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Transcatheter Aortic Valve Replacement

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A prospective, randomised trial of transapical transcatheter aortic valve implantation vs. surgical aortic valve replacement in operable elderly patients with aortic stenosis: the STACCATO trial Risk of Coronary Obstruction and Feasibility of Coronary Access After Repeat Transcatheter Aortic Valve Replacement With the Self-Expanding Evolut Valve: A Computed Tomography Simulation Study Comparison of Safety and Periprocedural Complications of Transfemoral Aortic Valve Replacement Under Local Anaesthesia: Minimalist Versus Complete Heart Team Left Ventricular Rapid Pacing Via the Valve Delivery Guidewire in Transcatheter Aortic Valve Implantation Short Length of Stay After Elective Transfemoral Transcatheter Aortic Valve Replacement Is Not Associated With Increased Early or Late Readmission Risk Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Timing of intervention in asymptomatic patients with valvular heart disease Transcatheter and surgical aortic valve replacement in patients with bicuspid aortic valve Early Versus Standard Discharge After Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort
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Editorial2020 Apr 6;S0828-282X(20)30316-0.

JOURNAL：Can J Cardiol. Article Link

Precision Medicine in TAVR: How to Select the Right Device for the Right Patient

G Marquis-Gravel, S Vemulapalli, AW Asgar et al. Keywords: patient selection; TAVR

ABSTRACT

Transcatheter aortic valve replacement (TAVR) represents a first-line option for the treatment of patients with severe symptomatic aortic stenosis across the entire spectrum of surgical risks. Given the expected growth of TAVR procedures in low-risk patients, many factors other than the primary endpoints of pivotal TAVR trials (either death, or the composite of death or stroke) need to be considered during the selection of a treatment strategy. Such factors include the risk of procedural complications (permanent pacemaker implantation, stroke, new-onset atrial fibrillation, vascular complications, etc), device hemodynamic performance and durability (paravalvular leak [PVL], reinterventions), indication for antithrombotic therapy, and patient quality of life. The pivotal TAVR trials have indicated that some complications with TAVR vs surgical aortic valve replacement (SAVR) vary according to the device under study. For example, rates of permanent pacemaker implantation were higher with TAVR vs SAVR in trials evaluating self-expanding valves, but not in the those evaluating balloon-expandable valves. TAVR represents a suitable option for all risk groups, but how do we personalise care and select the most appropriate device for our patients?
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