Publications by authors named "Steven Yakubov"
Article Synopsis
- A study compared transcatheter aortic valve replacement (TAVR) with traditional surgery in low-risk patients under 75 years old with severe aortic stenosis to evaluate safety and effectiveness over three years.* -
- Results showed that TAVR patients had similar overall mortality rates but significantly fewer disabling strokes (0.6%) compared to surgery patients (2.9%), while TAVR also resulted in better valve performance.* -
- Both treatment options had comparable low rates of valve reinterventions, but TAVR patients experienced higher rates of pacemaker implantation (21.0% vs. 7.1%).*
Management of Postprocedural Conduction Disturbances Using a Prespecified Algorithm in the Optimize PRO Study.
J Soc Cardiovasc Angiogr Interv
January 2024
Article Synopsis
- * Optimize PRO, a prospective study, implements two strategies: using a cusp overlap technique during TAVR and a CD algorithm that assesses patients based on their post-procedure ECG for early discharge decisions.
- * Results indicate that patients with conduction disturbances had a significantly higher PPI rate at 30 days compared to those without (28.1% vs 1.5%), but the standardized management of CDs led to similar safety outcomes, suggesting effective early recognition and monitoring of arrhythm
Transcatheter Aortic Valve Replacement in Discordant Aortic Stenosis: The Time Is Now.
J Soc Cardiovasc Angiogr Interv
March 2024
Simplifying Transcatheter Tricuspid Valve Replacement With 3-Dimensional Intracardiac Echocardiography.
J Soc Cardiovasc Angiogr Interv
April 2024
Transcatheter tricuspid valve replacement (TTVR) offers the potential for improved outcomes for the significant number of patients with severe tricuspid valve regurgitation relative to current treatment options. Imaging is a critical component of the success of this procedure. Here we describe strategies and techniques for the use of 3-dimensional intracardiac echocardiography as an adjunct to standard transesophageal echocardiography during TTVR procedure.
View Article and Find Full Text PDFBackground: Outcomes from transcatheter aortic valve replacement (TAVR) in low-surgical risk patients with bicuspid aortic stenosis beyond 2 years are limited.
Objectives: This study aimed to evaluate 3-year clinical and echocardiographic outcomes from the Evolut Low Risk Bicuspid Study.
Methods: The Evolut Low Risk Bicuspid Study is a prospective, multicenter, single-arm study conducted in 25 U.
Article Synopsis
- A study evaluated permanent pacemaker implantation (PPI) rates in patients who underwent transcatheter aortic valve replacement (TAVR) using Evolut valves from July 2018 to June 2021, reporting significant trends in PPI rates over time.
- Out of 54,014 procedures, the 30-day PPI rate dropped from 16.6% in 2018 to 10.8% in 2021, and in-hospital rates decreased by 40.1% during the same period, indicating improved outcomes.
- Key factors associated with a higher likelihood of needing a new PPI included existing conduction defects, atrial fibrillation, use of home
Background: Symptomatic patients with severe aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR) sustain comparable improvements in health status over 5 years after transcatheter aortic valve replacement (TAVR) or SAVR. Whether a similar long-term benefit is observed among intermediate-risk AS patients is unknown.
Objectives: The purpose of this study was to assess health status outcomes through 5 years in intermediate risk patients treated with a self-expanding TAVR prosthesis or SAVR using data from the SURTAVI (Surgical Replacement and Transcatheter Aortic Valve Implantation) trial.
There are limited data from randomized controlled trials assessing the impact of transcatheter aortic valve replacement (TAVR) or surgery in women with aortic stenosis and small aortic annuli. We evaluated 2-year clinical and hemodynamic outcomes after aortic valve replacement to understand acute valve performance and early and midterm clinical outcomes. This post hoc analysis pooled women enrolled in the randomized, prospective, multicenter Evolut Low Risk and Surgical Replacement and Transcatheter Aortic Valve Implantation (SURTAVI) intermediate risk trials.
View Article and Find Full Text PDFArticle Synopsis
- A study evaluated the safety and performance of the Intrepid transapical transcatheter mitral valve replacement (TMVR) system over two years in patients with symptomatic, moderate to severe mitral regurgitation (MR) who are at high surgical risk.
- 252 patients were analyzed, showing 13.1% all-cause mortality at 30 days, increasing to 36.2% by two years, along with significant heart failure rehospitalization rates.
