The Challenges of Aortic Valve Management After Left Ventricular Assist Device Implantation.

Background: Continuous retrograde flow across the aortic valve from left ventricular assist device (LVAD) therapy can result in cusp damage and progressive aortic regurgitation, potentially triggering recurrent heart and multiorgan failure. The management of aortic regurgitation after LVAD implantation has not been well defined.

Methods: This study retrospectively reviewed the investigators' experience with the management of de novo aortic regurgitation requiring intervention in patients with continuous-flow LVAD.

Five Year Outcomes in Low-Risk Patients Undergoing Surgery in the PARTNER 3 Trial.

Background: Surgery remains an important treatment for low-risk patients with severe symptomatic aortic stenosis (AS). We evaluated 5-year outcomes in low-risk patients undergoing isolated surgical aortic valve replacement (SAVR) or SAVR with concomitant procedures within the randomized PARTNER 3 trial.

Methods: In the PARTNER 3 trial, 454 patients underwent surgery for severe, symptomatic, tri-leaflet AS and were followed for 5 years.

Transcatheter Aortic Valve Replacement Explant in the Setting of a Porcelain Aorta.

Porcelain aorta describes circumferential calcification in the ascending aorta that may extend through the aortic arch. This is commonly observed in patients with a history of mediastinal radiation, end-stage renal disease, or chronic vascular inflammation. Mediastinal radiation has been shown to cause intimal and medial calcification of the aorta, as well as diastolic myocardial dysfunction, valvular disease, and coronary artery disease.

Contribution margins and utilization of transcatheter aortic valve replacement versus surgical aortic valve replacement in the Medicare population.

Background: Hospitals and health systems must balance the demand for transcatheter aortic valve replacement (TAVR) against financial sustainability. Patients may be eligible for both TAVR and surgical aortic valve replacement (SAVR), but financial realities for hospitals may affect differential access to those therapies. We sought to understand the landscape of costs and reimbursement for TAVR and SAVR in the US and to understand the association of procedural reimbursement with receipt of either.