Evidence map›Paper›PMID 33531442›Full record

ArticleThe Journal of invasive cardiology2021

Development of the Minimalist Approach for Transcatheter Aortic Valve Replacement at a Veterans Affairs Medical Center.

Matthew Y Lum, Sue X Wang, Andrew D Wisneski, Norah E Liang, Jeffrey Zimmet, Kendrick A Shunk, Martin Stechert, Martin J London, Liang Ge, Elaine E Tseng

Open access · greenAbstract read
In one paragraph

Article in The Journal of invasive cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Matthew Y Lum
Sue X Wang
Andrew D Wisneski
Norah E Liang
Jeffrey Zimmet
Kendrick A Shunk
Martin Stechert
Martin J London
Liang Ge
Elaine E TsengUniversity of California San Francisco Medical Center, Cardiothoracic Surgery, San Francisco VA Medical Center, 4150 Clement St. 112D, San Francisco, CA 94121 USA. Elaine.Tseng@ucsf.edu.
San Francisco VA Medical Center · US

Funding

Clinical and Translational Science InstituteUL1TR001872 · NCATS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI COLLARD, HAROLD R, JACOBY, VANESSA · 2016 to 2025
$112.1M
Biomechanical Understanding of Ascending Thoracic Aortic AneurysmsR01HL119857 · NHLBI · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI GE, LIANG, TSENG, ELAINE EVELINA · 2015 to 2018
$1.5M
NCATS NIH HHS UL1 TR001872NHLBI NIH HHS R01 HL119857
6 · The paper itself

Abstract

objectivesWhile a minimalist transcatheter aortic valve replacement (TAVR) approach has shown safety and efficacy at civilian hospitals, limited data exist regarding developing this approach at Veterans Affairs (VA) medical centers (VAMCs). We implemented TAVR with minimalist approach (MA) using conscious sedation (CS) with transthoracic echocardiography (TTE) and compared safety and outcomes with general anesthesia (GA) with transesophageal echocardiography (TEE) at a university-affiliated VAMC.

methodsA total of 258 patients underwent transfemoral TAVR at a VAMC between November 2013 and October 2019. Ninety-three patients underwent GA/TEE and 165 patients underwent CS/TTE with dexmedetomidine and remifentanil. Propensity-score matching with nearest-neighbor matching was used to account for baseline differences, yielding 227 participants (81 GA, 146 CS).

resultsMA-TAVR had no effect on 30-day mortality or paravalvular leakage. No differences were found in permanent pacemaker implantation, major vascular complications, or postoperative hemodynamics. In this population, MA-TAVR did not reduce procedural time, hospital length of stay, or intensive care unit length of stay.

conclusionsUnlike civilian hospitals, MA with CS/TTE did not reduce overall length of stay in the veteran population; however, it was safe and effective for transfemoral TAVR without impacting clinical outcomes of mortality, major vascular complications, and paravalvular leakage.

Indexed as

Aortic Valve StenosisTranscatheter Aortic Valve ReplacementVeteransAortic ValveHospitalsHumansLength of StayRetrospective StudiesRisk FactorsTime FactorsTreatment Outcomeconscious sedationgeneral anesthesiaTAVR

Identifiers

PMID33531442
PMCPMC8589465
OpenAlexW3127445825

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.