index Evolut R reduces the neoskirt height with no significant compromise to S3 valve function despite a higher degree of leaflet overhang. Low S3 implantation may facilitate future coronary access after redo transcatheter aortic valve replacement. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2022
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9. Multimodality Imaging to Assess Leaflet Height in Mitral Bioprosthetic Valves: Implications for Mitral Valve-in-Valve Procedure.
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Akodad, Mariama, Sathananthan, Janarthanan, Tzimas, Georgios, Salcudean, Hannah, Hensey, Mark, Gulsin, Gaurav S., Meier, David, (Anthony) Chuang, Ming-yu, Chatfield, Andrew G., Landes, Uri, Blanke, Philipp, Sondergaard, Lars, Payne, Geoffrey W., Lutter, Georg, Puehler, Thomas, Wood, David A., Webb, John G., Leipsic, Jonathon A., and Sellers, Stephanie L.
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- 2022
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10. Nationally Representative Repeat Transcatheter Aortic Valve Replacement Outcomes: Report From the Centers for Medicare and Medicaid Services.
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Percy, Edward D., Harloff, Morgan T., Hirji, Sameer, McGurk, Siobhan, Yazdchi, Farhang, Newell, Paige, Malarczyk, Alexandra, Sabe, Ashraf, Landes, Uri, Webb, John, Reardon, Michael J., Thourani, Vinod H., Tang, Gilbert H.L., Bapat, Vinayak, Bhatt, Deepak, O'Gara, Patrick, Gleason, Thomas, Shah, Pinak, and Kaneko, Tsuyoshi
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The aim of this study was to examine real-world experience with repeat transcatheter aortic valve replacement (TAVR) in a population-based national database. Repeat TAVR is a growing option in patients requiring reintervention for TAVR. However, large-scale studies with longitudinal follow-up are limited. All Medicare beneficiaries who underwent TAVR from 2012 to 2017 were included. Outcomes included 30-day and longitudinal mortality and major adverse cardiovascular events, defined as death, stroke, pacemaker insertion, major bleeding, acute kidney injury, or cardiac arrest. Outcomes of repeat TAVR were compared with surgical explantation after TAVR (TAVR explantation) in a matched analysis. Of 133,250 patients who underwent TAVR, 617 (0.46%) underwent subsequent repeat TAVR at a median interval of 154 days (interquartile range: 58-537 days). Mortality at 30 days and 1 year was 6.0% and 22.0%, respectively. Rates of 30-day stroke and pacemaker insertion were 1.8% and 4.2%. Mortality at 30 days was lower in those who underwent their first TAVR during the later era (2015-2017) compared with earlier years (2012-2014) (4.6% vs 8.7%; P = 0.049). Repeat TAVR was associated with lower 30-day mortality compared with a matched group undergoing TAVR explantation (6.2% vs 12.3%; P = 0.05), although 1-year mortality was similar (21.0% vs 20.8%; P = 1.000). The incidence of 30-day major adverse cardiovascular events was higher with TAVR explantation compared with repeat TAVR (risk ratio: 2.92; 95% CI: 1.88-4.99; P ≤ 0.001). Repeat TAVR was performed with acceptable 30-day mortality in this high-risk population. Short-term outcomes were superior to surgical explantation, but 1-year outcomes were similar. Repeat TAVR will likely be an important option for aortic valve reintervention after TAVR. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2021
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11. Effect of Transcatheter Aortic Valve Replacement on Concomitant Mitral Regurgitation and Its Impact on Mortality.
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Witberg, Guy, Codner, Pablo, Landes, Uri, Schwartzenberg, Shmuel, Barbanti, Marco, Valvo, Roberto, De Backer, Ole, Ooms, Joris F., Islas, Fabian, Marroquin, Luis, Sedaghat, Alexander, Sugiura, Atsushi, Masiero, Giulia, Werner, Paul, Armario, Xavier, Fiorina, Claudia, Arzamendi, Dabit, Santos-Martinez, Sandra, Fernández-Vázquez, Felipe, and Baz, Jose A.
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The purpose of this study was to examine the impact of residual mitral regurgitation (MR) on mortality in patients undergoing transcatheter aortic valve replacement (TAVR). MR is common in patients undergoing TAVR. Data on optimal management of patients with significant MR after TAVR are limited. The registry consisted of 16 TAVR centers (n = 7,303). Outcomes of patients with ≥ moderate versus lesser grade MR after TAVR were compared. In 1,983 (27.2%) patients, baseline MR grade was ≥ moderate. MR regressed in 874 (44.1%) patients and persisted in 1,109 (55.9%) after TAVR. Four-year mortality was higher for those with MR persistence, but not for those with MR regression after TAVR, compared with nonsignificant baseline MR (43.8% vs. 35.1% vs. 32.4%; hazard ratio [HR]: 1.38; p = 0.008; HR: 1.02; p = 0.383, respectively). New York Heart Association functional class III to IV after TAVR was more common in those with MR persistence vs. regression (14.4% vs. 3.9%; p < 0.001). In a propensity score–matched cohort (91 patients' pairs), with significant residual MR after TAVR who did or did not undergo staged mitral intervention, staged intervention was associated with a better functional class through 1 year of follow-up (82.4% vs. 33.3% New York Heart Association functional class I or II; p < 0.001), and a numerically lower 4-year mortality, which was not statistically significant (64.6% vs. 37.5%; HR: 1.66; p = 0.097). Risk stratification based on improvement in MR and symptoms after TAVR can identify patients at increased mortality risk after TAVR. These patients may benefit from a staged transcatheter mitral intervention, but this requires further proof from future studies. (Transcatheter Treatment for Combined Aortic and Mitral Valve Disease. The Aortic+Mitral TRAnsCatheter [AMTRAC] Valve Registry [AMTRAC]; NCT04031274). [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2021
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12. Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses.
