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Expert Review of Cardiovascular Therapy Volume 13, 2015 - Issue 12
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Reviews

Optimizing clinical outcomes of transcatheter aortic valve implantation patients with comorbidities

Crochan J O’SullivanDepartment of Cardiology, Stadtspital Triemli, Zürich, Switzerland
&
Peter WenaweserDepartment of Cardiology, Bern University Hospital, Bern, SwitzerlandCorrespondence[email protected]
Pages 1419-1432 | Published online: 19 Oct 2015

References

  • Papers of special note have been highlighted as:
  • • of interest
  • Andersen HR, Knudsen LL, Hasenkam JM. Transluminal implantation of artificial heart valves. Description of a new expandable aortic valve and initial results with implantation by catheter technique in closed chest pigs. Eur Heart J. 1992;13:704–708.

• The first paper to describe the feasibility of percutaneous aortic valve implantation in a swine model.

  • Cribier A, Eltchaninoff H, Bash A, et al. Percutaneous transcatheter implantation of an aortic valve prosthesis for calcific aortic stenosis: first human case description. Circulation. 2002;106:3006–3008.

• The first-in-man transcatheter aortic valve implantation (TAVI) was performed in an antegrade fashion using a transseptal puncture. This article describes the first ever experience of TAVI in man.

  • O’Sullivan CJ, Stortecky S, et al. Preinterventional screening of the TAVI patient: how to choose the suitable patient and the best procedure. Clin Res Cardiol. 2014;103:259–274.
  • Stefanini GG, Stortecky S, Cao D, et al. Coronary artery disease severity and aortic stenosis: clinical outcomes according to SYNTAX score in patients undergoing transcatheter aortic valve implantation. Eur Heart J. 2014;35:2530–2540.

• This study assesses the impact of coronary artery disease severity as assessed using the SYNTAX score on clinical outcomes after transcatheter aortic valve implantation.

  • O’Sullivan CJ, Stefanini GG, Stortecky S, et al. Coronary revascularization and TAVI: before, during, after or never? Minerva Med. 2014;105:475–485.
  • Stortecky S, Buellesfeld L, Wenaweser P, et al. Atrial fibrillation and aortic stenosis: impact on clinical outcomes among patients undergoing transcatheter aortic valve implantation. Circ Cardiovasc Interv. 2013;6:77–84.
  • Amat-Santos IJ, Rodés-Cabau J, Urena M, et al. Incidence, predictive factors, and prognostic value of new-onset atrial fibrillation following transcatheter aortic valve implantation. J Am Coll Cardiol. 2012;59:178–188.
  • Urena M, Hayek S, Cheema AN, et al. Arrhythmia burden in elderly patients with severe aortic stenosis as determined by continuous electrocardiographic recording: toward a better understanding of arrhythmic events after transcatheter aortic valve replacement. Circulation. 2015;131:469–477.
  • Allende R, Webb JG, Munoz-Garcia J, et al. Advanced chronic kidney disease in patients undergoing transcatheter aortic valve implantation: insights on clinical outcomes and prognostic markers from a large cohort of patients. Eur Heart J. 2014;35:2685–2696.
  • Oguri A, Yamamoto M, Mouillet G, et al. Impact of chronic kidney disease on the outcomes of transcatheter aortic valve implantation: results from the France 2 registry. EuroIntervention. 2015;10:e1–e9.
  • Yamamoto M, Hayashida K, Mouillet G, et al. Prognostic value of chronic kidney disease after transcatheter aortic valve implantation. J Am Coll Cardiol. 2013;62:869–877.
  • Dvir D, Waksman R, Barbash IM, et al. Outcomes of patients with chronic lung disease and severe aortic stenosis treated with transcatheter versus surgical aortic valve replacement or standard therapy: insights from the PARTNER Trial (placement of aortic transcatheter valve). J Am Coll Cardiol. 2014;63:269–279.
  • O’Sullivan CJ, Wenaweser P, Ceylan O, et al. Effect of pulmonary hypertension hemodynamic presentation on clinical outcomes in patients with severe symptomatic aortic valve stenosis undergoing transcatheter aortic valve implantation: insights from the new proposed pulmonary hypertension classification. Circ Cardiovasc Interv. 2015;8:e002358.

• The first study to assess the impact of pulmonary hypertension hemodynamic presentation on clinical outcomes after transcatheter aortic valve implantation using invasive hemodynamic characteristics.

