Structural heart disease articles


Low risk patients: TAVI or surgical replacement?

Low risk patients: TAVI or surgical replacement?

Original Title: Transcatheter Aortic Valve Implantation Compared With Surgical Aortic Valve Replacement in Low-Risk Patients. Reference: Stefano Rosato et al. Circ Cardiovasc Interv. 2016 May;9(5):e003326. The proved efficacy of transcatheter aortic valve implantation (TAVI) in high risk patients is leading the expansion of its indication for lower risk patients. All the same, compared to the

Evaluación Hemodinámica de la Insuficiencia Aórtica post TAVR

Hemodynamic assessment of post TAVR aortic regurgitation

Original Title: Hemodynamic Assessment of Aortic Regurgitation after Transcatheter Aortic Valve Replacement – The Diastolic Pressure-Time Index. Reference: Robert Höllriegel et al. JACC Cardiovasc Interv. 2016 Apr 16.   Courtesy of Dr. Agustín Vecchia.   In 2012 Sinning and collaborators presented a study in the “Journal of the American College of Cardiology” about an index

Favorable Outcomes with New Generation Transcatheter Heart Valves in Bicuspids

Original Title: Bicuspid Aortic Valve Stenosis Favorable Early Outcomes UIT a Next-Generation Transcatheter Heart Valve in a Multicenter Study. Reference: Gidon Y. Perlman J Am Coll Cardiol Interv 2016;9:817-24 Courtesy of Dr. Carlos Fava. Congenital bicuspid aortic valves are infrequent and are associated with severe calcification in elderly patients. Transcatheter aortic valve replacement to treat bicuspid

Occupational Hazzard in the Cath Lab

Original Title: Occupational Health Risks in Cardiac Catheterization Laboratory Workers. Reference: Maria Grazia Andreassi et al. Circ Cardiovasc Interv. 2016 Apr;9(4).   Orthopedic lesions and radiation exposure are among the health risks Cath Lab staff take. However, the potential occupational hazard in quantitative terms is still unclear. The purpose of this study was to examine the

TAVI in asymptomatic severe aortic stenosis?

Original Title: Natural history, diagnostic approaches, and therapeutic strategies for patients with asymptomatic severe aortic stenosis. Reference: Généreux P et al. J Am Coll Cardiol. 2016; Epub ahead of print.   Given that transcatheter aortic valve replacement (TAVI) is now being prescribed to lower risk patients, some wonder whether it is time to study the benefit

Transcatheter Tricuspid Valve in valve

Original Title: Transcatheter Tricuspid Valve-in-Valve Implantation for the Treatment of Dysfunctional Surgical Bioprosthetic Valve. An International, Multicenter Registry Study. Reference: Doff B. McElhinney, et al. Circulation 2016;133:1582-93 Courtesy of Dr. Carlos Fava. Transcatheter tricuspid valve in valve implantation (TVIV) is infrequent, complex and biological valves last from 10 to 15 years. Reoperation is associated with high

MitraClip: Should we prescribe it earlier?

Courtesy of Dr. Carlos Fava. Patients with severe mitral regurgitation unfit for surgery due to high surgical risk are likely to develop chronic kidney disease (CKD). There is limited information available on patients with CKD receiving MitraClip.   This study analyzed patients receiving MitraClip and presenting chronic kidney disease.   CKD was defined as a

TAVR with Sapien XT: similar to surgical replacement in intermediate risk patients

Original Title: Transcatheter or Surgical Aortic-Valve Replacement in Intermediate-Risk Patients. PARTNER 2A. Reference: Martin B. Leon et al. NEJM April 2, 2016 Courtesy of Dr. Juan A. Terré Studies have shown mortality rates after transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in high risk patients are similar (PARTNER 2 – Cohort B). This is

TAVI in Low-Flow / Low-Gradient

Original Title: Transcatheter Aortic Valve Implantation for Paradoxical Low-Flow Low-Gradient Aortic Stenosis Patients. Reference: Nicolas Debry et al. Catheter Cardiovasc Interv. 2016 Mar;87(4):797-804. Courtesy of Dr. Carlos Fava. Approximately 10 to 13% of low-flow low-gradient severe aortic stenosis cases (LF-LG) have preserved left ventricular function. Its physiopathology remains unclear and it has been associated with a

TAVI: Good Outcomes with Intermediate Risk

Original Title: Transcatheter Aortic Valve Replacement versus Surgical Valve Replacement in Intermediate-Risk Patients: A Propensity Score Analysis. Reference: Vinod H Thourani et al. Lancet Published Online April 3, 2016. Courtesy of Dr. Carlos Fava. The transcatheter Aortic Valve Replacement (TAVI) has shown benefits in high risk patients or inoperable patients, but there is little evidence

TAVI in ≥90 year old patients: as beneficial as in younger patients

Original Title: Should Transcatheter Aortic valve replacement Be Performed in Nonagenarians? Insights from the STS/ACC TVT Registry. Reference: Mani Arsalan et al. J Am Coll Cardiol. 2016 Mar 29;67(12):1387-95. Courtesy of Dr. Carlos Fava The benefit of the transcatheter aortic valve replacement (TAVI) has already been shown in the general population undergoing this procedure. The number