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Landes, Uri, Sathananthan, Janarthanan, Witberg, Guy, De Backer, Ole, Sondergaard, Lars, Abdel-Wahab, Mohamed, Holzhey, David, Kim, Won-Keun, Hamm, Christian, Buzzatti, Nicola, Montorfano, Matteo, Ludwig, Sebastian, Conradi, Lenard, Seiffert, Moritz, Guerrero, Mayra, El Sabbagh, Abdallah, Rodés-Cabau, Josep, Guimaraes, Leonardo, Codner, Pablo, and Okuno, Taishi
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AORTIC valve , *HEART valve prosthesis implantation , *PERCUTANEOUS balloon valvuloplasty , *AORTIC valve insufficiency , *PROPENSITY score matching , *CARDIAC surgery , *RESEARCH , *OPERATIVE surgery , *RESEARCH methodology , *AORTIC stenosis , *ACQUISITION of data , *CORONARY disease , *MEDICAL cooperation , *EVALUATION research , *COMPARATIVE studies , *PROSTHETIC heart valves , *CARDIAC pacemakers , *ACUTE kidney failure , *PROBABILITY theory , *HEMORRHAGE , *PATIENT safety - Abstract
Background: Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) are now both used to treat aortic stenosis in patients in whom life expectancy may exceed valve durability. The choice of initial bioprosthesis should therefore consider the relative safety and efficacy of potential subsequent interventions.Objectives: The aim of this study was to compare TAVR in failed transcatheter aortic valves (TAVs) versus surgical aortic valves (SAVs).Methods: Data were collected on 434 TAV-in-TAV and 624 TAV-in-SAV consecutive procedures performed at centers participating in the Redo-TAVR international registry. Propensity score matching was applied, and 330 matched (165:165) patients were analyzed. Principal endpoints were procedural success, procedural safety, and mortality at 30 days and 1 year.Results: For TAV-in-TAV versus TAV-in-SAV, procedural success was observed in 120 (72.7%) versus 103 (62.4%) patients (p = 0.045), driven by a numerically lower frequency of residual high valve gradient (p = 0.095), ectopic valve deployment (p = 0.081), coronary obstruction (p = 0.091), and conversion to open heart surgery (p = 0.082). Procedural safety was achieved in 116 (70.3%) versus 119 (72.1%) patients (p = 0.715). Mortality at 30 days was 5 (3%) after TAV-in-TAV and 7 (4.4%) after TAV-in-SAV (p = 0.570). At 1 year, mortality was 12 (11.9%) and 10 (10.2%), respectively (p = 0.633). Aortic valve area was larger (1.55 ± 0.5 cm2 vs. 1.37 ± 0.5 cm2; p = 0.040), and the mean residual gradient was lower (12.6 ± 5.2 mm Hg vs. 14.9 ± 5.2 mm Hg; p = 0.011) after TAV-in-TAV. The rate of moderate or greater residual aortic regurgitation was similar, but mild aortic regurgitation was more frequent after TAV-in-TAV (p = 0.003).Conclusions: In propensity score-matched cohorts of TAV-in-TAV versus TAV-in-SAV patients, TAV-in-TAV was associated with higher procedural success and similar procedural safety or mortality. [ABSTRACT FROM AUTHOR]- Published
- 2021
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13. Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction.
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Landes, Uri, Webb, John G, De Backer, Ole, Sondergaard, Lars, Abdel-Wahab, Mohamed, Crusius, Lisa, Kim, Won-Keun, Hamm, Christian, Buzzatti, Nicola, Montorfano, Matteo, Ludwig, Sebastian, Schofer, Niklas, Voigtlaender, Lisa, Guerrero, Mayra, El Sabbagh, Abdallah, Rodés-Cabau, Josep, Guimaraes, Leonardo, Kornowski, Ran, Codner, Pablo, and Okuno, Taishi
- Abstract
Background: Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail.Objectives: The authors sought to examine outcomes following redo-TAVR.Methods: The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively.Results: Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm2 and 1.51 ± 0.57 cm2; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively.Conclusions: Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern. [ABSTRACT FROM AUTHOR]- Published
- 2020
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14. Bioprosthetic Valve Leaflet Displacement During Valve-in-Valve Intervention: An Ex Vivo Bench Study.
