{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:31:26Z","timestamp":1787729486985,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,11,12]],"date-time":"2016-11-12T00:00:00Z","timestamp":1478908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF\u2010TAVR) in patients with severe chronic obstructive pulmonary disease (COPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>TF\u2010TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety\/efficacy of this technique in patients with severe COPD is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared demographics, 30\u2010day outcomes and 1\u2010year survival of patients with severe COPD (FEV1% \u226450) who underwent minimalist vs. standard TF\u2010TAVR between 2008 and 2015 at our institution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 88 patients with severe COPD, 46 underwent minimalist and 42 underwent standard TF\u2010TAVR. There were no differences on baseline characteristics, except for more history of coronary artery bypass grafting (45.5% vs. 20.6%, <jats:italic>P<\/jats:italic>\u2009=\u20090.03) and less history of cerebrovascular disease (16.7% vs. 45.5%, <jats:italic>P<\/jats:italic>\u2009=\u20090.03) in the standard TF\u2010TAVR. Seventeen minimalist TF\u2010TAVR patients (41.0%) were transferred directly to the general medical ward with telemetry monitoring (without ICU stay); all standard TF\u2010TAVR patients went to the ICU. Minimalist TF\u2010TAVR patients had shorter procedure time (97 vs. 129 min, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), ICU time (21.8 vs. 29.8 hr, <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and length of stay (2 vs. 5 days, <jats:italic>P<\/jats:italic>\u2009=\u20090.001). There were no differences in procedure complications and 30\u2010day mortality between groups. In our multivariate analysis, minimalist TF\u2010TAVR (HR 0.28, 95%CI 0.08\u20130.97) and previous coronary revascularization (HR 0.24, 95%CI 0.09\u20130.65) were associated with increased 1\u2010year survival. In contrast, moderate paravalvular leak (HR 7.73, 95%CI 1.94\u201330.84) was associated with decreased 1\u2010year survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with severe COPD, Minimalist TF\u2010TAVR results in less resource utilization and improved 1\u2010year survival compared to standard approach. Our findings should be validated in a larger cohort of patients with severe COPD. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26683","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T16:03:21Z","timestamp":1479312201000},"page":"775-780","source":"Crossref","is-referenced-by-count":18,"title":["Does minimalist transfemoral transcatheter aortic valve replacement produce better survival in patients with severe chronic obstructive pulmonary disease?"],"prefix":"10.1002","volume":"89","author":[{"given":"Jose F.","family":"Condado","sequence":"first","affiliation":[{"name":"Structural Heart and Valve Center, Divisions of Cardiology Emory University Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moosa N.","family":"Haider","sequence":"additional","affiliation":[{"name":"Department of Medicine Emory University Atlanta 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