A comparison of patient characteristics and 30-day mortality outcomes after transcatheter aortic valve implantation and surgical aortic valve replacement for the treatment of aortic stenosis: a two-centre study

AIMS: It is unclear whether transcatheter aortic valve implantation (TAVI) addresses an unmet clinical need for those currently rejected for surgical aortic valve replacement (SAVR) and whether there is a subgroup of high-risk patients benefiting more from TAVI compared to SAVR. In this two-centre, prospective cohort study, we compared baseline characteristics and 30-day mortality between TAVI and SAVR in consecutive patients undergoing invasive treatment for aortic stenosis. METHODS AND RESULTS: We pre-specified different adjustment methods to examine the effect of TAVI as compared with SAVR on overall 30-day mortality: crude univariable logistic regression analysis, multivariable analysis adjusted for baseline characteristics, analysis adjusted for propensity scores, propensity score matched analysis, and weighted analysis using the inverse probability of treatment (IPT) as weights. A total of 1,122 patients were included in the study: 114 undergoing TAVI and 1,008 patients undergoing SAVR. The crude mortality rate was greater in the TAVI group (9.6% vs. 2.3%) yielding an odds ratio [OR] of 4.57 (95%-CI 2.17-9.65). Compared to patients undergoing SAVR, patients with TAVI were older, more likely to be in NYHA class III and IV, and had a considerably higher logistic EuroSCORE and more comorbid conditions. Adjusted OR depended on the method used to control for confounding and ranged from 0.60 (0.11-3.36) to 7.57 (0.91-63.0). We examined the distribution of propensity scores and found scores to overlap sufficiently only in a narrow range. In patients with sufficient overlap of propensity scores, adjusted OR ranged from 0.35 (0.04-2.72) to 3.17 (0.31 to 31.9). In patients with insufficient overlap, we consistently found increased odds of death associated with TAVI compared with SAVR irrespective of the method used to control confounding, with adjusted OR ranging from 5.88 (0.67-51.8) to 25.7 (0.88-750). Approximately one third of patients undergoing TAVI were found to be potentially eligible for a randomised comparison of TAVI versus SAVR. CONCLUSIONS: Both measured and unmeasured confounding limit the conclusions that can be drawn from observational comparisons of TAVI versus SAVR. Our study indicates that TAVI could be associated with either substantial benefits or harms. Randomised comparisons of TAVI versus SAVR are warranted.

2. 6 Memorial for Lloyd Gaines, St. Peter's Cemetery, Normandy, St. Louis County, Missouri

What happened to Gaines? There are many ideas ranging from being murdered or lynched, being bribed to run away, or disappearing on his own to get away from the pressure of celebrity. That final possibility was brought about by Dr. Greene, who claimed that a man who sounded like Gaines had phoned him while in Mexico and wished to meet. The man never showed up. A recent theory is one of where Lloyd was kidnapped by opponents of the Gaines court decision who took him to Jefferson City and lynched him in McClung Park. All of these theories are speculation and the fact remains that Lloyd Gaines’ whereabouts are a mystery to this day.

Valedictory poem delivered in the Chapel of Harvard University on the 21 June 1796: in the presence of the President Proffers & Tutors & the four classes of understudents at the request of the class who completed their college studies on that day

Handwritten draft of the Charles P. Sumner’s valedictory poem to the Harvard class of 1796, in a 19th century hardcover binding beginning “The youth by adverse fortune forced to roam…”. The poem mentions John Russell, a member of the Class of 1796 who died in November 1795. The copy includes edits and struck-out words.

Addresses given by Adam Winthrop, 1724-1727

This small notebook with marbled paper covers contains three Latin addresses delivered by Adam Winthrop during Harvard College ceremonies: the valedictory oration on Class Day, 1724, the "Oratio Salutatoria" at the 1724 Commencement, and the "Oratio Gratulatoria" which closed the exercises of the 1727 Commencement. The last page of the volume is signed "Adam Winthrop Jun'r."

Memorial services held in the House of representatives of the United States, together with remarks presented in eulogy of Florian Lampert.

Mode of access: Internet.

Memorial services held in the House of representatives of the United States, together with remarks presented in eulogy of Ole J. Kvale, late a representative from Minnesota.

Mode of access: Internet.

Memorial services held in the House of Representatives and Senate of the United States, together with tributes presented in eulogy of Lawrence P. McDonald, late a Representative from Georgia, Ninety-eighth Congress, first session.

"Compiled under the direction of the Joint Committee on Printing"--T.p. verso.

Herbert Putnam, 1861-1955 : a memorial tribute.

Foreword, by L. Q. Mumford.--Address: Herbert Putnam and his responsible eye, a memorial tribute, by D. C. Mearns.--Bibliography: writings and addresses of Herbert Putnam and books and articles about him, by H. D. Jones.--Herbert Putnam, a chronology, by D. C. Mearns.

Minutes of the ... annual meeting and reunion of the United Confederate Veterans ...

The issue for 1917 has title: Reunion of United Confederate Veterans. Proceedings of the twenty-seventh annual reunion of the Confederate Veterans, the eighteenth annual convention of the Confederate Southern Memorial Association and the twenty-second annual reunion of the Sons of Confederarte Veterans, held in Washington, D. C. June 4, 5, 6 and 7, 1917. Washington, 1918.

Papers and addresses.

The stone mason of Cromarty -- Class-day poem -- Alchemy and the alchemists -- Twelfth-night observances -- Mysteries and masques -- The settlement of New Amsterdam -- Historical sketch of Christ church -- Ticonderoga and Crown Point -- New York in 1801 -- Mysterious disappearances and presumptions of death in insurance cases -- The law of mortmain -- The law of life insurance -- Speech at Boston, Mass. -- Speech at Savannah, Ga. -- Address to Boston life underwriters -- Speech at Wilmington, Del. -- Life insurance in its relation to legal medicine -- Speech at St. Nicholas club dinner -- Speech at dinner of alumni of Trinity College.

A memoir of the life of John Codman Ropes, LL. D., with the proceedings of various societies, addresses, papers, and resolutions in commemoration of him.

"500 copies ... printed by D. B. Updike, at The Merrymount press, Boston, in April, 1901."

An address delivered at the commencement of the General Theological seminary of the Protestant Episcopal church in the United States, held in Christ church, New-york, on the twenty-ninth day of July, 1825;

Mode of access: Internet.

The influence of moral causes upon opinion, science, and literature : a discourse delivered on the day preceding the annual commencement of Amherst College, August 27th, 1834, at the request of the literary societies of that institution /

Mode of access: Internet.

Two addresses to "The Associated Members of the Bar of Philadelphia." Pronounced by William Rawle,Esquire, Chancellor of the Association.

Pages [19]-36 contain: "The Great Law, or, The body of laws of ye province of Pennsylvania and territorys thereunto belonging, past at an assembly at Chester, als. Upland, the seventh day of ye tenth month, December, 1682." Corrections in capitalization have been made in a contemporary hand.

The writings of Thomas Jefferson; containing his autobiography, notes on Virginia, parliamentary manual, official papers, messages and addresses, and other writings, official and private, now collected and published in their entirety for the first time ...

Mode of access: Internet.