Courtesy of SBHCI. This work, which was presented during the TCT 2019 Scientific Sessions and simultaneously published in the Lancet, randomized patients to the ACURATE Neo prosthesis (n = 373) vs. the SAPIEN 3 (n = 367) in a head-to-head comparison involving 20 European sites. Transfemoral access was used in all patients. The study had a noninferiority design, and its primary…
TAVR in Bicuspid Has the Same Results in Surgery at Hospital Level
Courtesy of Dr. Carlos Fava. Bicuspid aortic stenosis patients (bicuspid AS) represent a small group and have not been included in the larger transcatheter aortic valve replacement (TAVR) studies, since they present different morphology and asymmetric calcification, which might come along with more paravalvular leak and less accurate positioning. Between 2012 and 2016, 475,315 patients…
ESC 2019 | How Benign Is Moderate Aortic Stenosis?
Data from a great Australian registry of nearly 250,000 people with a 5-year follow-up, presented at the European Society of Cardiology (ESC) Congress 2019 in Paris and simultaneously published in J Am Coll Cardiol, suggest that mortality due to severe aortic stenosis is similar to that due to moderate aortic stenosis. These data warn us…
Experts Reach Consensus on Post TAVR Pacemaker Indication
This new consensus published this week in J Am Coll Cardiol has provided us with an algorithm to manage conduction disturbances after transcatheter aortic valve replacement. This consensus is intended to reduce potential deaths caused by conduction disturbances and, at the same time, reduce unnecessary definite pacemaker implantation. This document is a big step ahead…
Physiological and Clinical Changes After Tricuspid Repair
After the recent announcement by the US Food and Drug Administration (FDA) green-lighting transcatheter aortic valve replacement (TAVR) in patients across the whole spectrum, and given the advancements regarding devices already in the market (such as MitraClip) and a variety of pulmonary valves, there is only one territory left to conquer: the long forgotten tricuspid…
Impact of Edge to Edge Transcatheter Tricuspid Valve Repair
Reducing tricuspid regurgitation with transcatheter valve repair is associated to improved liver function, which is often ignored by many cardiologists. This is especially true in cases with deteriorated liver function prior valve repair. Instead, kidney function did not show any changes. Transcatheter tricuspid valve repair seems attractive especially in patients with liver failure. Edge to…
Surgery to Improve Survival in Isolated Tricuspid Regurgitation
Patients with isolated tricuspid regurgitation (i.e., who have no associated left-sided valve disease) are frequently treated conservatively. In many cases, valve disease is highly symptomatic, even with the optimization of medical treatment; however, an invasive strategy is seldom proposed. The aim of this work was to measure the impact of surgery on isolated tricuspid regurgitation…
FDA Expands TAVR Indication to Low-Risk Patients
Both the self-expandable valve Evolut R and its direct competitor, balloon-expandable valve Sapien 3, received the authorization to be indicated for low-risk patients in a long-awaited announcement made on August 16th, 2019. The US Food and Drug Administration (FDA) has approved and expanded the indication for the Evolut series (Medtronic) and the Sapien 3 and…
Loss in Life Expectancy after Surgical Aortic Valve Replacement
This study found after surgical aortic valve replacement (SAVR) patients had shorter life expectancy, compared against the general population. This loss in life expectancy was significant, especially in young patients. These results provide essential information to advice patients before and after SAVR. This is an observational national cohort study to assess long term relative survival…
Clinical Implications of the New Hypertension Guidelines
Hypertension is the first modifiable risk factor affecting morbidity and mortality in nearly half of the adults in the US. The new ACC/AHA guidelines have issued new standards for the detection assessment and management of high blood pressure. The major change compared against their prior version was stage 1 hypertension definition, defined as systolic blood…
New Promising Alternatives for Mitral Regurgitation
PASCAL transcatheter valve repair system for mitral regurgitation has shown feasibility and safety to treat patients with grade 3+ or 4+, regardless etiology. Regurgitation grade was significantly reduced, and this was accompanied by clinical improvement in functional class, exercise capacity and quality of life. This study soon to be published in J Am Coll Cardiol…