Structural heart disease articles

Terapia endovascular en stroke: mucha evidencia y pocos operadores entrenados

TAVR Learning Curve and Volume-Outcomes Relationship Plateau

TAVR Learning Curve and Volume-Outcomes Relationship Plateau

Every operator keeps track of their cases. Have they reached their potential or are they still learning and improving their technique? After 1000 procedures, can we expect them to have better results than someone that has only done 500? Prior studies have reached conflictive results and consequently the relationship between learning curve and volume-outcomes remains

DEFENSE-PFO: el cierre FOP con ciertas características disminuye eventos combinados y stroke

Long-Term Foramen Ovale Closure after Cryptogenic Stroke

Patent foramen ovale closure is the standard treatment for cryptogenic stroke patients. However, there are is little information on its long-term evolution. The aim of this study was to determine clinical outcomes (death, ischemic or bleeding events) after foramen ovale closure over a 10-year evolution.   The study included 201 consecutive patients (mean age 47

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The Most Read Articles of March in Interventional Cardiology

1- What to Do with Blood Pressure Levels Between 130/80 and 139/89 mmHg The decision to be made with a treatment-free patient with systolic blood pressure over 160 mmHg or diastolic blood pressure over 100 mmHg is an easy one. All guidelines agree: treatment should be started immediately alongside lifestyle changes. Read more    2-

Más coincidencias de las esperadas entre válvulas bicúspides y tricúspides

Is Tricuspid Regurgitation after TAVR Significant?

Courtesy of Dr. Carlos Fava. Severe or moderate mitral regurgitation is associated to worse evolution after TAVR. However, we should not forget the tricuspid valve that, even though not extensively researched, is also associated to a negative impact in its evolution. A meta-analysis of 12 studies with a total 41485 patients was carried out.

Sub análisis del EXCEL: angioplastia vs cirugía en insuficiencia renal crónica

Kidney Insufficiency and the Risk of Developing Aortic Stenosis in the Future

Chronic kidney disease, even in moderate or severe stages before dialysis, is associated with an increased risk of aortic stenosis according to this work recently published in J Am Coll Cardiol. Both share several risk factors, something that complicates the identification of the association between these diseases due to multiple confounding variables.   The study

El marcapaso definitivo continua siendo “el tendón de Aquiles” del TAVI

Modern Valves Reduce the Need for a Pacemaker

Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons. The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with

Subclavian and Axillary Access for TAVR: a Valid Alternative

Courtesy of Dr. Carlos Fava. The femoral approach is preferred when it comes to TAVR, but sometimes it is not viable. This is when other access sites come into play, such as the trans-subclavian/axillary (TS/TAx), the apical, transcaval, transcarotid (TC) or transaortic. At present, few studies have looked into this matter, which is why it

Mitral Valve Repair with MirtaClip Was Feasible and Safe

Transcatheter mitral valve repair (TMVR) with MitraClip was shown feasible and safe, and therefore a viable option for symptomatic patients with severe mitral valve regurgitation of prohibitive risk. In this regard, the procedure alleviates symptoms, cardiac regurgitation and has a potential benefit on ventricular remodeling. However, many patients presented atrial fibrillation (AF) and mitral valve

TAVI en insuficiencia aórtica pura, nuevos dispositivos con nuevos resultados

We Must Still Fear the “Big Five Complications” After TAVR

Surgical risk scores cannot be used for transcatheter aortic valve replacement (TAVR) and they usually overestimate procedural risk. There are 5 big complications after TAVR, specifically, that cannot be predicted by conventional surgical scores.   These 5 peri-procedural complications are considered important because they have a somewhat significant impact on survival after TAVR.   They are: 1)

acceso carotideo tavi

Transcaval Access Is Safe in TAVR

Courtesy of Dr. Carlos Fava. One of the limitations to percutaneous interventions is poor or impossible femoral access. This happens especially in TAVR, with endoprosthesis or ventricular assistance devices, when the transcaval approach with cardiac occluder rises as a viable alternative. We have started to use it in TAVR, but at present there is little

La diálisis nueva post TAVI aumenta la mortalidad.

After 100,000+ Patients, TAVR Becomes the New Standard of Care

Eighty years did the trick for one the countries with more experience in transcatheter aortic valve replacement (TAVR), which made it the new “standard of care” to treat elderly patients. Following in the footsteps of pioneer Alain Cribier, Germany has led the adoption of TAVR in Europe and the rest of the world. Since 2008,