Tsuyoshi Kaneko, MD: PLO-FLOW TAVR, July Effect, & Alternative Access TAVR

Few surgical advances this century have had an impact equal to that of transcatheter aortic valve replacement (TAVR) and, if anyone were to need evidence in support of this, they need to look no further than the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

A testament to the ongoing advances in cardiology, the annual conference highlights advances in the field and can provide a barometer of the hottest topics in cardiology—this year, the lengthy list of abstracts related to the procedure cement TAVR’s place in both of these groups.

Among those associated with the aforementioned abstracts is Tsuyoshi Kaneko, MD, a cardiac surgeon at Brigham and Women’s Hospital and assistant professor of surgery at Harvard Medical School. In total, Kaneko received attribution on more than half a dozen pieces of research at this year’s conference.

Included in that group are 3 studies that became the subject of discussion during a recent ACC House Call with Kaneko. Specifically, the 3 studies examine results from the PLO-FLOW TAVR study, a potential July Effect in transcatheter surgeries, and peripheral versus central access for alternative access TAVR procedures.

The PLO-FLOW TAVR study results presented examined the quality in life of patients classified as stage D3 aortic stenosis patients undergoing TAVR compared to patients stages D1, D2, or D4. Results of the study indicated these patients had significant improvements when undergoing TAVR as opposed to surgical aortic valve replacement.

The July Effect study is a follow-up to a previous study from Kaneko and colleagues at Brigham and Women’s Hospital assessing the impact of procedure timing with onset of academic year. Similarly to the previous study which examined the July Effect in cardiac surgery, results of this study suggest the July Effect was not present for structural heart interventions—indicating early resident and fellow teaching can be achieved without endangering the safety of patients or outcomes of procedures.

Lastly, the study comparing peripheral versus central access for alternative access TAVR was a retrospective analysis of the TVT registry. Using 1-year outcomes, investigators determined peripheral access was associated with improved mortality and comorbidity outcomes compared to central access, but was also associated with an apparent increase in stroke risk.

For more on these studies and what he hopes colleagues in the field might take from these studies, check out our interview with Kaneko below.