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…
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…
Left Atrial Appendage Closure vs Direct Anticoagulants at Long Term
The PRAGUE-17 has shown that left atrial appendage closure is not inferior to direct anticoagulants at long term to prevent major cardiovascular, neurological, or bleeding events. Moreover, procedures not related to prosthesis implantation saw significant reduction. The PRAGUE-17 was a randomized non-inferiority study comparing left atrial appendage closure (Watchman or Amulet) with direct anticoagulants (95%…
The Most Relevant of 2021 In Structural Heart Disease
This last year, new data in structural heart disease gave way to changes in practices and new hypotheses, when not simply further justified the already existing evidence. In this new editorial section, we share the most relevant of last year’s works to keep you up to speed on the main topics in the field. The…
The Most Read Articles of 2021: Structural Heart Disease
A new year is coming to an end and at SOLACI we are going over the most read studies on our website, on a vital topic, peripheral vascular disease. Follow us to keep up to date. The Most Read Articles of 2021: Structural Heart Disease 01- Surgeons’ Claim on Low-Risk Patients with Aortic Stenosis Recent…
PRAGUE-17: Appendage Closure vs. Direct Anticoagulant Agents
After four years of follow-up, the PRAGUE-17 study showed that appendage closure is non-inferior to direct anticoagulant agents (non-warfarin oral anticoagulants, NOAC) to prevent major neurological events, cardiovascular events, and bleeding events in patients at high risk of atrial fibrillation. Appendage studies were compared with warfarin studies—it was necessary to update anticoagulant agents and reach…
CHOICE-CLOSURE | Which Closure Device for TAVR is Better?
In patients who undergo transcatheter aortic valve replacement (TAVR) through transfemoral access, a closure device based on plug technology (MANTA VCD) is associated with a higher chance of access-related complications, but with shorter hemostasis time compared with a device with suture technology such as ProGlide VCD. Nowadays, most patients undergo TAVR through transfemoral access. Percutaneous…
Prosthesis-Annular Size Ratio and Its Impact on Leaks
In low-risk patients, there was a very low incidence of greater than moderate leak, including in patients with minimal oversizing. The degree of prosthesis oversizing had a great impact on mild paravalvular leak reduction and the need for post-dilation without changing valve hemodynamics. This research investigated the impact of the perimeter and the area, measured…
Ten Commandments for 2021 Guidelines on Valvular Heart Disease
Since the latest version to the Valvular Heart Disease Guidelines from the European Society of Cardiology, plenty of evidence has been accumulating, finally leading to this updated version. In this regard, below you will find what has been called “10 commandments” that sum up this new document, to keep you in the loop. The incidence…
AHA 2021 | AVATAR: Early Intervention in Asymptomatic Aortic Stenosis
Early surgical aortic valve replacement (SAVR) in patients with severe asymptomatic aortic stenosis can be beneficial in selected patients vs. waiting for symptoms. Severe AS in patients with no symptoms and conserved ventricular function raises few questions, clinically speaking. However, there is little evidence in favor of early intervention vs. close observation. The best data…