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Hensey, Mark, Sellers, Stephanie, Sathananthan, Janarthanan, Lai, Althea, Landes, Uri, Alkhodair, Abdullah, McManus, Bruce, Cheung, Anson, Wood, David, Blanke, Philipp, Leipsic, Jonathon, Ye, Jian, and Webb, John
- Abstract
The aim of this study was to examine the effect of different transcatheter heart valves (THVs) on valve leaflet displacement when deployed within bioprosthetic surgical valves and, thereby, risk for coronary obstruction. Coronary obstruction is a potentially devastating complication during valve-in-valve (ViV) transcatheter aortic valve replacement. Strategies such as provisional stenting and intentional bioprosthetic valve leaflet laceration have been developed to mitigate this risk. Alternatively, the use of a THV that retracts the bioprosthetic leaflet away from the coronary ostium may prevent coronary obstruction. A 25-mm J-Valve, a 26-mm Evolut Pro, and a 23-mm JenaValve were implanted into both a 25-mm Trifecta surgical valve and a 25-mm Mitroflow surgical valve. A 23-mm and a 26-mm SAPIEN 3 were deployed into the Trifecta and Mitroflow, respectively. Displacement of the surgical valve leaflets (retraction vs. expansion) was measured with implantation of each THV by measuring displacement angle and maximal displacement distance. Within both the Trifecta and Mitroflow valves, implantation of the J-Valve and JenaValve resulted in retraction of the surgical valve leaflets, and placement of the Evolut Pro and SAPIEN 3 resulted in tubular expansion of the surgical valve leaflets. There were significant differences in displacement angles and distances between both the J-Valve and JenaValve and the SAPIEN 3 and Evolut Pro (p < 0.0001). ViV implantation with new-generation THVs that directly interact with bioprosthetic valve leaflets results in surgical valve leaflet retraction. This might mitigate the risk for coronary obstruction in selected cases of ViV transcatheter aortic valve replacement and also facilitate coronary reaccess after ViV TAVR. [ABSTRACT FROM AUTHOR]
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- 2020
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15. Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years.
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Sathananthan, Janarthanan, Hensey, Mark, Landes, Uri, Alkhodair, Abdullah, Saiduddin, Adeeb, Sellers, Stephanie, Cheung, Anson, Lauck, Sandra, Blanke, Philipp, Leipsic, Jonathon, Ye, Jian, Wood, David A., and Webb, John G.
- Abstract
This study assessed the long-term durability of nominally deployed transcatheter heart valves (THV) to 1 billion cycles (equivalent to 25 years) and non-nominal (overexpansion, underexpansion, and elliptical) THV deployments to 200 million cycles (equivalent to 5 years) with accelerated wear testing. The long-term durability of THVs is currently unknown. As transcatheter aortic valve replacement expands to lower-risk patients, durability will be of increasing importance. SAPIEN 3 THVs, sized 20, 23, 26, and 29 mm were assessed. Nominally deployed THVs underwent hydrodynamic performance and mechanical durability as assessed with accelerated wear testing to 1 billion cycles. Magna Ease surgical valves were used as comparators. Durability of non-nominal THV deployments was tested to 200 million cycles. Valves were tested to International Standards Organization 5840:2013 standard. THV durability was excellent for both the nominal and non-nominal THV deployments to 1 billion and 200 million cycles, respectively. At 1 billion cycles the regurgitant fraction for the 20-, 23-, 26-, and 29-mm SAPIEN 3 was 0.92 ± 0.47%, 1.29 ± 0.04%, 1.73 ± 0.46%, and 2.47 ± 0.15%, respectively. There was also excellent durability in the comparator Magna Ease valves. The regurgitant fraction of non-nominal overexpanded (20 mm, 4.36 ± 0.53; 23 mm, 7.68 ± 1.39; 26 mm, 6.80 ± 1.17; 29 mm, 9.00 ± 0.37), underexpanded (20 mm, 3.06 ± 0.28; 23 mm, 4.46 ± 0.45; 26 mm, 7.72 ± 0.48; 29 mm, 8.65 ± 2.01), and elliptical (20 mm, 3.30 ± 0.38; 23 mm, 6.13 ± 0.94; 26 mm, 6.77 ± 1.22; 29 mm, 8.72 ± 0.24) THVs were excellent at 200 million cycles. Nominal SAPIEN 3 THVs demonstrated excellent durability, to an equivalent of 25-years wear. THV durability was similar to the comparator surgical valves tested. Non-nominal (overexpansion, underexpansion, and elliptical) THV deployments also had excellent durability to an equivalent of 5 years wear. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
16. Leaflet and Neoskirt Height in Transcatheter Heart Valves: Implications for Repeat Procedures and Coronary Access.
- Author
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Akodad, Mariama, Sellers, Stephanie, Gulsin, Gaurav S., Tzimas, Georgios, Landes, Uri, Chatfield, Andrew G., Chuang, Anthony, Meier, David, Leipsic, Jonathon, Blanke, Philippe, Ye, Jian, Cheung, Anson, Wood, David A., Khan, Jaffar M., Webb, John G., and Sathananthan, Janarthanan
- Published
- 2021
- Full Text
- View/download PDF
17. Iliofemoral artery lumen volume assessment with three dimensional multi-detector computed tomography and vascular complication risk in transfemoral transcatheter aortic valve replacement.
