Structural heart disease articles


Coronary Access After TAVR: A Potential Problem Ahead

Coronary Access After TAVR: A Potential Problem Ahead

Coronary cannulation after transcatheter aortic valve replacement (TAVR) was unsuccessful in almost 10% of patients. This problem occurred almost exclusively in those who received a self-expanding valve. This study, recently published in JACC Cardiovasc Interv., was sought to investigate the feasibility of coronary ostia access after TAVR and describe potential predictors of coronary access impairment.

cierre percutaneo fuga paravalvular

Suture-Based Percutaneous Closure vs. Plug for Large Arteriotomies

This research was designed to test the superiority of plug-based vs. suture-based vascular closure devices in large arteriotomies, such as transcatheter aortic valve replacement (TAVR). Vascular complications from TAVR are relevant and, in many cases, derive from problems with the closure device. The MASH (MANTA vs. Suture-based vascular closure after transcatheter aortic valve replacement) study

Experiencia de la cirugía

Should We Discontinue Anticoagulation Before TAVR?

Against what common sense dictates, continuing oral anticoagulation pre- and post- transcatheter aortic valve replacement (TAVR) is safe, according to this article soon to be published in JACC Interventions. There was no increase in hemorrhagic or vascular complications and, paradoxically, those who continued using anticoagulant agents received fewer transfusions that those who did not. A


Risk of Coronary Obstruction in Repeat TAVR

As we gradually consolidate the information on the duration of transcatheter aortic valve replacement (TAVR) the focus seems to be moving towards the feasibility of repeat TAVR. How long the valve will last no longer matters as much as how feasible a new procedure is.  The supra-annular leaflet position and tall stent frame of the

La prudencia es buena consejera para decidir una transfusión en el TAVI

Transfusion in TAVR: Caution Is Best

Periprocedural red blood cell transfusion in transcatheter aortic valve replacement (TAVR) correlates with increased mortality and acute kidney injury. It also resulted an independent predictor of 30-day mortality, irrespective of bleeding and vascular complications.  The global trend that limits transfusion, in all procedures in general, has finally reached TAVR.  The multicenter registry TRITAVI (Transfusion Requirements


ProGlide vs. Prostar XL to Close Post-TAVR Access

Minimalist transcatheter aortic valve replacement (TAVR) is a strategy that is here to stay. We have previously published papers comparing local vs. general anesthesia, use of transthoracic vs. transesophageal echocardiography, and early discharge in TAVR. In all these papers, the “minimalist approach” included percutaneous closure of vascular access. However, few papers compare closure devices in

The Most Read Articles in Structural Heart Disease in 2020

The Most Read Articles in Structural Heart Disease of 2020

In this selection, we summarize for you the most important scientific news of 2020 in the field of structural heart disease. 01- 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

Evolución de pacientes jóvenes con miocardiopatía hipertrófica tratados con ablación septal por alcoholización.

NT-proBNP Level Predicts Who May Benefit From TAVR

A normal or (on the other end) a very high level of NT-proBNP should make us look for a cause other than aortic stenosis. If aortic stenosis is not the culprit of the clinical case, a transcatheter aortic valve replacement (TAVR) will hardly benefit these patients. These data come from a recently published paper in

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

Sapien 3 Performs Well in “Jobs” for Which It Is Not Designed

Using Sapien 3, transcatheter mitral valve replacement to treat failed bioprosthetic valves can be performed with a high degree of technical success. Failed mitral bioprosthetic valves are truly challenging due to how frequent symptoms are and the high morbidity/mortality associated with a new surgical replacement. Furthermore, there are no catheter options specifically designed to treat this


Balloon-Expandable Valve Outdoes Itself

The objective of this paper recently published in J Am Coll Cardiol Intv was to compare the outcomes of transcatheter aortic valve replacement (TAVR) with the new Sapien 3 Ultra vs. Sapien 3. Successful implantation was extremely high with both balloon-expandable devices, which also had a very low adverse event rates. However, Sapien Ultra was significantly better

AHA 2020 | Anticoagulación post TAVI en pacientes con fibrilación auricular

AHA 2020 | Post-TAVR Anticoagulation in Patients with Atrial Fibrillation

Direct anticoagulant agents were associated with lower long-term mortality in patients with atrial fibrillation discharged after successful transcatheter aortic valve replacement (TAVR) compared with classic vitamin K inhibitors. Optimal anticoagulation in patients with atrial fibrillation (AF) undergoing TAVR is unclear. We are actually just starting to know what the ideal antiplatelet therapy is for patients undergoing