After a first procedure carried out in 2002 by Pr Cribier's, Transcatheter Aortic Valve Replacement or TAVR revolutionized the management of aortic stenosis with a constant increase in the number of procedures performed worldwide. Experience of operators and teams and evolution of the technique has been accompanied by a drastic reduction in complications in patients at lower surgical risk. In parallel, the procedure was considerably simplified, carried out more and more under local anesthesia, with percutaneous femoral approach, secondary radial approach, prosthesis implantation without predilatation, rapid pacing on left ventricle wire and early discharge. Thus, the "simplified" TAVR adopted in most centers nowadays is a real revolution of the technique. However, simplified TAVR must be accompanied upstream by a rigorous selection of patients who can benefit from a minimalist procedure in order to guarantee its safety.
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| http://dx.doi.org/10.1016/j.ancard.2019.09.017 | DOI Listing |
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[Local versus locoregional anesthesia in transfemoral TAVI procedures].
Ann Cardiol Angeiol (Paris)
November 2024
Service de cardiologie, Centre Hospitalo-Universitaire de Reims, 51 avenue Cognacq Jay, 51100 Reims, France. Electronic address:
Introduction: Transcatheter aortic valve implantation (TAVI) has become the treatment of choice for the most fragile patients with severe aortic stenosis. The transfemoral route is preferred as the simplest and safest. The aim of our study was to compare the efficacy, tolerance and safety of local vs.
View Article and Find Full Text PDFBalloon predilation or direct valve implantation in TAVI for women: Insights from the DIRECTAVI study.
Catheter Cardiovasc Interv
July 2024
Department of Cardiology, Montpellier University Hospital, Montpellier, France.
Background: The randomized DIRECTAVI trial demonstrated safety and feasibility of transcatheter aortic valve implantation (TAVI) without balloon aortic valvuloplasty (BAV) using SAPIEN 3 balloon-expandable devices. However, the female population with smaller anatomy may have potential higher risk of residual gradient and/or mismatch.
Purpose: We assessed the impact of BAV on the procedural success rate and clinical outcomes in the female population of the DIRECTAVI trial.
Transcatheter aortic valve implantation in patients with uninterrupted vitamin K antagonists.
Catheter Cardiovasc Interv
August 2022
Department of Cardiology, Nimes University Hospital, Nimes, France.
Background: Bridging of vitamin K antagonist (VKA) with heparin is usually not promoted during interventional or surgical procedures related to increased risk of bleeding and thrombotic events but this strategy has not been evaluated during transcatheter aortic valve implantation (TAVI).
Purpose: The aim of this study was to evaluate the rate of major bleeding and vascular complications after TAVI performed in patients with uninterrupted VKA.
Methods: From January 2016 to October 2017, consecutive patients who underwent TAVI with uninterrupted VKA (International Normalized Ratio [INR] between 1.
Evolution of TAVI patients and techniques over the past decade: The French TAVI registries.
Arch Cardiovasc Dis
April 2022
University Hospital of Brest, 29200 Brest, France. Electronic address:
Article Synopsis
- The French TAVI registries analyzed patient data from TAVI procedures from 2010 to 2021 to identify trends in patient characteristics and outcomes.
- Over the decade, while the age of patients remained stable around 83 years, the surgical risk score improved, indicating better overall health among patients undergoing the procedure.
- Key findings included a significant increase in TAVI procedures, a shift toward iliofemoral access, and a decrease in mortality rates and hospital stay lengths, showcasing improvements in the procedure's safety and efficiency.
Might simplification of transcatheter aortic valve implantation reduce the burden on hospital resources?
Eur Heart J Suppl
April 2022
Department of Cardiology, University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University, Šrobárova 50, Prague 10, 100 34, Czech Republic.
Transcatheter aortic valve implantation (TAVI) varies considerably in terms of the procedural approach taken and the hospital length of stay (LoS); both directly affect the cost of care. Our coronary and standard cardiology unit aimed to simplify TAVI (and thus shorten the LoS) while maintaining safety. A shorter LoS would also reduce the burden on hospital resources and free up beds for other patients.
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