Indicating apixaban after transcatheter aortic valve replacement (TAVR) does not significantly reduce the risk of sub-clinical leaflet thrombosis compared with the standard of care. These data come from the computerized tomography (CT) scan sub-study from ATLANTIS, presented during the scientific sessions of the American College of Cardiology (ACC) 2021 Congress. In patients with no prior…
ACC 2021 | ATLANTIS: Apixaban After TAVR vs. Standard of Care
Adding apixaban to the treatment of patients undergoing transcatheter aortic valve replacement (TAVR) was non-superior to standard antithrombotic treatment, according to the randomized ATLANTIS trial presented today at the American College of Cardiology (ACC) 2021 Congress. Given its easy indication and good safety profile, it could be an option to vitamin K antagonists for patients with…
Is Rheumatic Etiology Counter Indicated for TAVR?
Patients with rheumatic aortic stenosis have been systematically excluded from all studies on transcatheter aortic valve replacement (TAVR). This study compared TAVR vs surgical aortic valve replacement (SAVR) outcomes in patients with rheumatic aortic stenosis and also vs TAVR outcomes in patients with degenerative aortic stenosis. The study looked at rheumatic aortic stenosis patients receiving…
Validating Consensus on Post TAVR Conduction Disturbances in the Clinical Practice
Little over a year ago, JACC published the expert consensus on the management of post transcatheter aortic valve replacement (TAVR) conduction disturbances. This publication homogenized criteria and was welcomed by operators who, when in doubt, tended to prematurely indicate definite pacemaker implantation or delayed discharge in order to monitor patients. These criteria, however, was nothing…
Watch again our Webinar on TAVR in Low-Risk Patients
Watch again our Webinar on “TAVR in Low-Risk Patients” on our Youtube account. The event was held on May 6th, 2021.
ST-Segment Elevation Infarction After TAVR: Problems in Every Aspect
For interventional cardiologists, treating an ST-segment elevation infarction in a patient with transcatheter aortic valve replacement (TAVR) is challenging in many ways. Longer door-to-balloon times and higher rates of primary angioplasty failure than in the general population are translated into very high short- and mid-term mortality. This multicenter study, recently published in JACC, included 118 patients…
SOLVE-TAVI after 12-month followup: self-expanding vs. balloon expandable and general vs. local anesthesia
The ambitious SOLVE-TAVI (soon to be published in JACC) is aimed at answering to of the most important questions we make when facing a TAVR procedure: What valve do we choose, a self-expanding or a balloon expandable? And once we have chosen our device, do we proceed with general anesthesia or conscious sedation? The…
Incidence, Predictors, and Results of Acute Kidney Injury in Patients Undergoing TAVR
Acute kidney injury after transcatheter aortic valve replacement (TAVR) is a well-known adverse event for all interventional cardiologists. However, it has been understudied: only small observational research has been conducted, showing too wide incidence rates. This research included all patients who underwent TAVR in the USA between 2016 and 2018, totaling over 100,000 patients. All subjects…
Dual Antiplatelet Therapy and TAVR: Obsolete Guidelines
The current guidelines recommend dual antiplatelet therapy (DAPT) 3 to 6 months after transcatheter aortic valve replacement (TAVI). Some recent data finally condensed in the present meta-analysis and recently published in JAHA happen to challenge these guidelines. Clinical studies that investigated single antiplatelet therapy versus DAPT until November 2020 were analyzed and divided according to…