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…
Impact of Right Ventricular Pacing in Patients with Permanent Pacemaker Implantation after TAVR
Permanent pacemaker implantation (PPI) is a relevant complication in patients undergoing transcatheter aortic valve replacement (TAVR) despite there being new devices. The current information on the long term impact of this complication remains unclear and recent evidence suggests post-TAVR ventricular pacing (VP) might be associated to higher risk of all-cause mortality and hospitalization for cardiac…
EuroPCR 2023 | TAVR in TAVR Results with Balloon-Expandable Valves
With the expansion of transcatheter aortic valve replacement (TAVR) use in the low-risk population, more patients will need repeat valve replacement in the future, making it paramount to understand the performance of repeat TAVR. Currently, this information is limited. The aim of this study was to analyze the real-world experience of performing a second TAVR…
Echo- Stress during Edge-to-Edge Mitral Valve Repair Can Be Useful
Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a…
EuroPCR 2023 | ACURATE Neo2: Results After 5 Years
The ACURATE Neo2 valve is an evolution of the first-generation ACURATE Neo valve with a low rate of pacemaker implantation and a decrease in paravalvular leak, also compatible with the 14F introducer. This prospective study included patients with symptomatic severe aortic stenosis at high surgical risk who underwent ACURATE Neo2 valve implantation. The primary endpoint…
EuroPCR 2023 | TAVR in Patients with Bicuspid Aortic Valve Stenosis
Bicuspid aortic valve (BAV) stenosis is the most common congenital valve disease, affecting up to 2% of the population. Patients with BAV disease undergoing transcatheter aortic valve replacement (TAVR) account for 0.5%. In this context, TAVR data on BAV stenosis patients has been limited to observational studies on first generation valves that had resulted in…
EuroPCR 2023 |Chimney Stenting vs BASILICA for the Prevention of Coronary Obstruction during TAVR
Coronary obstruction is a complication from TAVR that can cause death (up to 50% mortality), even though its incidence is lower than 1%. One of the most frequent strategies used in the prevention of this complication is chimney stenting in patients at high anatomical risk (valve in valve, narrow sinotubular junction, short coronary ostium height).…
EuroPCR 2023 |TAVR in Cardiogenic Shock
Patients presenting aortic stenosis with cardiogenic shock are at extreme risk, with 70% mortality until the aortic obstruction is resolved, and taking into account they make poor transplant candidates. Safety and efficacy of TAVR in patients with cardiogenic shock remains unclear. The aim of this study was to assess events in patients undergoing TAVR with…
EuroPCR 2023 | Events after Redo TAVR in Balloon-Expandable Valves
With the treatment of aortic valve disease in younger patients, a significant number of them will need redo TAVR at some point in their life. However, to date there are few data on redo TAVR. The aims of this study was to look at real life experience on redo TAVR with balloon-expandable SAPIEN valves and…
Latest Developments in Tricuspid Regurgitation
The natural history of tricuspid regurgitation is associated to hospitalization for cardiac failure and mortality. This is why the AHA/ACC guidelines recommend surgery when the tricuspid fails during left valve surgical repair, because its slow progression is associated with high mortality (35%). Many of these patients are high risk and percutaneous intervention has surged as…
Low Gradient Aortic Stenosis: Is Invasive Assessment Viable?
There is an important group of patients presenting low flow, low-gradient severe aortic stenosis (defined as mean gradient <40 mmHg). This is why we do dobutamine stress echocardiogram (DSE), to confirm whether we are dealing with truly severe aortic stenosis. However, it might not be well tolerated and a CT angiography will be done to…