  • Sinning JM, Hammerstingl C, Chin D, et al. Decrease of pulmonary hypertension impacts on prognosis after transcatheter aortic valve replacement. EuroIntervention. 2014;9:1042–1049.
  • Lucon A, Oger E, Bedossa M, et al. Prognostic implications of pulmonary hypertension in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation: study from the France 2 registry. Circ Cardiovasc Interv. 2014;7:240–247.
  • Ben-Dor I, Goldstein SA, Pichard AD, et al. Clinical profile, prognostic implication, and response to treatment of pulmonary hypertension in patients with severe aortic stenosis. Am J Cardiol. 2011;107:1046–1051.
  • Nombela-Franco L, Ribeiro HB, Urena M, et al. Significant mitral regurgitation left untreated at the time of aortic valve replacement: a comprehensive review of a frequent entity in the transcatheter aortic valve replacement era. J Am Coll Cardiol. 2014;63:2643–2658.

• Excellent comprehensive review about the effect of moderate or severe mitral regurgitation on clinical outcomes after either transcatheter aortic valve implantation or surgical aortic valve replacement.

  • Nombela-Franco L, Eltchaninoff H, Zahn R, et al. Clinical impact and evolution of mitral regurgitation following transcatheter aortic valve replacement: a meta-analysis. Heart. 2015. DOI:10.1136/heartjnl-2014-307120.
  • Chakravarty T, Van Belle E, Jilaihawi H, et al. Meta-analysis of the impact of mitral regurgitation on outcomes after transcatheter aortic valve implantation. Am J Cardiol. 2015;115:942–949.
  • Barbanti M, Webb JG, Hahn RT, et al. Impact of preoperative moderate/severe mitral regurgitation on 2-year outcome after transcatheter and surgical aortic valve replacement: insight from the placement of aortic transcatheter valve (PARTNER) trial cohort A. Circulation. 2013;128:2776–2784.
  • Lindman BR, Maniar HS, Jaber WA, et al. Effect of tricuspid regurgitation and the right heart on survival after transcatheter aortic valve replacement: insights from the placement of aortic transcatheter valves II inoperable cohort. Circ Cardiovasc Interv. 2015;8:e002073.
  • Barbanti M, Binder RK, Dvir D, et al. Prevalence and impact of preoperative moderate/severe tricuspid regurgitation on patients undergoing transcatheter aortic valve replacement. Catheter Cardiovasc Interv. 2015;85:677–684.
  • Kempny A, Diller GP, Kaleschke G, et al. Impact of transcatheter aortic valve implantation or surgical aortic valve replacement on right ventricular function. Heart. 2012;98:1299–1304.
  • Wenaweser P, O’Sullivan CJ. Aortic stenosis and the right heart at risk: is transcatheter aortic valve implantation the better option ? Heart. 2012;98:1265–1266.
  • O’Sullivan CJ, Stortecky S, Heg D, et al. Clinical outcomes of patients with low-flow, low-gradient, severe aortic stenosis and either preserved or reduced ejection fraction undergoing transcatheter aortic valve implantation. Eur Heart J. 2013;34:3437–3450.
  • O’Sullivan CJ, Englberger L, et al. Clinical outcomes and revascularization strategies in patients with low-flow, low-gradient severe aortic valve stenosis according to the assigned treatment modality. J Am Coll Cardiol Intv. 2015;8:704–717.
  • O’Sullivan CJ, Stortecky S, Bütikofer A, et al. Impact of mitral regurgitation on clinical outcomes of patients with low-ejection fraction, low-gradient severe aortic stenosis undergoing transcatheter aortic valve implantation. Circ Cardiovasc Interv. 2015;8:e001895.
  • Herrmann HC, Pibarot P, Hueter I, et al. Predictors of mortality and outcomes of therapy in low-flow severe aortic stenosis: a placement of aortic transcatheter valves (PARTNER) trial analysis. Circulation. 2013;127:2316–2326.
  • Le Ven F, Freeman M, Webb J, et al. Impact of low flow on the outcome of high-risk patients undergoing transcatheter aortic valve replacement. J Am Coll Cardiol. 2013;62:782–788.
  • Le Ven F, Thèbault C, Dahou A, et al. Evolution and prognostic impact of low flow after transcatheter aortic valve replacement. Heart. 2015;101:1196–1203.
  • Amabile N, Agostini H, Gilard M, et al. Impact of low preprocedural transvalvular gradient on cardiovascular mortality following TAVI: an analysis from the France 2 registry. EuroIntervention. 2014;10:842–849.
  • Lauten A, Figulla HR, Möllmann H, et al. TAVI for low-flow, low-gradient severe aortic stenosis with preserved or reduced ejection fraction: a subgroup analysis from the German aortic valve registry (GARY). EuroIntervention. 2014;10:850–859.
  • Binder RK, Rodès-Cabau J, Wood DA, et al. Transcatheter aortic valve replacement with the SAPIEN 3: a new balloon-expandable transcatheter heart valve. J Am Coll Cardiol Intv. 2013;6:293–300.
  • Kodali S Clinical and echocardiographic outcomes at 30 days with the SAPIEN 3 TAVR system in inoperable, high-risk and intermediate-risk AS patients. Oral presentation at the American College of Cardiology Scientific Sessions; 2015 March 15; San Diego.
  • Meredith IT, Walters DL, Dumonteil N, et al. Transcatheter aortic valve replacement for severe symptomatic aortic stenosis using a repositionable valve system: 30-day primary endpoint results from the REPRISE II study. J Am Coll Cardiol. 2014;64:1339–1348.
  • Binder RK, Schäfer U, Kuck KH, et al. Transcatheter aortic valve replacement with a new self-expanding transcatheter heart valve and motorized delivery system. J Am Coll Cardiol Intv. 2013;6:301–307.
  • Urena M, Mok M, Serra V, et al. Predictive factors and long-term clinical consequences of persistent left bundle branch block following transcatheter aortic valve implantation with a balloon-expandable valve. J Am Coll Cardiol. 2012;60:1743–1752.
  • Houthuizen P, Van Garsse LAFM, Poels TT, et al. Left bundle-brance bock induced by transcatheter aortic valve implantation increased risk of death. Circulation. 2012;126:720–728.

