Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Feb 2014
Randomized Controlled Trial Comparative StudyRandomized trial of surgical cutdown versus percutaneous access in transfemoral TAVR.
To compare iliofemoral arterial complications with transfemoral transcatheter aortic valve replacement (TF-TAVR) utilizing surgical cutdown versus percutaneous access with closure devices in a randomized trial. ⋯ While surgical cutdown in TF-TAVR is the recommended access for new centers initiating a TAVR program, this small randomized pilot study suggests the lesser invasive percutaneous method in an experienced center is equivalent in safety to the surgical method. Doppler ultrasound may be useful in predicting complications prior to the procedure.
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Catheter Cardiovasc Interv · Feb 2014
Case ReportsSheathless transcatheter aortic valve implantation via the direct aortic approach.
Transcatheter aortic valve replacement (TAVR) has become an accepted alternate treatment modality to surgical aortic valve replacement in high surgical risk patients. There remains, however, a subset of patients in whom safe delivery of a TAVR device cannot be achieved by the femoral or subclavian routes. In such cases the direct aortic or transapical routes can be used though this still requires suitable anatomy. We present the first reported case of a direct aortic TAVR using a sheathless technique in order to provide sufficient distance to safely deliver the prosthesis.
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Catheter Cardiovasc Interv · Feb 2014
Multicenter StudyPatent foramen ovale closure with the Gore septal occluder: initial UK experience.
To report procedural outcome and short-term follow-up data for the Gore septal occluder (GSO), a new device for closure of patent foramen ovale (PFO). ⋯ The GSO is an effective occlusion device for closure of PFO of all types. Longer-term follow-up particularly to document later closure rates are required.
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Catheter Cardiovasc Interv · Feb 2014
Comparative Study Observational StudyOutcomes of small coronary artery stenting with bare-metal stents versus drug-eluting stents: results from the NHLBI Dynamic Registry.
Examine 1-year outcomes of patients with small coronary arteries in the National Heart, Lung, and Blood Institute Dynamic Registry (NHLBI) undergoing drug-eluting stent (DES) vs. bare-metal stent (BMS) placement. ⋯ In this real-world registry, patients with small coronary arteries treated with DES had significantly lower rates of repeat revascularization and major adverse cardiovascular events at 1 year compared to patients treated with BMS, with no increase in the risk of death and MI. These data confirm the efficacy and safety of DES over BMS in the treatment of small coronary arteries in routine clinical practice.