Structural heart disease articles

MitraClip: ¿debemos intervenir antes a nuestros pacientes?

Continuous Monitoring of Left Atrial Pressure during MitraClip, Regardless Echocardiography

Continuous Monitoring of Left Atrial Pressure during MitraClip, Regardless Echocardiography

The aim of this study was to assess the use of measuring left atrial pressure to complement transesophageal echocardiography and doppler imaging. Procedure efficacy is measured in the cath lab by echocardiography. However, these measurements are operator dependent and might be influenced by left ventricular function and changes in left atrial compliance.   The study

Centera Valvula expandible

Balloon-Expandable vs. Self-Expanding: To Each Valve Its Own Annulus

The former generation of valves, the balloon expandable (Sapien XT), was associated to less paravalvular leak than the self-expanding valves only in patients with larger annuli. The new generation of self-expanding valves (Evolut R) has managed to significantly improve sealing in patients with larger annuli and still holds potential benefits for smaller annuli. The aim

Debemos tener en cuenta a la isquemia crítica de MM II en el TAVI

Is TAVR at Hospitals Without Backup Cardiovascular Surgery Feasible?

Patients undergoing transcatheter aortic valve replacement (TAVR) at hospitals without cardiovascular surgery available are at significantly higher risk. That in itself is a call for attention; however, a propensity-matched analysis shows that the short- and long-term mortality rates are similar among patients treated at hospitals with and without cardiovascular surgery backup. This debate emerged a

acceso carotideo tavi

Aortic Stenosis and Dialysis: Is TAVR the Strategy of Choice?

Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration.  This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events.   For some time, we have been using an

Disminuye la profilaxis de endocarditis luego de las guías del 2007

AHA 2018 | Endocarditis Prophylaxis More Limited after AHA 2007 Guidelines

The incidence of infective endocarditis had decreased after AHA 2007 recommendations. At present, some patients are not receiving antibiotic prophylaxis as they should. After AHA restricted the use of antibiotic prophylaxis in 2007, high-risk patients undergoing dental procedures were prescribed less antibiotics. These patients had always been prescribed antibiotic prophylaxis, regardless they had less restrictive

La enfermedad coronaria funciona como un predictor a 30 días en el TAVI

CoreValve US Pivotal High Risk Trial: at 5 years, similar results

Courtesy of Dr. Carlos Fava. We are well aware of transcatheter aortic valve replacement’s (TAVR) effect in high-risk or inoperable patients at 5 years, even more after the PARTNER 1 trial. Yet, the outcomes of another relevant randomized study remained pending: el CoreValve US Pivotal High-Risk Trial. The CoreValve US Pivotal High-Risk Trial looked at the

¿Es durable el TAVI a más de 5 años?

Surprises in the Physiopathology of Critical Ischemia

Luminal thrombotic occlusions associated with non-significant atherosclerosis are commonly observed in patients with critical lower limb ischemia, which suggests the possibility of thromboembolic disease as a great contributor to ischemia. This was particularly verifiable in infrapopliteal vessels, thus showing a possible mechanism of progression from peripheral vascular disease to critical ischemia, as well as a

TAVI-compressor

Differences in Stroke between TAVR and SAVR in Intermediate Risk Patients

Transcatheter aortic valve replacement (TAVR) is more and more frequent in lower risk populations that had previously been treated with surgical valve replacement (SAVR). A small difference in neurological events could have significant consequences when it comes to deciding a course of action. This study is a sub-analysis of the randomized study SURTAVI (Surgical Replacement

TAVI en bajo riesgo con “cero” mortalidad y “cero” stroke

TAVR in Low-Risk Patients with “Zero” Mortality and “Zero” Stroke

Transcatheter aortic valve replacement (TAVR) is now the standard of care for patients with symptomatic severe aortic stenosis who are at extreme, high, or intermediate risk for surgery. This multicenter, prospective study (Feasibility of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic, Severe Aortic Stenosis) included low-risk patients and was approved by the United

Cortar las valvas, una medida extrema para evitar la oclusión coronaria post TAVI

How to predict post TAVR quality of life in “real world” patients

Despite the benefit for most patients, a small number of patients still show poor outcomes after transcatheter aortic valve implantation (TAVR). This work was able to recalibrate a previously developed risk model to predict post TAVR quality of life and provide us with a potential tool to properly estimate the chances of good recovery, or

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

What Should We Use for the Functional Assessment of Coronary Lesions in Severe Aortic Stenosis?

This systematic analysis measured intracoronary pressure in different phases of the cardiac cycle and flow velocity in patients with severe aortic stenosis and coronary artery disease, who were scheduled for transcatheter aortic valve replacement (TAVR). The aim was to determine the impact of aortic stenosis on: 1) flow, at different phases; 2) hyperemic coronary flow;

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