• This study assessed the effect of new-onset left bundle branch block (LBBB) on clinical outcomes after transcatheter aortic valve implantation. New-onset LBBB was associated with higher 1-year mortality rates.

  • Testa L, Latib A, De Marco F, et al. Clinical impact of persistent left bundle-branch block after transcatheter aortic valve implantation with CoreValve revalving system. Circulation. 2013;127:1300–1307.
  • Siontis GCM, Jüni P, Pilgrim T, et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: a meta-analysis. J Am Coll Cardiol. 2014;64:129–140.

• Large meta-analysis analyzing the predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation.

  • Urena M, Webb JG, Cheema A, et al. Impact of new-onset persistent left bundle brance block on late clinical outcomes in patients undergoing transcatheter aortic valve implantation with a balloon-expandable valve. J Am Coll Cardiol Intv. 2014;7:128–136.
  • Tarantini G, Mojoli M, Purita P, et al. Unravelling the (arte)fact of increased pacemaker rate with the Edwards SAPIEN 3 valve. EuroIntervention. 2015;11:343–350.
  • van der Boon RMA, Houthuizen P, Nuis RJ, et al. Clinical implications of conduction abnormalities and arrhythmias after transcatheter aortic valve implantation. Curr Cardiol Rep. 2014;16:429.
  • van der Boon RMA, Nuis RJ, Van Mieghem NM, et al. New conduction abnormalities after TAVI – frequency and causes. Nat Rev Cardiol. 2012;9:454–463.

• Excellent review article on the vexing issue about the frequency and causes of new-onset conduction abnormalities after TAVI.

  • Buellesfeld L, Stortecky S, Heg D, et al. Impact of permanent pacemaker implantation on clinical outcome among patients undergoing transcatheter aortic valve implantation. J Am Coll Cardiol. 2012;60:493–501.
  • Vahanian A, Alfieri O, Andreotti F, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33:2451–2496.
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• Comprehensive review of the effect of concomitant coronary artery disease on clinical outcomes after transcatheter aortic valve implantation.

