Kiran Sarathy

Trends in Transcatheter Aortic Valve Implantation in Australia

Publisher: Radcliffe Media Media Ltd

Date: 21-03-2022

DOI: 10.15420/ICR.2021.27

Abstract: Aortic valve stenosis is the most common valvular lesion in Australia, with a rising prevalence in line with the ageing population. Recent trials have demonstrated the efficacy of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement in consecutively lower surgical risk patient cohorts. Despite this, the current indication for TAVI in Australia is for the treatment of severe symptomatic aortic stenosis in patients who are of prohibitive or high surgical risk and ultimately deemed suitable by a heart team. This article summarises the trends in TAVI in Australia over the last 5 years in terms of funding, accreditation and service delivery, as well as advances in technique, technology, patient selection and local outcomes.

Platelet Quiescence in Patients With Acute Coronary Syndrome Undergoing Coronary Artery Bypass Graft Surgery

Publisher: Ovid Technologies (Wolters Kluwer Health)

Date: 02-03-2021

DOI: 10.1161/JAHA.120.016602

Abstract: The optimal antiplatelet strategy for patients with acute coronary syndromes who require coronary artery bypass surgery remains unclear. While a more potent antiplatelet regimen will predispose to perioperative bleeding, it is hypothesized that through “platelet quiescence,” ischemic protection conferred by such therapy may provide a net clinical benefit. We compared patients undergoing coronary artery bypass surgery who were treated with a more potent antiplatelet inhibition strategy with those with a less potent inhibition through a meta‐analysis. The primary outcome was all‐cause mortality after bypass surgery. The analysis identified 4 studies in which the antiplatelet regimen was randomized and 6 studies that were nonrandomized. Combining all studies, there was an overall higher mortality with weaker strategies compared with more potent strategies (odds ratio, 1.38 95% CI, 1.03–1.85 P =0.03). Our findings support the concept of platelet quiescence, in reducing mortality for patients with acute coronary syndrome requiring coronary artery bypass surgery. This suggests the routine up‐front use of potent antiplatelet regimens in acute coronary syndrome, irrespective of likelihood of coronary artery bypass graft.

Large Bore Vascular Access Closure Device Strategies

Publisher: Elsevier BV

Date: 03-2021

DOI: 10.1080/24748706.2021.1872818

Prince Of Wales Hospital

Location: Australia

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University Of Sydney

Location: Australia

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Royal College Of Physicians And Surgeons Of Canada

Location: Canada

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University Of New South Wales

Location: Australia

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Royal Australasian College Of Physicians

Location: Australia

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Gosford Hospital

Location: Australia

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