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• W2893821827 abstract "The modern treatment of aortic stenosis (AS) includes transcatether (TAVI) valves as the preferred approach in an increasing number of patients. While the current recommendation for TAVI programs is to offer this therapy as part of a multidisciplinary team, the team composition remains poorly defined. Since the inception of the TAVI program at the New Brunswick Heart Centre in 2010, the team has included members from interventional cardiology, cardiac surgery and interventional radiology. All were assigned complementary roles: vascular access (interventional radiology and cardiac surgery), temporary pacing plus valve crossing (interventional cardiology) and valve deployment (all members). All procedures were carried out in the cardiac catheterization laboratory or the interventional radiology suite with cardiopulmonary bypass standby. A total of 333 TAVI procedures were performed between 2010 and 2017 with a mean age of 80+/-9 years, 40% female, 34% previous heart surgery and 38% peripheral vascular disease. The median STS score was 5.2 (3-9 IQR) and decreased significantly over time from 7.4 in 2010 to 3.9 in 2017 (p=0.001). The majority of valves implanted were balloon expandable (83%). Transfemoral approach was used in 84% of patients but increased significantly over time (2010: 53%, 2017: 100%, p<0.0001). In 2017, 100% of patients were approached using a percutaneous approach and conscious sedation. Overall in hospital mortality was 1.5% and this did not change over time. Significant access complications were seen in only two patients (0.6%) with minor complications limited to 3.9% of patients. Moderate or greater aortic insufficiency post procedure was limited to 2.3% of patients and the permanent pacemaker rate was 10.2%. The New Brunswick Heart Centre was an early adopter of TAVI in Atlantic Canada and established a highly functional team, which included not only cardiology and cardiac surgery but also interventional radiology. The present model has allowed the program to not only evolve towards a percutaneous femoral approach in the majority of patients but has also allowed for low rates of vascular and/or other complications despite a high-risk patient population." @default.
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• W2893821827 date "2018-10-01" @default.
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• W2893821827 title "HOW INTERVENTIONAL RADIOLOGY CAN ENHANCE THE PERFORMANCE OF A TAVI TEAM: NEW BRUNSWICK HEART CENTRE EXPERIENCE" @default.
• W2893821827 doi "https://doi.org/10.1016/j.cjca.2018.07.145" @default.
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