  • Goel SS, Agarwal S, Tuzcu EM, et al. Percutaneous coronary intervention in patients with severe aortic stenosis: implications for transcatheter aortic valve replacement. Circulation. 2012;125:1005–1013.
  • Abramowitz Y, Banai S, Katz G, et al. Comparison of early and late outcomes of TAVI alone compared to TAVI plus PCI in aortic stenosis patients with and without coronary artery disease. Catheter Cardiovasc Interv. 2014;83:649–654.
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  • Griese DP, Reents W, Toth A, et al. Concomitant coronary intervention is associated with poorer early and late clinical outcomes in selected elderly patients receiving transcatheter aortic valve implantation. Eur J Cardio-thoracic Surg. 2014;46:1–7.
  • Abdel-Wahab M, Mostafa AE, Geist V, et al. Comparison of outcomes in patients having isolated transcatheter aortic valve implantation versus combined with preprocedural percutaneous coronary intervention. Am J Cardiol. 2012;109:581–586.
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  • Gasparetto V, Fraccaro C, Tarantini G, et al. Safety and effectiveness of a selective strategy for coronary artery revascularization before transcatheter aortic valve implantation. Catheter Cadriovasc Interv. 2013;81:376–383.
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  • Aregger F, Wenaweser P, Hellige GJ, et al. Risk of acute kidney injury in patients with severe aortic stenosis undergoing transcatheter valve replacement. Nephrol Dial Transplant. 2009;24:2175–2179.
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  • O’Sullivan CJ, Praz F, Stortecky S, et al. Assessment of low-flow, low-gradient, severe aortic stenosis: an invasive evaluation is required for decision making. EuroIntervention. 2014;10(Suppl U):U61–U68.
  • O’Sullivan CJ, Wenaweser P, Reclassification of low-gradient aortic stenosis severity in patients with preserved ejection fraction: when is severe truly severe? Eur Heart J. 2015;36:2039–2041.
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  • Abdel-Wahab M, Mehilli J, Frerker C, et al. Comparison of balloon-expandable vs self-expandable valves in patients undergoing transcatheter aortic valve replacement: the CHOICE randomized clinical trial. JAMA. 2014;311:1503–1514.
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  • Jilaihawi H, Kashif M, Fontana G, et al. Cross-sectional computed tomographic assessment improves accuracy of aortic annular sizing for transcatheter aortic valve replacement and reduces the incidence of paravalvular aortic regurgitation. J Am Coll Cardiol. 2012;14:1275–1286.

• This is an important article demonstrating that three dimensional assessment of the aortic valve annulus using computed tomography is essential for proper sizing and leads to a reduction in the incidence of paravalvular aortic regurgitation.

  • Jilaihawi H, Doctor N, Kashif M, et al. Aortic annular sizing for transcatheter aortic valve replacement using cross-sectional 3-dimensional transesophageal echocardiography. J Am Coll Cardiol. 2013;61:908–916.
  • Piazza N, Martucci G, Lachapelle K, et al. First-in-human experience with the Medtronic CoreValve Evolut R. EuroIntervention. 2014;9:1260–1263.
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  • Gilard M, Eltchaninoff H, Lung B, et al. Registry of transcatheter aortic-valve implantation in high-risk patients. N Engl J Med. 2012;366:1705–1715.
  • Blackstone EH, Suri RM, Rajeswaran J, et al. Propensity-matched comparisons of clinical outcomes after transapical or transfemoral transcatheter aortic valve replacement: a placement of aortic transcatheter valves (PARTNER)-I trial substudy. Circulation. 2015;131:1989–2000.
  • Huber C, Praz C, O’Sullivan CJ, et al. Transcarotid aortic valve-in-valve implantation for degenerated stentless aortic root conduits with severe regurgitation: a case series. Interact Cardiovasc Thorac Surg. 2015;20:694–700.
  • Oguri A, Yamamoto M, Mouillet G, et al. Clinical outcomes and safety of transfemoral aortic valve implantation under general versus local anesthesia: subanalysis of the French Aortic National CoreValve and Edwards 2 Registry. Circ Cardiovasc Interv. 2014;7:602–610.
  • Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364:2187–2198.
  • Cardialysis. [cited 2015 Jul 27]. Available from: http://www.cardialysis.com/galileo/
  • Naber CK, Ghanem A, Abizaid AA, et al. First-in-man use of a novel embolic protection device for patients undergoing transcatheter aortic valve implantation. EuroIntervention. 2012;8:43–50.
  • Mylotte D, Lefevre T, Sondergaard L, et al. Transcatheter aortic valve replacement in bicuspid aortic valve disease. J Am Coll Cardiol. 2014;64:2330–2339.

• This is the largest multicenter collection to date of data analyzing the clinical outcomes of patients with bicuspid aortic valves undergoing transcatheter aortic valve implantation.

  • Khawaja MZ, Wang D, Pocock S, et al. The percutaneous coronary intervention prior to transcatheter aortic valve implantation (ACTIVATION) trial: study protocol for a randomized controlled trial. Trials. 2014;15:300.
  • Leon MB, Smith CR, Mack M, et al. Transcatheter aortic valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–1607.

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