Edge-to-edge treatment of the mitral valve is currently a valid alternative to surgery in cases of mitral regurgitation. Different studies have taken residual mitral regurgitation as a parameter of success, but little research has been conducted on the residual gradient once the procedure has been completed. What has been published is that a mean gradient…
Transcatheter Edge-To-Edge Repair Is Favorable for Elderly Patients at High Surgical Risk
Mitral valve prolapse is the most frequent cause of mitral valve regurgitation and is associated to hospitalization for cardiac failure and mortality. At present, the preferred treatment for operable patients is mitral valve surgical repair. Transcatheter edge to edge repair (TEER) has shown great benefit patients at high surgical risk; however, it has not been…
Is Increased Mitral Valve Gradient After MitraClip a Long-Term Prognostic Factor?
Transcatheter mitral valve repair using the edge-to-edge strategy has become a therapeutic alternative for patients with severe primary mitral valve regurgitation (MVG) who are at high or extreme surgical risk. However, both degree of residual regurgitation and gradient after the procedure should be taken into account, as in previous studies the latter was associated with…
Avatar Trial: Is It Time to Use Surgical Aortic Valve Replacement in Asymptomatic Patients?
It is still unclear whether surgical aortic valve replacement (SAVR) is beneficial in asymptomatic patients with severe aortic stenosis (AS) and conserved left ventricular function (C1 indication according to AHA guidelines). The European American guidelines only recommend intervention in asymptomatic patient when there is ventricular compromise (ejection fraction <50%, class I indication) or with a…
ACC 2022 | CLASP TR Study: Tricuspid Valve Repair with the PASCAL Device
The study included 65 patients who received endovascular treatment of the tricuspid valve with the PASCAL device. Forty-six completed the 12-month follow-up. At 1-year follow-up, the major events endpoint was 16.9%; the most frequent event was bleeding (9.2%). In addition, there were three cases of stroke, one reintervention, two vascular access complications, and five cardiovascular-related…
ACC 2022 | ADAPT-TAVR: Endoxaban Is Not Superior to DAPT After TAVR
DAPT-TAVR is a randomized trial that tested endoxaban in patients with no indication for anticoagulation who underwent successful transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis. This study included 229 patients whose mean age was 80 years; 42% of them were male. Patients were randomized to either endoxaban 60 mg or 30 mg every 24 h or…
ACC 2022 | APOLLO
Lipoprotein a (Lp a) is an important risk factor for atherothrombosis and atherosclerotic cardiovascular disease, but it has no approved treatments to this day. The aim of this randomized study in phase 1 was to assess adverse events and siRNA tolerance (small interfering RNA) to reduce liver production of Lp a and assess plasma concentration…
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…