Recent Developments in Transcatheter Aortic Valve Implantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 693

Special Issue Editor


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Guest Editor
The Cardiac Centre NSW, 3 Rawson St, Wollongong, NSW 2500, Australia
Interests: cardiac catheterisation; coronary angioplasty; TAVI; coronary interventions; aortic valve interventions; echocardiogram

Special Issue Information

Dear Colleagues,

Aortic stenosis (AS) is a common heart valve disease that can lead to heart failure and death. For patients with AS, valve repair or replacement surgery has historically been the mainstay of treatment, given that medical treatments have no proven benefit. However, transcatheter aortic valve implantation (TAVI) is increasingly becoming a preferred treatment option when compared to surgery, particularly for patients at an advanced age or those with comorbidities, as recovery from the treatment is typically much quicker.

TAVI is a minimally invasive treatment, as biological valve implantation is performed percutaneously (on top of the diseased valve without its removal) via an intra-arterial sheath. This technology has evolved over the past 20 years to be equivalent in terms of safety and efficacy to aortic surgery with up to 10 years follow-up. There are also numerous advantages for patients and healthcare systems,  including abbreviated hospitalisation periods for treatment, less perioperative discomfort, and quicker recovery times.

This Special Issue aims to promote academic exchanges, progress the field of TAVI, and promote the widespread application of this technology in the treatment of heart valve diseases, including in more complex patient cases and scenarios.

Dr. Edward James Frazer Danson
Guest Editor

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Keywords

  • transcatheter aortic valve implantation
  • TAVI
  • aortic valve stenosis
  • interventional cardiac surgery
  • heart valve disease

Published Papers (1 paper)

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Research

13 pages, 1282 KiB  
Article
Platelet Reduction after Transcatheter Aortic Valve Implantation: Results from the PORTRAIT Study
by Federica Jiritano, Michele Di Mauro, Giuseppe Filiberto Serraino, Pasquale Mastroroberto, Elena Caporali, Enrico Ferrari, Mariusz Kowalewski, Roberto Scrofani, Leonardo Patanè, Giuseppe Visicchio, Domenico Paparella, Giosuè Falcetta, Andrea Colli, Matteo Matteucci, Giangiuseppe Cappabianca, Francesco Pollari, Theodor Fischlein and Roberto Lorusso
J. Clin. Med. 2024, 13(6), 1579; https://doi.org/10.3390/jcm13061579 - 10 Mar 2024
Viewed by 532
Abstract
Background: An unexplained condition that follows transcatheter aortic valve implantation (TAVI) is platelet count reduction (PR). According to published research, patients with balloon-expandable valves (BEVs) had a greater PR than those with self-expandable valves (SEVs). Objectives: The purpose of this study was to [...] Read more.
Background: An unexplained condition that follows transcatheter aortic valve implantation (TAVI) is platelet count reduction (PR). According to published research, patients with balloon-expandable valves (BEVs) had a greater PR than those with self-expandable valves (SEVs). Objectives: The purpose of this study was to investigate the incidence and clinical effects of PR following TAVI. Methods: In total, 1.122 adult TAVI patients were enrolled. Propensity score matching was carried out in a 1:1 ratio between patients with BEVs and those with SEVs. The analysis included changes in platelet count, in-hospital mortality, and early postoperative adverse events. Results: Notably, 632 patients were matched (BEV:316; SEV:316). All patients’ post-procedural platelet counts changed according to a parabolic curve, using a mixed regression model for repeated analyses (estimate = −0.931; standard error = 0.421; p = 0.027). The platelet count varied comparably in patients with BEVs and SEVs (estimate = −4.276, standard error = 4.760, p = 0.369). The average time for obtaining the nadir platelet count value was three days after implantation (BEV: 146 (108–181) vs. SEV: 149 (120–186); p = 0.142). Overall, 14.6% of patients (92/632) had post-procedural platelet count <100,000/µL. There was no difference between the two prosthesis types (BEV:51/316; SEV:41/316; p = 0.266). Thrombocytopenia was found to be significantly linked to blood product transfusions, lengthier stays in the intensive care unit and hospital, and in-hospital mortality. Conclusions: TAVI, irrespective of the type of implanted valve, is linked to a significant but temporary PR. Thrombocytopenia increases the risk of serious complications and in-hospital death in TAVI patients. To explore and clarify the causes and associated effects, further prospective research is necessary. Full article
(This article belongs to the Special Issue Recent Developments in Transcatheter Aortic Valve Implantation)
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