Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · May 2020
Meta AnalysisTranscatheter Versus Surgical Aortic Valve Replacement in Low-Surgical-Risk Patients: A Meta-Analysis of Randomized-Controlled Trials and Propensity-Matched Studies.
We performed a meta-analysis of randomized trials (RCT) and propensity-matched (PSM) studies comparing transcatheter aortic valve implantation (TAVI) with surgical aortic valve replacement (SAVR) in low surgical risk patients. ⋯ TAVI in low surgical risk patients is associated with lower short-term morbidity and mortality compared with SAVR.
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Cardiovasc Revasc Med · May 2020
Clinical Indications of IMPELLA Short-Term Mechanical Circulatory Support in a Tertiary Centre.
The Impella family of devices are short-term mechanical circulatory support (MCS) pumps that hold promise in treating patients with acute cardiogenic shock, acting as bridge to recovery, transplant or durable left ventricular assist device. We assessed the clinical utility, indications and outcomes of the Impella family of devices in a tertiary centre. ⋯ The Impella short-term mechanical assist device provides immediate improvement in hemodynamic parameters and end organ function recovery. Patient outcomes are heavily influenced by the stage of shock and the timely insertion of MCS.
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Cardiovasc Revasc Med · May 2020
Comparative Study Observational StudyTransfemoral Transcatheter Aortic Valve Replacement Using Fascia Iliaca Block as an Alternative Approach to Conscious Sedation as Compared to General Anesthesia.
General Anesthesia (GA) and conscious sedation (CS) are anesthetics for transfemoral transcatheter aortic valve replacement (TF-TAVR). We compared TF-TAVR outcomes using a novel anesthetic approach with fascia iliaca block (FIB) plus minimal CS (MCS) versus GA. ⋯ TF-TAVR using FIB-MCS is feasible and safe with shorter OR time, ICU and hospital LOS, lower risk of 30-day re-hospitalization, similar 30-day and 1-year mortality with better quality of life at 1-year follow-up.
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Cardiovasc Revasc Med · Apr 2020
Review Meta AnalysisLow-Risk Transcatheter Versus Surgical Aortic Valve Replacement - An Updated Meta-Analysis of Randomized Controlled Trials.
To perform a meta-analysis including all available randomized controlled trials (RCTs) to date comparing transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) and low surgical risk. ⋯ In low-risk patients with severe AS, TAVR has a lower early mortality compared to SAVR with no difference in long-term mortality. Although complication rates varied between TAVR and SAVR, our study findings suggest that transfemoral-TAVR is an appropriate treatment option for severe symptomatic AS in patients with low surgical risk.