Transcatheter aortic valve implantation

Slides:

Advertisements

Similar presentations

Advertisements

AGVISE Laboratories %Zone or Grid Samples – Northwood laboratory

Mental Mind Gym coming …. 30 Second Challenge - Early Additive.

Two Special Right Triangles

Linoxsmart S DX Master Study

EuroCondens SGB E.

Multiplication X 1 1 x 1 = 1 2 x 1 = 2 3 x 1 = 3 4 x 1 = 4 5 x 1 = 5 6 x 1 = 6 7 x 1 = 7 8 x 1 = 8 9 x 1 = 9 10 x 1 = x 1 = x 1 = 12 X 2 1.

Division ÷ 1 1 ÷ 1 = 1 2 ÷ 1 = 2 3 ÷ 1 = 3 4 ÷ 1 = 4 5 ÷ 1 = 5 6 ÷ 1 = 6 7 ÷ 1 = 7 8 ÷ 1 = 8 9 ÷ 1 = 9 10 ÷ 1 = ÷ 1 = ÷ 1 = 12 ÷ 2 2 ÷ 2 =

NTDB ® Annual Report 2009 © American College of Surgeons All Rights Reserved Worldwide Percent of Hospitals Submitting Data to NTDB by State and.

Global Health Estimates: Key figures and tables

2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt 2 pt 3 pt 4 pt 5 pt 1 pt Time Money AdditionSubtraction.

TCT 2011 | San Francisco, CA | November 10, 2011 Two-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in Inoperable Patients With Severe.

A Fractional Order (Proportional and Derivative) Motion Controller Design for A Class of Second-order Systems Center for Self-Organizing Intelligent.

$100 $200 $300 $400 $100 $200 $300 $400 $100 $200 $300 $400 $100 $200 $300 $400 $100 $200 $300 $400.

Break Time Remaining 10:00.

The basics for simulations

Look at This PowerPoint for help on you times tables

70’s - Today Standard therapy for critical AS is/was Surgical Aortic Valve Replacement 30day Mortality 3% Options for sAVR:

TCCI Barometer March “Establishing a reliable tool for monitoring the financial, business and social activity in the Prefecture of Thessaloniki”

1 Prediction of electrical energy by photovoltaic devices in urban situations By. R.C. Ott July 2011.

15. Oktober Oktober Oktober 2012.

Transcatheter Aortic Valve Therapies

2011 WINNISQUAM COMMUNITY SURVEY YOUTH RISK BEHAVIOR GRADES 9-12 STUDENTS=1021.

Before Between After.

2011 FRANKLIN COMMUNITY SURVEY YOUTH RISK BEHAVIOR GRADES 9-12 STUDENTS=332.

Addition 1’s to 20.

Static Equilibrium; Elasticity and Fracture

1 Unit 1 Kinematics Chapter 1 Day

& dding ubtracting ractions.

“Reading Measurement Scales”. MNI = marked number interval AMI = adjacent number interval.

Chapter 8: Dialysis Providers 2014 ANNUAL DATA REPORT VOLUME 2: E ND -S TAGE R ENAL D ISEASE.

TCT 2014 | September 13, 2014 Five-Year Outcomes of Transcatheter Aortic Valve Replacement (TAVR) in “Inoperable” Patients With Severe Aortic Stenosis:

Five-Year Outcomes after Randomization to Transcatheter or Surgical Aortic Valve Replacement: Final Results of The PARTNER 1 Trial Michael J. Mack, MD.

INTERNATIONAL. CAUTION: For distribution only in markets where CoreValve ® has been approved. The CoreValve ® System is not currently approved in the USA,

STS 2015 John V. Conte, MD Professor of Surgery Johns Hopkins University School of Medicine On Behalf of the CoreValve US Investigators Transcatheter Aortic.

ACC 2015 Michael J Reardon, MD, FACC On Behalf of the CoreValve US Investigators A Randomized Comparison of Self-expanding Transcatheter and Surgical Aortic.

