TAVR or SAVR: Beyond the STS Score
5/24/2017
TAVR or SAVR: Beyond the STS Score
Juan Crestanello, MD
Lakshmi Prasad Dasi, PhD
Division of Cardiac Surgery Department of Biomedical Engineering
The Ohio State University Wexner Medical Center
1
Disclosures
Dr. Dasi NIH/NHLBI NIH/NIBIB NIH/NCAI AHA
Dr. Crestanello Research Grants from:
Medtronic Boston Scientific Abbot Vascular
2
1
5/24/2017
Patient Selection for SAVR vs TAVR
Risk Profile STS PROM + Frailty + Other Comorbidities
Low Risk
Intermediate Risk
High Risk
Extreme Innoperable
Risk
SAVR
TAVR
Moving Beyond Risk
Age-Life Expectancy-Valve Durability Concomitant cardiac disease
Mitral valve disease Coronary artery disease Valve and Aortic Root Anatomy Bicuspid Aortic Valve LVOT Calcification Small root-low lying coronary ostia
2
Moving Beyond Risk
Age-Life Expectancy-Valve Durability Concomitant cardiac disease
Mitral valve disease Coronary artery disease Valve and Aortic Root Anatomy Bicuspid Aortic Valve LVOT Calcification Small root-low lying coronary ostia
5/24/2017
Age and Life Expectancy: Longer Survival
Survival General Population
40
32
30 24
20
17
10
8
Survival after Surgical AVR
40
30
21
20 15
11
10
6
Survival (Years) Survival (Years)
0 50 60 70 80 Age
0 50 60 70 80 Age
Social Security Life Tables
6
Birkmeyer et al. Ann Thorac Surg 2000
3
5/24/2017
Surgical Valve Durability
Freedom from Structural Valve Deterioration: Surgical AVR
10-15 years
Bourguinion et al. Ann Thorac Surg 2015
7
Age and Life Expectancy: Longer Survival
Survival General Population
40
32
30 24
20
17
10
8
Survival after Surgical AVR
40
30
21
20 15
11
10
6
Survival (Years) Survival (Years)
0
0
50 60 70 80
50 60 70 80
FArgeeedom From SVD: Surgical AVARge
Social Security Life Tables
8
Birkmeyer et al. Ann Thorac Surg 2000
4
5/24/2017
Age and Life Expectancy: Longer Survival
Survival General Population
40
32
30 24
20
17
10
8
Survival after Surgical AVR
40
32% 21% 12% 3%
30
21
20
REO1P5ERATION
11
10
6
Survival (Years) Survival (Years)
0
0
50 60 70 80
50 60 70 80
FArgeeedom From SVD: Surgical AVARge
Social Security Life Tables
9
Birkmeyer et al. Ann Thorac Surg 2000
TAVR Durability
10
5
TAVR Durability
5/24/2017
11
Age and Life Expectancy: Longer Survival
Survival General Population
40
32
30 24
20
17
10
8
Survival
after Surgical AVR
40
HIGHER
REOPERATION
30
RATE
21
20 15
11
10
6
Survival (Years) Survival (Years)
0
0
50 60 70 80
50 60 70 80
Age Freedom From SVD: TAVR Age
12
6
Moving Beyond Risk
Age-Life Expectancy-Valve Durability Concomitant cardiac disease
Mitral valve disease Coronary artery disease Ascending aortic aneurysms Other Valve and Aortic Root Anatomy LVOT Calcification Small root-low lying coronary ostia Bicuspid Aortic Valve
Moving Beyond Risk
Age-Life Expectancy-Valve Durability Concomitant cardiac disease
Mitral valve disease Coronary artery disease Ascending aortic aneurysms Other Valve and Aortic Root Anatomy Annular and LVOT Calcification Small root-low lying coronary ostia Bicuspid Aortic Valve
5/24/2017 7
Annular and LVOT Calcification
LVOT Calcification
Valve Underexpansion
Paravalvular Leak
15
Annular Rupture
Annular and LVOT Calcification
Paravalvular Leak - opposing side
16
5/24/2017 8
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- how to use risk score systems on severe aortic stenosis
- tavr criteria procedure pre post care
- tavr trends risk assessment for transcatheter aortic valve
- high risk conventional cardiac surgery current strategy
- summary of safety and effectiveness data
- the society of thoracic surgeons 2018 adult cardiac
- performance of the euroscore ii and the sts score for
- i introduction sts
- appendix c the society of thoracic surgeons european
- title a novel echo parameter supersedes the society of
Related searches
- beyond the sea of ice
- beyond the ice limit book
- beyond the ice limit
- beyond the ice limit preston
- find the z score of a number
- what lies beyond the universe
- beyond the observable universe
- beyond the ordinary meaning
- beyond the ordinary show live
- beyond the ordinary podcast
- beyond the ordinary show replay
- john beyond the ordinary