The association between aortic stenosis and coronary disease is common, since both conditions share pathogenesis, risk factors, and symptoms. Transcatheter aortic valve replacement (TAVR) is currently indicated for high-risk and inoperable patients. It also appears as a valid alternative for the treatment of intermediate-risk patients, and it could soon be indicated for low-risk patients. Coronary…
Surgical or Percutaneous Management of Mitral Leak
Mitral paravalvular leaks are relatively common after surgical mitral replacement, with an incidence of 7%-17%. Most of these are subclinical leaks, a mere echocardiogram finding, but about 3% of patients can develop heart failure, hemolysis, or a combination of both, thus requiring a new intervention. For symptomatic patients, new surgery has been the traditional treatment…
Leading Manufacturer of Balloon-Expandable Valves Launches Self-Expanding Device
Edwards Lifesciences could have been satisfied after the success of the PARTNER trials and the improvements to its balloon-expandable valve (mainly as regards the delivery system profile and paravalvular leak reduction) in its last model, SAPIEN 3. However, it was not. The company decided to keep going, developing a valve that is radically different from its…
Mild Leaks: TAVR’s Silent Enemies
Courtesy of Dr. Carlos Fava. Even though the presence of paravalvular regurgitation (PVR) has been reduced, thank to greater experience and new devices, it is still frequent and has an impact in survival (especially moderate and severe PVR). Recent research has shown that mild PVR also has a negative impact. However, these data were provided…
Who Lives Longer After TAVR, Men or Women?
Courtesy of Dr. Carlos Fava. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men.…
Transcatheter Mitral Valve Replacement Devices Multiply
The Transcatheter mitral valve replacement has been established as gold standard for patients with intermediate or high risk severe aortic stenosis. The supporting evidence was initially gathered with one or two safe and effective devices that worked really well, so that later on prosthetic valves multiplied, for competing companies wanted their share of the market. However,…
WIN TAVI: The Largest Female TAVR Registry So Far
Courtesy of Dr. Carlos Fava. In most randomized or observational studies, women comprise more than 50% of patients undergoing TAVR, and they have showed better evolution, compared against surgery. The main differences between men and women with severe aortic stenosis are that women have smaller annular dimension, shorter distance to coronary ostia, smaller peripheral arteries, and…
Lotus Valve in Real Life Patients: the near total lack of leaks is its greatest strength
Even though the incidence of complications in transcatheter aortic valve replacement (TAVR) have significantly decreased, there is one in particular that remains a concern since, when mild, it is associated to increased events rate. This complication is prosthetic paravalvular leak , which happens between the native annulus and the stent. The Lotus valve, completely repositionable, uses a…
Critical Lower Limb Ischemia Should Be Taken into Account in TAVR
Courtesy of Dr. Carlos Fava. Peripheral vascular diseases (PVD) present the same risk factors as aortic stenosis. In consequence, these disorders usually coexist. The frequency and impact of their various stages on patients undergoing TAVR is yet to be thoroughly assessed. Read also: “Peripheral Vascular Disease Is Associated to More Events in TAVR”. This study analyzed…
Durability: Evidence on TAVR and Long-Term Outcomes
Durability: Evidence on TAVR and Long-Term Outcomes. Presenters: Dr. Diego Godoy, Chile. Dr. Juan Gaspar, Uruguay. This video, sponsored and funded by Medtronic, was filmed during SOLACI-CACI 2017 Congress, at Hilton Buenos Aires Hotel (in Argentina). Do you want to take a look at all other SOLACI-CACI 2017 Congress Medtronic cases? Watch them We are interested in your opinion.…
Bicuspid Aortic Valve: Considerations for a Successful Procedure
Bicuspid Aortic Valve: Considerations for a Successful Procedure. Presenters: Dr. Luis Gutierrez Jaikel, Costa Rica. Dr. Fernando Pineda, Chile. This video, sponsored and funded by Medtronic, was filmed during SOLACI-CACI 2017 Congress, at Hilton Buenos Aires Hotel (in Argentina). Do you want to take a look at all other SOLACI-CACI 2017 Congress Medtronic cases? Watch them We are interested…