- Author
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Hammer, Yoav, Landes, Uri, Zusman, Oren, Kornowski, Ran, Witberg, Guy, Orvin, Katia, Levi, Amos, Codner, Pablo, Vaknin-Assa, Hanna, Nassar, Mithal, Shafir, Gideon, Assali, Abid, and Hamdan, Ashraf
- Abstract
Abstract Background Transfemoral Transcatheter Aortic Valve Replacement (TAVR) carries a risk of Vascular Complications (VCs) at the access site. The currently used measures for assessing the risk for VCs are not accurate enough, and sometimes fail to predict them. We therefore aimed to examine whether Iliofemoral artery lumen volume (IFV) assessment with 3-dimensional computed tomography (CT) predicts VCs after transfemoral TAVR. Methods We identified 45/560 trans-femoral TAVR patients with VC, then performed nearest neighbor 1:1 matching for patients with no VC, matching for age, sex, TAVR year, valve size and type, closure-device, sheath size and peripheral vascular disease. IFV, minimal diameter, tortuosity, and calcification were measured, and their diagnostic performance assessed. Results The final analysis included 45 patients with and 45 patients without VCs. The two groups were well balanced. For all patients, median IFV was 8.65 ml (IQR 6.5–11.95). IFV was lower in patients with VC compared to patients without VC: 7.10 ml (IQR 5.4–9.0) vs. 10.10 ml (IQR 8.3–13.3), p < 0.001. VC risk had marginal association with iliofemoral artery minimal diameter (p = 0.06) and no association with tortuosity or calcification. Compared with other measurements, IFV had the most favorable receiver operating curve for the prediction of VC, with an area under the curve (AUC) of 0.78. Conclusion IFV measurement using 3-dimensional CT is significantly associated with VCs in transfemoral TAVR patients and might be superior to currently accepted parameters. IFV should be further studied among extended cohorts of TAVR treated patients as a novel tool for VC risk assessment prior to transfemoral TAVR. Since currently used parameters for predicting vascular complications (VCs) after transfemoral TAVR are not accurate enough, we aimed to investigate whether Iliofemoral artery lumen volume (IFV) measurement by 3D CT might be used as a screening tool. Included were 45 patients with VCs and 45 matched patients with no VC. IFV was significantly lower in patients with VC compared to patients without VC and had the most favorable receiver operating curve for the prediction of VC compared to currently accepted methods. Thus, this novel 3D based measurement may aid in the preoperative assessment before transfemoral TAVR. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
18. CRT-700.41 Balloon-Expandable Valve for Treatment of Evolut Valve Failure: Implications on Neo-Skirt Height and Leaflet Overhang.
- Author
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Akodad, Mariama, Sellers, Stephanie, Landes, Uri, Meier, David, Tang, Gilbert H.L., Gada, Hemal, Rogers, Toby, Caskey, Michael, Rutkin, Bruce, Puri, Rishi, Rovin, Joshua, Leipsic, Jonathon, Sondergaard, Lars, Grubb, Kendra J., Gleason, Patrick, Garde, Kshitija, Tadros, Hatem, Teodoru, Sebastian, Wood, David A., and Webb, John G.
- Published
- 2022
- Full Text
- View/download PDF
19. Type 2 myocardial infarction: A descriptive analysis and comparison with type 1 myocardial infarction.
- Author
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Landes, Uri, Bental, Tamir, Orvin, Katia, Vaknin-Assa, Hana, Rechavia, Eldad, Iakobishvili, Zaza, Lev, Eli, Assali, Abid, and Kornowski, Ran
- Abstract
Background While ‘plaque rupture’ is the paradigm of type 1 myocardial infarction (T1MI), T2MI is myocardial necrosis secondary to oxygen supply-demand mismatch. Being a heterogeneous and rather newly defined group, data are lacking about T2MI. Methods A retrospective review of medical records of patients diagnosed with T2MI in the Rabin Cardiology Center, Israel between the years 2007 and 2012 was performed. Following a descriptive analysis, we used multivariate time dependent models to estimate the association of T2MI with the risk for 30-day, 1-year, and 5-year all-cause-mortality and major adverse cardiovascular events (MACE), and compared it to a T1MI group matched for age, gender and electrocardiographic changes. Results The study included 107 T2MI (and 107 T1MI) patients. Sepsis, anemia, and atrial fibrillation were the most common etiologies. Triple anti-thrombotic therapy was given to 22% of T2MI patients (vs. 82% of T1MI patients, p < 0.001). Twenty-five percent were managed using urgent percutaneous coronary intervention. Angiography unmasked acute plaque rupture in 29% of T2MI patients group. Compared to T1MI, T2MI was associated with higher all-cause-mortality rate: adjusted-hazard-ratio 7.14 (1.31–38.9) at 30 days, 3.42 (1.51–7.75) at 1 year, and 2.08 (1.14–3.81) at 5 years follow-up. MACE risk was consistent between T2 and T1MI patients. Conclusions The most common T2MI triggers are sepsis, anemia, and atrial fibrillation. Compared to a T1MI population, T2MI is associated with higher short- and long-term mortality rates but equal cardiovascular mortality and MACE risk. As many as 30% may harbor plaque rupture and in fact have T1MI. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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- View/download PDF
