Transatlantic editorial on transcatheter aortic valve replacement

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Presentation transcript:

Transatlantic editorial on transcatheter aortic valve replacement Vinod H. Thourani, MD, Michael A. Borger, MD, PhD, David Holmes, MD, Hersh Maniar, MD, Fausto Pinto, MD, PhD, Craig Miller, MD, Josep Rodés-Cabau, MD, Friedrich-Wilhelm Mohr, MD, PhD, Holger Schröfel, MD, PhD, Neil E. Moat, MBBS, MS, Friedhelm Beyersdorf, MD, PhD, G. Alexander Patterson, MD, Richard Weisel, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 154, Issue 1, Pages 7-21 (July 2017) DOI: 10.1016/j.jtcvs.2017.03.047 Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Components of the heart team. Cath Lab, Catheter laboratory; OR, operating room; TAVR, transcatheter aortic valve replacement; CT, computed tomography. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Decreasing incidence of severe transcatheter aortic valve replacement complications in Germany from 2011 to 2013 (with permission from Walther and colleagues11). The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Observed versus STS predicted risk of mortality rates in TAVR registries and trials. Observed mortality rate from the TVT registry is roughly equal to STS score, whereas device approval studies tend to have lower observed mortality rates. TAVR, Transcatheter aortic valve replacement; AVR, aortic valve replacement; STS, Society of Thoracic Surgeons; OM, observed mortality; PROM, Predicted Risk of Mortality. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Mortality and stroke rates for surgical aortic valve replacement versus TAVR in intermediate-risk patients (with permission from Leon and colleagues13). No significant difference was observed between groups. CI, Confidence interval; TAVR, transcatheter aortic valve replacement. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Leaflet thrombosis demonstrated by transesophageal echocardiography and 4-dimensional CT in patients with CoreValve, Medtronic (A-C), SAPIEN XT, Edwards Lifesciences (D-F), Portico, St Jude, (G-I), and Carpentier Edwards PERIMOUNT, Edwards Lifesciences (J-L) prostheses (with permission from Makkar and colleagues89). The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

The treatment of aortic stenosis is changing rapidly, and sharing ideas from across the Atlantic will help us provide the most optimal care for our patients. The Journal of Thoracic and Cardiovascular Surgery 2017 154, 7-21DOI: (10.1016/j.jtcvs.2017.03.047) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions