Author
Stan Chetcuti
Other affiliations: Mount Sinai Health System
Bio: Stan Chetcuti is an academic researcher from University of Michigan. The author has contributed to research in topics: Valve replacement & Aortic valve replacement. The author has an hindex of 9, co-authored 10 publications receiving 3170 citations. Previous affiliations of Stan Chetcuti include Mount Sinai Health System.
Papers
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Icahn School of Medicine at Mount Sinai1, Harvard University2, Houston Methodist Hospital3, Riverside Methodist Hospital4, The Texas Heart Institute5, University of Michigan6, University of Pittsburgh7, United States Department of Veterans Affairs8, Spectrum Health9, University of Kansas10, Saint Francis University11, Duke University12, Johns Hopkins University13, PinnacleHealth System14, Medtronic plc15, Mayo Clinic16
TL;DR: In patients with severe aortic stenosis who are at increased surgical risk, TAVR with a self-expanding transcatheter aorti-valve bioprosthesis was associated with a significantly higher rate of survival at 1 year than surgical aorticsvalve replacement.
Abstract: BACKGROUND We compared transcatheter aortic-valve replacement (TAVR), using a self-expanding transcatheter aortic-valve bioprosthesis, with surgical aortic-valve replacement in patients with severe aortic stenosis and an increased risk of death during surgery. METHODS We recruited patients with severe aortic stenosis who were at increased surgical risk as determined by the heart team at each study center. Risk assessment included the Society of Thoracic Surgeons Predictor Risk of Mortality estimate and consideration of other key risk factors. Eligible patients were randomly assigned in a 1:1 ratio to TAVR with the self-expanding transcatheter valve (TAVR group) or to surgical aortic-valve replacement (surgical group). The primary end point was the rate of death from any cause at 1 year, evaluated with the use of both noninferiority and superiority testing. RESULTS A total of 795 patients underwent randomization at 45 centers in the United States. In the as-treated analysis, the rate of death from any cause at 1 year was significantly lower in the TAVR group than in the surgical group (14.2% vs. 19.1%), with an absolute reduction in risk of 4.9 percentage points (upper boundary of the 95% confidence interval, −0.4; P<0.001 for noninferiority; P = 0.04 for superiority). The results were similar in the intention-to-treat analysis. In a hierarchical testing procedure, TAVR was noninferior with respect to echocardiographic indexes of valve stenosis, functional status, and quality of life. Exploratory analyses suggested a reduction in the rate of major adverse cardiovascular and cerebrovascular events and no increase in the risk of stroke. CONCLUSIONS In patients with severe aortic stenosis who are at increased surgical risk, TAVR with a self-expanding transcatheter aortic-valve bioprosthesis was associated with a significantly higher rate of survival at 1 year than surgical aortic-valve replacement. (Funded by Medtronic; U.S. CoreValve High Risk Study ClinicalTrials.gov number, NCT01240902.)
2,432 citations
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Houston Methodist Hospital1, Mount Sinai Health System2, Riverside Methodist Hospital3, The Texas Heart Institute4, University of Michigan5, University of Pittsburgh6, Spectrum Health7, University of Kansas8, Saint Francis University9, Duke University10, PinnacleHealth System11, Johns Hopkins University12, Kaiser Permanente13, Mayo Clinic14, Medtronic plc15, Harvard University16
TL;DR: In patients with severe aortic stenosis who are at increased surgical risk, the higher rate of survival with a self-expanding TAVR compared with surgery was sustained at 2 years.
369 citations
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University of Michigan1, Houston Methodist Hospital2, Riverside Methodist Hospital3, The Texas Heart Institute4, University of Pittsburgh5, Spectrum Health6, University of Kansas Hospital7, Duke University8, Pinnacle Financial Partners9, Johns Hopkins University10, Kaiser Permanente11, University of Rochester12, Mount Sinai Health System13, Beth Israel Deaconess Medical Center14
TL;DR: Patients with severe aortic stenosis at increased risk for surgery had improved 3-year clinical outcomes after TAVR compared with surgery, and aorti valve hemodynamics were more favorable in TAVr patients without differences in structural valve deterioration.
276 citations
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TL;DR: This study shows similar mid-term survival and stroke rates in high-risk patients following TAVR or SAVR, and suggests that valve reinterventions were uncommon.
254 citations
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TL;DR: It is concluded that this novel self-expandable TAV bioprosthesis is safe and effective for the treatment of patients with severe aortic stenosis who are suboptimal for surgery.
Abstract: Objectives: This study sought to evaluate this transcatheter aortic valve (TAV) bioprosthesis in patients who are poorly suitable for surgical aortic valve (AV) replacement.Background: A no...
154 citations
Cited by
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TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
13,400 citations
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TL;DR: ACCF/AHAIAI: angiotensin-converting enzyme inhibitor as discussed by the authors, angio-catabolizing enzyme inhibitor inhibitor inhibitor (ACS inhibitor) is a drug that is used to prevent atrial fibrillation.
Abstract: ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation
7,489 citations
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TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
Abstract: ACC/AHA
: American College of Cardiology/American Heart Association
ACCF/AHA
: American College of Cardiology Foundation/American Heart Association
ACE
: angiotensin-converting enzyme
ACEI
: angiotensin-converting enzyme inhibitor
ACS
: acute coronary syndrome
AF
: atrial fibrillation
6,757 citations
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TL;DR: This year's edition of the Statistical Update includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals.
Abstract: Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovas...
5,078 citations
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4,790 citations