Structural heart disease articles

Mejoras tecnológicas en las válvulas que se traducen en resultados clínicos

Technological Improvements in Valves Translate into Clinical Results

Technological Improvements in Valves Translate into Clinical Results

Three generations of self-expanding valves, three different prognoses for our patients. Design improvements and better materials in self-expanding, supra-annular aortic valves, and their better results, have allowed for the expansion of the indication for transcatheter aortic valve replacement (TAVR). Particularly, the addition of a pericardial skirt improves annular sealing and results in a significantly low

Predilatación en TAVI ¿Datos definitivos para no complicarse tomando decisiones?

Predilation in TAVR: Definitive Data for Easier Decision-Making?

Direct implantation (without predilation) resulted non-inferior vs. the conventional strategy with prior balloon aortic valvuloplasty using the S3 prosthesis (even though this did not translate into a simplified procedure). In a few patients, the prosthesis was not able to cross the native valve, which resulted in device retrieval and subsequent valvuloplasty. According to these data,

Virtual ACC 2020 | First Results of Evolut in Low-Risk Bicuspid Valves

The initial results of this study presented “virtually” at the American College of Cardiology (ACC) 2020 Scientific Session suggest that patients with severe bicuspid aortic stenosis can be treated with self-expandable valve Evolut. This is a small study presenting its 30-day outcomes. There is still a long way to go. The rate of all-cause mortality

Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points

After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up.  Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms

ACC Virtual 2020 | A diferencia del TAVI, el volumen de cirugías mitrales no mejora la reparación por catéter

Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs

Soon, our website will feature an interesting study showing that sites with a higher number of conventional surgical aortic valve replacements had better outcomes in transcatheter aortic valve replacement procedures. The study featured in this article was scheduled for presentation at the American College of Cardiology 2020 Scientific Session along the World Congress of Cardiology.

Virtual ACC 2020 | Conscious Sedation in TAVR

According to the TVT Registry, patients who undergo transcatheter aortic valve replacement (TAVR) with conscious sedation have better outcomes, including lower mortality rates. A minimalist strategy always (sooner or later) proves to be superior across our whole range of procedures, from a simple diagnostic study with local anesthesia and a 4-Fr transradial access, to a

Anillo pequeño, ¿debemos comenzar a elegir la válvula?

TAVR in Extremely Large Annuli: Different Patients Might Need Different Prostheses

Nearly all prostheses for transcatheter aortic valve replacement (TAVR) commercially available at present are adequate for most patients. However, there are certain subgroups, relatively small, that could benefit from a particular one. Yesterday we went over the best suited for small annuli, which turned out to be the self-expandable in general and the Evolut PRO

tavi calcificación del anillo mitral

TAVR in Small Annuli: Is There a Better Valve?

Transcatheter aortic valve replacement with the self-expandable valves has shown optimal clinical and electrocardiographic results in patients with small annuli. These supra-annular prosthetic valves seem somewhat better than the intra-annular balloon expandable.  TAVR in general has better functional results in terms of patient/prosthesis mismatch. This seems especially true for patients with a small annulus.  The

acceso_transcaval

Europe Advances the Transcaval Approach for TAVR

The transfemoral access is clearly the preferred approach to transcatheter aortic valve replacement (TAVR), followed by the trans-axillary or trans-subclavian. Despite the alternatives, some patients are still ineligible. This study recently published in EuroIntervention reports initial experiences in Europe with the transfemoral transcaval approach.  It included 50 patients from 5 centers assessed according to the

Estenosis aórtica moderada y disfunción ventricular ¿debería apurarse la indicación del recambio?

Treating Both Atrial Valves Improves Survival

Courtesy of Dr. Carlos Fava. There a few treatment options for tricuspid valve disease. It is practically limited to diuretics and surgery, is associated to high mortality and, generally, mitral regurgitation.  Developing the “edge-to-edge” strategy with MitraClip has been shown beneficial and, at present, there are studies that claim this technique could be greatly beneficial

Cirugía para mejorar la sobrevida en insuficiencia tricuspidea aislada

PASCAL in Tricuspid Regurgitation with Encouraging Results

Courtesy of Dr. Carlos Fava. Tricuspid regurgitation (TR) is associated with higher mortality and morbidity, and it most frequently has a functional cause. Furthermore, it has been proven that tricuspid surgery has mortality rates between 8% and 20%. On the other hand, it has been verified that, in the case of left-sided disease affecting the

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