20. Predictors of Long Term Outcomes in 11,441 Consecutive Patients Following Percutaneous Coronary Interventions.
- Author
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Landes, Uri, Kornowski, Ran, Assali, Abid, Vaknin-Assa, Hana, Greenberg, Gabriel, Lev, Eli I., and Bental, Tamir
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MORTALITY , *PEOPLE with diabetes , *ANGIOPLASTY , *EPIDEMIOLOGY , *TERTIARY care , *MYOCARDIAL infarction - Abstract
Given the vicissitudes of percutaneous coronary intervention (PCI) technology, epidemiology, and mode of practice, the aim of this study was to define contemporary outcome predictors in a very large consecutive patient cohort. Data from 11,441 consecutive patients who underwent PCI at a tertiary medical center from April 2004 to September 2013 are presented. A comprehensive database was built using various data sources, with outcome end points defined as all-cause mortality and as a composite of death or nonfatal myocardial infarction during follow-up. Candidate variables to influence outcome were chosen a priori and were tested using multivariate time-dependent models to estimate each interaction. Mean follow-up was 5.5 years (range 3 months to 9.5 years). The cohort consisted of 75% men, 42% patients with diabetes, and 61% patients who underwent PCI in acute coronary syndrome settings and 7.8% for ST-elevation myocardial infarction. Drug-eluting stents were used in 43.4% of patients, bare-metal stents in 52%, and balloon angioplasty alone in 4.6%. In multivariate analysis, in addition to already well-recognized predictors of death or myocardial infarction such as advanced age (hazard ratio [HR] 1.031, p <0.001), female gender (HR 1.23, p <0.001), urgent setting (HR 1.23, p <0.001) and diabetes mellitus (HR 1.28, p <0.001), we particularly noted previous anemia (HR 1.55 p <0.001), previous chronic kidney injury (HR 1.93, p <0.001) and previous moderate to severe left ventricular dysfunction (HR 2.29, p <0.001). Drug-eluting stent placement was associated with better outcomes (HR 0.70, p <0.001). In conclusion, this analysis confirms the effect of some known predictors of PCI outcomes. However, the extent of their effect is modest, while other predictors may have a greater influence on outcomes. Risk stratification of PCI patients should take into account kidney injury, anemia, and left ventricular function. Drug-eluting stents provide sustained benefit. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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- View/download PDF
21. Reply: Redo-TAVR May Not Always Be an Option.
- Author
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Landes, Uri, Sathananthan, Janarthanan, Wood, David, and Webb, John G.
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HEART valve prosthesis implantation , *AORTIC valve transplantation , *PROSTHETIC heart valves , *COMPLICATIONS of prosthesis ,AORTIC valve surgery - Published
- 2020
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22. TRANSCATHETER AORTIC VALVE REPLACEMENT IN ONCOLOGY PATIENTS WITH AORTIC STENOSIS.
- Author
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Landes, Uri, Jubran, Ayman, Yoon, Sung-Han, Taramasso, Maurizio, Russo, Marco, Sinning, Jan-Malte, Luigi, Biasco, Pedrazzini, Giovanni, Latib, Azeem, Pagnesi, Matteo, Tamburino, Corrado, Arrigo, Paolo D’, Pilgrim, Thomas, Tchetche, Didier, Iftikhar, Omer, Bosmans, Johan, Bedzra, Edo, Dvir, Danny, Mylotte, Darren, and De Bruijn, Sabine
- Published
- 2018
- Full Text
- View/download PDF
23. BIODEGRADABLE POLYMERDRUG ELUTING STENTS VERSUS DURABLE POLYMER DRUG ELUTING STENTS FOR PERCUTANEOUS CORONARY INTERVENTION: A PROPENSITY SCORE MATCHED ANALYSIS.
- Author
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Levi, Amos, Landes, Uri, Bental, Tamir, Assali, Abid, Assa, Hana Vaknin, Lev, Eli, and Kornowski, Ran
- Published
- 2018
- Full Text
- View/download PDF
24. Balloon-Expandable Valve for Treatment of Evolut Valve Failure: Implications on Neo-Skirt Height and Leaflet Overhang.
- Author
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Akodad, Mariama, Sellers, Stephanie, Landes, Uri, Meier, David, Tang, Gilbert H.L., Gada, Hemal, Rogers, Toby, Caskey, Michael, Rutkin, Bruce, Puri, Rishi, Rovin, Joshua, Leipsic, Jonathon, Sondergaard, Lars, Grubb, Kendra J., Gleason, Patrick, Garde, Kshitija, Tadros, Hatem, Teodoru, Sebastian, Wood, David A., and Webb, John G.
- Subjects
- *
VALVES , *PAMPHLETS , *THERAPEUTICS - Published
- 2022
- Full Text
- View/download PDF
25. Annular size and interaction with trans-catheter aortic valves for treatment of severe bicuspid aortic valve stenosis: Insights from the BEAT registry.