- Despite early challenges, more than half of the patients showed improvement in functional status and mild MR at two years, indicating potential benefits from the TMVR system.
Article Synopsis
- The study compares the 5-year rates of valve reintervention after transcatheter aortic valve replacement (TAVR) using CoreValve/Evolut versus surgical aortic valve replacement (SAVR).
- It found that TAVR had a higher overall reintervention rate (2.2%) compared to SAVR (1.5%), particularly within the first year.
- Evolut TAVR showed significantly fewer reinterventions than CoreValve TAVR, but its rates were comparable to SAVR, indicating varying risks associated with different valve types.
Article Synopsis
- The study investigates whether adding left atrial appendage ligation to catheter pulmonary vein isolation enhances the treatment of nonparoxysmal atrial fibrillation (AF).
- It was conducted as a multicenter, randomized clinical trial involving 404 patients, comparing a group that received both treatments to another that only received pulmonary vein isolation.
- The main objectives were to evaluate the effectiveness of preventing atrial arrhythmias and the safety of the procedures, with follow-up monitoring extending up to 12 months after treatment.
Background: There are limited data regarding treatment for failed balloon-expandable transcatheter heart valves (THVs) in redo-transcatheter aortic valve implantation (TAVI).
Aims: We aimed to assess THV performance, neoskirt height and expansion when performing redo-TAVI with the ACURATE platform inside a SAPIEN 3 (S3) compared to redo-TAVI with an S3 in an S3.
Methods: Redo-TAVI was performed on the bench using each available size of the S3, the ACURATE neo2 (ACn2) and the next-generation ACURATE Prime XL (AC XL) implanted at 2 different depths within 20 mm/23 mm/26 mm/29 mm S3s serving as the "failed" index THV.
Background: Bicuspid aortic valve (BAV) is present in approximately 0.5%-2% of the general population, causing significant aortic stenosis (AS) in 12%-37% of affected individuals. Transcatheter aortic valve replacement (TAVR) is being considered the treatment of choice in patients with symptomatic AS across all risk spectra.
View Article and Find Full Text PDFPacing After TAVR: Just Give Me the Beat, But Improve the Instruments.
JACC Cardiovasc Interv
May 2023
Background: Procedural success and clinical outcomes after transcatheter aortic valve replacement (TAVR) have improved, but residual aortic regurgitation (AR) and new permanent pacemaker implantation (PPI) rates remain variable because of a lack of uniform periprocedural management and implantation.
Objectives: The Optimize PRO study evaluates valve performance and procedural outcomes using an "optimized" TAVR care pathway and the cusp overlap technique (COT) in patients receiving the Evolut PRO/PRO+ (Medtronic) self-expanding valves.
Methods: Optimize PRO, a nonrandomized, prospective, postmarket study conducted in the United States, Canada, Europe, Middle East, and Australia, is enrolling patients with severe symptomatic aortic stenosis and no pre-existing pacemaker.
Background: Randomized data comparing outcomes of transcatheter aortic valve replacement (TAVR) with surgery in low-surgical risk patients at time points beyond 2 years is limited. This presents an unknown for physicians striving to educate patients as part of a shared decision-making process.
Objectives: The authors evaluated 3-year clinical and echocardiographic outcomes from the Evolut Low Risk trial.
Since the first transcatheter delivery of an aortic valve prosthesis was performed by Cribier et al in 2002, the picture of aortic stenosis (AS) therapeutics has changed dramatically. Initiated from an indication of inoperable to high surgical risk, extending to intermediate and low risk, transcatheter aortic valve replacement (TAVR) is now an approved treatment for patients with severe, symptomatic AS across all the risk categories. The current evidence supports TAVR as a frontline therapy for treating severe AS.
View Article and Find Full Text PDFImportance: The frequency and clinical importance of structural valve deterioration (SVD) in patients undergoing self-expanding transcatheter aortic valve implantation (TAVI) or surgery is poorly understood.
Objective: To evaluate the 5-year incidence, clinical outcomes, and predictors of hemodynamic SVD in patients undergoing self-expanding TAVI or surgery.
Design, Setting, And Participants: This post hoc analysis pooled data from the CoreValve US High Risk Pivotal (n = 615) and SURTAVI (n = 1484) randomized clinical trials (RCTs); it was supplemented by the CoreValve Extreme Risk Pivotal trial (n = 485) and CoreValve Continued Access Study (n = 2178).