TAVI et al Flashcards
Life expectancy recommendation for TAVI
the patient should have a predicted post-TAVI survival of 12 months
Life expectancy for aortic stenosis symptomatic with angina
5 years
life expectancy for aortic stenosis symptomatic with syncope
3 years
life expectancy for aortic stenosis symptomatic with chf
two years
(as opposed to syncope, there have been changes to the LV)
who makes the core valve
Medtronic
who makes the Sapien valve
Edwards
Which valve is balloon expanding
Edwards - Sapien
Which valve is self-expanding
Medtronic Core Valve
what sizes are available for the Edwards Sapien
20, 23, 26, 29 mm
which valve was involved in the PARTNER trial
the Sapien (Edwards)_
Partner A study groups
compared TAVR against SAVR in high-risk surgical patients
predicted by a surgical death of 15%
PARTNER A results at:
1 month
1 - year
5- year
1 month: TAVR: 3.4 SAVR: 6.6
1 year: TAVR: 24.2%, SAVR: 26.8 (p = 0.001)
5 year: TAVR: 67.8%; SAVR: 62.4 (p = 0.76)
Partner B Trial study groups
compared TAVR vs Medical therapy
patients who were not considered suitable for surgery by a combined risk of:
Death + irreversible comorbid > 50%
Partner A trial
30-day mortality
1 month: TAVR: 3.4 SAVR: 6.6
Partner A trial
1-year mortality
1 year: TAVR: 24.2%, SAVR: 26.8 (p = 0.001)
Partner A trial
5-year Mortality
5 year: TAVR: 67.8%; SAVR: 62.4 (p = 0.76)
results of the PARTNER C trial at
1 year
5 years
1 year: TAVR 30.7 / OMM: 50.7
5 years: 71.8 / OMM: 93.6
sizes available for the CORE valve
23, 26, 29,31 mm
what trial compared ballon and self-expandable TAVI valves
in what outcomes was there a difference?
the CHOICE trial
The self-expandable had higher rates of
- new pacemaker implant
- Aortic regurgitation
- valve embolization
- need for more than one valve
Predictors of 30-day mortality after TAVI
- requirement for open heart surgery
- Tamponade
- Vascular sequelae
- Poor LVEF (<40%) i.e. low flow
- prior balloon valvuloplasty
- Diabetes
