Severe aortic regurgitation (AR) may account for 20% to 30% of all surgical aortic valve replacements (SAVR) and is often associated with aortic stenosis (AS). Transcatheter treatment of these patients is limited due to anatomical factors such as root and annular dilation, large annular dimensions, and less calcification in the valve leaflets to serve as…
TAVI in Moderate Aortic Stenosis with Low Ejection Fraction
The presence of aortic stenosis, heart failure, and decreased ventricular function is associated with poor prognosis and high mortality. For this reason, both European and American guidelines classify severe stenosis as a Class I indication. There are two retrospective analyses that demonstrate the benefits of transcatheter aortic valve implantation (TAVI) via transfemoral access. The TAVR…
TAVR: Does HALT Affect Follow-Up?
Transcatheter aortic valve replacement (TAVR) in low-risk patients has been shown to be superior or noninferior in randomized studies, but the presence of valvular thrombosis, in its different forms, has not been well analyzed, nor is there much information on its impact on evolution. Researchers conducted an analysis of the LTR study that included 200…
Mitral Valve Surgery after Edge-to-Edge Repair
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 |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…
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…