Transcatheter Aortic-Valve Replacement with a Balloon-Expandable Valve in Low-Risk Patients.

Aged Aortic Valve / surgery Aortic Valve Stenosis / complications Atrial Fibrillation / etiology Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation / adverse effects Humans Kaplan-Meier Estimate Length of Stay Male Patient Readmission / statistics & numerical data Postoperative Complications / epidemiology Prosthesis Design Risk Factors Stroke / epidemiology Transcatheter Aortic Valve Replacement / adverse effects

Journal

The New England journal of medicine
ISSN: 1533-4406
Titre abrégé: N Engl J Med
Pays: United States
ID NLM: 0255562

Informations de publication

Date de publication:
02 05 2019
Historique:
pubmed: 19 3 2019
medline: 29 5 2019
entrez: 19 3 2019
Statut: ppublish

Résumé

Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk. We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery. The primary end point was a composite of death, stroke, or rehospitalization at 1 year. Both noninferiority testing (with a prespecified margin of 6 percentage points) and superiority testing were performed in the as-treated population. At 71 centers, 1000 patients underwent randomization. The mean age of the patients was 73 years, and the mean Society of Thoracic Surgeons risk score was 1.9% (with scores ranging from 0 to 100% and higher scores indicating a greater risk of death within 30 days after the procedure). The Kaplan-Meier estimate of the rate of the primary composite end point at 1 year was significantly lower in the TAVR group than in the surgery group (8.5% vs. 15.1%; absolute difference, -6.6 percentage points; 95% confidence interval [CI], -10.8 to -2.5; P<0.001 for noninferiority; hazard ratio, 0.54; 95% CI, 0.37 to 0.79; P = 0.001 for superiority). At 30 days, TAVR resulted in a lower rate of stroke than surgery (P = 0.02) and in lower rates of death or stroke (P = 0.01) and new-onset atrial fibrillation (P<0.001). TAVR also resulted in a shorter index hospitalization than surgery (P<0.001) and in a lower risk of a poor treatment outcome (death or a low Kansas City Cardiomyopathy Questionnaire score) at 30 days (P<0.001). There were no significant between-group differences in major vascular complications, new permanent pacemaker insertions, or moderate or severe paravalvular regurgitation. Among patients with severe aortic stenosis who were at low surgical risk, the rate of the composite of death, stroke, or rehospitalization at 1 year was significantly lower with TAVR than with surgery. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov number, NCT02675114.).

Sections du résumé

BACKGROUND
Among patients with aortic stenosis who are at intermediate or high risk for death with surgery, major outcomes are similar with transcatheter aortic-valve replacement (TAVR) and surgical aortic-valve replacement. There is insufficient evidence regarding the comparison of the two procedures in patients who are at low risk.
METHODS
We randomly assigned patients with severe aortic stenosis and low surgical risk to undergo either TAVR with transfemoral placement of a balloon-expandable valve or surgery. The primary end point was a composite of death, stroke, or rehospitalization at 1 year. Both noninferiority testing (with a prespecified margin of 6 percentage points) and superiority testing were performed in the as-treated population.
RESULTS
At 71 centers, 1000 patients underwent randomization. The mean age of the patients was 73 years, and the mean Society of Thoracic Surgeons risk score was 1.9% (with scores ranging from 0 to 100% and higher scores indicating a greater risk of death within 30 days after the procedure). The Kaplan-Meier estimate of the rate of the primary composite end point at 1 year was significantly lower in the TAVR group than in the surgery group (8.5% vs. 15.1%; absolute difference, -6.6 percentage points; 95% confidence interval [CI], -10.8 to -2.5; P<0.001 for noninferiority; hazard ratio, 0.54; 95% CI, 0.37 to 0.79; P = 0.001 for superiority). At 30 days, TAVR resulted in a lower rate of stroke than surgery (P = 0.02) and in lower rates of death or stroke (P = 0.01) and new-onset atrial fibrillation (P<0.001). TAVR also resulted in a shorter index hospitalization than surgery (P<0.001) and in a lower risk of a poor treatment outcome (death or a low Kansas City Cardiomyopathy Questionnaire score) at 30 days (P<0.001). There were no significant between-group differences in major vascular complications, new permanent pacemaker insertions, or moderate or severe paravalvular regurgitation.
CONCLUSIONS
Among patients with severe aortic stenosis who were at low surgical risk, the rate of the composite of death, stroke, or rehospitalization at 1 year was significantly lower with TAVR than with surgery. (Funded by Edwards Lifesciences; PARTNER 3 ClinicalTrials.gov number, NCT02675114.).

