#Ultra balloon online update

Google Scholar See all References PVL has been called the “Achilles Heel” of TAVR. Computed tomography–based oversizing degrees and incidence of paravalvular regurgitation of a new generation transcatheter heart valve. Google Scholar See all References, 5 x 5 Blanke, P, Pibarot, P, Hahn, R et al. Impact of paravalvular aortic regurgitation after transcatheter aortic valve implantation on survival. ALICE (All-literature investigation of cardiovascular evidence) group. Google Scholar See all References The incidence of moderate or severe paravalvular leak (PVL) for TAVR has been reported to be between 3.6% and 21%. Transcatheter aortic-valve replacement with a self-expanding valve in low-risk patients. Google Scholar See all References, 3 x 3 Popma, JJ, Deeb, GM, Yakubov, SJ et al. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. 2 x 2 Mack, MJ, Leon, MB, Thourani, VH et al.

Google Scholar See all References The recent results of the Evolut Low Risk and the PARTNER 3 trials have established TAVR as the standard of care for uncomplicated severe aortic stenosis in low-risk groups as well.

#Ultra balloon online update

AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease American heart association task force on clinical practice guidelines. 1 x 1 Nishimura, R, Otto, CM, Bonow, R et al. Transcatheter aortic valve replacement (TAVR) has become the standard of care for severe aortic stenosis in both intermediate and high-risk patient groups. For example, the annular eccentricity index has been associated with significant PVL for CoreValve THV, but these results have not been reproduced for the Sapien family of THV.

There are several other anatomical characteristics that are being studied as potential factors in PVL. We compared the two groups on three characteristics (LVOT calcification, percent oversizing, and calcium nodularity) known to be associated with PVL. The baseline characteristics were also notably similar between groups. On the other hand, despite inclusion of most Ultra cases (33 out of 37), no Ultra cases were found to have mild or more PVL. However, all of the included cases were performed by consistent operators and reviewed by one, blinded radiologist and cardiologist, reducing inter-reader variability, a known limitation of similar studies.

Twenty-one out of 54 S3 cases were excluded, which could have increased or decreased the actual percentage with mild PVL. As a retrospective study with 29% of cases excluded due to insufficient data, the study is vulnerable to selection bias. Institutional Review Board approval was obtained and informed consents were not applicable, since this was a retrospective review without patient identifiers. Patients with 29 mm S3 valves were excluded as there is no 29 mm Ultra valve for direct comparison of hemodynamics. Valve procedures in which there was incomplete data were excluded.

Three operators consistently performed all of the procedures and in many instances co-scrubbed into the cases. Valve selection had been based on availability at the time of the procedure. All procedures were noted to have been performed under conscious sedation by cardiac anesthesia with fluoroscopic and transthoracic echo guidance. A retrospective review of these cases was performed. Patients who presented to Mills Peninsula Medical Center (Burlingame, CA) and California Pacific Medical Center (San Francisco, CA) underwent TAVR with balloon expandable valves, either the Edwards SAPIEN 3 or S3 Ultra valve, from Septemto August 15, 2019.