Valvular Aortic valve articles

TAVI en insuficiencia aórtica pura, nuevos dispositivos con nuevos resultados

We Must Still Fear the “Big Five Complications” After TAVR

We Must Still Fear the “Big Five Complications” After TAVR

Surgical risk scores cannot be used for transcatheter aortic valve replacement (TAVR) and they usually overestimate procedural risk. There are 5 big complications after TAVR, specifically, that cannot be predicted by conventional surgical scores.   These 5 peri-procedural complications are considered important because they have a somewhat significant impact on survival after TAVR.   They are: 1)

acceso carotideo tavi

Transcaval Access Is Safe in TAVR

Courtesy of Dr. Carlos Fava. One of the limitations to percutaneous interventions is poor or impossible femoral access. This happens especially in TAVR, with endoprosthesis or ventricular assistance devices, when the transcaval approach with cardiac occluder rises as a viable alternative. We have started to use it in TAVR, but at present there is little

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

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

Estenosis-aórtica-severa2-compressor

Are Aortic Stenosis and Kidney Dysfunction Associated?

Courtesy of Dr. Carlos Fava. Aortic stenosis happens in 2.8% of patients over 75, and is even more frequent in dialysis patients. However, it remains unclear whether kidney dysfunction increases the risk of aortic stenosis. The present study looked at 1,121,875 patients from the SCREAM project (Stockholm CREAtinine Measurements).   Mean age was 50, and

La anticoagulación jugando un papel controvertido en el TAVI

Anticoagulation Plays a Controversial Role in TAVR

Men gender, kidney failure and atrial fibrillation are the factors that most affect 3-year mortality after transcatheter aortic valve replacement. On the other hand, surprisingly enough, anticoagulation (mostly indicated for atrial fibrillation) reduces mortality risk – especially the risk of valve deterioration – after TAVR. Should anticoagulation be included in post TAVR protocols? This question

La enfermedad vascular periférica se asocia a más eventos en el TAVI

The Physiopathology Behind Valve Degeneration in TAVR

The degeneration of transcatheter biological valves clearly depends on time and starts with thrombus generation and subsequent histological changes resulting in valve failure (due to regurgitation, stenosis, or both). Thrombus formation is the first change, observed early in computerized tomography (CT) scans after implantation. Most times it is completely asymptomatic, which leaves many of us

Manejo quirúrgico o percutáneo de los leaks mitrales

Bundle Branch Block and Need for Permanent Pacemaker, a Major Challenge after TAVR

Courtesy of Dr. Carlos Fava. The development of new valves for TAVR and the increased experienced of operators have significantly decreased paravalvular leak. However, new bundle Branch block (BBB) and the need for permanent pacemaker (PPM) are still relatively high, and their impact and evolution remain controversial.   The study looked at 816 patients, 437

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