19. Evolución de la estenosis aórtica 1.S.J Lester et al.Chest 1998 Cuadro: Ross J Jr, Braunwald Aortic Stenosis Circulation 1968
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21.
22. Surgery was denied in 33% of elderly patients with severe, symptomatic AS.
23. Sobrevida de pacientes con EA severa con y sin RVA AS=aortic stenosis; AVR=aortic valve replacement. 1. Varadarajan P, et al. Eur J Cardiothorac Surg . 2006;30:722-727.
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25. 2007 2008 2009 2010 No of procedures 1.2% 6.5% 13% 20% TAVI SAVR
26. TAVI valves Today Tomorrow Boston Sci. Lotus™ HLT Direct Flow Saint Jude Portico™ Symetis ACCURATE JenaValve Medtronic Engager Edwards Sapien Medtronic CoreValve Next Gen. Medtronic CoreValve Edwards Sapien XT Edwards Sapien XT
28. CoreValve ® EU Safety and Performance Study Hemodynamic Performance at 2 Years 1. Buellesfeld L, et al. J Am Coll Cardiol . 2011;57:1650-1657.
29. CoreValve ® EU Safety and Performance Study Functional Improvement at 2 Years 1. Gerckens U. Stable durability and effectiveness at 2 years with CoreValve ® transcatheter aortic valve. Presented at: EuroPCR; May 17-20, 2011; Paris, France.
30. CoreValve ® EU Safety and Performance Study Aortic Regurgitation at 2 Years 1. Gerckens U. Stable durability and effectiveness at 2 years with CoreValve ® transcatheter aortic valve. Presented at: EuroPCR; May 17-20, 2011; Paris, France.
38. Timing of Neurological Events 0-2 days 3-5 days 31-364 days 11-30 days 6-10 days 2-3 years 1-2 years AATS May, 2011 D. Craig Miller , M.D. >51% Periprocedural AVR TAVR AVR TAVR AVR TAVR AVR TAVR AVR TAVR AVR TAVR AVR TAVR
Pre-closing with ProStar™ No cardiac assistance ProStar - Source: Grube, et al. Progress and Current Status of Percutaneous AVR: Results of three device generations of the CRS, Dec 2008 , Circ Cardivasc Intervent
Key Message: There were sustained improvements in hemodynamic performance through 2 years. The CoreValve ® System EU Safety and Performance Study also investigated valve performance (including transvalvular gradient and valve regurgitation grade as measured by control Doppler echocardiography as well as effective prosthetic valve orifice area) over time, up to 2 years post implantation. In all measurements, valve performance showed a marked improvement at implantation (as a result of the new valve), and these analyses demonstrated that for those patients with evaluable echo data, the mean outcomes of valve performances across time points remained relatively stable to 2 years. For example, the available mean effective orifice area for all groups combined increased from 0.72 cm 2 to 1.81 cm 2 at discharge and ranged from 1.71 cm 2 to 1.81 cm 2 between discharge and 2 years post operative. It is notable that none of the follow-up readings of aortic regurgitation from the Echo Core Lab were grade 2 or higher at any time point in any of the risk assessment groups. Reference: Buellesfeld L, et al. J Am Coll Cardiol . 2011;57:1650-1657.
Key Message: There was a significant and sustained NYHA functional heart class improvement at 2 years. This slide illustrates the change in functional status over time for the combined cohort as well as for the 3 risk groups at discharge, 1 month, 6 months, 1 year, and 3 years post implantation. In the figure, levels refers to NYHA functional classes (I to IV). Although the sample sizes vary among groups and the total number of evaluable patients decreases over time, a majority of patients maintain an improved functional status at every time point. Reference: Gerckens U. Stable durability and effectiveness at 2 years with CoreValve ® transcatheter aortic valve. Presented at: EuroPCR; May 17-20, 2011; Paris, France.
Key Message: There were clinically acceptable rates of aortic regurgitation at 2 years. CoreValve ® System performance, including transvalvular gradient and valve regurgitation grade, was measured over time, up to 2 years post implantation. It is notable that none of the follow-up readings of aortic regurgitation from the Echo Core Lab were grade 2 or higher at any time point in any of the risk assessment groups. Reference: Gerckens U. Stable durability and effectiveness at 2 years with CoreValve ® transcatheter aortic valve. Presented at: EuroPCR; May 17-20, 2011; Paris, France.
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