Comparing different transcatheter heart valves (THVs) is necessary to obtain relevant information that facilitates the selection of the appropriate valve for each patient. A previous study compared early outcomes between the self-expanding ACURATE Neo2 valve and the balloon-expandable Sapien 3 Ultra valve. However, there are no comparative data on these two valves in the medium…
EuroPCR 2024 | NOTION-2: TAVI vs SAVR, Randomized Study on Low-Risk Young Patients with Severe Tricuspid Disease or Bicuspid Stenosis
Many of the studies comparing TAVR against SAVR in low risk patients included patients between 70-75 years, excluding those with tricuspid valves. This study included low surgical risk patients with severe aortic stenosis and symptoms, 75 years or younger. Participants were randomized 1:1 to receiving TAVR or SAVR, stratified according to sex, need for new…
EuroPCR 2024 | OBSERVANT II: TAVR in the “Real World”
This study analyzed 2,493 “real world” patients, 1,352 receiving the Evolut R/Pro, 675 the SAPIEN, 3,270 the Acurate Neo and 192 the Portico. Primary end point was all cause mortality and major adverse cardiovascular events (MACE) at 5 years. Populations were similar, with EuroSCORE 4.9%, and there were no significant differences in comorbidities or echocardiographic…
EuroPCR 2024 | SOLVE-TAVI: Self Expanding or Balloon Expandable Valves?
This was a randomized study with 447 patients carried out to compare the 5-year evolution of TAVR using Evolut R and SAPIEN 3, as well as general anesthesia vs. conscious sedation. Randomization was in two stages: first valve selection and later the anesthesia technique, that is, conscious sedation vs general anesthesia. The populations were similar.…
Aortic Stenosis Progression Evolution
Aortic stenosis is an increasingly common valvulopathy because people are living longer now. A present, the main treatment consists of surgical (SAVR) or transcatheter aortic valve replacement. (TAVR). One of the main challenges of this disease is its progression. The European guidelines recommend Doppler echocardiograms every 2 to 3 years for mild cases, mildly calcified,…
Quality of Life in Medium-Risk Patients Treated with TAVR vs SAVR
Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) have demonstrated similar outcomes in symptomatic aortic stenosis patients (at high or intermediate risk) in terms of 5-year survival. When evaluating the quality of life (QoL) of these two treatment strategies in patients with high surgical risk, there were no significant differences at 5…
Evolution of Leak in Left Atrial Appendage Closure
Atrial fibrillation is common in elderly people and is associated with a higher risk of ischemic stroke. Left atrial appendage occlusion (LAAO) is a valid strategy, especially in patients at high risk of bleeding. The presence of peridevice leak (PDL) has been linked to stroke, although some analyses, such as the PROTEC-AF Study, suggest that…
TAVR in Bicuspid Valves
Bicuspid aortic valve (BAV) disease affects 1%-2% of the population and manifests with severe aortic stenosis in the middle-aged. It characterizes for a very different anatomy with more calcification than the tricuspid aortic valve. At present, surgical aortic valve replacement (SAVR) is the first treatment indication. TAVR in this scenario has shown, in different studies,…
Acute Myocardial Infarction After TAVI: Retrospective Analysis of >200,000 Implants
Coronary artery disease is common among patients considered for transcatheter aortic valve implantation (TAVI). With the expansion of the indication for TAVI to a population with lower surgical risk, and therefore younger, there has been a gradual increase in the incidence of coronary events. However, there is limited data on treatment strategy and outcomes in…
Reinterventions in TAVR with Self-Expanding Valves
TAVR treatment of severe aortic stenosis is becoming more and more common, showing comparable evolution, or even superior in some studies when using the femoral approach, vs. surgical aortic valve replacement (SAVR). One of the current challenges is TAVR durability vs. SAVR. Even though 9 or 10 years has been deemed acceptable by current standards,…
12-Month Evolution of Edge-to-Edge Repair with PASCAL
Mitral regurgitation (MR) is the most frequent valve disease. Mitral transcatheter edge-to-edge repair (M-TEER) has been shown beneficial in high or prohibitive risk patients in cases of degenerative and functional MR. The PASCAL device has been shown safe and effective by the CLASP II, but we still need further research in clinical “real world” environments. …