Lessons from TAVR Randomized Trials and Registries E Murat Tuzcu, MD Professor of Medicine Cleveland Clinic Financial disclosures: None PARTNER Executive.

One Year Outcomes in Real World Patients Treated with Transcatheter Aortic Valve Implantation The ADVANCE Study Axel Linke University of Leipzig Heart.

INTERNATIONAL. CAUTION: For distribution only in markets where CoreValve® is approved. Not for distribution in U.S., Canada or Japan. Medtronic, Inc

Conflicts of interests for Leif Thuesen, M.D.

University Heart Center Hamburg

Dr Martyn Thomas Director of Cardiac Services Guys and St Thomas NHS Foundation Trust A Member of Kings Health Partners London.

The Risk and Extent of Neurological Events Are Equivalent for High-Risk Patients Treated With Transcatheter or Surgical Aortic Valve Replacement Thomas.

Axel Linke University of Leipzig Heart Center, Leipzig, Germany Sabine Bleiziffer German Heart Center, Munich, Germany Johan Bosmans University Hospital.

© 2012 EuroIntervention. All rights reserved. EuroIntervention 2012;8: published online ahead of print October 2012 Updated standardized endpoint.

TCT 2015 | San Francisco | October 15, 2015 Transcatheter Aortic Valve Replacement for Failed Surgical Bioprostheses Danny Dvir, MD John G. Webb, MD and.

GENDER DISPARITIES AMONG PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT Michael A. Gaglia, Jr.; Michael J. Lipinski; Rebecca Torguson; Jiaxiang.

UC c EN. Through Medtronic sponsored research, the Transcatheter Aortic Valves clinical portfolio is studying over 11,000 subjects at over 125.

INTERNATIONAL. CAUTION: For distribution only in markets where CoreValve® is approved. Not for distribution in U.S., Canada or Japan. Medtronic, Inc

INTERNATIONAL. CAUTION: For distribution only in markets where CoreValve® is approved. Not for distribution in U.S., Canada or Japan. Medtronic, Inc

Longest Follow-up After Implantation of a Self-Expanding Repositionable Transcatheter Aortic Valve: Final Follow-up of the Evolut R CE Study Stephen Brecker,

Patients at intermediate surgical risk undergoing isolated interventional or surgical aortic valve replacement for severe symptomatic aortic valve stenosis.

TAVR Medtronic CoreValve® Subclavian Approach Clinical Data

Vatsal Ladia, MD, Hemang B. Panchal, MD, MPH, Terrence J

Are we ready to perform TAVI in Intermediate Risk Patients?

Updates From NOTION: The First All-Comer TAVR Trial

30-Day Safety and Echocardiographic Outcomes Following Transcatheter Aortic Valve Replacement with the Self-Expanding Repositionable Evolut PRO System.

Trans-Apical Aortic Valve Implant:

30 Day Outcomes from the SOURCE XT TAVI Post Approval Study

University of Pennsylvania

Giuseppe Tarantini MD, PhD

Insights from the NCDR® STS/ACC TVT Registry.

Axel Linke University of Leipzig Heart Center, Leipzig, Germany

One Year Outcomes in Real World Patients Treated with Transcatheter Aortic Valve Implantation The ADVANCE Study Axel Linke University of Leipzig Heart.

University Heart Center Hamburg

Balloon-Expandable Transcatheter Valve System : OUS Data

Late Follow-Up from the PARTNER Aortic Valve-in-Valve Registry

Reply The Annals of Thoracic Surgery

Five-Year Outcomes after Randomization to Transcatheter or Surgical Aortic Valve Replacement: Final Results of The PARTNER 1 Trial Michael J. Mack, MD.

