Courtesy of Dr. Carlos Fava. The risk of repeat surgical mitral valve repair involves 6% to15% mortality at 30 days, even close to 20% in acute cases. However, mortality can rise to over 40% when it comes to a third or fourth surgical intervention. One of the solutions to this serious problem is transcatheter mitral…
Aortic Valvuloplasty as a Bridge to TAVR: Are We Wasting Our Time?
Doing a balloon aortic valvuloplasty can be a good way to “buy” time before a transcatheter aortic valve replacement (TAVR), according to a registry to be published this week in J Am Coll Cardiol Intv. This study analyzed the database of a whole country to find out the incidence, predictors and outcomes of balloon aortic…
Tricuspid valve: Is Percutaneous Intervention Feasible in Patients with Definite Pacemaker?
Courtesy of Dr. Carlos Fava. As we know, with higher life expectancy comes a significant increase in the use of definite pacemakers, defibrillators and resynchronization devices. Along these lines, the presence of catheters is associated to tricuspid regurgitation, which over time might become severe, leading to cardiac regurgitation and potentially heart failure. This group is…
Technological Improvements in Valves Translate into Clinical Results
Three generations of self-expanding valves, three different prognoses for our patients. Design improvements and better materials in self-expanding, supra-annular aortic valves, and their better results, have allowed for the expansion of the indication for transcatheter aortic valve replacement (TAVR). Particularly, the addition of a pericardial skirt improves annular sealing and results in a significantly low…
Predilation in TAVR: Definitive Data for Easier Decision-Making?
Direct implantation (without predilation) resulted non-inferior vs. the conventional strategy with prior balloon aortic valvuloplasty using the S3 prosthesis (even though this did not translate into a simplified procedure). In a few patients, the prosthesis was not able to cross the native valve, which resulted in device retrieval and subsequent valvuloplasty. According to these data,…
Virtual ACC 2020 | First Results of Evolut in Low-Risk Bicuspid Valves
The initial results of this study presented “virtually” at the American College of Cardiology (ACC) 2020 Scientific Session suggest that patients with severe bicuspid aortic stenosis can be treated with self-expandable valve Evolut. This is a small study presenting its 30-day outcomes. There is still a long way to go. The rate of all-cause mortality…
Virtual ACC 2020 | POPULAR TAVR: Post TAVR Anticoagulation without Clopidogrel?
In patients undergoing transcatheter aortic valve replacement (TAVR) that also required anticoagulation for another indication (mostly atrial fibrillation), the incidence of major bleeding between month 1 and 12 was lower in those receiving only anticoagulation instead of anticoagulation + clopidogrel. The present study presented as part of the scientific sessions at the virtual ACC 2020,…
Virtual ACC 2020 | PARTNER 3: TAVR vs CABG in Low Risk at 2 Years
The 2-year outcomes in patients with severe aortic stenosis and low surgical risk continue to show a numerical benefit in favor of transcatheter aortic valve replacement (TAVR) vs. surgical replacement (CABG) for the primary end point of death, stroke or repeat hospitalization for cardiovascular reasons. However, the initially higher advantage of TAVR has been narrowing…
Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points
After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up. Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms…
Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs
Soon, our website will feature an interesting study showing that sites with a higher number of conventional surgical aortic valve replacements had better outcomes in transcatheter aortic valve replacement procedures. The study featured in this article was scheduled for presentation at the American College of Cardiology 2020 Scientific Session along the World Congress of Cardiology.…
Virtual ACC 2020 | Conscious Sedation in TAVR
According to the TVT Registry, patients who undergo transcatheter aortic valve replacement (TAVR) with conscious sedation have better outcomes, including lower mortality rates. A minimalist strategy always (sooner or later) proves to be superior across our whole range of procedures, from a simple diagnostic study with local anesthesia and a 4-Fr transradial access, to a…