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Transcatheter Aortic Valve Replacement: Current Evidence from Large Multicenter Registries

Chapter

Abstract

Background: Surgical aortic valve replacement (SAVR) has been considered as a standard of care for treatment of severe symptomatic aortic stenosis (AS). Transcatheter aortic valve replacement (TAVR) has emerged as an attractive alternative for treatment of severe AS in high-risk patients. Despite several large multicenter registries, only one randomized trial (PARTNER) has been published. In the following section, we have summarized the safety and efficacy data from the large multicenter registries.

Results: Although there was a significant degree of heterogeneity in estimates from various registries, the current data have established a reasonable degree of safety and efficacy of TAVR in treatment of severe AS. The 30-day mortality rate ranged from 5.6 % to 13.8 % across the registries. One-year mortality rate ranged from 14.9 % to 36.9 % across all multicenter registries. Besides mortality, the section also reviews incidence rates of several endpoints including myocardial infarction, stroke, conduction abnormalities, arrhythmias and so on. Notably, the 30-day stroke incidence ranged between 1.2 to 4.4 % across the multicenter registries, which was considerably lower than that observed in the PARTNER trial.

Conclusions: TAVR has demonstrated a great degree of promise in treatment of severe symptomatic AS, with favorable short-term and medium-term outcomes. The data from the available multicenter registries has clearly demonstrated that patient selection would be the key to cost-effective utilization of this revolutionary technology.

Keywords

Multicenter registries Transcatheter aortic valve replacement Mortality Permanent pacemaker Aortic stenosis Aortic regurgitation Stroke Edwards SAPIEN CoreValve 

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Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  1. 1.Department of Cardiovascular MedicineCleveland ClinicClevelandUSA
  2. 2.Department of Interventional Cardiology, Sones Cardiac Catheterization Laboratories, Interventional Cardiology Fellowship ProgramCleveland ClinicClevelandUSA

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