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10. Long-Term Durability of Transcatheter Aortic Valve Prostheses

Author

Blackman, Daniel J., Saraf, Smriti, MacCarthy, Philip A., Myat, Aung, Anderson, Simon G., Malkin, Christopher J., Cunnington, Michael S., Somers, Kathryn, Brennan, Paul, Manoharan, Ganesh, Parker, Jessica, Aldalati, Omar, Brecker, Stephen J., Dowling, Cameron, Hoole, Stephen P., Dorman, Stephen, Mullen, Michael, Kennon, Simon, Jerrum, Melanie, Chandrala, Pavan, Roberts, David H., Tay, Justin, Doshi, Sagar N., Ludman, Peter F., Fairbairn, Timothy A., Crowe, Joanne, Levy, Richard D., Banning, Adrian P., Ruparelia, Neil, Spence, Mark S., and Hildick-Smith, David

Published
2019
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22. Long‐term durability of self‐expanding and balloon‐expandable transcatheter aortic valve prostheses: UK TAVI registry.

Author

Ali, Noman, Hildick‐Smith, David, Parker, Jessica, Malkin, Christopher J., Cunnington, Michael S., Gurung, Shuslim, Mailey, Jonathan, MacCarthy, Philip A., Bharucha, Apurva, Brecker, Stephen J., Hoole, Stephen P., Dorman, Stephen, Doshi, Sagar N., Wiper, Andrew, Buch, Mamta H., Banning, Adrian P., Spence, Mark S., and Blackman, Daniel J.

Published
2023
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24. Changing trends in the incidence, management and outcomes of coronary artery perforation over an 11-year period: single-centre experience

Author

Umar, Hamza, primary, Sharma, Harish, additional, Osheiba, Mohammed, additional, Roy, Ashwin, additional, Ludman, Peter F, additional, Townend, Jonathan N, additional, Nadir, M Adnan, additional, Doshi, Sagar N, additional, George, Sudhakar, additional, Zaphiriou, Alex, additional, and Khan, Sohail Q, additional

Published
2022
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26. A Longitudinal Study of Mitral Regurgitation Detected after Acute Myocardial Infarction

Author

Sharma, Harish, primary, Yuan, Mengshi, additional, Shakeel, Iqra, additional, Hodson, James, additional, Radhakrishnan, Ashwin, additional, Brown, Samuel, additional, May, John, additional, O’Connor, Kieran, additional, Zia, Nawal, additional, Doshi, Sagar N., additional, Hothi, Sandeep S., additional, Townend, Jonathan N., additional, Myerson, Saul G., additional, Ludman, Peter F., additional, Steeds, Richard P., additional, and Nadir, M. Adnan, additional

Published
2022
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28. The characteristics of mitral regurgitation: Data from patients admitted following acute myocardial infarction

Author

Sharma, Harish, primary, Radhakrishnan, Ashwin, additional, Nightingale, Peter, additional, Brown, Samuel, additional, May, John, additional, O'Connor, Kieran, additional, Shakeel, Iqra, additional, Zia, Nawal, additional, Doshi, Sagar N., additional, Townend, Jonathan N., additional, Myerson, Saul G., additional, Kirchhof, Paulus, additional, Ludman, Peter F., additional, Adnan Nadir, M., additional, and Steeds, Richard P., additional

Published
2021
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31. ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic VAlve implantaTION): A Randomized Clinical Trial

Author

Patterson, Tiffany, Clayton, Tim, Dodd, Matthew, Khawaja, Zeeshan, Morice, Marie Claude, Wilson, Karen, Kim, Won-Keun, Meneveau, Nicolas, Hambrecht, Rainer, Byrne, Jonathan, Carrié, Didier, Fraser, Doug, Roberts, David H, Doshi, Sagar N, Zaman, Azfar, Banning, Adrian P, Eltchaninoff, Hélène, Le Breton, Hervé, Smith, David, Cox, Ian, Frank, Derk, Gershlick, Anthony, de Belder, Mark, Thomas, Martyn, Hildick-Smith, David, Prendergast, Bernard, Redwood, Simon, and ACTIVATION Trial Investigators

Subjects
Transcatheter Aortic Valve Replacement, Canada, surgical procedures, operative, Percutaneous Coronary Intervention, Treatment Outcome, Humans, cardiovascular diseases, Aortic Valve Stenosis
Abstract

OBJECTIVES: This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm). BACKGROUND: PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice. METHODS: Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR. The primary endpoint was a composite of all-cause death or rehospitalization at 1 year. Noninferiority testing (prespecified margin of 7.5%) was performed in the intention-to-treat population. RESULTS: At 17 centers, 235 patients underwent randomization. At 1 year, the primary composite endpoint occurred in 48 (41.5%) of the PCI arm and 47 (44.0%) of the no-PCI arm. The requirement for noninferiority was not met (difference: -2.5%; 1-sided upper 95% confidence limit: 8.5%; 1-sided noninferiority test P = 0.067). On analysis of the as-treated population, the difference was -3.7% (1-sided upper 95% confidence limit: 7.5%; P = 0.050). Mortality was 16 (13.4%) in the PCI arm and 14 (12.1%) in the no-PCI arm. At 1 year, there was no evidence of a difference in the rates of stroke, myocardial infarction, or acute kidney injury, with higher rates of any bleed in the PCI arm (P = 0.021). CONCLUSIONS: Observed rates of death and rehospitalization at 1 year were similar between PCI and no PCI prior to TAVR; however, the noninferiority margin was not met, and PCI resulted in a higher incidence of bleeding. (Assessing the Effects of Stenting in Significant Coronary Artery Disease Prior to Transcatheter Aortic Valve Implantation; ISRCTN75836930).

