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.
CME: https://earnc.me/NVVNUT
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.
Terrific podcast! One important consideration with TAVR procedures that is worth mentioning, is the risk of stroke. The following editorial sums up some of the key points nicely:
http://circinterventions.ahajournals.org/content/8/6/e002801
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)