Valvular Aortic valve articles

2 Encuentro Educativo ProEducar | Implante de Válvula Aórtica

2° ProEducar Educational Meeting – Aortic Valve Implantation. Session II

2° ProEducar Educational Meeting – Aortic Valve Implantation. Session II

Watch again our “2nd ProEducar Educational Meeting on “Transcatheter Aortic Valve Implantation” on our Youtube account.  We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

valve_in_valve-compressor

Valve in Valve Presents Better Evolution than re-SARV

Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement with bioprosthesis has proved its benefits, but it fails after 10 to 15 years.  Transcatheter aortic valve replacement has been shown valid, especially in high risk patients, but we still have little information and no “head to head” studies to know what is best in this

La válvula CoreValve Evolut R arroja resultados positivos en una población importante de pacientes La Evolut R, al igual que su predecesora CoreValve, es una válvula autoexpandible, supra-anular, de pericardio porcino en un stent de nitinol. Entre las mejoras de esta válvula se pueden enumerar su mejor perfil y la posibilidad de re-envainarla. Esto la hace completamente reposicionable e incluso recapturable. Faltaba ver si estas ventajas técnicas se traducirían en ventajas clínicas (lo cual es -en definitiva- lo que importa) en una población grande de pacientes del mundo real. El estudio FORWARD (CoreValve Evolut R FORWARD) es un registro prospectivo que incluyó 1038 pacientes de 53 centros y cuatro continentes. Los pacientes tuvieron una edad media de 81.8 ± 6.2 años y un STS de 5.5 ± 4.5%, lo cual constituye un riesgo intermedio y coincide con la tendencia actual de la práctica clínica. La capacidad de reposicionar la válvula debió ser utilizada en el 25.8% de los pacientes, característica que permitió el implante de una sola válvula en el lugar correcto en el 98.9% de los casos. A 30 días, la mortalidad fue del 1.9% y el stroke incapacitante del 1.8%. Solo el 1.9% de los pacientes presentó insuficiencia aórtica moderada a severa; la tasa de marcapaso definitivo fue del 17.5%. Ambos datos están por debajo de lo que mostró el estudio SURTAVI con la CoreValve en una población similar (3.4% y 25.9% respectivamente) y la mejora se puede atribuir a la posibilidad de reposicionar el dispositivo. Conclusión La nueva generación de la válvula autoexpandible es segura y efectiva en pacientes con estenosis aórtica severa no seleccionados del mundo real. Comentario editorial La mortalidad por cualquier causa del 1.9% está claramente por debajo del 5.5% esperado según el score de STS y en sintonía con la del 1.1% descripta en el registro que testeó la última generación de la válvula balón expandible SAPIEN 3 en una población similar. El 98% de los pacientes fueron tratados por acceso femoral, lo cual también es la tendencia mundial gracias a la significativa disminución del perfil de los dispositivos. Afortunadamente, la enorme mayoría de las mejoras técnicas que han incorporado los nuevos dispositivos (tanto este como la competencia) han logrado traducirse en mejoras clínicas para los pacientes, logrando reducir la insuficiencia paravalvular, la tasa de marcapaso y las complicaciones vasculares. Título original: Clinical Outcomes With a Repositionable Self-Expanding Transcatheter Aortic Valve Prosthesis. The International FORWARD Study. Referencia: Eberhard Grube et al. J Am Coll Cardiol 2017;70:845–53.

After 8-year Followup, Good News for the Self Expandable Valve

As the transcatheter aortic valve replacement (TAVR) gains ground in lower risk populations and with better survival rate, concern over its durability has grown.  This study brings us data and good news on the first-generation self-expandable valve after quite a long follow up. It included 990 inoperable or high-risk patients treated with CoreValve in 8

Coronavirus y corazón ¿Cómo deben prepararse los cardiólogos?

Vasculitis, Thrombosis and Angiogenesis: Covid-19´s Unique Patters

In this small, yet interesting series, we observe angiogenesis could differentiate pulmonary physiopathology by Covid-19 vs. from viral infections of similar severity (such as influenza). Being quite small, we can hardly consider it universal, or whether it could have clinical impact. Meanwhile, we keep learning about the new virus.  Progressive respiratory failure is the main

La revascularización incompleta se asocia a mortalidad en el TAVI

Post TAVR Regression of Ventricular Mass

This study looked at patients with moderate to severe left ventricular hypertrophy and aortic stenosis treated with transcatheter aortic valve replacement (TAVR). Patients with reduced hypertrophy had lower mortality and fewer hospitalizations at 5 years.  It included all moderate to severe risk patients with ventricular hypertrophy undergoing TAVR in the studies and registries PARTNER (I,

EuroPCR 2020 | Valve in Valve aórtico a largo plazo

EuroPCR 2020 | Aortic Valve in Valve in the Long Term

The outcomes of this work are important to plan valve replacement with the largest possible prosthesis allowed by patient anatomy in the index procedure. As a worldwide trend, increasingly more patients are receiving bioprostheses, which have improved a lot but still tend to become deteriorated and require a valve-in-valve procedure if the patient is no

EuroPCR 2020 | EVOQUE: nuevo sistema de reemplazo mitral por catéter, promesas a corto plazo y esperanzas para el futuro

EuroPCR 2020 | CLASP: New Device for Mitral Repair with at One Year Follow Up

The CLASP looked into patients treated with the new device for transcatheter mitral repair called PASCAL and showed low complications rate, high survival rate, significant mitral regurgitation reduction and improved quality of life at one year.  In July 2019 we published on our web page the 30 year outcomes of the PASCAL device () which

EuroPCR 2020 | EVOQUE: nuevo sistema de reemplazo mitral por catéter, promesas a corto plazo y esperanzas para el futuro

EuroPCR 2020 | EVOQUE: New Transcatheter Mitral Valve Replacement System, Promises at Short Term and Future Hope

Transeptal transcatheter mitral valve replacement offers a less invasive alternative vs. surgery and with fewer anatomical limitations than transcatheter repair (e.g. MitraClip) in patients with severe mitral valve failure.  The first patients treated with the new system EVOQUE were included between September 2018 and October 2019 and its outcomes were presented at the virtual EuroPCR

tavi calcificación del anillo mitral

Contained Annulus Rupture after TAVR: What Should We Do?

Courtesy of Dr. Carlos Fava. Aortic annulus rupture is a catastrophic event that presents in nearly 0.9% of cases, but there is another entity called contained annulus rupture, associated to oversized devices and annulus calcification and diagnosed with CT angiography, with up to 5% frequency. 1602 patients from the ENCORE registry were analyzed. 21 of

oclusiones totales cronicas plataformas bioabsorbibles stents liberadores de droga

Stenting of Lipid-Rich vs Fibrous and calcified Plaques: Different Prognosis?

Coronary PCI with contemporary drug eluting stents (DES) in lipidic-rich plaques were not associated with increased periprocedural events at long term compared against plaques with no significant lipidic composition.  This study recently published in J Am Coll Cardiol looked into the association between lipidic rich plaques detected by near-infrared spectroscopy (NIRS) and clinical events in

TAVI: Balón expandible o autoexpandible ¿Cuál es la respuesta?

Self-Expanding Valve vs. Balloon-Expandable Valve, Randomized, Head to Head

The “arms race”among transcatheter valves has been vertiginous. By the time we received the mid- or long-term outcomes of studies focused on a given valve, we were already using its next generation in clinical practice. As a result, there is little information addressing which valve is the best. Nowadays, this “arms race” has reached a

Top