1,721,378 research outputs found

    Minimalist transfemoral transcatheter aortic valve replacement: Make it as simple as possible, but not simpler

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    Transfemoral (TF) transcatheter aortic valve replacement (TAVR) has evolved dramatically. Improvements in technique, devices, operator's experience, and patient selection have resulted in markedly lower rates of procedural complications, thus allowing further technical simplification at every step of the procedure. Implementing a minimalist approach for TF TAVR (including transradial secondary access, angio-guidewire-ultrasound guidance for femoral puncture, and left ventricle guidewire pacing) may improve outcomes and reduce complications without compromising patient safety in contemporary clinical practice. Although this simplified approach is applicable for most patients undergoing TF TAVR, careful patient selection remains of paramount importance

    Transcatheter aortic valve replacement without previous conduction disturbances: The importance of preventing iatrogenic pacemaker implantation

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    Transcatheter aortic valve replacement (TAVR) patients given pacemakers operating in mandatory DDD mode had more ventricular pacing, heart failure hospitalization, and mortality compared with AAI-DDD or VVI modes. AV conduction disturbances are often transient after TAVR. Minimizing ventricular pacing where possible avoids the risk of pacemaker-induced cardiomyopathy. Pacemaker specialists should be consulted for any TAVR patient with mild rhythm abnormalities given the high incidence of AV block. Careful stratification of patients with conduction disturbances during TAVR may help identify the patients who will require an early permanent pacemaker implantation strategy

    Treatment of aortic stenosis in patients with chronic liver disease: Another win for transfemoral TAVR?

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    Chronic liver disease is associated with increased operative risk of open-heart surgery. In this study, transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) carried high periprocedural mortality, but transfemoral TAVR appeared to be superior to SAVR in terms of long-term survival. Better risk stratification tools are needed for patients with liver dysfunction to avoid futile TAVR and SAVR procedures
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