Data on long-term outcomes in patients undergoing transcatheter aortic valve implantation (TAVI) is scarce.
We investigated long term outcomes of consecutive patients undergoing TAVI with balloon- ...and self-expandable bioprostheses (Edwards SAPIEN (ESV), Edwards Lifesciences Inc., Irvine, CA, USA; Medtronic Corevalve system (MCS), Medtronic Inc., Minneapolis, MN, USA).
Among 628 patients (mean age 82.4 ± 5.8 years, 55% female), 489 (77.8%) underwent transfemoral TAVI. 309 (63.2%) patients received a MCS prosthesis, whereas 180 (36.8%) patients were treated with an ESV prosthesis. The median duration of follow-up amounted to 5.2 years (range 3.4–8.3 years). All-cause mortality did not differ between the two groups (MCS 46.9%, ESV 53.4%, CI 95%: RR 1.21 0.93–1.57, P = 0.15), whereas cardiac mortality was higher in the ESV cohort after 5 years of follow-up (MCS 35.1%, ESV 45.4%, CI 95%: RR 1.37 1.01–1.86, P = 0.04). Structural valve deterioration, which was on average diagnosed 41.9 months (range 18–60 months) after TAVI, occurred in 8 cases (1.6%), resulting in one repeat intervention.
While half of all patients died within 5 years after TAVI with no significant differences in all-cause mortality, structural valve deterioration was documented in <2% of cases.
•The occurrence of structural valve deterioration (SVD) is rare (<2%).•SVD is diagnosed on average 3.5 years after the index procedure.•Comparing valve-types, no differences in all-cause mortality or stroke can be seen.•Repeat interventions for prosthetic heart valve related problems occur sporadically.
Abstract Objective To evaluate a newly developed education programme for Parkinson's disease (PD) patients. Methods The programme consisted of eight sessions and aimed at improving knowledge and ...skills related to self-monitoring, health promotion, stress management, depression, anxiety, social competence, and social support, all with special reference to PD. The programme was formatively evaluated in seven European countries (Spain, Finland, Italy, The Netherlands, United Kingdom, Estonia, Germany) with 151 patients diagnosed with idiopathic PD. The evaluation included patients’ ratings of the comprehensibility and feasibility of the programme as well as mood ratings before and after each session. Patients also completed questionnaires at the beginning and end of the programme to explore possible changes in disease-related psychosocial problems, quality of life, and depression. Results The programme was feasible to run, and patients were able to understand its elements. Patients reported mood elevations following individual sessions and reduced disease-related psychosocial problems after completing the programme. There were no substantial differences in results between cultures. Conclusion Patient education appears to have potential as a useful and feasible intervention, complementing medical treatment in PD. Practice implications The present programme will soon be available in seven European languages and can be tested in different health care systems.
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