Publications by authors named "Daniel C Overduin"
Objectives: Screening for obstructive coronary artery disease (CAD) with coronary computed tomography angiography (CCTA) could prevent unnecessary invasive coronary angiography (ICA) procedures during work-up for trans-catheter aortic valve implantation (TAVI). CT-derived fractional flow reserve (CT-FFR) improves CCTA accuracy in chest pain patients. However, its reliability in the TAVI population is unknown.
View Article and Find Full Text PDFBackground: Concomitant coronary artery disease (CAD) is highly prevalent in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). The optimal treatment strategy for CAD is a topic of debate. An initial conservative strategy for CAD in patients undergoing TAVI may be favorable as multiple studies have failed to show an evident beneficial effect of percutaneous coronary intervention (PCI) on mortality after TAVI.
View Article and Find Full Text PDFArticle Synopsis
- - The study evaluated the safety and efficacy of using an upper-extremity approach for secondary access during transfemoral transcatheter aortic valve implantation (TAVI) compared to the traditional lower-extremity method, as it may reduce significant bleeding risks.
- - Conducted between November 2022 and November 2023 in the Netherlands, the TAVI XS trial involved 238 patients with severe aortic stenosis, who were randomly assigned to either the upper or lower access groups.
- - Results showed that the upper-extremity approach had a lower incidence of clinically relevant bleeding (4.2% vs. 13.4% for the lower extremity), suggesting it could be a safer option for patients undergoing
Article Synopsis
- Major or life-threatening bleeding and stroke are complications that can occur after transcatheter aortic valve implantation (TAVI), impacting both mortality and quality of life (QoL).
- Major bleeding increases the risk of death significantly, while minor bleeding does not affect mortality; however, both types of bleeding and stroke lead to lower mental QoL scores.
- The study highlights that monitoring these complications is essential, as they correlate with poorer mental well-being in patients during the first year post-TAVI.
Article Synopsis
- * In a trial with 858 patients, results showed no significant difference in major complications between those who continued anticoagulation (16.5% experienced primary outcomes) and those who interrupted it (14.8%).
- * Continuation of anticoagulation led to higher incidences of major bleeding (31.1% vs. 21.3%), suggesting that interrupting anticoagulation is safer in this patient population undergoing TAVI.
Background: During transcatheter aortic valve implantation (TAVI), secondary access is required for angiographic guidance and temporary pacing. The most commonly used secondary access sites are the femoral artery (angiographic guidance) and the femoral vein (temporary pacing). An upper extremity approach using the radial artery and an upper arm vein instead of the lower extremity approach using the femoral artery and femoral vein may reduce clinically relevant secondary access site-related bleeding complications, but robust evidence is lacking.
View Article and Find Full Text PDF