Publications by authors named "Dhaval Kolte"
Relationship Between Hospital Mortality and Readmission Rates After Transcatheter Aortic Valve Replacement.
Eur Heart J Qual Care Clin Outcomes
November 2024
Background: There is substantial hospital-level variation in 30-day risk-standardized mortality rate (RSMR) and risk-standardized readmission rate (RSRR) after transcatheter aortic valve replacement (TAVR). However, the relationship between hospital RSMRs and RSRRs has not been well characterized.
Methods: We analyzed data on 141,905 Medicare fee-for-service beneficiaries who underwent TAVR across 512 hospitals between October 1, 2015 and December 31, 2020.
Background: Several transcatheter tricuspid valve (TV) repair devices for tricuspid regurgitation (TR) have emerged. However, few studies have compared transcatheter TV repair with medical therapy (MT) alone or isolated TV surgery.
Methods: PubMed and EMBASE were searched in February 2024.
Article Synopsis
- The study compares two treatment methods for patients with tricuspid regurgitation: tricuspid transcatheter edge-to-edge repair (T-TEER) and surgical tricuspid valve repair, focusing on outcomes like two-year all-cause mortality and other complications.
- Analysis was conducted on 1,143 Medicare beneficiaries aged 65 to 99, revealing no significant difference in two-year mortality rates between the two treatments, but noted a rise in T-TEER procedures over the years.
- T-TEER showed lower in-hospital mortality and fewer cases requiring pacemaker implantation, but more tricuspid valve reinterventions were needed compared to surgical repair, indicating a need for further research on treatment selection and timing
Article Synopsis
- - This study examined the effects of transcatheter aortic valve replacement (TAVR) on patients with heart failure and moderate aortic stenosis, comparing TAVR with clinical surveillance followed by valve replacement if the condition worsened.
- - A total of 178 patients were randomly assigned to either TAVR or surveillance, and results indicated that TAVR was associated with better clinical outcomes, though the statistical significance was borderline.
- - TAVR led to a more substantial improvement in heart failure symptoms, as measured by the Kansas City Cardiomyopathy Questionnaire, compared to the surveillance group after one year of follow-up.
Background: The choice of transcatheter aortic valve replacement (TAVR) prosthesis is crucial in optimizing short- and long-term outcomes. The objective of this study was to conduct a meta-analysis comparing outcomes of third-generation balloon-expandable valves (BEV) vs self-expanding valves (SEV).
Methods: Electronic databases were searched from inception to June 2023 for studies comparing third-generation BEV vs SEV.
Background: Evidence is limited regarding the effectiveness of leadless pacemaker implantation for conduction disturbance following transcatheter aortic valve replacement (TAVR).
Objectives: This study sought to examine the national trends in the use of leadless pacemaker implantation following TAVR and compare its performance with transvenous pacemakers.
Methods: Medicare fee-for-service beneficiaries aged ≥65 years who underwent leadless or transvenous pacemakers following TAVR between 2017 and 2020 were included.
Previous research indicates varying stroke rates after mitral valve (MV) interventions. This study aimed to compare postprocedural stroke risks after transcatheter and surgical MV interventions. Electronic databases were searched from inception to February 2024 for studies comparing stroke rates after mitral transcatheter edge-to-edge repair (mTEER), surgical MV repair/replacement, or guideline-directed medical therapy (GDMT).
View Article and Find Full Text PDFBackground: Prior studies have reported decreased use of an invasive approach for acute myocardial infarction (AMI) in patients undergoing transcatheter aortic valve replacement (TAVR).
Objectives: The aim of this study was to determine whether prior TAVR affects the use of subsequent coronary revascularization and outcomes of AMI in a contemporary national data set.
Methods: Consecutive TAVR patients from 2016 to 2022 were identified from the U.
Background: There is currently little evidence for transcatheter edge-to-edge mitral valve repair (TEER) for mitral regurgitation (MR) in patients with cardiogenic shock (CS). Therefore, this study investigated the characteristics and outcomes of CS patients who underwent TEER for MR.
Methods: PubMed, EMBASE were searched in July 2023.
Background: Transcatheter aortic valve replacement (TAVR) is as an alternative treatment to surgical AVR, but the long-term outcomes of TAVR remain unclear.
Aims: This study aimed to analyze long-term outcomes following TAVR using meta-analysis.
Methods: A literature search was performed with MEDLINE, EMBASE, Cochrane Library, Web of Science, and Google Scholar through November 2022; studies reporting clinical outcomes of TAVR with follow-up periods of ≥8 years were included.
