Structural heart disease articles

TAVI: Balón expandible o autoexpandible ¿Cuál es la respuesta?

Considerations for Optimal Device Selection in TAVR

Considerations for Optimal Device Selection in TAVR

Many studies have tried to answer the question about whether there is a superior device in transcatheter aortic valve replacement (TAVR). Today, there is no evidence to support such claim, and most patients will likely find operator experience more beneficial than any device per se.   However, there are certain patients with specific characteristics that might

Trombólisis local en tromboembolismo pulmonar

TAVR After Endocarditis? Contraindication or Last Resort

Transcatheter aortic valve replacement (TAVR) can be an alternative for aortic valves with endocarditis successfully treated with antibiotics, which no longer are severe valve lesions. At one year, the risk of endocarditis relapse was low and the mortality rate was similar to that of patients without a history of infection. This aim of this study

Score de Calcio, “dónde está” parece más importante que “cuánto hay”

Outflow Tract Calcification and the Best Valve in This Context

Moderate or severe left ventricle outflow tract calcification increases the risk of annulus rupture, residual aortic regurgitation and the need for a second valve. This recent study analyzed the performance of different contemporary prosthetic valves in patients with this particular anatomy.  Since the early days of transcatheter aortic valve replacement (TAVR) outflow tract calcification has

ESC 2020 | Guías de Fibrilación Auricular 2020: Novedades sobre diagnóstico, clasificación y tratamiento

ESC 2020 | 2020 Atrial Fibrillation Guidelines: News on Diagnosis, Classification, and Care

New guidelines for the diagnosis and treatment of atrial fibrillation (AF) were released at the 2020 European Society of Cardiology (ESC) virtual congress. This document incorporates several findings from the latest clinical trials, but also represents a great shift in terms of how physicians from different specialties should classify and manage arrhythmia after confirming the

ESC 2020 | Guías de Fibrilación Auricular 2020: Novedades sobre diagnóstico, clasificación y tratamiento

ESC 2020 | New Drug Improves Functional Capacity in Hypertrophic Cardiomyopathy

In patients with hypertrophic cardiomyopathy, myosin inhibitor mavacamten plus optimal medical therapy improved hemodynamics, functional capacity, and symptoms. Mavacamten is the first myosin inhibitor drug of its class. Presented virtually at the European Society of Cardiology 2020 Congress (ESC 2020) and published simultaneously in The Lancet, the EXPLORER-HCM study showed that 37% of patients who received

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

3rd Generation Valves in Large and X-Large Annuli

In patients with large and extra-large annuli, transcatheter aortic valve replacement (TAVR) is safe and feasible with 3rd generation valves: the 29mm balloon expandable valve Sapien-3, and their competitor, the self-expandable 34mm Evolut R.  The largest size of both devices was designed specifically for patients with large or extra-large annuli. However, one of them seems

Doble puente mamario para reducir la chance de nuevas revascularizaciones

Surgical Valve Replacement Might Soon Be History

Patients with dysfunctional biological prosthetic valves have better outcomes with TAVR vs. surgical reintervention, beyond surgical risk. This study outcomes might even call into question the age cutoff to consider a mechanical vs. a biological prosthesis at first surgery. This analysis recently published in JACC looked at the outcomes of both possible strategies to treat

El estudio SOURCE 3 confirma los buenos resultados de la válvula SAPIEN 3 a un año de seguimiento

SAPIEN 3: Good Outcomes in Bicuspids

Courtesy of Dr. Carlos Fava. Bicuspid aortic valves are found in approximately 2% of patients and represent the most frequent cause of aortic stenosis in young adults requiring valve replacement. Though TAVR has advanced significantly, this entity has not yet been included in the different randomized studies. At present, we have data from different reports,


Valve-in-Valve: Good Evolution at Long-Term

Courtesy of Dr. Carlos Fava. In the last decades, there has been a marked increase in the use bioprosthetic valves in aortic position given their benefits over mechanical valves. However, long term follow-up has shown structural valve degeneration (SVD). Given the risk of a second surgery after TAVR, valve-in-valve (ViV) has been on the rise,

Incidencia, características y tratamiento de la trombosis valvular post TAVI

Arrhythmias Wrongfully Linked to TAVR?

Continuous electrocardiographic monitoring pre-transcatheter aortic valve replacement (TAVR) detected arrhythmic events in almost half the patients analyzed in this study (which will be published soon in JACC Interventions). A fourth of these patients needed urgent therapeutic actions before the procedure. Previous conduction disorders—particularly, right bundle branch block and chronic renal insufficiency—were linked to a higher