Courtesy of del Dr. Carlos Fava. The bicuspid aortic valve is highly anatomically challenging because of valve asymmetric calcification, increased annulus diameter, raphe calcification and ascending aorta dilation. The new valves have shown to improve results, but we still lack data on this group. 301 patients presenting bicuspid aortic valve undergoing transcatheter aortic…
SAPIEN 3: Low One-Year-Mortality in High Risk or Inoperable Patients
In the first PARTNER trial (Placement of Aortic Transcatheter Valves), mortality at one year was 24% for high risk patients and 31% for inoperable patients. A recent report on SAPIEN 3 outcomes at 30 days ─ the last generation balloon expandable valve ─ showed a rather lower adverse events rate. However, additional information at longer…
Bivalirudin or Heparin to Decrease Cerebral Embolization Post TAVI?
Cerebral embolization is a relatively frequent complication during transcatheter aortic valve replacement (TAVR). The hypothesis behind this study is that the incidence of cerebral embolization might be decreased by anticoagulation with bivalirudin, instead of heparin. The first study objective was to determine the proportion of patients with new cerebral embolus after TAVI and…
Pre-TAVI Mitral Regurgitation Is Associated with Higher Mortality
Courtesy of Dr. Carlos Fava. This study sought to analyze the clinical impact and the level of improvement of mitral regurgitation (MR) in patients who receive a transcatheter aortic valve replacement (TAVR), and to find potential candidates for double valve repair with percutaneous techniques. Of 1.110 patients included, 177 (15.9%) suffered from severe pre-TAVR mitral…
Sex Specific Outcomes: Women after TAVI
Courtesy of Dr. Carlos Fava. The benefits of transcatheter aortic valve implantation (TAVI) have been widely shown, but there is no evidence on sex-specific outcomes. Some studies have shown lower mortality and better evolution of the ventricular function in women, yet with more bleeding and stroke; however, it remains unclear. This study included 1,019 patients…
Low BMI Is a Predictor of Death for TAVI
Courtesy of Dr. Carlos Fava. Body mass index (BMI) has always played an important role in heart surgery. However, there is little evidence on BMI effects on TAVI. This study included 491 patients, which were divided according to BMI into: low (<20 Kg/m2 ) normal (20-24.9 Kg/m2 ) overweight (25-30 Kg/m2 ) obese…
A New Score to Predict Post TAVI Mortality
Few studies have evaluated the impact of new comorbidities, fragility and disability indices on transcatheter aortic valve replacement (TAVI) outcomes. This study analyzes Medtronic CoreValve U.S. Pivotal patients to develop a new, simpler scoring system to use in addition to the standard assessment of TAVI patients. A multidisciplinary heart team used objective criteria, the…
SAPIEN 3 for TAVR: Lower One-Year Mortality
Original Title: One-year clinical outcomes with SAPIEN 3 transcatheter aortic valve replacement in high risk and inoperable patients with severe aortic stenosis. Reference: Herrmann H et al. Circulation. 2016; Epub ahead of print. Data presented at this last TCT annual meeting about the low rate of events at one year in inoperable patients with…
Post TAVR AVB: Is Telemetry Monitoring Necessary?
Original Title: The Electrocardiogram after Transcatheter Aortic Valve Replacement Determines the Risk for Post-Procedural High-Degree AV Block and the Need for Telemetry Monitoring Reference: J Am Coll Cardiol Intv. 2016;9(12):1269-1276. Courtesy of Dr. Agustín Vecchia. So far, we have not been able to determine the moment high degree atrioventricular block (AVB) takes place after…
Aortic Angulation: Impact on the Success of TAVR
Original Title: Aortic Angulation Attenuates Procedural Success Following Self-Expandable But Not Balloon-Expandable TAVR. Reference: Abramowitz Y et al. JACC Cardiovasc Imaging. 2016 Jul 8. [Epub ahead of print]. The angulation degree between aorta and heart can make precise valve implantation challenging, especially extreme angulation, such as a horizontal aortic root. As obvious as it…
Left Atrial Appendage Closure: Effective to Reduce Risk of Stroke?
Original Title: Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence. Reference: North Noelck et al. Circ Cardiovasc Qual Outcomes. July 2016. Published ahead of print. Atrial fibrillation is an important cause of stroke. Oral anticoagulation reduces the risk of stroke but, on the…