Navigation Links
TAVI is safe alternative to redo cardiac surgery
Date:9/2/2013

Use of bioprosthetic heart valves has dramatically increased (from 18% in 1991 to 59% in 2003), mainly in older patients with comorbidities. This is due to the increased risk of bleeding complications associated with lifelong use of anticoagulation for mechanical prostheses.

But structural valve deterioration is one the main complications associated with bioprosthetic heart valves. In large registries including more than 300 000 patients undergoing aortic valve replacement the reoperation rate for patients receiving a bioprosthesis was 3.1% at 11-13 years of follow-up compared with 2.3% reoperation rate for recipients of an aortic mechanical prosthesis.1

Dr Katsanos said: "Reoperation for failed bioprostheses, also called redo cardiac surgery, is associated with increased rates of mortality and morbidity. Less invasive treatments have emerged such as transcatheter valve-in-valve implantation, a type of TAVI operation which is a safe therapeutic option for patients with failed bioprostheses and contraindications for surgery. But until now there has not been a direct comparison of survival between high risk patients treated with either reoperation or a TAVI operation."

The current study assessed the prognosis of patients with failed bioprosthetic aortic and mitral valves and high predicted operative risk who underwent transcatheter valve-in-valve intervention with the Edwards Sapien (23 or 26 mm) valve. They were compared with a historical cohort of patients who underwent elective redo cardiac surgery for failing mitral and aortic prostheses and failing mitral valve annuloplasty.

The TAVI group (age 802 years, 25% men) included 12 patients with failing aortic bioprostheses, 2 with failing mitral bioprostheses and 2 with failed mitral valve annuloplasty. The redo cardiac surgery group (age 701 years, 50% men) had 15 patients with failing aortic bioprostheses and 1 with failing mitral bioprostheses. The reason for valve dysfunction was stenosis in 11 patients, regurgitation in 14 patients and mixed pathology in 7 patients. Patients with endocarditis were excluded. Both groups had similar operative risk, New York Heart Association functional class, and left ventricular ejection fraction.

After a median follow up of 21 (range 7-44) months, 10 (30%) patients died. As shown in the figure, 3-year survival did not differ between patients treated with transcatheter valve-in-valve implantation and those treated with redo cardiac surgery (log-rank p=0.939).

Dr Katsanos said: "We have shown for the first time that the long term survival of high risk patients with failing bioprostheses treated with transcatheter valve-in-valve implantation is comparable to high risk patients treated with redo cardiac surgery."

He concluded: "Transcatheter valve-in-valve implantation is a minimally invasive procedure performed through transfemoral or transapical approach under fluoroscopic guidance and does not require sternotomy and cardiopulmonary bypass. Elderly patients deemed not operable and also high risk patients with failing bioprostheses may have a treatment alternative to redo cardiac surgery."


'/>"/>

Contact: Celine Colas
press@escardio.org
44-773-005-7146
European Society of Cardiology
Source:Eurekalert

Related medicine news :

1. Procedure gives patients with A-fib who cant take blood thinners alternative to reduce stroke
2. Study Supports Value of Sigmoidoscopy, an Alternative to Colonoscopy
3. Approval of Safer Alternative to Pradaxa Delayed by FDA
4. Smokers Drop Pricey Cigarettes for Cheaper Alternatives: CDC
5. Alternatives to Medicares fee-for-service payment system examined
6. NHS should replace traditional autopsies with non-invasive alternative
7. Complementary and alternative therapy improved lives of arthritis patients
8. Water Workouts a Great Alternative: Study
9. Controversial Alternative Heart Treatment Shows Hint of Benefit
10. GW researcher receives $4.1 million grant to find alternative treatment for kidney stones
11. Potential new technique for anticancer radiotherapy could provide alternative to brachytherapy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/29/2016)... ... , ... Our bodies are bombarded daily by environmental and lifestyle factors that ... is to adopt a more healthful diet, but too many people think that food ... Nutritionist and the creator of the Newport Beach Cleanse and 14-Day Eating Plan, disagrees ...
(Date:4/29/2016)... ... April 29, 2016 , ... The ... in repaying their loans, more information about their loan terms and accounts, and ... student loan debt, including federal and private loans, has reached $1.3 trillion, with ...
(Date:4/29/2016)... ... 29, 2016 , ... Spine Team Texas, a comprehensive spine physician group specializing ... their physicians has been invited to be a featured speaker at the Texas Society ... on April 30, 2016. , Dr. R. Scott McPherson, a physical medicine and ...
(Date:4/29/2016)... Toronto, ON (PRWEB) , ... April 29, 2016 ... ... GlutenFreeCoupons.ca and the Canadian Celiac Association (CCA), is pleased to announce the launch ... about gluten-free products, nutritional articles, recipes, and more. The purpose of the ...
(Date:4/29/2016)... ... 2016 , ... Reltok Nasal Products proudly announces that Boston Medical Products, Inc., ... and throat specialty, has added the KOTLER NASAL AIRWAY™ to its diverse product line. ... newly patented safety device secured by nasal surgeons onto the floor of the nasal ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... 27, 2016 Global  urinalysis ... billion by 2022, according to a new report ... (Logo: http://photos.prnewswire.com/prnh/20150105/723757 ) , ... efficiency and accuracy delivered by the new generation ... novel urinalysis instruments and consumables. For instance, the ...
(Date:4/27/2016)... , April 27, 2016 ... announced the launch of a Phase 2 clinical study ... hearing in patients undergoing cochlear implantation (CI) surgery. This ... patients in Germany and ... the middle ear at the time of surgery. "Despite ...
(Date:4/26/2016)... 2016 Hill-Rom Holdings, Inc. (NYSE: HRC ... the Deutsche Bank 41 st Annual Health Care Conference ... You are invited to listen to the live discussion ... it directly at http://edge.media-server.com/m/p/mr4uxgas . A recorded replay of ... the live event and accessible at the links above until ...
Breaking Medicine Technology: