Courtesy of the SBHCI. The risk of surgical mitral valve replacement in patients with significant annular calcification is very high. There are isolated reports of transcatheter mitral valve replacement with balloon-expandable valve in this patient population. In consequence, this multicenter registry tries to concentrate information and analyzes the outcomes a year after the procedure. ...
Coronary Artery Disease in TAVR: Unsolved Dilemma
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially...
Transcatheter Mitral Valve Replacement: DOAC or VKA?
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR...
TricValve: 12-Month Evolution
Tricuspid regurgitation has become increasingly common, and current pharmacological treatment options are limited. In turn, surgery, which is a complex alternative, carries considerable rates of complications and mortality. In response to this issue, various percutaneous systems are being developed, such as edge-to-edge treatment, percutaneous annuloplasty, and caval valve implantation (CAVI), among others. In the analysis...
Degenerative Mitral Regurgitation: Impact on Post-Procedural Gradient
Primary or degenerative mitral regurgitation (MR) occurs frequently. Even though surgery continues to be the standard treatment at present, it remains risky for one group of patients, which makes edge-to-edge mitral valve repair (MV-TEER) a viable alternative. We are well aware that moderate to severe MR is associated with worse prognosis. However, post procedural mean...
Transcatheter Mitral Valve Replacement vs. Medical Therapy
Mitral valve regurgitation (MR) is a common cause behind heart failure and is associated to hospitalization for heart failure and higher mortality. Transcatheter edge-to-edge repair (TEER), together with guideline-directed medical therapy (GDMT) has been shown beneficial in high risk patients, according to the COAPT study. However, there is a significant group of patients that make...
Mitral Valve Surgery after Edge-to-Edge Repair
In last few years, transcatheter edge-to-edge repair (TEER) with MitraClip has been shown safe and effective, both for primary and secondary mitral valve regurgitation (MR), given the increasing interventionist and echocardiographer experience. However, there is a group of patients that require surgery after failed TEER, either because of bad evolution or because device implantation...
MitraScore: What Does the Final Result of Edge-to-Edge Treatment of Mitral Regurgitation Provide?
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
The Most Important Articles of 2022 in Structural Heart Disease
Discover the most read scientific articles on interventional cardiology of 2022 in our website. We Should Treat Significant Stable CAD in Patients Undergoing TAVR Aortic stenosis is associated to significant coronary artery disease (CAD) in nearly 50% of cases. When we decide to treat aortic disease using surgery, it has been established we should also treat...
Secondary Mitral Regurgitation: Stages of Heart Failure and Prognostic Implications after Transcatheter Edge-to-Edge Repair
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease...