Structural heart disease articles

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Balloon-Expandable Valve Outdoes Itself

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

AHA 2020 | Aumenta el alta precoz en el TAVI con un costo esperado

AHA 2020 | Rise in Early Discharge After TAVR Has the Expected Cost

As hospitalization time after a transcatheter aortic valve replacement (TAVR) is reduced, we are observing a concomitant increase in re-hospitalizations due to conduction disorders. Early discharge is a great step, but it should be noted that conduction disorders can happen beyond 48 hours. A few years ago, pacemaker implantation rates after discharge were about 7%;

Infarto agudo de miocardio y lesiones de múltiples niveles

Asymptomatic Severe Aortic Stenosis, When Should We Intervene?

Data from recent observational randomized studies suggest that most patients with asymptomatic severe aortic stenosis will eventually receive an indication for valve replacement.   Mortality in this “asymptomatic” population is caused not only by sudden death, but also by cardiac death. Early intervention may prevent these deaths as a consequence of aortic stenosis symptoms. Researchers

Sedación consciente vs anestesia general en el TAVI

Conscious Versus General Anesthesia in TAVR

Patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) can safely undergo the procedure under conscious sedation. Conscious sedation has been adopted in clinical practice as a natural way of simplifying and conducting the procedure in the least invasive way possible. Currently, up to 50% of patients undergo TAVR under conscious sedation, but

TCT 2020 | Eficacia del dispositivo de protección cerebral TriGUARD 3 durante el TAVI

TCT 2020 | Efficacy of Cerebral Protection Device TriGUARD 3 During TAVR

Cerebral protection device TriGUARD 3, designed to cover all supra-aortic vessels during transcatheter aortic valve replacement (TAVR), is safe to use, according to the outcomes of the REFLECT II study. The technical feasibility of the device, which requires transfemoral access, does not seem to have an impact over clinical events. The primary safety endpoint was a VARC-2-defined

Post TAVR ASA Monotherapy Consolidates

This meta-analysis to be published in J Am Cardiol supports the use of aspirin monotherapy (ASA) after transcatheter aortic valve replacement (TAVR). The use of aspirin alone is associated to less bleeding without increased ischemic events such as strokes or mortality.  The combined outcomes of four studies, including the recently published POPular TAVI (cohort A),

TAVR via trans-carotidea anestesia local o general

Minimalist TAVR to the Max

Transcatheter aortic valve replacement (TAVR) is increasingly being performed under conscious sedation, which is associated with a multi-point benefit (including mortality).  This paper, recently published in JACC Intv., shows that general anesthesia is becoming obsolete, although the magnitude the benefit derived from conscious sedation appears to be lower than in previous studies. The aim of

valve_in_valve

Size Does Matter for Long Term ViV

The size of the original bioprosthetic valve impacts long term mortality, as does the type of bioprosthetic valve used in percutaneous reinterventions.  The number of patients with failed bioprosthesis is on the rise, mainly due to increased life expectancy.  Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) has become more and more common these days and

TAVI bajo riesgo

TAVR as Anti-Inflammatory? An effect few imagined

We never saw it coming, such a pleiotropic effect: who would have though a mechanical device could have such a systemic anti-inflammatory effect? Transcatheter aortic valve replacement (TAVR) does in fact have it.  The shear stress aortic stenosis produces activates multiple inflammatory responses mediated by monocytes. This study identified the most important mechanoreceptor, involved in

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

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

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