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
- 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
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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