Episode 48: TAVRs with Clint Tippett

In this episode, episode 48, I welcome Dr. Clint Tippett to the show.  Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns.

Regarding stroke risk here is an editorial (Thanks to Stephen Freiberg for providing this link): http://circinterventions.ahajournals.org/content/8/6/e002801

And Dr. Tippett wanted to add that early studies of the 1st and second generation valves had higher stroke rates than SAVR, however the most current genreration valves(Edwards Sapien 3 and Medtronic Evolut R) both have been shown to have not significantly different stroke rates from TAVR.(Surtavi trial and this observational study http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30073-3.pdf).

Finally, when discussing benefits of TAVR, we should have mentioned a significantly lower risk of post-op AFib in addition to lower bleeding risk and lower rates of AKI.

2 Replies to “Episode 48: TAVRs with Clint Tippett”

    1. Thanks Stephen, great point. Dr. Tippett agrees and wanted to add the following: Concerning stroke risk, early studies of the 1st and second generation valves had higher stroke rates than SAVR, however the most current generation valves(Edwards Sapien 3 and Medtronic Evolut R) both have been shown to have not significantly different stroke rates from TAVR.(Surtavi trial and this observational study http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30073-3.pdf)

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