Identifiants

DOI: 10.1056/NEJMoa1814052 PMID: 30883058
pubmed: 30883058
doi: 10.1056/NEJMoa1814052
doi:

Banques de données

ClinicalTrials.gov
['NCT02675114']

Types de publication

Comparative Study Equivalence Trial Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1695-1705

Investigateurs

Mohammad El-Hajjar (M)
Stephen Bailey (S)
John Brown (J)
Robert Kipperman (R)
Mark Webster (M)
Frank Zidar (F)
Faraz Kerendi (F)
Ashish Pershad (A)
Kenith Fang (K)
H Garrett (H)
Basil Paulus (B)
Pinak Shah (P)
Tsuyoshi Kaneko (T)
Bassem Chehab (B)
Brett Grizzell (B)
Michael Rinaldi (M)
Eric Skipper (E)
Raj Makkar (R)
Alfredo Trento (A)
Andrew Eisenhauer (A)
Susheel Kodali (S)
Isaac George (I)
Tamim Nazif (T)
Shing Chiu Wong (SC)
Arash Salemi (A)
James DeVries (J)
Joseph DeSimone (J)
Vinod Thourani (V)
Robert Guyton (R)
Vasilis Babaliaros (V)
Kevin Accola (K)
Raymond McKay (R)
Robert Hagberg (R)
William O'Neill (W)
Gaetano Paone (G)
DImitrios Apostolou (D)
Jorge Castellanos (J)
Anthony Caffarelli (A)
Shahram Yazdani (S)
Eric Sarin (E)
Brian Whisenant (B)
Kent Jones (K)
Marcos Nores (M)
Mark Rothenberg (M)
Edward McNulty (E)
Richard Richter (R)
Kentaro Hayashida (K)
Paul Coady (P)
Scott Goldman (S)
David Holmes (D)
Kevin Greason (K)
Bruce Bowers (B)
Todd Dewey (T)
David Daniels (D)
Conrad Vial (C)
Noah Jones (N)
Patrick Wells (P)
Steve Xydas (S)
Nirat Beohar (N)
Willis Wu (W)
Curtis Anderson (C)
Steven Martin (S)
James Wudel (J)
Mathew Williams (M)
Mark Russo (M)
Bruce Haik (B)
Ted Feldman (T)
Hyde Russell (H)
Chris Malaisrie (C)
Charles Davidson (C)
Stephen Ramee (S)
Patrick Parrino (P)
Mark Bodenhamer (M)
Mohammad Ghani (M)
Yasushi Sakata (Y)
John Gill (J)
Robert Hodson (R)
Jeffrey Swanson (J)
Joseph Montarello (J)
Clifford Kavinsky (C)
Adnan Chhatriwalla (A)
Evelio Rodriguez (E)
Andrew Morse (A)
Paul Mahoney (P)
Joseph Newton (J)
John Webb (J)
Craig Miller (C)
Alan Yeung (A)
Pei-Hsiu Huang (PH)
Michael Ingram (M)
Ken Kozuma (K)
Dean Kereiakes (D)
Geoffrey Answini (G)
Samir Kapadia (S)
David Brown (D)
Michael Mack (M)
Christian Spies (C)
Benjamin Plank (B)
Jeffrey Lau (J)
Richard Smalling (R)
Tuyen Tom Nguyen (TT)
Brad Oldemeyer (B)
Mark Guadagnoli (M)
Vijay Iyer (V)
Gary Grosner (G)
James Davies (J)
Richard Shemin (R)
William Suh (W)
Thomas Beaver (T)
David Anderson (D)
Phillip Horwitz (P)
Gregory Helmer (G)
Kenneth Liao (K)
Joseph Bavaria (J)
Howard Herrmann (H)
Gorav Ailawadi (G)
James McCabe (J)
Gabriel Aldea (G)
Giorgio Gimelli (G)
Lucian Lozonschi (L)
Satoru Osaki (S)
Alan Zajarias (A)
Hersh Maniar (H)
George Hanzel (G)
Francis Shannon (F)
Richard Schwartz (R)
William Nicholson (W)
Mark Burlingame (M)