Background Data on clinical outcomes after transcatheter aortic valve replacement (TAVR) in specific cancer types or the presence of metastatic disease remain sparse. This study aimed to investigate the impact of active cancer on short-term mortality, complications, and readmission rates after TAVR across different cancer types. Methods and Results The authors assessed the Nationwide Readmissions Database for TAVR cases from 2012 to 2019.
View Article and Find Full Text PDFArticle Synopsis
- Atherosclerotic cardiovascular disease is common in patients with severe aortic stenosis who are treated with transcatheter aortic valve replacement (TAVR), and the presence of polyvascular disease (PVD) significantly impacts patient outcomes.
- A study analyzed data from nearly 444,000 TAVR patients to examine the association of PVD with mortality and other complications after the procedure.
- Results showed that patients with PVD had higher 1-year all-cause mortality rates and more complications, with risks increasing as the number of affected vascular beds rose, particularly for those with three vascular beds involved.
Data on the association between hospital procedural volume and 30-day readmissions after mitral valve transcatheter edge-to-edge repair (mTEER) are limited. We used the 2019 Nationwide Readmissions Database to identify hospitals that performed at least 5 mTEERs. Hospitals were categorized based on tertiles of annual mTEER volume as low-volume (5 to 13), medium-volume (14 to 28), and high-volume (29 to 171).
View Article and Find Full Text PDFAim: The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease."
Methods: A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
Aim: The "2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease" provides an update to and consolidates new evidence since the "2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease" and the corresponding "2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease."
Methods: A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
In-hospital Outcomes and Cost Associated With Treatments for Non-ST-elevation Myocardial Infarction.
J Soc Cardiovasc Angiogr Interv
November 2022
Background: Although variation in the management of patients with non-ST-elevation myocardial infarction (NSTEMI) is well documented across US hospitals, few data exist characterizing variation in outcomes following specific management strategies.
Methods: Admissions for NSTEMI to hospitals performing coronary angiography, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery between 2016 and 2018 were identified from the National Inpatient Sample. Patients were categorized according to treatment rendered (medical therapy alone, angiography without revascularization, PCI, or CABG).
Severity of and Recovery From Anemia After Transcatheter Aortic Valve Replacement: An Analysis of the PARTNER Trials and Registries.
J Soc Cardiovasc Angiogr Interv
November 2022
Background: Anemia is associated with increased mortality in patients undergoing transcatheter aortic valve replacement (TAVR); however, data on the effect of the severity of and recovery from anemia on clinical outcomes are limited. This study examined the impact of the severity of and recovery from anemia after TAVR.
Methods: Patients with symptomatic, severe aortic stenosis across all surgical risk groups from the Placement of Aortic Transcatheter Valves (PARTNER) I, II, and III trials and registries who underwent TAVR were analyzed.
Malnutrition is a common co-morbidity among candidates for transcatheter aortic valve implantation (TAVI). This study aimed to investigate the association between nutritional status determined by objective nutritional indices and outcomes of patients who underwent TAVI. We systematically searched PubMed, Embase, Web of Science, Scopus, and Cochrane Library from inception until April 18, 2022 to identify studies examining the association of preprocedural nutritional status with post-TAVI outcomes.
View Article and Find Full Text PDFPatients who underwent transcatheter edge-to-edge repair (TEER) for mitral regurgitation with atrial fibrillation (AF) at baseline have higher mortality than those without AF. Data on new-onset AF (NOAF) after TEER are limited. Using the 2016 to 2018 Nationwide Readmissions Database, we identified a cohort of patients who underwent TEER and classified them into 3 groups based on AF presence during the study period.
View Article and Find Full Text PDFBackground Despite improvements in the management and prevention of stroke, increasing hospitalizations for stroke and stagnant mortality rates have been described in young adults. However, there is a paucity of contemporary national mortality estimates in young adults. Methods and Results Trends in mortality related to stroke in young adults (aged 25-64 years) were assessed using the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database.
View Article and Find Full Text PDFImportance: In patients with severe aortic stenosis and left ventricular ejection fraction (LVEF) less than 50%, early LVEF improvement after transcatheter aortic valve replacement (TAVR) is associated with improved 1-year mortality; however, its association with long-term clinical outcomes is not known.
Objective: To examine the association between early LVEF improvement after TAVR and 5-year outcomes.
Design, Setting, And Participants: This cohort study analyzed patients enrolled in the Placement of Aortic Transcatheter Valves (PARTNER) 1, 2, and S3 trials and registries between July 2007 and April 2015.