Structural heart disease articles

ACC 2019 | TAVI en bicúspides es seguro y factible en pacientes seleccionados del mundo real

ACC 2019 | TAVR in Bicuspids is Safe and Feasible in Real World Patients

ACC 2019 | TAVR in Bicuspids is Safe and Feasible in Real World Patients

Experts still won’t agree on whether to carry out randomized trial to put an end to this discussion, but it seems clear that balloon expandable TAVR is valid only for certain anatomies.   TAVR in real world bicuspid valve populations is associated with similar outcomes at 30 days and one year when compared against cohorts

ACC 2019 | POET: los antibióticos vía oral con buenos resultados a largo plazo en endocarditis

ACC 2019 | POET: Oral Antibiotics with Good Long-Term Results for Endocarditis

This work found better survival rates with oral treatment, an outcome that may be credited to shorter hospital stays and the subsequent reduction of complications related to them. A strategy of switching to oral treatment after a short intravenous (IV) regimen confers long-term safety and efficacy. These data are derived from an exploratory analysis of

ACC 2019 | PARTNER 3: TAVI en bajo riesgo con menos eventos al año que la cirugía

ACC 2019 | PARTNER 3: Low Risk TAVR vs. Surgery, Fewer Events per Year

Courtesy of Dr. Carlos Fava. TAVR has largely been shown superior or non-inferior in high or intermediate risk patients.  Indeed, the development of new technologies, the more simplified procedure and the increased experience of operators and team have allowed these groups to benefit from this strategy. However, there is little evidence available on low risk

ACC 2019 | Prometedores resultados para el TAVI en bajo riesgo

ACC 2019 | TAVR in Low-Risk Patients Is Noninferior

Courtesy of Dr. Carlos Fava. Self-expanding supraannular aortic valves have proved to be superior to surgery in high-risk patients and noninferior in intermediate-risk patients. However, the current challenge is posed by low-risk, generally younger, patients. In that sense, our purpose is to determine device effectiveness and safety in terms of mortality and stroke rates (which are

Transcarotid Approach for Transfemoral in TAVR

Courtesy of Dr. Carlos Fava. At present, the transfemoral is the preferred access site in TAVR, for it has been shown to present fewer complications. However, whenever not feasible, we can resort to other approaches. These include the subclavian, the transapical, the transcaval, the transaortic, and the transcarotid. This last one has been studied few

Es posible realizar MitraClip sin anestesia general

Cost-Effectiveness of TAVR in Intermediate-Risk Patients

Prior economic analyses had shown that transcatheter aortic valve replacement (TAVR) is cost-effective (which does not mean that it saves money) in high-risk patients compared with surgical replacement. In intermediate-risk patients, this equation was mere speculation until this work recently published in Circulation came along. Physicians started wondering about costs and durability after PARTNER 2 showed

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

NOTION and UK TAVI Report Good Long-Term Outcomes

Both studies followed beyond 5 years patients with severe aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR). Findings included low rates of significant valve degeneration and failure, in both cases. While data on the long-term degeneration of transcatheter-implanted valves are scarce, follow-up from the NOTION trial of low-risk patients and from the UK TAVI

¿Qué usar para medir funcionalmente una lesión coronaria en el contexto de estenosis aórtica severa?

Un Underestimated Symptom of Aortic Stenosis

For the first time, this long term observational study on a large cohort of contemporary patients with aortic stenosis (AS), has shown syncope is an underestimated threat, associated with worse prognosis after surgical aortic valve replacement (SAVR). It is interesting to note that other symptoms or early signs of AS that will normally indicate SAVR

Anillo pequeño, ¿debemos comenzar a elegir la válvula?

How long should we wait with asymptomatic aortic stenosis and preserved LVEF?

Courtesy of Dr. Carlos Fava. Asymptomatic severe aortic stenosis with preserved ventricular function is challenging. At present, it remains unclear whether we should operate or not and, according to some recent reports, neither do we know what patients will benefit from surgery. The study looked at 1678 patients with asymptomatic or minimally asymptomatic severe aortic

La reparación de la válvula mitral con Mitraclip es segura en pacientes de alto riesgo

Good Outcomes for MitraClip “Off Label”

Courtesy of Dr. Carlos Fava. Mitral regurgitation is the most frequent type of valve disease, accounting for >6% of patients over 65 years old. Surgery is currently the strategy of choice, but percutaneous treatment is a valid alternative.   The long-term progress of symptomatic patients at high surgical risk who do not meet the formal indications for

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