Advancements in therapies to reduce the impact of stroke in asymptomatic carotid artery stenosis have been hard to come by over the last decade. Several points of disagreement among published randomized trials prevented their information from being integrated into daily clinical practice. However, over the past 5 years, there has been some alignment, allowing for this…
Does Surgeon (Instead of Operator) Experience Affect TAVR?
There is a correlation between the volume of conventional surgical aortic valve replacement procedures and better outcomes in transcatheter aortic valve replacement (TAVR), with higher 30-day and 1-year mortality in sites with lower volume. This is a probable indication that a good surgical team is complemented by a good hemodynamic team and, ultimately, a good…
BIOFLOW V: Ultrathin Struts Confirm their Benefits
For several years we have been testing new devices that have introduce changes with respect to their predecessors in the hope they will bring clinical benefits. And so, the different generations of drug eluting stents came about (DES) even though we found ourselves stuck in the second generation, with the classical everolimus eluting stents. All…
TAVR Long-Term Durability: from the Cath Lab to Real Life
Nominally deployed transcatheter heart valves SAPIEN 3 has shown excellent durability in accelerated testing to an equivalent 25 year-wear. S3 durability resulted comparable to surgical biological valve durability. Non-nominal implants (overexpansion, underexpansion, and elliptical) also showed excellent durability to an equivalent 5 year-wear. The aim of this study was to test nominally deployed S3 durability to 1 billion…
The Whole Toolkit Tested in Carotid Artery Stenting
This study sought to randomly compare the double-layer Roadsaver stent (Terumo) with the single-layer Carotid Wallstent device (Boston) in association with either distal filter-like embolic protection device FilterWire (Boston) or proximal protection device Mo.Ma (Medtronic) in patients with lipid-rich carotid plaques. This is a very interesting work because there are no head-to-head simultaneous comparisons between…
Cerebrovascular Events After TAVR May Be Especially Serious
Stroke events do not seem to be related to valve thrombosis or structural degeneration, but to a higher baseline risk in patients who undergo transcatheter aortic valve replacement (TAVR). About 1 in 20 patients who underwent TAVR experienced a stroke or transient ischemic attack during follow-up. According to this new analysis, the consequences of these events…
SURTAVI Follow-Up Completed with Good News
The assessment of all severe aortic stenosis patients at intermediate risk of the SURTAVI was finally completed, confirming inferiority against the traditional surgical replacement (SAVR) in hard points such as all-cause mortality and disabling stroke. The aim of this study was to report SURTAVI 2-year outcomes (Surgical Replacement and Transcatheter Aortic Valve Implantation) and confirm…
Prolonged Exposure to Pollution Increases the Risk for Cardiovascular Disease
In the midst of the COVID-19 pandemic, it is hard to think of anything else that might be affecting worldwide health, particularly in China. As a topic, pollution (especially by fine particulate matter, PM2.5) has been relegated these days. At the same time, however, the preventive closing of many factories in China due to the…
ECS Guidelines for COVID-19 Management
One of the first statements in this document points out these are not “regular guidelines” developed after thorough analysis of all the available evidence published since the last update. Instead, they are meant to provide temporary basic management pointers on how to handle different scenarios of cardiac patients in the context of the COVID-19 pandemic.…
TAVR Reaches Low-Risk Patients with Bicuspid Valves
Transcatheter aortic valve replacement (TAVR) seems to be safe in low-risk patients with bicuspid aortic valve stenosis. Their hospital length of stay was very short, with zero mortality, and zero disabling stroke. Subclinical leaflet thrombosis and device durability are still unknown. The United States Food and Drug Administration (FDA) approved TAVR for low-risk patients. However,…