Current Trends and Outcomes for Infective Endocarditis.
New York; Heart Valve Prosthesis; California; Antibiotic Prophylaxis; Endocarditis; Hemodialysis; Oral Health; Bacterial – Epidemiology
Using large databases from New York and California, investigators found the overall incidence of infective endocarditis remained stable between 1998 and 2013, and 90-day mortality declined. Changes were noted in pathogen etiology and patient characteristics over time.
Watkins Richard R
Infectious Disease Alert
2017
2017-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Safety and efficacy of transcatheter aortic valve replacement for native aortic valve regurgitation: A systematic review and meta-analysis.
Female; Humans; Male; Aged; Middle Aged; Treatment Outcome; Risk Factors; Aged 80 and over; Risk Assessment; Prosthesis Design; Recovery of Function; Heart Valve Prosthesis; Aortic Valve/diagnostic imaging/physiopathology/surgery; aortic valve insufficiency; heart diseases; heart valve prosthesis; Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality; Aortic Valve Insufficiency/diagnostic imaging/mortality/physiopathology/surgery
OBJECTIVE: The objective of this study was to analyze the available literature on using transcatheter aortic valve replacement (TAVR) for native aortic regurgitation (AR). BACKGROUND: Surgical aortic valve replacement is the gold standard therapy for native AR. TAVR has emerged as an alternative approach in high-risk patients. METHODS: MEDLINE, Scopus, and Cochrane CENTRAL were searched for reports of at least 5 patients undergoing TAVR for native AR. Outcomes included 30-day mortality, myocardial infarction, stroke, major bleeding, postprocedural moderate to severe AR, and device success. Pooled estimates were calculated using a random-effects model. Subgroup analysis and a meta-regression were performed to study the effects of study level covariates on outcomes. RESULTS: Nineteen studies (n =998 patients) were included. The rate of procedural success per Valve Academic Research Consortium - 2 (VARC-2) criteria was 86.2% (78.8%-92.2%]. Thirty-day mortality was 11.9% (9.4%-14.7%). Subgroup analysis showed the use of new generation valves was associated with lower 30-day mortality (P = 0.02) and higher device success (P = 0.009) compared with early generation valves. There was no significant difference (P = 0.13) in the rate of 30-day mortality between patients receiving purpose-specific [8.2% (4.3%-13.1%); I2 = 0%] and nonpurpose specific valves [13.0% (8.2%-18.6%); I2 = 25%]. However, device success was higher (P = 0.02) in patients who received purpose-specific valves [96.3% (92.2%-98.9%); I2 = 0%] compared with nonpurpose specific valves [84.4% (75%-91.9%); I2 =46%]. CONCLUSION: TAVR for native AR is associated with acceptable procedural success but increased early mortality. However, the safety and the efficacy of the procedure increased with newer valves.
Rawasia WF; Khan MS; Usman MS; Siddiqi TJ; Mujeeb FA; Chundrigar M; Kalra A; Alkhouli M; Kavinsky CJ; Bhatt DL
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
2019
2019-02-01
© 2018 Wiley Periodicals, Inc.
journalArticle
<a href="http://doi.org/10.1002/ccd.27840" target="_blank" rel="noreferrer noopener">10.1002/ccd.27840</a>
PMID: 30269437
Vascular complications associated with transcatheter aortic valve replacement.
*bleeding; *transcatheter aortic valve replacement (TAVR); *vascular complications; Aortic Valve Stenosis/diagnosis/physiopathology/*surgery; Aortic Valve/physiopathology/*surgery; Heart Valve Prosthesis; Humans; Incidence; Prosthesis Design; Risk Factors; Severity of Illness Index; Transcatheter Aortic Valve Replacement/*adverse effects/instrumentation; Treatment Outcome; vascular access; Vascular Diseases/diagnostic imaging/*epidemiology/therapy
Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR. Early recognition of these complications and appropriate management is paramount. In this article, we review the most commonly encountered vascular complications associated with currently approved TAVR devices and their optimal percutaneous management techniques.
Sardar M Rizwan; Goldsweig Andrew M; Abbott J Dawn; Sharaf Barry L; Gordon Paul C; Ehsan Afshin; Aronow Herbert D
Vascular medicine (London, England)
2017
2017-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/1358863X17697832" target="_blank" rel="noreferrer noopener">10.1177/1358863X17697832</a>