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Abdulla A. Damluji, MD, PhD Profile picture
@DrDamluji
Nov 5, 2021 • 26 tweets • 17 min read • Read on X
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SURTAVI

No differences in death ,stroke, MI, or HF between TAVR and Surgery during longer follow-up

#TCT2021
Hemodynamics

Total AR and PVL

KCCQ no difference after 1 year

NYHA class at one year 1
Summary for SURTAVI

Self expanding valve

#TCT2021
Excellent!
5 year data for 4,000 patients is now out (intermediate risk).

@djc795
Economic outcomes of PARTNER #3

@djc795

Cost effectiveness study along side of PARTNER 3 trial

funded by Edwards
Costing: definitions

US population only

Medicare data link
Results Baseline

TAVR vs SAVR PARTNER 3 Economic Study
Index Hospital Costs

Follow-up Cost
Overall no cost difference

QALY difference (borderline?!)

#TCT2021
All costs and effects discounting

TAVR is cost effective
Subgroups (pre-specified)

Sensitivity analyses

#TCT2021
Sensitivity Analyses
Summary!

84% CI that we will improve outcomes and at the same time achieve cost effectiveness.

10 year outcomes will affect cost effectiveness - to come...

Outstanding presentation @djc795 @DrMauricioCohen

#TCT2021
"When mortality rate is the same between SAVR and TAVR: patient preference is what matter next."

"No one wants a sternotomy."

@djc795

#TCT2021
CHOICE CLOSURE

Vascular Closure for TAVR but this also applies to shock space also (Safety Bundle)

#TCT2021

@Radial_ICG @behnam_tehrani @agtruesdell @ShashankSinhaMD @JACCJournals
Available Evidence

Aim Choice Closure

Randomization: pure plug based vs primary suture based

#TCT2021
Inclusion and Exclusion

Primary Endpoint
Secondary Endpoints

Study Methods

Angioseal was used...

3 Locations in Germany

#TCT2021
Study Flow

258 MANTA vs 258 ProGlide

#TCT2021
Baseline Results

Vessel Characteristics

Procedural Details

Low ultrasound use?! @Radial_ICG

#TCT2021
Manta had higher complications!!

Important data!

#TCT2021
Subgroup analysis

Hospital Outcomes

30-Day Outcomes

#TCT2021
Limitation
Conclusion

Excellent trial @Mo_A_W

Applies to shock too

***Editorializing: Losing the wire access with MANTA is a big problem.

#SafetyBundle

#TCT2021
Comparison of a Pure Plug-Based versus a Primary Suture-Based Vascular Closure Device Strategy for Transfemoral Transcatheter Aortic Valve Replacement: The CHOICE-CLOSURE Randomized Clinical Trial

@CircAHA

ahajournals.org/doi/abs/10.116…

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More from @DrDamluji

Abdulla A. Damluji, MD, PhD Profile picture
Dec 21
Atrial Fibrillation: @JAMA_current

🥸 Nice review in JAMA on AF by @darae_ko and team; congratulations.

😱 20-points here

👇👇👇 Image
🥸 1️⃣ Atrial fibrillation (AF) affects ~10.55 million US adults. It increases the risk of stroke, heart failure (HF), myocardial infarction, chronic kidney disease, dementia, and death.

😱Managing AF effectively is critical to improving CV outcomes.
🥸 2️⃣ AF symptoms range from palpitations, shortness of breath, chest pain, presyncope, and fatigue to being completely asymptomatic.

😱About 10-40% of people with AF don’t notice symptoms, which makes screening and incidental detection critical.
Read 23 tweets
Abdulla A. Damluji, MD, PhD Profile picture
Nov 17
Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity: @NEJM

🥸The SUMMIT trial - @AHAScience

😱 Summary

👇👇👇 Image
🥸 1️⃣ Obesity drives heart failure with preserved ejection fraction (HFpEF) through systemic inflammation and visceral adiposity. Tirzepatide, a dual GIP and GLP-1 receptor agonist, offers weight loss and potential cardiovascular benefits.
🥸 2️⃣ The SUMMIT trial evaluated 731 HFpEF patients with obesity (BMI ≥30), randomized to tirzepatide or placebo for 52 weeks. Primary outcomes were a composite of cardiovascular death or worsening HF events and improvement in health status (KCCQ-CSS).
Read 21 tweets
Abdulla A. Damluji, MD, PhD Profile picture
Nov 17
Left Atrial Appendage Closure after Ablation for Atrial Fibrillation: @NEJM

🥸The OPTION trial: @AHAScience

😱 Summary

👇👇👇👇 Image
🥸 1️⃣ Oral anticoagulation is standard after atrial fibrillation (AF) ablation for stroke prevention but comes with bleeding risks and patient burdens. Left atrial appendage closure (LAAC) offers an alternative, but data comparing these strategies post-ablation have been limited.
🥸 2️⃣ The OPTION trial evaluated 1,600 patients post-AF ablation, randomized to LAAC (device group) or oral anticoagulation (anticoagulation group). Patients had a CHA2DS2-VASc score ≥2 (men) or ≥3 (women), indicating moderate-to-high stroke risk.
Read 21 tweets
Abdulla A. Damluji, MD, PhD Profile picture
Nov 17
Routine Spironolactone in Acute Myocardial Infarction: @NEJM

🥸 Great trials from #AHA24: @AHASc

😱 Summary

👇👇👇 Image
🥸 1️⃣ Aldosterone levels predict worse outcomes after myocardial infarction (MI).

😱High levels are associated with increased mortality, and therapies targeting aldosterone have shown promise in other cardiovascular conditions.
🥸 2️⃣ Spironolactone has reduced mortality in patients with chronic heart failure with reduced ejection fraction (HFrEF).

😱It’s a cornerstone therapy for managing HFrEF and reducing hospitalizations.
Read 22 tweets
Abdulla A. Damluji, MD, PhD Profile picture
Nov 1
Transcatheter Valve Replacement in Severe Tricuspid Regurgitation: @NEJM

🥸 TRISCEND II Trial - #TCT2024

😱 Summary

👇👇👇 Image
🥸 1️⃣ Severe tricuspid regurgitation leads to high symptom burden and increases risk of mortality.
🥸 2️⃣ This trial compared 400 patients with tricuspid regurgitation: valve replacement + medical therapy vs. medical therapy alone.
Read 17 tweets
Abdulla A. Damluji, MD, PhD Profile picture
Oct 28
Transcatheter Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis: @NEJM

🥸 I was at #TCT2024 all day - just got to a desk @TCTMD

😱 Summary of EARLY TAVR trial

👇👇👇 Image
🥸1️⃣ The EARLY TAVR trial focused on patients with asymptomatic severe aortic stenosis and preserved LV function to see if early transcatheter aortic-valve replacement (TAVR) outperformed standard surveillance.
🥸2️⃣ 901 patients (75.8 years average) were randomly split: 455 received early TAVR, 446 were under clinical surveillance per current guidelines, with close monitoring for worsening symptoms or health declines.
Read 21 tweets

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