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Moscarella, Elisabetta, Mangieri, Antonio, Giannini, Francesco, Tchetchè, Didier, Kim, Won-Keun, Sinning, Jan-Malte, Landes, Uri, Kornowski, Ran, De Backer, Ole, Nickenig, Georg, De Biase, Chiara, Søndergaard, Lars, De Marco, Federico, Bedogni, Francesco, Ancona, Marco, Montorfano, Matteo, Regazzoli, Damiano, Stefanini, Giulio, Toggweiler, Stefan, and Tamburino, Corrado
- Subjects
- *
HEART valve prosthesis implantation , *AORTIC stenosis , *MITRAL valve , *AORTIC valve , *HEART valves , *VENTRICULAR ejection fraction - Abstract
Transcatheter aortic valve replacement (TAVR) is safe and feasible in patients with bicuspid aortic valve (BAV), but whether annular size may influence TAVR results in BAV patients remains unclear. We aimed at evaluating the impact of aortic annular size on procedural and clinical outcomes of BAV patients undergoing TAVR, as well as potential interactions between annular dimension and trans-catheter heart valve (THV) type (balloon-expandable (BEV) vs. self-expanding (SEV). BEAT is a multicenter registry of consecutive BAV stenosis undergoing TAVR. For this sub-study patients were classified according to annular dimension in small-annulus (area < 400 mm2 or perimeter <72 mm), medium-annulus (area ≥ 400 and < 575 mm2, perimeter ≥72 mm and< 85 mm), large-annulus (area ≥ 575 mm2 or perimeter ≥85 mm). Primary endpoint was Valve Academic Research Consortium-2 (VARC-2) device success. 45(15.5%) patients had small, 132(45.3%) medium, and 114(39.2%) large annuli. Compared with other groups, patients with large annuli were more frequently male, younger, with higher body mass index, larger aortic valve area, higher rate of moderate-severe calcification, lower mean trans-aortic valve gradient and lower left ventricular ejection fraction. In large-annuli SEVs were associated with a lower VARC-2 device success (75.9% vs. 90.6%, p = 0.049) driven by a higher rate of paravalvular valvular leak (PVL) compared to BEVs (20.7% vs. 1.2%, p < 0.001). However, no differences in clinical outcomes were observed according to annular size nor THV type. TAVR in BAV patients is feasible irrespective of annular size. However in patients with large aortic annulus SEVs were associated with a significantly higher rate of PVLs compared to BEVs. • TAVR can be successfully performed in severe bicuspid aortic stenosis. • However, interaction between annular size and THV type is still unclear. • We compared BEV and SEV hemodynamics by aortic annulus size in BAV patients. • In large annuli a higher rate of PVLs was observed SEVs compared to BEVs. • No differences in clinical outcomes were observed according to annular size nor THV. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
26. Procedural and clinical outcomes of type 0 versus type 1 bicuspid aortic valve stenosis undergoing trans-catheter valve replacement with new generation devices: Insight from the BEAT international collaborative registry.
- Author
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Ielasi, Alfonso, Moscarella, Elisabetta, Mangieri, Antonio, Giannini, Francesco, Tchetchè, Didier, Kim, Won-Keun, Sinning, Jean-Malte, Landes, Uri, Kornowski, Ran, De Backer, Ole, Nickenig, Georg, De Biase, Chiara, Søndergaard, Lars, De Marco, Federico, Bedogni, Francesco, Ancona, Marco, Montorfano, Matteo, Regazzoli, Damiano, Stefanini, Giulio, and Toggweiler, Stefan
- Subjects
- *
MITRAL valve , *AORTIC stenosis , *CARDIAC pacemakers , *AORTIC valve , *HEART valve prosthesis implantation , *COMPUTED tomography , *HEART valves - Abstract
Although bicuspid aortic valve (BAV) is not considered a "sweet spot" to trans-catheter aortic valve replacement (TAVR), a certain number of BAV underwent TAVR. Whether BAV phenotype affects outcomes following TAVR remains debated. We aimed at evaluating the impact of BAV phenotype on procedural and clinical outcomes after TAVR using new generation trans-catheter heart valves (THVs). patients included in the BEAT registry were classified according to the BAV phenotype revealed at multi-slice computed tomography (MSCT) in type 0 (no raphe) vs. type 1 (1 raphe). Primary end-point was Valve Academic Research Consortium–2 (VARC-2) device success. Secondary end-points included procedural complications, rate of permanent pacemaker implantation, clinical outcomes at 30-day and 1-year. Type 0 BAV was present in 25(7.1%) cases, type 1 in 218(61.8%). Baseline characteristics were well balanced between groups. Moderate-severe aortic valve calcifications at MSCT were less frequently present in type 0 vs. type 1 (52%vs.71.1%, p = 0.05). No differences were reported for THV type, size, pre and post-dilation between groups. VARC-2 success tended to be lower in type 0 vs. type 1 BAV (72%vs86.7%; p = 0.07). Higher rate of mean transprosthetic gradient ≥20 mmHg was observed in type 0 vs. type 1 group (24%vs6%, p = 0.007). No differences were reported in the rate of post-TAVR moderate-severe aortic regurgitation and clinical outcomes between groups. Our study confirms TAVR feasibility in both BAV types, however a trend toward a lower VARC-2 device success and a higher rate of mean transprosthetic gradient ≥20 mmHg was observed in type 0 vs. type 1 BAV. • Despite being a relative contraindication a certain number of BAV underwent TAVR. • We assessed the impact of BAV type on procedural and clinical outcomes post TAVR. • VARC-2 success tended to be lower in type 0 vs. type 1 BAV. • higher rate of high residual gradient was observed in type 0 compared to type 1 BAV. • No differences were noted in the rate of AR and clinical outcomes between BAV types. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
