Transcatheter aortic valve replacement (TAVR) has widely demonstrated its significant benefits, both in high-risk and inoperable patients, as well as in those with intermediate and low risk. While paravalvular regurgitation has been a challenge, its management has improved with operator experience and a deeper understanding of CT angiographies. However, in cases of regurgitation, elevated gradient,…
Promising Results of Transcatheter Mitral Valve Replacement in Bioprosthesis Failure
Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the…
Coronary Artery Disease in TAVR: Unsolved Dilemma
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially…
Transcatheter Mitral Valve Replacement: DOAC or VKA?
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR…
Use of Apixaban and Post TAVR Valve Thrombosis
TAVR can be associated to early valve thrombosis, characterized by thrombi formation near or attached to the prosthetic valve, with or without valve dysfunction. This dysfunction is associated with increased leaf thickening and reduced leaflet motion, as well as reduced orifice area or increased transvalvular gradient. Triggered multislice CT allows dynamic valve assessment and thrombosis…
TricValve: 12-Month Evolution
Tricuspid regurgitation has become increasingly common, and current pharmacological treatment options are limited. In turn, surgery, which is a complex alternative, carries considerable rates of complications and mortality. In response to this issue, various percutaneous systems are being developed, such as edge-to-edge treatment, percutaneous annuloplasty, and caval valve implantation (CAVI), among others. In the analysis…
Health Status Scores after Transcatheter Repair in Patients with Tricuspid Regurgitation: TRILUMINATE Analysis
Severe tricuspid regurgitation (TR) has been associated with higher mortality and significant limitations to patient quality of life, with considerable rates of hospitalization for cardiac failure (CF). Transcatheter edge-to-edge repair (TEER) with TriClip has been shown effective to reduce symptoms, with low risk of periprocedural complications. The aim of this study was to assess functional…
Carotid Stenosis and TAVR
Aortic Stenosis affects over 5% of the population over 65. Even though TAVR has advanced in the treatment of this disease, many patients present carotid aortic stenosis (CAS), which involves additional surgical risk. This risk has not been thoroughly assessed in the context of TAVR. A meta-analysis was carried out including 5 observational studies with…
ACURATE Neo2: One-Year Hemodynamic and Clinical Benefit Results
Both Acurate Neo2 and its predecessor, Acurate Neo, have proven their safety and efficacy in the percutaneous treatment of severe aortic stenosis. The Acurate platform offers a lower gradient and a larger effective orifice area, as well as a low risk of periprocedural complications, according to previous registries. However, the first-generation Acurate device had some…
Evolution of Bicuspid Valves at 12 Months
Severe aortic stenosis due to a bicuspid aortic valve (BAV) is uncommon, especially in individuals under 65 years of age. While there are usually no significant differences according to the type of valve when it comes to surgery, with transcatheter aortic valve replacement (TAVR) some may arise. TAVR has seen significant advancements in the treatment…
TAVR: High Implantation of Self-Expanding Valves Directly Impacts ECG
TAVR has been shown beneficial, especially in high risk or inoperable patients. However, there are limitations to its use, especially with self-expanding valves, which are the need for pacemaker implantation and ECG changes after procedure. To address this matter, researchers assessed the right and left cusp overlap effect on 254 patients undergoing TAVR with self-expanding…