TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation.
Identifieur interne : 001618 ( PubMed/Checkpoint ); précédent : 001617; suivant : 001619TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation.
Auteurs : Rishi Puri [États-Unis] ; Bernard Iung [France] ; David J. Cohen [États-Unis] ; Josep Rodés-Cabau [Canada]Source :
- European heart journal [ 1522-9645 ] ; 2016.
Abstract
Transcatheter aortic valve implantation (TAVI) has spawned the evolution of novel catheter-based therapies for a variety of cardiovascular conditions. Newer device iterations are delivering lower peri- and early post-procedural complication rates in patients with aortic stenosis, who were otherwise deemed too high risk for conventional surgical valve replacement. Yet beyond the post-procedural period, a considerable portion of current TAVI recipients fail to derive a benefit from TAVI, either dying or displaying a lack of clinical and functional improvement. Considerable interest now lies in better identifying factors likely to predict futility post-TAVI. Implicit in this are the critical roles of frailty, disability, and a multimorbidity patient assessment. In this review, we outline the roles that a variety of medical comorbidities play in determining futile post-TAVI outcomes, including the critical role of frailty underlying the identification of patients unlikely to benefit from TAVI. We discuss various TAVI risk scores, and further propose that by combining such scores along with frailty parameters and the presence of specific organ failure, a more accurate and holistic assessment of potential TAVI-related futility could be achieved.
DOI: 10.1093/eurheartj/ehv756
PubMed: 26819226
Affiliations:
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Cohen</name><affiliation wicri:level="2"><nlm:affiliation>Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Saint Luke's Mid America Heart Institute, Kansas City, MO</wicri:regionArea><placeName><region type="state">Missouri (État)</region></placeName></affiliation></author><author><name sortKey="Rodes Cabau, Josep" sort="Rodes Cabau, Josep" uniqKey="Rodes Cabau J" first="Josep" last="Rodés-Cabau">Josep Rodés-Cabau</name><affiliation wicri:level="1"><nlm:affiliation>Québec Heart and Lung Institute, Laval University, 2725 chemin Ste-Foy, Québec City, QC, Canada josep.rodes@criucpq.ulaval.ca.</nlm:affiliation><country wicri:rule="url">Canada</country><wicri:regionArea>Québec Heart and Lung Institute, Laval University, 2725 chemin Ste-Foy, Québec City, QC</wicri:regionArea><wicri:noRegion>QC</wicri:noRegion></affiliation></author></analytic><series><title level="j">European heart journal</title><idno type="eISSN">1522-9645</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Transcatheter aortic valve implantation (TAVI) has spawned the evolution of novel catheter-based therapies for a variety of cardiovascular conditions. Newer device iterations are delivering lower peri- and early post-procedural complication rates in patients with aortic stenosis, who were otherwise deemed too high risk for conventional surgical valve replacement. Yet beyond the post-procedural period, a considerable portion of current TAVI recipients fail to derive a benefit from TAVI, either dying or displaying a lack of clinical and functional improvement. Considerable interest now lies in better identifying factors likely to predict futility post-TAVI. Implicit in this are the critical roles of frailty, disability, and a multimorbidity patient assessment. In this review, we outline the roles that a variety of medical comorbidities play in determining futile post-TAVI outcomes, including the critical role of frailty underlying the identification of patients unlikely to benefit from TAVI. We discuss various TAVI risk scores, and further propose that by combining such scores along with frailty parameters and the presence of specific organ failure, a more accurate and holistic assessment of potential TAVI-related futility could be achieved.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">26819226</PMID><DateCreated><Year>2016</Year><Month>07</Month><Day>22</Day></DateCreated><DateRevised><Year>2016</Year><Month>07</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1522-9645</ISSN><JournalIssue CitedMedium="Internet"><Volume>37</Volume><Issue>28</Issue><PubDate><Year>2016</Year><Month>Jul</Month><Day>21</Day></PubDate></JournalIssue><Title>European heart journal</Title><ISOAbbreviation>Eur. Heart J.</ISOAbbreviation></Journal><ArticleTitle>TAVI or No TAVI: identifying patients unlikely to benefit from transcatheter aortic valve implantation.</ArticleTitle><Pagination><MedlinePgn>2217-25</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1093/eurheartj/ehv756</ELocationID><Abstract><AbstractText>Transcatheter aortic valve implantation (TAVI) has spawned the evolution of novel catheter-based therapies for a variety of cardiovascular conditions. Newer device iterations are delivering lower peri- and early post-procedural complication rates in patients with aortic stenosis, who were otherwise deemed too high risk for conventional surgical valve replacement. Yet beyond the post-procedural period, a considerable portion of current TAVI recipients fail to derive a benefit from TAVI, either dying or displaying a lack of clinical and functional improvement. Considerable interest now lies in better identifying factors likely to predict futility post-TAVI. Implicit in this are the critical roles of frailty, disability, and a multimorbidity patient assessment. In this review, we outline the roles that a variety of medical comorbidities play in determining futile post-TAVI outcomes, including the critical role of frailty underlying the identification of patients unlikely to benefit from TAVI. We discuss various TAVI risk scores, and further propose that by combining such scores along with frailty parameters and the presence of specific organ failure, a more accurate and holistic assessment of potential TAVI-related futility could be achieved.</AbstractText><CopyrightInformation>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Puri</LastName><ForeName>Rishi</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Québec Heart and Lung Institute, Laval University, 2725 chemin Ste-Foy, Québec City, QC, Canada Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Iung</LastName><ForeName>Bernard</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Cardiology Department, AP-HP, Hôpital Bichat Claude Bernard, Paris, France University Paris Diderot, Sorbonne Paris Cité, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cohen</LastName><ForeName>David J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodés-Cabau</LastName><ForeName>Josep</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Québec Heart and Lung Institute, Laval University, 2725 chemin Ste-Foy, Québec City, QC, Canada josep.rodes@criucpq.ulaval.ca.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>01</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Eur Heart J</MedlineTA><NlmUniqueID>8006263</NlmUniqueID><ISSNLinking>0195-668X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Aortic stenosis</Keyword><Keyword MajorTopicYN="N">Futility</Keyword><Keyword MajorTopicYN="N">Risk scores</Keyword><Keyword MajorTopicYN="N">Transcatheter aortic valve implantation</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>08</Month><Day>14</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>12</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2016</Year><Month>1</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>1</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>1</Month><Day>29</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">26819226</ArticleId><ArticleId IdType="pii">ehv756</ArticleId><ArticleId IdType="doi">10.1093/eurheartj/ehv756</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Canada</li><li>France</li><li>États-Unis</li></country><region><li>Missouri (État)</li><li>Ohio</li><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="États-Unis"><region name="Ohio"><name sortKey="Puri, Rishi" sort="Puri, Rishi" uniqKey="Puri R" first="Rishi" last="Puri">Rishi Puri</name></region><name sortKey="Cohen, David J" sort="Cohen, David J" uniqKey="Cohen D" first="David J" last="Cohen">David J. Cohen</name></country><country name="France"><region name="Île-de-France"><name sortKey="Iung, Bernard" sort="Iung, Bernard" uniqKey="Iung B" first="Bernard" last="Iung">Bernard Iung</name></region></country><country name="Canada"><noRegion><name sortKey="Rodes Cabau, Josep" sort="Rodes Cabau, Josep" uniqKey="Rodes Cabau J" first="Josep" last="Rodés-Cabau">Josep Rodés-Cabau</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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