At present, an important group of patients with mitral valve disease are at high surgical risk, especially those with deteriorated bio-prosthesis, severe mitral annulus calcification or those who had received mitral annuloplasty. Percutaneous treatment with balloon expandable valves is a valid option to treat these patients, seeing as their 30 day and one-year outcomes look…
Valve-in-Valve Shows Good Evolution after 2 Years
The degeneration of bioprostheses in aortic position occurs at approximately after 10 to 15 years. In this scenario, the treatment of choice used to be redo surgery, but with the evolution of transcatheter aortic valve replacement (TAVR), it became a valid alternative with a level IIa B evidence. While there are currently multiple analyses of…
Severe Mitral Regurgitation and Cardiogenic Shock: Is Edge-to-Edge a Valid Strategy?
At present, cardiogenic shock continues to present high mortality despite the new treatments and ventricular assistance devices available in some centers. In this group, the presence of severe mitral regurgitation (MR) is around 5% and, on many occasions, it cannot be treated with surgery because of hemodynamic conditions. Edge-to-edge repair has been looked at by…
Edge-to-Edge Repair Reduces Hospitalization and Mortality Rates in Secondary Mitral Valve Regurgitation?
Severe secondary mitral valve regurgitation is associated to hospitalization and mortality. The COAPT study has shown the superiority of guideline directed medical therapy at maximal tolerated doses according to guidelines (GDMT) plus edge-to-edge transcatheter repair (TEER) versus GMDT alone. However, at present there is no information on the impact of hospitalizations and their relationship to…
We Should Start Considering Pulmonary Hypertension After TAVR
Pulmonary hypertension is associated with higher mortality after both aortic valve replacement and transcatheter aortic valve replacement (TAVR). This is a dynamic phenomenon, and what happens after TAVR —during the periprocedure— and its impact are yet to be evaluated. Researchers conducted a subanalysis of the Japanese OCEAN TAVI Registry, which included 1872 patients who were divided…
SURTAVI at 5 Years
Transcatheter aortic valve replacement (TAVR) by transfemoral access has shown great benefit for different risk groups, but its long-term durability is still uncertain. Available evidence comes from small analysis and a single randomized trial with 280 patients and an 8 year follow-up: the NOTION Trial, where TAVR showed less valvular degeneration than aortic valve replacement (AVR) surgery.…
A Simple Score for Mortality and Cardiac Failure after Edge-to-Edge with MitraClip
Mitral regurgitation (MR) is the most frequent type of valve heart disease, and the COAPT has shown that edge-to-edge with guideline directed medical treatment (GDMT) at maximal tolerated dose (MTD) is superior to medical treatment alone. However, we did not have a score to predict patient evolution when treated with this strategy. Researchers analyzed the…
Prognostic Impact of Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair
Tricuspid failure (TF) mostly affects the elderly and, because of this, is associated with comorbidities that increase surgical risk. Tricuspid edge to edge repair (TEER) has surged as a valid alternative for the mitral valve in high-risk patients and, at present, is increasingly being used for tricuspids. One of the complications following TEER is acute…
Is Right Ventricle-Pulmonary Artery (RV-PA) Coupling Important in Low Risk TAVR?
TAVR has long been an effective strategy to treat aortic stenosis. However, ventricular damage starts further before symptom onset, also affecting the left ventricle, pulmonary vessels, the right ventricle, the tricuspid valve, and the right atrium. It increases arterial afterload and uncouples the right ventricle and the pulmonary artery, defined by transthoracic echocardiogram as the relationship…
TCT 2022 | PROTECTED TAVR
Stroke is still a major complication of transcatheter aortic valve replacement (TAVR), with a 30-day mortality of 16.7%. Even in the absence of symptoms, most patients (68-93%) have some type of diffusion imaging defect after TAVR implantation. The Sentinel cerebral protection device (CPD) (Boston Scientific) received FDA approval for the capture of emboligenic material that…
TCT 2022 | Edge-to-Edge Repair in Patients with Severe Mitral Insufficiency and Cardiogenic Shock: Analysis of the TVT Registry
Approximately 1 in 5 patients admitted for cardiogenic shock (CS) were observed to have moderate to severe mitral insufficiency (MI), which increases the risk of mortality by about 60%. To date, there is limited data on the role of transcatheter edge-to-edge repair therapy in this setting. The aim of this study was to describe the…