Most Read Articles
Roshini Claire Anthony, 3 days ago

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

5 days ago
Eating behaviours have been shown to moderate the relationship between cumulated risk factors in the first 1,000 days and adiposity outcomes at 6 years of age, which underscores modifiable behavioural targets for interventions, reports a study.
Stephen Padilla, 4 days ago
Use of noninvasive ventilation (NIV), similar to invasive mechanical ventilation (IMV), appears to lessen mortality but may increase the risk for transmission of the novel coronavirus disease (COVID-19) in healthcare workers, suggest the results of a study.
Tristan Manalac, 25 May 2020
Minimally invasive pancreatectomy (MIP) offers a feasible alternative to open pancreatectomy (OP) for the treatment of pancreatic neuroendocrine neoplasms (PNEN), according to a recent Singapore study has found.

Redo-TAVR a safe, effective option for patients with valve dysfunction

04 May 2020

Repeat transcatheter aortic valve replacement (redo-TAVR) is relatively safe and effective, making it a feasible alternative for patients with valve dysfunction following TAVR, suggests a study.

Data on consecutive patients who underwent redo-TAVR at 37 centres were obtained from the Redo-TAVR registry. The authors classified patients as probable TAVR failure or probable transcatheter heart valve (THV) failure if they presented within or beyond 1 year of their index TAVR, respectively.

Of the 63,876 TAVR procedures identified, 212 (0.33 percent) were consecutive redo-TAVR: 74 within and 138 beyond 1 year of the initial procedure. TAVR-to-redo-TAVR time was 68 (38 to 154) days for within and 5 (3 to 6) years for beyond 1 year of index procedure.

The indications for redo-TAVR in the two groups were THV stenosis in 12 (16.2 percent) and 51 (37.0 percent; p=0.002) and regurgitation or combined stenosis–regurgitation in 62 (83.8 percent) and 86 (62.3 percent; p=0.028), respectively.

Using the VARC-2 criteria, 180 patients (85.1 percent) achieved device success. Most failures were due to high residual gradients (14.1 percent) or regurgitation (8.9 percent). Residual gradients were 12.6±7.5 at 30-day and 12.9±9.0 mm Hg at 1-year follow-up. The corresponding valve areas were 1.63±0.61 and 1.51±0.57 cm2, while ≤mild regurgitation occurred in 91 percent and 91 percent, respectively.

Rates of peri-procedural complication were low (three strokes, 1.4 percent; seven valve malpositions, 3.3 percent; two coronary obstructions, 0.9 percent; 20 new permanent pacemakers, 9.6 percent; and zero deaths). There was substantial symptomatic improvement as well. Survival was 94.6 percent and 98.5 percent at 30 days (p=0.101) and 83.6 percent and 88.3 percent at 1 year (p=0.335) for patients presenting with early and late valve dysfunction, respectively.

“These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern,” the authors said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 3 days ago

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

5 days ago
Eating behaviours have been shown to moderate the relationship between cumulated risk factors in the first 1,000 days and adiposity outcomes at 6 years of age, which underscores modifiable behavioural targets for interventions, reports a study.
Stephen Padilla, 4 days ago
Use of noninvasive ventilation (NIV), similar to invasive mechanical ventilation (IMV), appears to lessen mortality but may increase the risk for transmission of the novel coronavirus disease (COVID-19) in healthcare workers, suggest the results of a study.
Tristan Manalac, 25 May 2020
Minimally invasive pancreatectomy (MIP) offers a feasible alternative to open pancreatectomy (OP) for the treatment of pancreatic neuroendocrine neoplasms (PNEN), according to a recent Singapore study has found.