Presentation transcript:

Transcatheter aortic valve implantation Transcatheter aortic valve implantation. Brazilian reality and perspectives! Fábio S. Brito Jr., MD, PhD Hospital Israelita Albert Einstein São Paulo, Brazil fsbrito@einstein.br On behalf of the SBHCI TAVI Registry investigators

Brazil: Population Pyramid by Age and Gender 1980 2010 2030 > 75 years: 1,421,000 75 years: 5,027,000 Life Expectancy: 73,5 years Population: 190,000,000 > 75 years: 11,064,000

TAVR in Brazil: 618 cases (Jan/2008 - July 2012) CoreValve-Medtronic Sapien-Edwards Inovare-Braile Approval Jan 2008 410 cases: 395 TF 10 Subclavian 05 TransAo Approval Sept 2011 42 cases: 37 TF 05 TA Approval Sept 2011 166 cases: 157 TA 01 Tao 08 TF This has been the first valve prosthesis that can be implanted percutaneously. As you know Alan Cribier did the first-in-man few years ago and up to now, several centers implanted this device in high-risk patients with severe aortic valve disease. The Cribier Edwards valve is balloonexpandable, can be implanted antegardely and retrogradely and has a valve area of 1.7 cm. TAVR in Brazil: 618 cases (Jan/2008 - July 2012)

Numbers of TAVR in Brazil (Corevalve + Sapien)

Brazilian TAVI Registry Real World Registry. Electronic Monitoring: 100% Adverse Events Committee: Mortality Endpoints and Complications in acordance with Valve Academic Research Consortium Consensus on Event Definition CoreValve and Sapien cases.

TAVI Registry: Inclusion SBHCI TAVI Registry: 50% of all cases in Brazil and 66% of all CoreValve / Sapien

Inclusion / Center 85% em 5 centros

Brazilian TAVI Registry: Baseline Characteristics Age, years 81.7 (DP 7.6) Male, n (%) 132 (47.6%) Logistic EuroScore I, % 20.7 (DP 14.2) STS Score, % 14.2 (DP 13.2) Congestive Heart Failure (NYHA) I or II, n (%) 50 (18.1 %) III or IV, n (%) 227 (81.9 %) Diabetes, n (%) 84 (30.3 %) Renal Failure, n (%)* 216 (77.9 %) * GFR<60ml/min

Brazilian TAVI Registry: Procedure Characteristics Access Femoral, n (%) 268 (96.7 %) Subclavian, n (%) 8 (2.8 %) Other, n (%) 1 (0.3%) Valvuloplasty, n (%) 168 (69.1 %) Valve-in-valve 6 (2,1 %) Bioprosthesis Corevalve, n (%) 250 (90.2 %) Sapien XT, n (%) 27 (9.8 %) Post dilatation, n (%) 94 (33.9 %) Device Success, n (%) 241 (87 %) Device Failure, n (%) 35 (13%) Mod/Sev aortic regurgitation 16 (5.7%) 2nd device 15 (5.4%) Other cause 7 (2.5%)

Brazilian TAVI Registry: Echo Results p=ns p<0.001 p<0.001

Brazilian TAVI Registry: 30 Days Results Baseline (277 pts): ICC (NYHA) I or II, n (%) 50 (18.1 %) III or IV, n (%) 227 (81.9 %) 30 days (230 pts): ICC (NYHA) I or II, n (%) 218 (94.7%) III or IV, n (%) 12 (5.3 %)

Brazilian TAVI Registry: 30 Days Results n=277 Mortality, n (%) 27 (9.7 %) Cardiovascular Mortality, n (%) 22 (7.9 %) Myocardial Infarction 1 (0.4 %) Stoke 12 (4.3 %) Bleeding, n (%) 43 (15.5 %) Life-threatening, n (%) 13 (4.6 %) Major, n (%) 18 (6.4 %) Minor, n (%) Vascular Complication, n (%) 28 (10.1 %) 15 (5.4 %) Pacemaker, n (%) 51 (21.5 %) CoreValve, n (%) 51 (24.1%) Sapien, n (%)

