Same-day discharge (SDD) has been shown to be effective in angioplasties and some peripheral procedures, but the pandemic—because of the burden it caused on the healthcare system—has forced the optimization of hospitalization times for other pathologies and procedures. This strategy is yet to be tested in transcatheter aortic valve replacement (TAVR) due to the possible…
TRICENTO: Promising Results for Severe Tricuspid Valve Regurgitation
Difficult to treat, tricuspid valve failure poses great medical challenge. In addition, the mortality rate of surgical treatment these days is not exactly low, involving high risk, which often takes this alternative off the table. Several percutaneous devices have been developed to treat this disease, the most popular being edge-to-edge devices. The TRICENTO has an…
Low Risk Patients: TAVR with Self-Expanding Valves Offers Similar Outcomes to Surgery Based on a Bayesian Analysis?
When compared against surgical valve replacement (SAVR) transcatheter aortic valve replacement (TAVR) has shown benefits across different risk groups, not only in events as death and stroke, but also in quality of life (especially in the first months post procedure) and improved symptoms. However, a catch-up phenomenon was observed in low-risk patients between the first…
Are Self-Expandable Valves a Valid Option in Bicuspids?
Bicuspid Aortic Valves (VAV) are challenging for TAVR given its anatomical characteristics and the important presence of calcification. However, current data are promising. Even though traditionally excluded from the larger randomized studies, self-expandable valves appear to have similar evolution to tricuspid aortic valves (TAV) with severe stenosis. Researchers looked at the Low-Risk Bicuspid Study and…
Are Expandable-Balloon Valves an Option for the Bicuspid Valve in Low-Risk Patients?
Bicuspid aortic valve malformation is the most frequent cardiac malformation (about 1%), and a significant percentage of these cases generate severe aortic stenosis. As we know, transcatheter aortic valve replacement (TAVR) has been developed for tricuspid valves, which are studied in the most important randomized trials for high-, medium-, and low-risk patients. While current information…
Is Cusp Overlapping Projection the New Self-Expandable Valve Implantation Technique?
In Europe and the US, aortic stenosis is the most frequent cause of valve intervention, both surgical and percutaneous, and, as we all know, TAVR has made great progress in this regard. However, this technique has an Achilles heel when it comes to self-expandable valves: definite pacemaker implantation rate is 3 to 4 times higher…
MitraClip Failure: What Should We Do?
Currently, edge-to-edge therapy with MitraClip has demonstrated efficacy and safety for the treatment of patients with degenerative or functional mitral regurgitation who are at high risk for surgery. However, device-related complications are still present—though their frequency is subsiding due to greater experience, 3D doppler echocardiography development, and technological advancements: loss of leaflet insertion (LLI), single…
Infective Endocarditis in TAVR: What’s the Best Treatment?
Infective Endocarditis (IE) rate after TAVR ranges from 0.7% to 3.4%, depending on the different analyses, and is comparable to that after SAVR. Close to 50% of patients treated with surgery received a prosthetic valve; in TAVR, the figure is lower, possibly due to the characteristics of patients (even though it remains unclear). Researchers looked…
Melody: One of the Pioneers in Transcatheter Pulmonary Valve Replacement with Long Term Outcomes
At 10 years of the Melody Investigational Device Exemption we can observe this device for transcatheter pulmonary valve replacement might be a lifetime fix, both to extend the useful life of previously implanted right ventricular outflow tract (RVOT) conduits or bioprosthetic pulmonary valves. Patient enrollment for the US Investigational Device Exemption study of the Melody…
HYDRA CE | New Models for TAVR Development
The Hydra CE has shown favorable one year efficacy for the new transcatheter aortic valve model, with large effective orifice and low transvalvular gradient associated to an acceptable complications rate. With this study, the Hydra will obtain the CE mark and go after FDA approval (just as all new devices). This study looked at safety…
Minimizing One of Our Major Procedures to a Minimum
In some cases, full atrioventricular (AV) block occurs beyond two days after transcatheter aortic valve replacement (TAVR). This highlights the usefulness of extending monitoring after discharge, particularly in patients who tolerated the procedure well, but meet high-risk criteria. We have made great progress regarding conduction disorders in TAVR, especially after the publication of the consensus…