Hybrid Approach for Conventionally Inoperable Patients with Severe Aortic Valve Stenosis and Coronary Artery Disease

2015 ◽  
Vol 63 (S 01) ◽  
Author(s):  
S. Schleger ◽  
M. Lieber ◽  
J. Rieber ◽  
W. Eichinger ◽  
J. Szolnoky
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Hybrid Approach ◽  
Artery Disease

Use and outcomes of emergency treatment strategies in patients with aortic valve stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S.M Piepenburg ◽  
K Kaier ◽  
C Olivier ◽  
M Zehender ◽  
C Bode ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Hospital Mortality ◽  
Valve Replacement ◽  
Aortic Valve Stenosis ◽  
Emergency Treatment ◽  
Funding Source ◽  
Artery Disease

Abstract Introduction and aim Current emergency treatment options for severe aortic valve stenosis include surgical aortic valve replacement (SAVR), transcatheter aortic valve replacement (TAVR) and balloon valvuloplasty (BV). So far no larger patient population has been evaluated regarding clinical characteristics and outcomes. Therefore we aimed to describe the use and outcome of the three therapy options in a broad registry study. Method and results Using German nationwide electronic health records, we evaluated emergency admissions of symptomatic patients with severe aortic valve stenosis between 2014 and 2017. Patients were grouped according to SAVR, TAVR or BV only treatments. Primary outcome was in-hospital mortality. Secondary outcomes were stroke, acute kidney injury, periprocedural pacemaker implantation, delirium and prolonged mechanical ventilation >48 hours. Stepwise multivariable logistic regression analyses including baseline characteristics were performed to assess outcome risks. 8,651 patients with emergency admission for severe aortic valve stenosis were identified. The median age was 79 years and comorbidities included NYHA classes III-IV (52%), coronary artery disease (50%), atrial fibrillation (41%) and diabetes mellitus (33%). Overall in-hospital mortality was 6.2% during a mean length of stay of 22±15 days. TAVR was the most common treatment (6,357 [73.5%]), followed by SAVR (1,557 [18%]) and BV (737 8.5%]). Patients who were treated with TAVR or BV were significantly older than patients with SAVR (mean age 81.3±6.5 and 81.2±6.9 versus 67.2±11.0 years, p<0.001), had more relevant comorbidities (coronary artery disease 52–91% vs. 21.8%; p<0.001), worse NYHA classes III-IV (55–65% vs. 34.5%; p<0.001) and higher EuroSCORES (24.6±14.3 and 23.4±13.9 vs. 9.5±7.6; p<0.001) than SAVR patients. Patients treated with BV only had the highest in-hospital mortality compared with TAVR or SAVR (20.9% vs. 5.1 and 3.5%; p<0.001). Compared with BV only, SAVR patients (adjusted odds ratio [aOR] 0.25; 95% confidence interval [CI] 0.14–0.46; p<0.001) and TAVR patients (aOR 0.37; 95% CI 0.28–0.50; p<0.001) had a lower risk for in-hospital mortality. Conclusion In-hospital mortality for emergency patients with symptomatic severe aortic valve stenosis is high. Our results showed that BV only therapy was associated with highest mortality, which is in line with current research. Yet, there is a trend towards more TAVR interventions and this study might imply that balloon valvuloplasty alone is insufficient. The role of BV as a bridging strategy to TAVR or SAVR needs to be further investigated. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): Heart Center Freiburg University, Department of Cardiology and Angiology I, Faculty of Medicine, University of Freiburg, Freiburg, Germany

Relation of angina pectoris to coronary artery disease in aortic valve stenosis

1985 ◽  
Vol 55 (8) ◽  
pp. 1063-1065 ◽  
Author(s):  
Stephen J. Green ◽  
Roy A. Pizzarello ◽  
Vellore T. Padmanabhan ◽  
Lawrence Y. Ong ◽  
Michael H. Hall ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Artery Disease

scholarly journals Coronary Artery Disease Affects Symptomatology of Aortic Valve Stenosis

2017 ◽  
Vol 70 (8) ◽  
pp. 1103-1104 ◽  
Author(s):  
S. Matthijs Boekholdt ◽  
Benoit J. Arsenault ◽  
Patrick Mathieu
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Artery Disease

scholarly journals Role of inflammation, autotaxin and lipoprotein (a) in degenerative aortic valve stenosis in patients with coronary artery disease

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
A. L. Burdeynaya ◽  
O. I. Afanasyeva ◽  
E. A. Klesareva ◽  
N. A. Tmoyan ◽  
O. A. Razova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Control Group ◽  
Lymphocyte Ratio ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim. To study the relationship between the concentration of lipoprotein (a) (Lp (a)) and autotaxin (ATX) in patients with and without degenerative aortic valve stenosis (AoS) in the presence of coronary artery disease (CAD).Material and methods. The study included 461 patients (mean age, 66±11 years, men, 323), 354 of whom had CAD with stenosis ≥50% in at least one coronary artery according to angiography. Degenerative AoS was diagnosed with ultrasound. The control group consisted of 107 patients without CAD and degenerative AoS. Concentrations of Lp (a), ATX, lipids and blood cells were measured for all patients.Results. CAD without degenerative AoS (group 1) was diagnosed in 307 patients, while 47 patients had CAD and degenerative AoS (group 2). Patients in both groups were older than patients in the control group (66±10, 74±8, and 61±13 years, respectively). The ATX level was lower in group 1 (median [25; 75%]: 495 [406; 583] ng/ml) than in the control group (545 [412; 654] ng/ml) or group 2 (545 [476; 605] ng/ml) (p<0,05 for all). Lp (a) was lower in the control group (14,5 [5,5; 36,0] mg/dl) than in group 1 (24,9 [9,7; 58,4] mg/dl) (p<0,005) and group 2 (23,8 [9,9; 75,7] mg/dL) (p<0,05). According to the logistic regression, an increased ATX level, regardless of age and other risk factors, was associated with degenerative AoS only in patients with CAD, while age and neutrophil to lymphocyte ratio were associated with the development of degenerative AoS both in patients with CAD and the general group.Conclusion. An elevated Lp (a) level is associated with CAD regardless of the aortic valve involvement, while an increased concentration of ATX and neutrophil to lymphocyte ratio in patients with CAD were associated with degenerative AoS regardless of age and other risk factors.

scholarly journals Effects of the coronary artery disease associated LPA and 9p21 loci on risk of aortic valve stenosis

2019 ◽  
Vol 276 ◽  
pp. 212-217 ◽  
Author(s):  
Teresa Trenkwalder ◽  
Christopher P. Nelson ◽  
Muntaser D. Musameh ◽  
Ify R. Mordi ◽  
Thorsten Kessler ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Valve ◽  
Aortic Valve Stenosis ◽  
Artery Disease
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