Commentaires et corrections

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Informations de copyright

Copyright © 2019 Massachusetts Medical Society.

Auteurs

Michael J Mack (MJ)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Martin B Leon (MB)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Vinod H Thourani (VH)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Raj Makkar (R)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Susheel K Kodali (SK)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Mark Russo (M)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Samir R Kapadia (SR)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

S Chris Malaisrie (SC)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

David J Cohen (DJ)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Philippe Pibarot (P)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Jonathon Leipsic (J)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Rebecca T Hahn (RT)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Philipp Blanke (P)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Mathew R Williams (MR)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

James M McCabe (JM)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

David L Brown (DL)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Vasilis Babaliaros (V)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Scott Goldman (S)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Wilson Y Szeto (WY)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Philippe Genereux (P)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Ashish Pershad (A)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Stuart J Pocock (SJ)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Maria C Alu (MC)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

John G Webb (JG)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

Craig R Smith (CR)

From Baylor Scott and White Health, Plano, TX (M.J.M., D.L.B.); Columbia University Irving Medical Center and New York-Presbyterian Hospital (M.B.L., S.K.K., R.T.H., M.C.A., C.R.S.) and New York University Langone Medical Center (M.R.W.) - both in New York; Medstar Heart and Vascular Institute, Georgetown University, Washington, DC (V.H.T.); Cedars-Sinai Heart Institute, Los Angeles (R.M.); Robert Wood Johnson Medical School, Rutgers University, New Brunswick (M.R.), and Gagnon Cardiovascular Institute, Morristown Medical Center, Morristown (P.G.) - both in New Jersey; Cleveland Clinic, Cleveland (S.R.K.); Feinberg School of Medicine, Northwestern University, Chicago (S.C.M.); Saint Luke's Mid America Heart Institute, Kansas City, MO (D.J.C.); Quebec Heart and Lung Institute, Laval University, Quebec, QC (P.P.), and St. Paul's Hospital, University of British Columbia, Vancouver (J.L., P.B., J.G.W.) - both in Canada; University of Washington, Seattle (J.M.M.); Emory University Hospital, Atlanta (V.B.); Lankenau Medical Center, Wynnewood (S.G.), and the Hospital of the University of Pennsylvania, Philadelphia (W.Y.S.) - both in Pennsylvania; Banner University Medical Center, Phoenix, AZ (A.P.); and the London School of Hygiene and Tropical Medicine, London (S.J.P.).

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Système cardiovasculaire › Coeur › Valves cardiaques › Valve aortique › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Obstacle à l'éjection ventriculaire › Sténose aortique › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Prothèse valvulaire cardiaque › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Estimation de Kaplan-Meier › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Durée du séjour › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Hospitalisation › Réadmission du patient › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Équipement et fournitures › Prothèses et implants › Conception de prothèse › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Transcatheter Aortic-Valve Replacement with a...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Implantation de valve prothétique cardiaque › Remplacement valvulaire aortique par cathéter › Transcatheter Aortic-Valve Replacement with a...