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Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) Study Does pulsed field ablation regress over time? A quantitative temporal analysis of pulmonary vein isolation Single direct oral anticoagulant therapy in stable patients with atrial fibrillation beyond 1 year after coronary stent implantation Management and outcomes of patients with left atrial appendage thrombus prior to percutaneous closure 2015 ACC/HRS/SCAI Left Atrial Appendage Occlusion Device Societal Overview Transseptal puncture versus patent foramen ovale or atrial septal defect access for left atrial appendage closure Alcohol consumption, cardiac biomarkers, and risk of atrial fibrillation and adverse outcomes Detection of Device-Related Thrombosis Following Left Atrial Appendage Occlusion A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography​: A Comparison Between Cardiac Computed Tomography and Transesophageal Echocardiography Frailty and Clinical Outcomes of Direct Oral Anticoagulants Versus Warfarin in Older Adults With Atrial Fibrillation: A Cohort Study Gut microbiota dysbiosis promotes age-related atrial fibrillation by lipopolysaccharide and glucose-induced activation of NLRP3-inflammasome
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Review ArticleVolume 13, Issue 13, July 2020

JOURNAL:JACC Cardiovasc Interv. Article Link

Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease

F Khan, T Okuno, D Malebranche et al. Keywords: aortic regurgitation; mitral regurgitation; mitral stenosist; TAVR; tricuspid regurgitation

ABSTRACT

As transcatheter aortic valve replacement becomes a more dominant treatment option across all risk profiles, the frequency of encountering patients with multivalvular disease will increase. Furthermore, percutaneous interventions to treat other valvular lesions are also evolving. Understanding the clinical implications and treatment options for a second valvular lesion is becoming increasingly important to guide heart team decisions, and this paper aims to review the evidence around these situations. Diagnosis of multivalvular disease can be challenging because of changes in physiology. There are little randomized data to guide therapy in multivalvular disease. Multidisciplinary heart team decisions can be invaluable in integrating the plethora of clinical, hemodynamic, and imaging data on which an optimal management strategy can be planned. Prospective studies to assess the role of structural valve interventions in the transcatheter aortic valve replacement era would greatly help improve outcomes for structural heart patients.