Published
2021

35. Early Acurate Neo transcatheter heart valve degeneration in a haemodialysis patient successfully managed with Sapien 3 Ultra: a case report.

Author

Savvoulidis, Panagiotis, Nadir, Adnan, Ludman, Peter F, and Doshi, Sagar N

Subjects
HEART valves, HEART valve prosthesis implantation, BIOPROSTHETIC heart valves, AORTIC stenosis, AORTIC valve diseases, CHEST pain, MUCOCUTANEOUS lymph node syndrome
Abstract

Background Aortic valve disease is the most prevalent valvular abnormality in the developed world and carries a high risk of morbidity and mortality. Transcatheter aortic valve replacement (TAVR) is favoured over open-heart surgery in high-risk patient categories and is increasingly used in lower-risk groups. End stage kidney disease (ESKD) is associated with premature calcific degeneration of bioprosthetic heart valves. Redo-TAVR requires meticulous pre-procedural planning to avoid the important risks of sinus sequestration and impaired coronary access. Transcatheter aortic valve replacement with the Acurate Neo transcatheter heart valve (THV) has been clinically available for a short time only and there are limited reports describing redo-TAVR in the Acurate Neo. Case summary We present a case of early, rapid onset, structural valve degeneration in a Acurate Neo, supra-annular, self-expanding THV in a dialysis patient. The patient presented with chest pain and breathlessness 4 years after TAVR with a Acurate Neo for severe stenosis of a bicuspid aortic valve. Echocardiogram now showed severe stenosis of the THV and computed tomography revealed severe THV leaflet calcification but no pannus or leaflet thrombus. After careful pre-procedural planning a S3 Ultra balloon-expandable valve was selected and positioned relatively high to pin the first THV leaflets in a fully open position without compromising coronary artery flow or coronary access. Discussion End stage kidney disease may cause rapid, calcific degeneration of TAVR valves leading to presentation with severe aortic stenosis. Redo-TAVR in the Acurate Neo THV with a Sapien 3 Ultra is feasible with careful pre-procedural planning to mitigate the risks of sinus sequestration and impaired coronary access. [ABSTRACT FROM AUTHOR]

Published
2022
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36. Contemporary use of excimer laser in percutaneous coronary intervention with indications, procedural characteristics, complications and outcomes in a university teaching hospital

Author

Jawad-Ul-Qamar, Muhammad, primary, Sharma, Harish, additional, Vetrugno, Vincenzo, additional, Sandhu, Kully, additional, Ludman, Peter F, additional, Doshi, Sagar N, additional, Townend, Jonathan N, additional, Osheiba, Mohammed, additional, Zaphiriou, Alex, additional, and Khan, Sohail Q, additional

Published
2021
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42. In-hospital and thirty-day outcomes of the SAPIEN 3 Ultra balloon-expandable transcatheter aortic valve: the S3U registry

Author

Saia, Francesco, primary, Gandolfo, Caterina, additional, Palmerini, Tullio, additional, Berti, Sergio, additional, Doshi, Sagar N., additional, Laine, Mika, additional, Marcelli, Chiara, additional, Piva, Tommaso, additional, Ribichini, Flavio, additional, De Benedictis, Mauro, additional, Cardaioli, Francesco, additional, Cannata, Stefano, additional, and Tarantini, Giuseppe, additional

Published
2020
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49. Relative Survival After Transcatheter Aortic Valve Implantation:How Do Patients Undergoing Transcatheter Aortic Valve Implantation Fare Relative to the General Population?

Author

Martin, Glen P., Sperrin, Matthew, Hulme, William, Ludman, Peter F., de Belder, Mark A., Toff, William D., Alabas, Oras, Moat, Neil E., Doshi, Sagar N., Buchan, Iain, Deanfield, John E., Gale, Chris P., and Mamas, Mamas A.

Subjects
Transcatheter aortic valve implantation, Aortic stenosis, Mortality, Cardiology and Cardiovascular Medicine, Relative survival
Abstract

Background-Transcatheter aortic valve implantation (TAVI) is indicated for patients with aortic stenosis who are intermediatehigh surgical risk. Although all-cause mortality rates after TAVI are established, survival attributable to the procedure is unclear because of competing causes of mortality. The aim was to report relative survival (RS) after TAVI, which accounts for background mortality risks in a matched general population. Methods and Results-National cohort data (n=6420) from the 2007 to 2014 UK TAVI registry were matched by age, sex, and year to mortality rates for England and Wales (population, 57.9 million). The Ederer II method related observed patient survival to that expected from the matched general population. We modelled RS using a flexible parametric approach that modelled the log cumulative hazard using restricted cubic splines. RS of the TAVI cohort was 95.4%, 90.2%, and 83.8% at 30 days, 1 year, and 3 years, respectively. By 1-year follow-up, mortality hazards in the >85 years age group were not significantly different from those of the matched general population; by 3 years, survival rates were comparable. The flexible parametric RS model indicated that increasing age was associated with significantly lower excess hazards after the procedure; for example, by 2 years, a 5-year increase in age was associated with 20% lower excess mortality over the general population. Conclusions-RS after TAVI was high, and survival rates in those aged >85 years approximated those of a matched general population within 3 years. High rates of RS indicate that patients selected for TAVI tolerate the risks of the procedure well.

Published
2017

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