27. Outcomes following percutaneous coronary intervention in patients with cancer.
- Author
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Quintana, Raymundo A., Monlezun, Dominique J., Davogustto, Giovanni, Saenz, Humberto R., Lozano-Ruiz, Francisco, Sueta, Daisuke, Tsujita, Kenichi, Landes, Uri, Denktas, Ali E., Alam, Mahboob, Paniagua, David, Addison, Daniel, and Jneid, Hani
- Subjects
- *
PERCUTANEOUS coronary intervention , *CANCER patients , *RANDOM effects model , *CLINICAL trials - Abstract
Randomized clinical trials demonstrated the benefits of percutaneous coronary interventions (PCI) in diverse clinical settings. Patients with cancer were not routinely included in these studies. Literature search of PubMed, Cochrane, Medline, SCOPUS, EMBASE, and ClinicalTrials was conducted to identify studies that assessed one-year all-cause, cardiovascular and non-cardiovascular mortality in patients with historical or active cancer. Using the random effects model, we computed risk ratios (RRs) and standardized mean differences and their 95% confidence intervals for the dichotomous and continuous measures and outcomes, respectively. Of 171 articles evaluated in total, 5 eligible studies were included in this meta-analysis. In total, 33,175 patients receiving PCI were analyzed, of whom 3323 patients had cancer and 29,852 no cancer history. Patients in the cancer group had greater all-cause mortality [RR 2.22 (1.51–3.26; p < 0.001)], including cardiovascular mortality [RR 1.34 (1.1–1.65; p = 0.005)] and non-cardiovascular mortality [RR 3.42 (1.74–6.74; p ≤ 0.001], at one-year compared to non-cancer patients. Patients in the cancer group had greater one-month all-cause mortality [RR 2.01 (1.24–3.27; p = 0.005)] and greater non-cardiovascular mortality [RR 6.87 (3.10–15.21; p ≤0.001)], but no difference in one-month cardiovascular mortality compared to non-cancer patients. Meta-regression analyses showed that the difference in one-year all-cause and cardiovascular mortality between both groups was not attributable to differences in baseline characteristics, index PCI characteristics, or medications prescribed at discharge. Patients with cancer undergoing PCI have worse mid-term outcomes compared to non-cancer patients. Cancer patients should be managed by a multi-specialist team, in an effort to close the mortality gap. • First meta-analysis of outcomes after PCI in cancer patients • In total, 33,175 patients receiving PCI were analyzed in this study. • Cancer patients were found to have increased risk of 1-year all-cause mortality. • Cancer patients have increased risk of 1-year cardiovascular mortality. • In meta-regression, 1-year outcomes differences were independent of baseline traits. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
28. TCT-736 Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years.
- Author
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Sathananthan, Janarthanan, Hensey, Mark, Landes, Uri, Alkhodair, Abdullah, Saiduddin, Adeeb, Sellers, Stephanie, Cheung, Anson, Lauck, Sandra, Blanke, Philipp, Leipsic, Jonathon, Ye, Jian, Wood, David, and Webb, John
- Subjects
- *
HEART valves , *DURABILITY , *HEART valve prosthesis implantation - Published
- 2019
- Full Text
- View/download PDF
29. BIOFLOW-III satellite-One-year clinical outcomes of diabetic patients treated with a biodegradable polymer sirolimus-eluting stent and comprehensive medical surveillance.
- Author
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Kornowski, Ran, Roguin, Ariel, Danenberg, Haim, Assa, Hana Vaknin, Abergel, Eitan, Rozenbaum, Eliezer, Guetta, Victor, Landes, Uri, Jabara, Refat, Merdler, Amnon, Segev, Amit, Mosseri, Morris, and Assali, Abid
- Subjects
- *
DRUG-eluting stents , *DIABETES , *BIODEGRADABLE plastics , *RAPAMYCIN , *MYOCARDIAL revascularization - Abstract
Background: Drug-eluting stents with biodegradable polymer might be particularly useful in diabetic patients who are at increased risk for target lesion/target vessel revascularization. We therefore aimed at assessing the safety and performance of a biodegradable polymer sirolimus-eluting stent (BP-SES) in combination with comprehensive optimal medical therapy following coronary interventions.Methods: This prospective, multicenter registry was conducted at six centers in Israel. Aside of stent treatment, we aimed for an LDL-C level<70mg/dl; at one and six months post-intervention a diabetic consultancy was required, and follow-up data were collected at six and twelve months. The primary outcome measure was target vessel failure, a composite of cardiac death, target-vessel myocardial infarction and clinically driven target vessel revascularization. Secondary outcomes were target lesion failure, its individual components, and stent thrombosis.Results: From August 2013 until May 2014, 120 diabetic patients with 158 lesions were treated with a BP-SES. Mean age was 63.9±9.2years, 27.5% were insulin dependent, 28.3% had a history of myocardial infarction, and 47.5% had prior coronary interventions. By visual estimation, lesions were 3.0±0.5mm in diameter and 15.2±7.4mm long; mean stent diameter and length were 3.0±0.5mm and 19.2±6.8mm. Target vessel failure and target lesion failure at 12months occurred in seven (6.4% [95% CI: 3.1-13.0]) and four patients (3.5% [95% CI: 1.3-9.2]), respectively, and definite stent thrombosis in one patient (1.0% [95% CI: 0.1-7.0]).Conclusion: Treatment with a BP-SES demonstrated excellent target-vessel and target-lesion revascularization rates in a high-risk diabetic patient population undergoing catheter-based revascularization followed by intensified medical care.Annotated Table Of Contents: In 120 high-risk diabetic patients with coronary artery stenosis, treatment with the Orsiro sirolimus-eluting stent with biodegradable polymer and comprehensive antidiabetic therapy resulted in excellent clinical outcomes. Target vessel revascularization occurred in 6.4% of patients and target lesion revascularization in 3.5%. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
30. TCT-235 Annular Size and Its Interaction With Self-Expandable Versus Balloon-Expandable Transcatheter Heart Valves for the Treatment of Patients With Severe Bicuspid Aortic Valve Stenosis: Insights from the BEAT Registry.
