Patients with severe symptomatic aortic stenosis treated with aortic valve replacement might still present cardiac failure, even after successful procedures. According to some reports, the incidence of cardiac failure after TAVR varies between 9% and 24%. The prognostic relevance of rehospitalization in these patients has not been studied yet; in fact, it remains unclear whether…
Secondary Mitral Regurgitation: Stages of Heart Failure and Prognostic Implications after Transcatheter Edge-to-Edge Repair
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease…
Real-World Results of Different Devices for TAVR
Transcatheter aortic valve replacement (TAVR) keeps growing in terms of the development of new devices, more extensive operator experience, and enhanced procedure planning. Nowadays, there are multiple device options, which depend on patient characteristics and operator experience. Two-arm studies compared these devices, analyzing the potential benefits of a certain valve over the others. This multicenter…
Clinical Implications of the Presence of HALT in TAVR Patients: 5-Year Follow-Up
The duration of percutaneous aortic valve implants can be increasingly observed over time, regardless of their corresponding surgical risk. In the follow-up of different registries, the presence of subclinical valvular thrombosis, evidenced in tomographic studies as an increase in valvular thickness with hypoattenuation (a term known as HALT), was observed from protocolized images. This subclinical…
Is the PASCAL Device Effective against MitraClip?
Mitral regurgitation (MR) is the most common valvulopathy and full medical treatment at maximal tolerated doses has been shown quite effective to treat it. However, its limited in a group of patients that require valve intervention. At present, the ideal treatment is surgical valve replacement, which is in many cases is not viable because of…
Is There any Difference between Modern Valves and Self and Balloon Expandable Valves?
At present TAVR is a valid alternative to treat different risk groups of patients with severe aortic stenosis. Among the different valves, there are two types, the self-expanding (SEV) and the balloon expandable (BEV) valves, that are the most implanted and the most researched by randomized studies across different risk groups. There are different generations…
Mitral Trial: 2-Year Followup
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…