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Minimalist Transcatheter Aortic Valve Replacement: The New Standard for Surgeons and Cardiologists Using Transfemoral Access?

Sunday, August 16, 2015

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Source Name: The Journal of Thoracic and Cardiovascular Surgery


Jensen HA, Condado JF, Devireddy C, Binongo J, Leshnower BG., Babaliaros V, Sarin EL, Lerakis S, Guyton RA, Stewart JP, Syed AO, Mavromatis K, Kaebnick B, Rajei M, Tsai LL., Rahman A, Simone A, Keegan P, Block, Thourani, Vinod H.

The authors investigate the safety of minimally invasive Transcatheter Aortic Valve Replacement (MA-TAVR) and its learning curve.  MA-TAVR was performed by a team consisting of a cardiologist and cardiac surgeon. The patient was teated in a catheterization laboratory under conscious sedation. During the series the routine changed from transferring patients to the ICU to transferring patients to a regular telemetry room.  The authors found in 151 consecutive cases that the majority of patients were high surgical risk (STS-PROM of 10.0%). The rates of major stroke (3.3%), major vascular complications (3%) and paravalvular leak (7%) did not change over time.  The authors conclude that in a high-volume TAVR center, MA-TAVR is feasible. Moreover, they conclude that the learning curve for moving from regular TAVR to MA-TAVR is small and that TAVR centers actively pursue the minimalist technique.

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