Courtesy of Dr. Carlos Fava. The presence of pulmonary hypertension (PH) is frequent in severe aortic stenosis. This can be classified in: isolated pre-capillary PH, isolated post-capillary PH, and combined post-capillary and pre-capillary PH. At present, little research has looked into the disease from this perspective. The study looked at 1400 patients and divided them…
Infective Endocarditis After TAVI
Infective endocarditis after transcatheter aortic valve implantation (TAVI) is one of the most feared complications due to its morbidity and mortality. With the expansion of TAVI into all risk groups, endocarditis might be a long-term concern. However, its long-term risk seems similar to that of endocarditis with surgically-implanted biological valves; consequently, it should not affect…
Prosthesis Mismatch in Supra and Intra Annular valves
The self-expandable valve was associated to lower prosthesis-patient mismatch (PPM) compared against the balloon expandable valve regardless annular area, according to this study soon to be published in J Am Coll Cardiol Intv. This difference was basically driven by patients with larger body surface area (>1.83m²). Prosthesis mismatch has been associated to increased mortality after transcatheter…
Incidence and Prognosis of Heart Valve Embolization
The incidence of peri-procedural transcatheter heart valve embolization and migration (TVEM) is as low as 1%. However, it is associated with increased morbidity and mortality. Peri-procedural TVEM is one of the most feared complication given its potential to transform the procedure into a catastrophe, but little do we know about its incidence (except for a…
Trying to Reduce Post TAVR Kidney Injury
Acute kidney injury is a common complication after transcatheter aortic valve replacement (TAVR) and is associated to increased mortality both short and long-term. In patients undergoing percutaneous coronary intervention (PCI) forcing diuresis with controlled hydration has shown to reduce the incidence of acute kidney injury in nearly 50%. However, this has not been tested in…
More Evidence on Tricuspid Valve Repair
While still lacking large-scale randomized trials, evidence is slowly building for transcatheter tricuspid valve repair. This work, presented at the TCT 2019 Congress and simultaneously published in JACC, shows that transcatheter tricuspid valve repair is not only feasible, but also likely to reduce the rates of mortality and heart failure rehospitalization compared with medical therapy alone.…
TAVR Offers Better Quality of Life to Low Risk Patients
Courtesy of Dr. Carlos Fava. As we all know, TAVR is gaining ground fast in the lower risk patient population, but in addition to analyzing the most important events, researchers are increasingly looking at health status, not only at hospital level, but also after one year. This study looked into PARTNER 3 patient health status…
TCT 2019 | PARTNER 3: Obvious Short-Term Quality of Life Improvement, but What Happens Afterwards?
Courtesy of SBHCI. Patients with severe aortic stenosis and low surgical risk showed decreased mortality, stroke, and heart failure hospitalization at one year with transcatheter aortic valve replacement compared with surgery. Improved quality of life may seem an obvious consequence, but until now that was mere speculation. This work, presented at the TCT 2019 Scientific Sessions…
TCT 2019 | COAPT Cost Effectiveness: Better Quality of Life and Survival Rate, but Worth It?
Courtesy of SBHCI. The COAPT showed transcatheter repair of the mitral valve using the MitraClip resulted in reduced mortality and hospitalization for cardiac failure and improved quality of life, compared against optimal medical treatment in patients with cardiac failure and moderate to severe functional mitral regurgitation. The cost-effectiveness of this procedure has not been analyzed…
TCT 2019 | COAPT at 3 Years: MitraClip Reached Functional Mitral Regurgitation Target
Courtesy of SBHCI. Prognosis of patients with cardiac failure who develop secondary mitral regurgitation due to dilation is uncertain. The COAPT study was carried out in 78 centers across the US and Canada and included patients with moderate to severe mitral regurgitation (3 or 4 crossovers) symptomatic despite optimal medical treatment (OMT). 614 patients were…
TCT 2019 | PARTNER 2A at 5 Years: In Intermediate-Risk Patients, TAVR Is Still Head-to-Head with Surgery
Courtesy of the SBHCI. The 2-year results of the PARTNER 2A trial showed that transcatheter aortic valve implantation has a result similar to that of surgery in patients with aortic stenosis and intermediate surgical risk. We lacked long-term data, both clinical and related to prosthesis function. Now, at TCT 2019, researchers presented the 5-year data for this…