Percutaneous Valve Replacement
Leon MB et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010 Oct 21;363(17):1597-607 [PMID 20961243]
- 30% of patients with AS can’t under go surgery c/o co-morbidity
- TAVI developed, first performed in 2002
- 1 year mortality about 25% (without surgery mortality 50% after 2 years once symptomatic)
PARTNER Trial – Placement of Aortic Transcatheter Valves
- MRCT
- TAVI vs standard therapy in high-risk patients with severe AS
- n = 358 (179 standard medical therapy vs 179 TAVI)
- TAVI: high initial complication rate (bleeding, neurological events, vascular problems) and death rate -> death at 1 year: TAVI 31% vs 50% for medical therapy -> decreased repeat hospitalisation rates -> reduced symptoms
- Weaknesses -> funded by Edwards Life Sciences -> 9 of the 22 authors had financial links to EL -> exclusion of important subgroups -> significant learning curve for operators
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC