With the publication of the Placement of Aortic Transcatheter Valves (PARTNER) trial, transcatheter aortic valve replacement (TAVR) has undoubtedly become the gold standard for severe aortic stenosis in patients that ...With the publication of the Placement of Aortic Transcatheter Valves (PARTNER) trial, transcatheter aortic valve replacement (TAVR) has undoubtedly become the gold standard for severe aortic stenosis in patients that are not suitable candidate for surgical aortic valve replacement (AVR). The PARTNER trial also showed that TAVR is non-inferior to AVR in high-risk patients. A recent publication by Ben-Dor et al evaluated the outcome of high-risk patients with severe aortic stenosis who were referred to their institution for participation to the PARTNER trial. Only a minority of patients made it in the trial and the majority of patient ended being treated medically. Some patients were also treated with AVR outside the trial. The outcomes of all these patients were stratified by the treatment they received (AVR, TAVR or medical therapy with or without balloon aortic valvuloplasty). The 3 groups were different in their baseline characteristics. Ben-Dor et al found that patients treated medically had greater mortality than patients treated with TAVR or AVR. The survival of patients treated with TAVR was similar to those treated with AVR. Independent predictors of mortality were also found from their analysis. In this commentary, we discuss the finding of this study and compare it withthe current literature.展开更多
We describe a case of very late transcatheter heart valve(THV) thrombosis of a first-generation SAPIEN prosthesis(Edwards Lifesciences, Irvine, CA) implanted in a 64-yearold woman with severe symptomatic aortic stenos...We describe a case of very late transcatheter heart valve(THV) thrombosis of a first-generation SAPIEN prosthesis(Edwards Lifesciences, Irvine, CA) implanted in a 64-yearold woman with severe symptomatic aortic stenosis. More than 54 mo after implantation, she presented with severe symptomatic prosthesis dysfunction(stenosis) which was successfully treated with oral anticoagulation. To our knowledge, this is the tardiest case of THV thrombosis ever reported. This case should increase clinical awareness for THV thrombosis even beyond the first two-year period following implantation.展开更多
A 56-year-old man experienced an aborted sudden death followed by an arrhythmic storm. Angiography revealed a non-severe lesion on the left circumflex artery that was treated medically but an arrhythmic storm recurred...A 56-year-old man experienced an aborted sudden death followed by an arrhythmic storm. Angiography revealed a non-severe lesion on the left circumflex artery that was treated medically but an arrhythmic storm recurred. A repeat angiogram was comparable but optical coherence tomography imaging revealed a ruptured plaque with intraluminal thrombosis. Percutaneous coronary intervention was performed and no arrhythmia recurred.展开更多
文摘With the publication of the Placement of Aortic Transcatheter Valves (PARTNER) trial, transcatheter aortic valve replacement (TAVR) has undoubtedly become the gold standard for severe aortic stenosis in patients that are not suitable candidate for surgical aortic valve replacement (AVR). The PARTNER trial also showed that TAVR is non-inferior to AVR in high-risk patients. A recent publication by Ben-Dor et al evaluated the outcome of high-risk patients with severe aortic stenosis who were referred to their institution for participation to the PARTNER trial. Only a minority of patients made it in the trial and the majority of patient ended being treated medically. Some patients were also treated with AVR outside the trial. The outcomes of all these patients were stratified by the treatment they received (AVR, TAVR or medical therapy with or without balloon aortic valvuloplasty). The 3 groups were different in their baseline characteristics. Ben-Dor et al found that patients treated medically had greater mortality than patients treated with TAVR or AVR. The survival of patients treated with TAVR was similar to those treated with AVR. Independent predictors of mortality were also found from their analysis. In this commentary, we discuss the finding of this study and compare it withthe current literature.
文摘We describe a case of very late transcatheter heart valve(THV) thrombosis of a first-generation SAPIEN prosthesis(Edwards Lifesciences, Irvine, CA) implanted in a 64-yearold woman with severe symptomatic aortic stenosis. More than 54 mo after implantation, she presented with severe symptomatic prosthesis dysfunction(stenosis) which was successfully treated with oral anticoagulation. To our knowledge, this is the tardiest case of THV thrombosis ever reported. This case should increase clinical awareness for THV thrombosis even beyond the first two-year period following implantation.
文摘A 56-year-old man experienced an aborted sudden death followed by an arrhythmic storm. Angiography revealed a non-severe lesion on the left circumflex artery that was treated medically but an arrhythmic storm recurred. A repeat angiogram was comparable but optical coherence tomography imaging revealed a ruptured plaque with intraluminal thrombosis. Percutaneous coronary intervention was performed and no arrhythmia recurred.
