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Low Mortality and Stroke Rates With BASILICA Pre-TAVI, Registry Shows


Photo Credit: Ron Waksman/Medstar Washington Hospital Center
The BASILICA procedure, which involves the intentional laceration of a preexisting aortic leaflet prior to TAVI in order to prevent coronary obstruction, can be safely performed in the vast majority of patients, according to new data from an international registry.
Among 214 patients undergoing BASILICA at 25 centers, the rate of death at 30 days was 2.8%, as was the rate of stroke, and just one patient (0.5%) had a disabling stroke.
Senior investigator Ron Waksman, MD (MedStar Washington Hospital Center, Washington, DC), said BASILICA offers a “unique solution” to patients at high risk for coronary obstruction with TAVI, one that isn’t associated with increased cost. “We wanted to prove that BASILICA was safe, number one, and feasible, number two, and effective,” Waksman told TCTMD. ....

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Don't Screen Broadly for Asymptomatic Carotid Stenosis, USPSTF Reaffirms


February 02, 2021
The US Preventive Services Task Force (USPSTF) continues to recommend against screening the general adult population for asymptomatic carotid stenosis, maintaining its stance from 2014.
“The USPSTF found no new substantial evidence that could change its recommendation and therefore concludes with moderate certainty that the harms of screening for asymptomatic carotid artery stenosis outweigh the benefits,” according to its statement published in the February 2, 2021, issue of
JAMA.
Task force member Michael Barry, MD (Harvard Medical School, Boston, MA), explained the rationale. Few strokes are attributable to carotid stenosis, and among patients with carotid disease, the annual rate of stroke is only about 1%. Screening tests, usually duplex ultrasound, are fairly accurate, but false-positive results can lead to unnecessary downstream testing and treatment. Moreover, revascularization with carotid endarterectomy or stenting does not appear t ....

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New US Valve Guidance Tackles TAVR vs TAVI, Low-risk AS, Functional MR


December 23, 2020
Guidelines for the management of valvular heart disease (VHD) have been refreshed by the American College of Cardiology and American Heart Association the first full revision since 2014. Most salient among the changes is the inclusion of the pivotal low-risk TAVR trials that led to US Food and Drug Administration approval for that indication last fall.
With Catherine M. Otto, MD (University of Washington, Seattle), and Rick A. Nishimura, MD (Mayo Clinic, Rochester, MN), as co-chairs, the multisociety-produced document was published online last week in both
Circulation and the
Journal of the American College of Cardiology.
Patrick T. O’Gara, MD (Brigham and Women’s Hospital, Boston, MA), one of its authors, told TCTMD that, as for any guideline recommendations, what motivated the revision was the “publication of practice-changing science.” Beyond the low-risk TAVR trials, other influential studies included here are COAPT and MITRA-FR, ....

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