经皮穿刺治疗心脏瓣膜置换术后瓣周漏-英文课件PPT.ppt

Transcatheter Aortic Valve Implantation: Recent Clinical Data;Objectives;First TAVI- Dr Anderson 1992;First Successful Transcatheter Aortic Valve ImplantAntegrade Cribier-Edwards;First UK case 2007: Retrograde Corevalve90 y old lady;Rapid evolution of the Corevalve device;Ongoing evolution of the Edwards design;Edwards-Sapien: Approaches;Medtronic Corevalve: Approaches;Corevalve or Edwards?A complementary approach to TAVI for optimal outcome;TAVI Outcomes:What clinical results are important?;TAVI: Clinical data sequence;1. Improving procedural success;Summary: procedural success;2. Mortality: The standard is set highOpen AVR is a safe procedure in selected elderly patients;2. Mortality: Corevalve post CE mark expanded evaluation n=1483;2. Mortality post Edwards SOURCE registry;2. Mortality in SOURCE at 12 months;2. Mortality (30d) and learning curveVancouver Edwards experience n=250;2. Registry summary: 30 day mortality;3. Stroke;3. Stroke;3. Summary: Stroke;4. Myocardial infarction;5. Vascular complication- mortality REVIVE/REVIVAL;5. Vascular complications- SOURCE;5. Femoral vascular complications now not associated with increased death;5. Summary: Vascular complication;6. HemodynamicsPARTNER EU n=130;6. Valve area- Pooled Edwards;6. Hemodynamics Corevalve;6. Hemodynamics prosthesis-patient mismatch;7. Functional status and Corevalve;7. Functional status- Edwards PARTNER EU;8. Pacemaker- PARTNER EU;8. Corevalve- pacemaker;Edwards TAVI outcomes ;9. Quality of life- PARTNER EU;9. Corevalve QOL;FDA;US PARTNER;TAVI outcomes? Recent clinical data;Will outcomes continue to improvewith ongoing improvements in device design? eg. Edwards Novaflex delivery system;Conclusion;