On the bright side, the incidence of prosthetic valve endocarditis (PVE) post TAVR is not higher than post SAVR, according to this study recently presented at EuroPCR 2019, held in Paris. There is plenty of evidence describing PVE incidence, prognosis, risk factors, etc. after surgical valve replacement surgery (SAVR). However, we know little about the…
EuroPCR 2019 | Most Recent TAVR Meta-Analysis: The Spectrum of Treatment Reaches All Patients
This new meta-analysis combines all randomized transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement trials and expands the scope of TAVR. Evidence across the range of risk studied supports a paradigm shift in patients with symptomatic severe aortic stenosis. The clinical superiority of TAVR compared with surgery has been demonstrated across the spectrum…
EuroPCR 2019 | Leaflex: New Device for Pre-TAVR Calcium Fracture
Researchers behind this small study believe that fracturing the rigid calcium deposits on leaflets with this new device could delay the need for transcatheter aortic valve replacement (TAVR) or facilitate it. This device showed actual improvement of leaflet mobility together with mean gradient reduction. The Leaflex Performer system (Pi-Cardia) was used in 16 patients with…
EuroPCR 2019 | TAVR Durability Offers Certain Guarantees at 8 and 10 Years
It has been 3 years since EuroPCR 2016 and the presentation of the first data on possible transcatheter valve degeneration, which sparked fear regarding the possibility that transcatherter aortic valve replacement (TAVR) devices might degrade earlier than expected due to the pressure put on them to introduce them into the delivery catheter. At EuroPCR 2019,…
EuroPCR 2019 | Long-Term Follow-Up for New Left Bundle Branch Block After TAVR Is Reassuring with Certain Precautions
Long-term follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and developed left bundle branch block (LBBB) after the procedure seems reassuring. Although it is not benign, it is associated with more conduction defects, more pacemakers, and worsening ventricular function. Long-term follow-up “partially reassures” the concerns of many physicians about new LBBB after TAVR.…
EuroPCR 2019 | TRILUMINATE: Tricuspid Repair with Clip Improves Regurgitation and Quality of Life
Transcatheter therapy offers a promise for a largely forgotten valve given the lack of therapeutic options. Percutaneous edge-to-edge repair with clip seems to offer some hope to patients with tricuspid regurgitation according to the TRILUMINATE. At 30 days, transcatheter repair with clip significantly reduced tricuspid regurgitation at least in one grade in most patients, which…
EuroPCR 2019 | COAPT: Mitral Valve Reduction is Associated to Lower Hospitalization and Death
This new analysis shows the mechanism behind the benefit of using MitraClip and the necessary degree of residual mitral regurgitation (MR) to have an impact. Regardless the intervention type, patients with cardiac failure and secondary mitral regurgitation present lower hospitalization for cardiac failure, all-cause mortality and improved quality of life the lower the MR. MitraClip…
EuroPCR 2019 | CHOICE: Balloon-Expandable Valves vs. Self-Expanding Valves in High-Risk Patients
The CHOICE trial included 241 patients with severe aortic stenosis and high surgical risk who underwent transcatheter aortic valve replacement (TAVR) using transfemoral access. These patients were randomized to balloon-expandable valve (Edwards Sapien XT) vs. self-expanding valve (Medtronic CoreValve). The endpoints were all-cause mortality, stroke, readmission, valve function parameters as measured through an ultrasound, and…