Related Experiment Video
Updated: Dec 29, 2025
06:04
Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation
Published on: August 8, 2025
459
Acute Coronary Syndrome Following Transcatheter Aortic Valve Replacement.
Laurent Faroux1, Erika Munoz-Garcia2, Vicenç Serra3
1Quebec Heart and Lung Institute, Laval University, Canada (L.F., D.d.V., T.C., J.R.-C.).
Circulation. Cardiovascular Interventions
|January 30, 2020
Summary
Acute coronary syndrome after transcatheter aortic valve replacement (TAVR) is linked to poor outcomes. Revascularization improves survival, while STEMI increases mortality risk in TAVR patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Research
Background:
- Limited data exists on coronary events post-transcatheter aortic valve replacement (TAVR).
- No prior studies have identified factors associated with adverse outcomes following TAVR-related acute coronary syndrome (ACS).
Purpose of the Study:
- To investigate the clinical characteristics of ACS events in TAVR patients.
- To determine the outcomes and prognostic factors associated with ACS following TAVR.
Main Methods:
- A multicenter cohort study of 270 patients experiencing ACS post-TAVR.
- Data collected included ACS presentation, procedural strategies, and clinical outcomes such as death, myocardial infarction, stroke, and major adverse cardiovascular or cerebrovascular events.
Main Results:
- ACS presentations varied, with non-ST-segment-elevation myocardial infarction (STEMI) type 2 being most common (31.9%).
- In-hospital mortality was 10.0%, and at median follow-up, overall mortality reached 43.0%.
- Revascularization at ACS diagnosis reduced all-cause death risk (HR, 0.54), while STEMI increased mortality risk (HR, 2.06).
Conclusions:
- ACS events in TAVR recipients have distinct characteristics and are associated with high mortality.
- STEMI and lack of revascularization are significant risk factors for adverse outcomes.
- Findings emphasize the need for improved prevention and management strategies for ACS post-TAVR.
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
618
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
618
01:25Aortic Regurgitation III: Medical Management
312
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
312
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
317
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
317
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
300
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
300
01:28Acute Coronary Syndrome IV: Interprofessional Care
177
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
177
01:15Aortic Regurgitation I: Introduction
371
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
371