- Author
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Ielasi, Alfonso, Moscarella, Elisabetta, Mangieri, Antonio, Giannini, Francesco, Tchetche, Didier, Kim, Won-Keun, Sinning, Jan-Malte, Landes, Uri, Kornowski, Ran, de Backer, Ole, Nickenig, Georg, de Biase, Chiara, Sondergaard, Lars, de Marco, Federico, Bedogni, Francesco, Ancona, Marco, Montorfano, Matteo, Regazzoli, Damiano, Stefanini, Giulio, and Toggweiler, Stefan
- Subjects
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AORTIC stenosis , *MITRAL valve , *HEART valves - Published
- 2021
- Full Text
- View/download PDF
31. TCT-164 Leaflet and Neoskirt Height in Transcatheter Heart Valves: Implications for Repeated Procedures and Coronary Access.
- Author
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Akodad, Mariama, Sellers, Stephanie, Gulsin, Gaurav, Tzimas, Georgios, Landes, Uri, Chatfield, Andrew, Chuang, Anthony, Meier, David, Leipsic, Jonathon, Blanke, Philipp, Ye, Jian, Cheung, Anson, Wood, David, Khan, Jaffar, Webb, John, and Sathananthan, Janarthanan
- Subjects
- *
HEART valves , *PAMPHLETS , *MECHANICAL hearts - Published
- 2021
- Full Text
- View/download PDF
32. TCT-758 Assessment of Bioprosthetic Valve Leaflet Displacement During Valve-in-Valve TAVI; an Ex-Vivo Bench Study.
- Author
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Hensey, Mark, Sathananthan, Janarthanan, Sellers, Stephanie, Lai, Althea, Landes, Uri, Alkhodair, Abdullah, Cheung, Anson, Blanke, Philipp, Leipsic, Jonathon, Wood, David, Ye, Jian, and Webb, John
- Subjects
- *
VALVES , *PAMPHLETS , *HEART valve prosthesis implantation - Published
- 2019
- Full Text
- View/download PDF
33. TCT-767 Safety and Feasibility of Same Day Discharge Using the Vancouver PFO/ASD Clinical Pathway.
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Barker, Madeleine, Sathananthan, Janarthanan, Saw, Jacqueline, Lauck, Sandra, Teal, Philip, Fahmy, Peter, Gilhofer, Thomas, Parsa, Ashkan, Alsulaimi, Ali, Hensey, Mark, Alkhodair, Abdullah, Landes, Uri, Webb, John, and Wood, David
- Subjects
- *
ATRIAL septal defects , *CARDIAC surgery , *HOSPITAL admission & discharge - Published
- 2019
- Full Text
- View/download PDF
34. TCT-366 Novel Direct Visualization Technique Facilitates Safe and Reproducible Closure Post Large-Bore Sheath Removal: The FAST MANTA Pilot Study.
- Author
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Sathananthan, Janarthanan, Hensey, Mark, Gilhofer, Thomas, Parsa, Ashkan, Landes, Uri, Alkhodair, Abdullah, Barker, Madeleine, Cook, Richard, Webb, John, and Wood, David
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PILOT projects , *VISUALIZATION - Published
- 2019
- Full Text
- View/download PDF
35. TCT-80 Predictors of Residual Significant Mean Gradient After TAVR in Bicuspid Aortic Valve Stenosis: Insights From the BEAT International Collaborative Registry.
- Author
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Pagnesi, Matteo, Mangieri, Antonio, Tchetche, Didier, Kim, Won-Keun, Sinning, Jan-Malte, Landes, Uri, Kornowski, Ran, De Backer, Ole, Nickenig, Georg, Ielasi, Alfonso, De Biase, Chiara, Sondergaard, Lars, De Marco, Federico, Montorfano, Matteo, Chiarito, Mauro, Stefanini, Giulio, Presbitero, Patrizia, Toggweiler, Stefan, Tamburino, Corrado, and Immè, Sebastiano
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AORTIC stenosis , *MITRAL valve , *PERCUTANEOUS balloon valvuloplasty - Published
- 2019
- Full Text
- View/download PDF
36. TCT-33 Bioprosthetic Valve Fracture Performed Pre– Versus Post–Valve-in-Valve Transcatheter Aortic Valve Replacement: Insights From Bench Testing.
- Author
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Sathananthan, Janarthanan, Fraser, Rob, Hatoum, Hoda, Barlow, Aaron, Stanová, Viktória, Hensey, Mark, Landes, Uri, Alkhodair, Abdullah, Sellers, Stephanie, Cheung, Anson, Ye, Jian, Allen, Keith, Chhatriwalla, Adnan, Blanke, Philipp, Rieu, Régis, Pibarot, Philippe, Dasi, Lakshmi, Leipsic, Jonathon, Wood, David, and Webb, John
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HEART valve prosthesis implantation , *VALVES - Published
- 2019
- Full Text
- View/download PDF
37. TCT-416 Balloon vs Self-Expandable valve for the treatment of bicuspid Aortic valve sTenosis: insights from the BEAT international collaborative registry.
- Author
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Mangieri, Antonio, Tchetche, Didier, Kim, Won-Keun, Sinning, Jan-malte, Landes, Uri, De Backer, Ole, Kornowski, Ran, Busi, Gherardo, Poletti, Enrico, Popma, Jeffrey, Nickenig, Georg, Biase, Chiara de, Søndergaard, Lars, and Colombo, Antonio
- Subjects
- *
MITRAL valve , *AORTIC valve , *BICUSPIDS , *STENOSIS - Published
- 2018
- Full Text
- View/download PDF
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