scholarly journals Optimal Implantation Depth and Adherence to Guidelines on Permanent Pacing to Improve the Results of Transcatheter Aortic Valve Replacement With the Medtronic CoreValve System

2015 ◽  
Vol 8 (6) ◽  
pp. 837-846 ◽  
Author(s):  
Anna S. Petronio ◽  
Jan-Malte Sinning ◽  
Nicolas Van Mieghem ◽  
Giulio Zucchelli ◽  
Georg Nickenig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Adherence To Guidelines ◽  
Transcatheter Aortic Valve ◽  
Permanent Pacing ◽  
Implantation Depth ◽  
Medtronic Corevalve

Abstract 137: Thromboinflammatory Response in Patients Undergoing Transcatheter Aortic Valve Replacement Using the Sapien Xt or CoreValve

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Travis R Sexton ◽  
John Liu ◽  
Susan S Smyth
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Inflammatory Marker ◽  
Platelet Activity ◽  
Platelet Factor ◽  
Beneficial Effects ◽  
Transcatheter Aortic Valve ◽  
Medtronic Corevalve

Transcatheter aortic valve replacement (TAVR) has been increasingly used to treat patients with symptomatic aortic stenosis. Despite the evolution of the valves and their deployment, patients that have undergone TAVR continue to be at high risk for major adverse events following the procedure. We recently reported that TAVR elicits a thromboinflammatory state that may contribute to the observed post-procedural thrombocytopenia associated with worse clinical outcomes. With the approval of the newer generation valves and delivery systems, we have now compared thromboinflammatory responses in patients receiving the Medtronic CoreValve and Edward’s new SAPIEN XT valve. Blood cell numbers, platelet function, and biomarkers of systemic inflammation and thrombosis were analyzed in 34 sequential patients undergoing transcatheteraortic valve replacement with the Edward’s SAPIEN XT valve or the Medtronic CoreValve Following valve deployment, platelet count, platelet activity, and platelet factor 4 levels decreased, while the inflammatory marker interleukin-6 increased. There were no significant differences in any of the parameters between the two valve types. Interestingly, baseline inflammation status predicted the extent of thrombocytopenia observed in overall cohort. A comparions of the SAPIENT XT valve and the Medtronic CoreValve reveals that the new generation valves generate a lower inflammatory response than that observed in the older SAPIEN valce. Importantly, our results add to the growing body of literature that suggests the thromboinflammatory changes that occur early after TAVR may predict long-term outcomes and suggest potential beneficial effects of an anti-inflammatory strategic.

scholarly journals The Latest Evolution of the Medtronic CoreValve System in the Era of Transcatheter Aortic Valve Replacement

2018 ◽  
Vol 11 (22) ◽  
pp. 2314-2322 ◽  
Author(s):  
Katharina Hellhammer ◽  
Kerstin Piayda ◽  
Shazia Afzal ◽  
Laura Kleinebrecht ◽  
Matthias Makosch ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Medtronic Corevalve

Incidence and Predictors of Permanent Pacemaker Implantation in Patients Who Underwent Transcatheter Aortic Valve Replacement: Observation of a Chinese Population

Cardiology ◽  
2019 ◽  
Vol 145 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Fang Du ◽  
Qifeng Zhu ◽  
Jubo Jiang ◽  
Han Chen ◽  
Xianbao Liu ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Chinese Population ◽  
Transcatheter Aortic Valve Replacement ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Multivariable Logistic Regression Analysis ◽  
Transcatheter Aortic Valve ◽  
Implantation Depth

Aims: Permanent pacemaker (PPM) implantation is one of the most common complications after transcatheter aortic valve replacement (TAVR). We studied the incidence of PPM implantation and identified the predictors in patients who underwent TAVR in a Chinese population. Methods and Results: A total of 256 patients who underwent TAVR with self-expandable valves were included. The incidence of PPM implantation in our study population was 14.8%. In patients who received PPM implantation, the proportion of bicuspid aortic valve (BAV) patients was much lower compared to tricuspid aortic valve (TAV) patients (18.4 vs. 81.6%, p < 0.05). Patients with BAV were associated with a significantly lower PPM implantation rate and shallower implantation depth compared to patients with TAV (6.4 vs. 21.7% and 4.2 ± 4.4 vs. 6.2 ± 5.0 mm, respectively, p < 0.05 for both). In the multivariable logistic regression analysis, prior right bundle branch block (RBBB; OR 8.3, 95% CI 2.2–32.1, p < 0.05), implantation depth (OR 1.3, 95% CI 1.1–1.5, p = 0.01), and TAV (OR 4.7, 95% CI 1.5–14.4, p < 0.05) were independent predictors of PPM implantation after TAVR. There was no difference in 30-day and 1-year all-cause mortality between the 2 groups. Conclusions: The incidence of PPM implantation in patients with self-expandable valves after TAVR was 14.8% in our cohort study. Independent predictors of PPM implantation included prior RBBB, TAV, and implantation depth at the noncoronary sinus side. TAVR in BAV with a supra-annular structure-based sizing strategy might decrease the risk of PPM implantation.

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