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Temporal Trends and Outcomes of Transcatheter and Surgical Aortic Valve Replacement in Patients With Cardiac Amyloidosis and Severe Aortic Stenosis

      Cardiac amyloidosis (CA) is an infiltrative/restrictive cardiomyopathy, caused by the deposition of misfolded amyloid fibrils in the form of immunoglobulin light-chain or transthyretin amyloid within the myocardium. To date, there is no treatment to reverse the process already present at diagnosis; however, new pharmacologic therapies have shown promise in slowing down disease progression.
      • Nitsche C
      • Scully PR
      • Patel KP
      • Kammerlander AA
      • Koschutnik M
      • Dona C
      • Wollenweber T
      • Ahmed N
      • Thornton GD
      • Kelion AD
      • Sabharwal N
      • Newton JD
      • Ozkor M
      • Kennon S
      • Mullen M
      • Lloyd G
      • Fontana M
      • Hawkins PN
      • Pugliese F
      • Menezes LJ
      • Moon JC
      • Mascherbauer J
      • Treibel TA.
      Prevalence and outcomes of concomitant aortic stenosis and cardiac amyloidosis.
      ,
      • Bokhari S
      • Gupta R.
      Aging, aortic stenosis, and transthyretin cardiac amyloidosis: a perfect cardiac storm?.
      Aortic stenosis (AS) is one of the most common valvopathy, in which treatment is centered around valvular replacement with either transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Without valvular intervention, severe symptomatic AS is associated with a poor prognosis and 50% mortality rate within 2 years of diagnosis. Studies have shown the prevalence of transthyretin amyloid deposits, ranging from 4% to 29%, in patients with severe AS undergoing valvular intervention.
      • Nietlispach F
      • Webb JG
      • Ye J
      • Cheung A
      • Lichtenstein SV
      • Carere RG
      • Gurvitch R
      • Thompson CR
      • Ostry AJ
      • Matzke L
      • Allard MF.
      Pathology of transcatheter valve therapy.
      With the increasing life expectancy of the general population, many patients with CA remain suitable candidates for aortic valve replacement. Therefore, we sought to describe the trends and outcomes of TAVI and SAVR in patients who were diagnosed with concomitant CA and severe AS.
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