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1 υπέρ TAVI κατά

3 No conflict of interest

4 more than 200,000 implants have been done in 65 countries. TAVI is a common procedure with reduced complications, better case selection, and refined tools. PCR 2015 Έξυπνη διατύπωση Δεν αναφέρεται σαν καλύτερη θεραπεία κ.λ.π.

5 We've totally screwed up," said VW America boss Michael Horn Έξυπνη διατύπωση In November, VW also said it had found "irregularities" in tests to measure carbon dioxide emissions levels that could affect about 800,000 cars in Europe - including petrol vehicles.

7 Public Release: 19-May-2015 EuroPCR 2015: TAVI, safe and effective as surgical valves at 2 years in lower risk patients Transcatheter valve implantation is comparable to surgery for a composite endpoint of all-cause death, stroke, or MI EuroPCR (NOTION) trial

12 Μετά από 22 χρόνια η TAVI απευθύνεται όχι σε αυτούς που είχε «φτωχά» αποτελέσματα η χειρουργική AVR

13 Ισχνές μελέτες??????????? Μάλλον η AVR αποτελεί αξίωμα

17 CDU: Οι βουλευτές μπορούν να διατηρούν θέσεις σε πολυεθνικές εταιρίες

19 As I said before, reimbursement is an important factor in the penetration of TAVI in Europe. In the UK, the National Institute for Health and Clinical Excellence approved TAVI for inoperable patients in July In Germany, TAVI is part of a diagnosis-related group (DRG) and is reimbursed at 34,080; in France it is part of a DRG valued at 28,477, but it is restricted to 33 centres. Austria will include TAVI in a DRG of 27,227 in January. In Italy, there is regional reimbursement and, in Lombardia, for example, the DRG pays 25,308 for a TAVI procedure. In Spain, it is according to hospital budget. Switzerland is set to include TAVI in a DRG in January 2012, but the tariff is still under discussion.

23 Μείωση της επιβίωσης λόγω της αορτικής ανεπάρκειας Cardiac surgeon shot at Brigham and Women's Hospital dies Published January 21, 2015FoxNews.com

24 Predictors of 1-year mortality in patients with aortic regurgitation after transcatheter aortic valve implantation: an analysis from the multicentre German TAVI registry. Heart Aug;100(16): doi: /heartjnl Epub 2014 Jun 3. At 1 year, 61 patients (31%) with more-than-mild post-tavi AR had died.

27 Exclusion criteria I MI < 1 month before treatment Congenital unicuspid or bicuspid aortic valve or non-calcified aortic valve Mixed aortic valve disease Cardiac procedure resulting in a permanent implant performed within 30 days of the procedure or within 6 months if drug eluting coronary stent implanted Severe mitral insufficiency Leukopenia, acute anemia, thrombocytopenia, bleeding diathesis or coagulopathy Untreated clinically significant coronary artery disease Hemodynamic or respiratory instability within 30 days of screening Need for emergency surgery Hypertrophic cardiomyopathy

28 Exclusion criteria II Severe ventricular dysfunction ECHO evidence of intracardiac mass, thrombus or vegetation Active peptic ulcer or active GI bleeding within 3 months prior to procedure A known contraindication to anticoagulation or inability to be anticoagulated for the procedure Native aortic annulus size <18mm or >25mm CVA, TIA or cluster within 6 months of the procedure Renal insufficiency and/or end-stage renal disease requiring dialysis at the time of screening

29 Exclusion criteria III Estimated life expectancy <12 months due to non-cardiac conditions Significant aortic disease, such as abdominal aortic or thoracic aneurysm, marked tortuosity, aortic arch atheroma Ileofemoral vessel characteristics that would preclude safe placement of the introducer sheath such as severe obstructive calcification, severe tortuosity or vessel s size Participating in an investigational drug or another device study Active endocarditis or other active infections within 6 months of the procedure Bulky calcified aortic valve leaflets in close proximity to coronary ostia

30 TAVR is not recommended in patients with comorbidities that would preclude an expected benefit from correction of AS.

31 Transcatheter Aortic Valve Implantation 10-year Anniversary Eur Heart J. 2012;33(19): Since TAVI has been shown to be superior to standard medical therapy and non-inferior to SAVR and is increasingly being used in current practice, the incremental costs and costeffectiveness of this therapy warrant evaluation.

32 In the PARTNER IB trial, the mean cost for TF TAVI was $ which accumulated to $ for the initial hospitalization and $ at 1 year. [36] Compared with medical therapy, TAVI was ~$ (95% CI, $ $64 275) more expensive at 1 year

33 Εάν όλες οι βαλβίδες στην Ελλάδα TAVI Εάν όλες SAVR διαφορά Χρήματα που αντιστοιχούν ετησίως με τους μισθούς Διευθυντών Καρδιολόγων

Τι ξοδεύουμε σήμερα για τις TAVI στην Ελλάδα Περίπου 8.000.

34 Τι ξοδεύουμε σήμερα για τις TAVI στην Ελλάδα Περίπου δηλαδή μισθούς 215 καθηγητών πανεπιστημίου πρώτης βαθμίδας Οι δανειστές στην Αθήνα: Σκληρό παζάρι για τα ισοδύναμα

37 We are paying a lot [with TAVI] for quality of life, and it's the quality of the end of life

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