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Trends and Outcomes of Transcatheter Aortic Valve Implantation in Hypertrophic Cardiomyopathy

      The landmark clinical trials on the utility of transcatheter aortic valve implantation (TAVI) excluded patients with hypertrophic cardiomyopathy (HCM) and concomitant severe aortic stenosis.
      • Leon MB
      • Smith CR
      • Mack M
      • Miller DC
      • Moses JW
      • Svensson LG
      • Tuzcu EM
      • Webb JG
      • Fontana GP
      • Makkar RR
      • Brown DL
      • Block PC
      • Guyton RA
      • Pichard AD
      • Bavaria JE
      • Herrmann HC
      • Douglas PS
      • Petersen JL
      • Akin JJ
      • Anderson WN
      • Wang D
      • Pocock S
      PARTNER Trial Investigators
      Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery.
      TAVI in HCM presents unique technical or physiologic challenges called “suicide left ventricle,” that is, sudden reduction in afterload after TAVI exacerbates subvalvular obstruction, which leads to hemodynamic collapse.
      • Nguyen V
      • Iskandar M.
      Suicide left ventricle: the importance of continuing beta blockers in cardiogenic shock post-TAVR.
      Despite this, TAVI has increasingly been used in patients with HCM with no large-scale data on its safety.
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      References

        • Leon MB
        • Smith CR
        • Mack M
        • Miller DC
        • Moses JW
        • Svensson LG
        • Tuzcu EM
        • Webb JG
        • Fontana GP
        • Makkar RR
        • Brown DL
        • Block PC
        • Guyton RA
        • Pichard AD
        • Bavaria JE
        • Herrmann HC
        • Douglas PS
        • Petersen JL
        • Akin JJ
        • Anderson WN
        • Wang D
        • Pocock S
        • PARTNER Trial Investigators
        Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery.
        N Engl J Med. 2010; 363: 1597-1607
        • Nguyen V
        • Iskandar M.
        Suicide left ventricle: the importance of continuing beta blockers in cardiogenic shock post-TAVR.
        J Card Fail. 2018; 24: S85-S86
        • Bandyopadhyay D
        • Chakraborty S
        • Amgai B
        • Kapadia SR
        • Braunwald E
        • Naidu SS
        • Kalra A.
        Association of hypertrophic obstructive cardiomyopathy with outcomes following transcatheter aortic valve replacement.
        JAMA Netw Open. 2020; 3e1921669