Valvular heart disease management guidelines were updated last week by the AHA and the ACC. The last complete version had been published in 2014; therefore many of its recommendations have become obsolete before the latest evidence. The studies that made the FDA approve TAVI for low-risk patients are probably the most important incorporations. They also…
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…
Promising Outcomes of Transcatheter Mitral Valve Replacement in Complex Patients
Courtesy of Dr. Carlos Fava. The risk of repeat surgical mitral valve repair involves 6% to15% mortality at 30 days, even close to 20% in acute cases. However, mortality can rise to over 40% when it comes to a third or fourth surgical intervention. One of the solutions to this serious problem is transcatheter mitral…
Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points
After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations for cardiac failure at long term follow-up. Improved quality of life had already been presented, exactly one year ago at the ACC 2019. In that occasion, it was established that the MitraClip reduces symptoms…
Virtual ACC 2020 | Unlike in TAVR, the Number of Mitral Valve Surgeries Does Not Improve the Outcomes of Transcatheter Mitral Valve Repairs
Soon, our website will feature an interesting study showing that sites with a higher number of conventional surgical aortic valve replacements had better outcomes in transcatheter aortic valve replacement procedures. The study featured in this article was scheduled for presentation at the American College of Cardiology 2020 Scientific Session along the World Congress of Cardiology.…
Percutaneous Annuloplasty in Functional Mitral Regurgitation vs. Sham Procedure
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could…
Venous Pulmonary Waveforms in MitraClip Have Prognostic Value
Courtesy of Dr. Carlos Fava. The MitraClip has been shown to benefit a certain group of patients and it is a well-known fact that a ≥5 mmHg is associated to a more torpid evolution. However, there is little evidence when it comes to venous pulmonary waves, changes in left atrial pressure and V wave. 121…
1000 MitraClips: Results from the World’s Most Experienced Site
In September 2008, interventional physicians at the Heart and Vascular Centre Hamburg conducted the first MitraClip implantation after its Conformité Européenne (CE)-marking approval. In July 2019, the same site reached an amazing milestone, 1000 MitraClips implanted, and in doing so it became the most experienced site in the world. Those 1000 patients treated had an average logistic…
TCT 2019 | PARTNER 2A at 5 Years: In Intermediate-Risk Patients, TAVR Is Still Head-to-Head with Surgery
Courtesy of the SBHCI. The 2-year results of the PARTNER 2A trial showed that transcatheter aortic valve implantation has a result similar to that of surgery in patients with aortic stenosis and intermediate surgical risk. We lacked long-term data, both clinical and related to prosthesis function. Now, at TCT 2019, researchers presented the 5-year data for this…
TCT 2019 | Mitral Valve-in-Valve: 1-Year Results for Sapien 3 in Mitral Valve Replacement for Degenerated Bioprostheses
Courtesy of SBHCI. The aim of this work was to assess the contemporary outcomes of mitral valve-in-valve using Sapien 3 prostheses, see the differences between trasapical and transseptal access, and establish 1-year mortality predictors. Researchers analyzed retrospectively the data from the Society of Thoracic Surgeons [STS]/American College of Cardiology TVT Registry, which included 1576 patients who had…
MitraClip in the Real World: Mid-Term Progress
Courtesy of Dr. Carlos Fava. The fact that the outcomes of edge-to-edge repair with MitraClip have improved, particularly in the immediate and short term, is widely known. Such improvement is basically a result of more operator experience and the arrival of 3-D echocardiography. However, there are no mid-term follow-up studies available, except for the EVEREST…