Structural heart disease articles

Incidencia, características y tratamiento de la trombosis valvular post TAVI

Direct TAVR vs. Predilation: Potential Cost of a Simpler Procedure

Does simplifying TAVR involve a cost? At least for low-risk patients included in the PARTNER 3, the question appears somewhat abstract. Predilation and direct TAVR resulted equally safe, though the latter shortened procedural time and did not require further post dilation.  Both strategies resulted virtually identical in terms of clinical events.  The use of predilation

TAVI SURAVI

European Consensus on Antithrombotic Management in TAVR

All the controlled randomized evidence recently published called for an updated document on antithrombotic management in transcatheter aortic valve replacement (TAVR). While thrombotic and hemorrhagic complications have diminished over time—as both the technique and the devices have been perfected—, they still remain as common adverse events in TAVR.  Recommendations in the 2017 European Guidelines were

Post-dilatación de válvulas autoexpandibles

Self-Expanding Valve in Extreme Surgical Risk After 5 Years

Patients with aortic stenosis and extreme surgical risk have extremely high mortality due to known comorbidities. The short-term benefit of transcatheter aortic valve replacement (TAVR) with self-expanding valve is clear, and it warrants the procedure in this challenging population. While elderly patients with comorbidities who are at extreme surgical risk might be eligible for TAVR,

Síndrome de Hiperperfusión cerebral post-angioplastia carotídea: una complicación prevenible

Silent Embolism during TAVR: Just Images or Potential Cognitive Deterioration?

Finding new cerebral ischemic imaging after transcatheter aortic valve replacement (TAVR) is almost the rule, especially for self-expandable valves. These images might disappear over the months but, unfortunately, they are associated to small but significative cognitive deterioration.  Most patients undergoing TAVR develop silent cerebral ischemic lesions (SCILs) that show in magnetic resonance imaging (MRI). The

infarto peri-procedimiento

Post TAVR Acute Coronary Syndrome: Frequency and Potential Damage

After Transcatheter Aortic Valve Replacement (TAVR) acute coronary syndromes (ACS) are rare and mostly present as non-ST elevation events. In this context, the few ST elevation events have bad prognosis, with close to 30% mortality at 30 days.  This study included patients undergoing TAVR between 2012 and 2017 admitted for acute coronary syndrome during followup. 

Sangrados mayores en pacientes con AAS más rivaroxabán

AAS vs DAPT post TAVI: Meta-Analysis of Randomized Studies

Aspirin monotherapy (ASA) reduced the combined risk of thrombotic and bleeding events compared against dual antiplatelet therapy (DAPT) in patients receiving transcatheter aortic valve replacement (TAVR). This meta-analysis has only reproduced smaller randomize study outcomes and does not include the OCEAN-TAVI registry, the only one that has shown something different so far.  Even though ASA

Differences in American and European Atrial Fibrillation Guidelines

The recent publication of the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) guidelines provided an important update on multiple aspects of the management of atrial fibrillation (AF). However, these guidelines differ in terms of management and recommendation levels. As it might be expected, most differences arose in intermediate cases—both guidelines

Aspirina o clopidogrel post TAVI: Guías y estudios llenos de contradicciones

Post TAVR Aspirin vs. Clopidogrel: Conflicting Findings and Guidelines

One month ago we shared a meta-analysis stating aspirin (ASA) as the best antiplatelet following TAVR vs. 3 to 6 dual antiplatelet therapy suggested by guidelines.  At that time, guideline recommendations appeared obsolete. Several studies had started to support ASA monotherapy as the best antiaggregation scheme after TAVR. However, in the light of this new

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