Journal ArticleDOI
Transcatheter Aortic Valve Replacement with a Self-Expanding Prosthesis
David H. Adams,Jeffrey J. Popma,Michael J. Reardon,Steven J. Yakubov,Joseph S. Coselli,G. Michael Deeb,Thomas G. Gleason,Maurice Buchbinder,James B. Hermiller,Neal S. Kleiman,Stan Chetcuti,John Heiser,William Merhi,George L. Zorn,Peter Tadros,Newell Robinson,George Petrossian,G. Chad Hughes,J. Kevin Harrison,John V. Conte,Brijeshwar Maini,Mubashir Mumtaz,Sharla Chenoweth,Jae K. Oh +23 more
TLDR
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.)read more
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
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)
Journal ArticleDOI
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer +20 more
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.
Journal ArticleDOI
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer +20 more
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)
Journal ArticleDOI
Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Salim S. Virani,Alvaro Alonso,Emelia J. Benjamin,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Christina M. Shay,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Lisa B. VanWagner,Connie W. Tsao +40 more
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.
Journal ArticleDOI
2017 ESC/EACTS Guidelines for the management of valvular heart disease
Helmut Baumgartner,Volkmar Falk,Jeroen J. Bax,Michele De Bonis,Christian W. Hamm,Per Johan Holm,Bernard Iung,Patrizio Lancellotti,Emmanuel Lansac,Daniel Rodriguez Muñoz,Raphael Rosenhek,Johan Sjögren,Pilar Tornos Mas,Alec Vahanian,Thomas Walther,Olaf Wendler,Stephan Windecker,José Luis Zamorano +17 more
References
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ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease
Robert O. Bonow,Blase A. Carabello,Kanu Chatterjee,Antonio C. de Leon,David P. Faxon,Michael D. Freed,William H. Gaasch,Bruce W. Lytle,Rick A. Nishimura,Patrick T. O'Gara,Robert A. O'Rourke,Catherine M Otto,Pravin M. Shah,Jack S. Shanewise +13 more
TL;DR: It is important that the medical profession play a significant role in critically evaluating the use of diagnostic procedures and therapies as they are introduced in the detection, management, and management of diseases.
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Transcatheter Aortic-Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery
Martin B. Leon,Craig R. Smith,Michael J. Mack,D. Craig Miller,Jeffrey W. Moses,Lars G. Svensson,E. Murat Tuzcu,John G. Webb,Gregory P. Fontana,Raj Makkar,David L. Brown,Peter C. Block,Robert A. Guyton,Augusto D. Pichard,Joseph E. Bavaria,Howard C. Herrmann,Pamela S. Douglas,John L. Petersen,Jodi J. Akin,William N. Anderson,Duolao Wang,Stuart J. Pocock +21 more
TL;DR: In patients with severe aortic stenosis who were not suitable candidates for surgery, TAVI, as compared with standard therapy, significantly reduced the rates of death from any cause, the composite end point of deathFrom any cause or repeat hospitalization, and cardiac symptoms, despite the higher incidence of major strokes and major vascular events.
Journal ArticleDOI
Transcatheter versus Surgical Aortic-Valve Replacement in High-Risk Patients
Craig R. Smith,Martin B. Leon,Michael J. Mack,D. Craig Miller,Jeffrey W. Moses,Lars G. Svensson,E. Murat Tuzcu,John G. Webb,Gregory P. Fontana,Raj Makkar,Mathew R. Williams,Todd M. Dewey,Samir R. Kapadia,Vasilis Babaliaros,Vinod H. Thourani,Paul J. Corso,Augusto D. Pichard,Joseph E. Bavaria,Howard C. Herrmann,Jodi J. Akin,William N. Anderson,Duolao Wang,Stuart J. Pocock +22 more
TL;DR: In high-risk patients with severe aortic stenosis, transcatheter and surgical procedures for aorti-valve replacement were associated with similar rates of survival at 1 year, although there were important differences in periprocedural risks.
Journal ArticleDOI
Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis
TL;DR: Nonsurgical implantation of a prosthetic heart valve can be successfully achieved with immediate and midterm hemodynamic and clinical improvement, and PHV might become an important therapeutic alternative for the treatment of selected patients with nonsurgical aortic stenosis.
Journal ArticleDOI
Transcatheter Versus Surgical Aortic-Valve Replacement in High-Risk Patients
Craig R. Smith,Martin B. Leon,Michael J. Mack,D. Craig Miller,Jeffrey W. Moses,Lars G. Svensson,E. Murat Tuzcu,John G. Webb,Gregory P. Fontana,Raj Makkar,Mathew William,Todd M. Dewey,Samir R. Kapadia,Vasilis Babaliaros,Vinod H. Thourani,Paul J. Corso,Augusto D. Pichard,Joseph E. Bavaria,Howard C. Herrmann,Jodi J. Akin,William N. Anderson,Duolao Wang,Stuart J. Pocock +22 more
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