Essay on Transcatheter Aortic Valve Replacement

Essay on Transcatheter Aortic Valve Replacement

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Transcatheter aortic valve replacement (TAVR) introduction to the clinical practice revolutionized the interventional cardiology ,it is a valuable option for a non –operable patient with sever aortic stenosis or high risk population however ,TAVR is associated with a risk of cerebral embolization and ischemic vascular events and possible neurological impairment the estimate of these complication is vary but it have been reported early and late after the procedure moreover the reported incidence of bleeding associated with TAVI is relatively high .with this given incident of complication required adequate antithrombotic therapy during and following procedure ,however despite the current guidelines recommendation the optimal antithrombotic is not very well established .
Introduction:
Sever Aortic Stenosis (AS) is a major cause of mortality and morbidity in elderly duo to a bimodal age distribution ,degenerative calcification of Tricuspid valve is the major cause of AS in the population ,unlike the younger patient etiology which is : bicuspid valve calcification or rheumatic heart disease .1
The Burden of the disease is high with a prevalence of 3.4% 2. With the progressive nature of the disease and the increased severity of the symptoms made the surgery the gold standard for symptomatic AS patients ,however up to 30% of cases are considered too high risk for classical valve replacement surgery and remain untreated and experiencing poor prognosis . Fortunately , with the introduction of TAVR its offer a valuable option for the inoperable or at high risk of surgery patients3..the annual eligible candidate for this procedure expected to be 27,000 in 19 European countries and North America according to recent meta-analysis an...


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..., Welsh R, Feindel C, Lichtenstein S. Transcatheter aortic valve implantation: a Canadian Cardiovascular Society position statement. Can J Cardiol. 2012;28:520-8.
26-Noble S, Asgar A, Cartier R, Virmani R, Bonan R. Anatomopathological analysis after CoreValve ReValving system implantation.EuroIntervention 2009;5:78–85.
27-Ussia GP, Scarabelli M, Mulè M, et al. Dual antiplatelet therapy versus aspirin alone in patients undergoing transcatheter aortic valve implantation.Am J Cardiol 2011;108:1772–6.
28- Aspirin Versus Aspirin þ Clopidogrel Following Transcatheter Aortic Valve Implantation: the ARTE trial. 2012. Available at: http://clinicaltrials.gov/ct2/show/nct01559298?term¼nct01559298&rank¼1.Accessed May 30, 2012.
29-Jean-Philippe Collet, Gilles Montalescot, Antithrombotic and antiplatelet therapy in TAVI patients:a fallow field? EuroIntervention 2013;9:S43-S47



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