CoreValve Registries: 30-Day All-Cause Mortality 25% 20% 15.2% 15.1% 15% 12.4% % 9.7% 10% 9.0% 7.4% 7.2% 5.5% 5.6% 5% Medtronic. Data on file. Meredith IT. A Snapshot from the Ongoing Australia-New Zealand Medtronic CoreValve® Registry. Transcatheter Cardiovascular Therapeutics 2009, September 21-25, 2009. San Francisco, CA. Avanzas P, Munoz-Garcia AJ, Segura J, et al. Percutaneous implantation of the CoreValve® self-expanding aortic valve prosthesis in patients with severe aortic stenosis: early experience in Spain. Rev Esp Cardiol. 2010;63:141-148. Eltchaninoff. French Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. Bosmans. Belgian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. Zahn. German Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. Ludman. UK Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. Petronio. Italian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 0% 18 Fr S&E1 ANZ2 Spain3 French4 Belgian5 German6 UK7 Italian8 Brazilian 1. Medtronic Data on File. COR 2006-02: 18 Fr Safety & Efficacy Study Re-Analysis, August 14, 2009. 2. Meredith. VARC-adjudicated Outcomes in Inoperable and High Risk AS Patients. TCT 2010, Washington, DC. 3. Avanzas P, Munoz-Garcia AJ, Segura J, et al. Percutaneous implantation of the CoreValve® self-expanding aortic valve prosthesis in patients with severe aortic stenosis: early experience in Spain. Rev Esp Cardiol. 2010;63:141-148. 4. Eltchaninoff. French Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 5. Bosmans. Belgian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 6. Zahn. German Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 7. Ludman. UK Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 8. Petronio. Italian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 13

COREVALVE REGISTRIES: 30-Day Stroke Rate 20% 15% 9.6% 10% 4.5% 4.3% 5% 4.0% 4.0% 2.6% 2.9% 1.9% 1.7% 0% 18 Fr S&E ANZ French Belgian German UK Italian ADVANCE Brazilian 14 14

COREVALVE REGISTRIES: Pacemaker Implantation Weighted Average 28.5% 35.2% 26.9% 23% 42.5% 26% 18.5% 31.3% 40.0% 0% 10% 20% 30% 40% 50% 60% 18 Fr S&E ANZ Spain1 French2 Belgian2 German2 UK2 Italian2 Percent of Patients (%) 26.3% 24% Procedural variability, anatomical differences and clinical practice variation impact pacemaker implant rates:9,10 Depth of implant may induce conduction disturbances11 Valvuloplasty balloon size may impact conduction system11 Anatomical and patient-related factors may impact conduction disturbances12 Inter-hospital variability due to physician subjectivity, country-based healthcare norms and reimbursement strategies9 1. Medtronic Data on File. COR 2006-02: 18 Fr Safety& Efficacy Study Re-Analysis, August 14, 2009. 2. Meredith IT. A Snapshot from the Ongoing Australia-New Zealand Medtronic CoreValve® Registry. Transcatheter Cardiovascular Therapeutics 2009, September 21-25, 2009. San Francisco, CA. 3. Avanzas P, Munoz-Garcia AJ, Segura J, et al. Percutaneous implantation of the CoreValve® self-expanding aortic valve prosthesis in patients with severe aortic stenosis: early experience in Spain. Rev Esp Cardiol. 2010;63:141-148. 4. Eltchaninoff. French Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 5. Bosmans. Belgian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 6. German Registry data on file. New pacemakers with Corevalve 240/565. 7. Ludman. UK Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. 8. Petronio. Italian Registry, TAVI Facts, Figures and National Registries. EuroPCR 2010, Paris, France. ADVANCE Brazilian 15 15

Transcatheter aortic valve implantation Transcatheter aortic valve implantation. Brazilian reality and perspectives! Thank you!!!!!