Structural heart disease articles

La insuficiencia renal post tratamiento borde a borde tricuspídeo impacta en el pronóstico

Edge-to-Edge Repair in Cardiogenic Shock

Edge-to-Edge Repair in Cardiogenic Shock

The edge-to-edge approach with MitraClip has been established as a valid strategy for patients who experience severe symptomatic mitral regurgitation (MI) with high risk for surgery, currently with a IIa indication. MI complicated by cardiogenic shock, which results in a high risk for conventional valve surgery, is a particularly complex scenario. In such a case,

TAVI en insuficiencia aórtica pura

Short-Term Outcomes of TAVR in Asymptomatic or Minimally Symptomatic Patients

Aortic valve replacement (AVR) is indicated for symptomatic aortic stenosis (AS), while close follow-up is recommended for asymptomatic patients, unless they have elevated aortic gradients, low ejection fraction, or abnormal stress tests. However, the optimal timing to perform AVR is uncertain, especially with recent evidence suggesting that patients with AS associated with signs of myocardial

tavr insuficiencia aórtica pura

TAVR in Low Risk Patients: 10 Year Evolution

The Treatment of severe aortic stenosis has experienced a significant revolution with TAVR, especially in high and intermediate risk patients, and it is now extending to low risk patients. In the US, nearly half of patients under 64 are being treated with TAVR.  One of the fundamental questions that still remains unanswered revolves around device

Sobrevida en pacientes con insuficiencia tricuspídea según variables clínicas y ecocardiográficas (Clusters)

Should We Treat Obstructive Coronary Artery Disease in TAVI?

Coronary artery disease, both obstructive and non-obstructive, often coexists with significant aortic stenosis. Therapeutic decision-making in this scenario remains controversial, not only regarding the need for treatment, but also about when it should be addressed, considering its pros and cons. Various analyses have yielded contradictory data, as most lesions are chronic and stable. Currently, the

Cierre de orejuela izquierda

Left Atrial Appendage Closure and Concomitant Transcatheter Intervention: Can We?

Several scientific societies support performing left atrial appendage occlusion (LAAO) as a stand-alone procedure, even though it is often associated to other cardiomyopathies requiring transcatheter intervention.  Though still controversial, combining LAAO and any other cardiac intervention might reduce hospitalizations, as well as the need for additional punctures, anesthesia, red tape, a longer stay and higher

pacemaker marcapasos definitivo

Benefit of Cusp overlap method for self‐expanding transcatheter aortic valves

The need for permanent pacemaker implantation (PPM) continues to be one of the main challenges in TAVR, especially with self-expanding valves, with a pacemaker implantation rate that varies between 17.5% and 30% in large randomized studies, vs. 4% to 6.5% with self-expanding valves. Therefore, in an attempt to prevent the need for PPM implantation, the

angulación aórtica post TAVR

Does Post-Dilation in TAVR Affect its Long-Term Outcomes?

Transcatheter aortic valve replacement (TAVR) has widely demonstrated its significant benefits, both in high-risk and inoperable patients, as well as in those with intermediate and low risk. While paravalvular regurgitation has been a challenge, its management has improved with operator experience and a deeper understanding of CT angiographies. However, in cases of regurgitation, elevated gradient,

Costo efectividad de la reparación endovascular y quirúrgica en aneurismas complejos

Promising Results of Transcatheter Mitral Valve Replacement in Bioprosthesis Failure

Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the


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

apixaban en fibrilacion auricular tavi

Use of Apixaban and Post TAVR Valve Thrombosis

TAVR can be associated to early valve thrombosis, characterized by thrombi formation near or attached to the prosthetic valve, with or without valve dysfunction. This dysfunction is associated with increased leaf thickening and reduced leaflet motion, as well as reduced orifice area or increased transvalvular gradient. Triggered multislice CT allows dynamic valve assessment and thrombosis