This study was simultaneously presented at TCT and published at JACCE, and it aims at showing the one-year outcomes of this new TAVR device, though follow-up is at 5 years. Primary end point was all cause mortality and secondary end points included clinical and echocardiographic events. With a total 941 patients (82,4 ± 5,9…
TCT 2018 | NEOPRO: A Registry for Acurate neo and Evolut PRO
The purpose of this registry was to compare short-term clinical events and echocardiographic findings in two self-expanding valves used with transfemoral access, Acurate neo and Evolut PRO. The registry included a retrospective follow-up of 1551 patients, among whom 1263 received an Acurate neo valve and 288 received an Evolut Pro valve. The procedural success rates according to VARC-2 criteria were…
TCT 2018 | PARTNER 2 Valve-in-Valve: Clinical and Hemodynamic Results Maintained in the Long Term
The 1-year follow-up for this study was published last year in JACC, and it showed that transcatheter aortic valve replacement (TAVR) in failed bioprosthetic valves has low rates of complications, boosts significant hemodynamic improvement, and results in relatively low mortality. Now, the 3-year results are presented at TCT 2018. The study followed 365 patients who underwent valve-in-valve…
New Atrial Fibrillation After TAVR Indicates Prognosis
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as an important treatment alternative for intermediate- and high-risk patients. In that sense, the presence of atrial fibrillation (AF) before TAVR is high and it has been associated with worse outcomes and higher mortality. However, there is not much evidence available regarding new-onset atrial…
Mitral Valve Repair in Patients with Cardiac Failure
The mitral valve is a complex apparatus dependent on left atrium and left ventricle functionality. Dilation of these cavities might affect mitral annulus morphology and lead to valve dysfunction, generating mitral regurgitation (MR). This type of MR has been called functional, since leaflets and tendinous chordae do not present lesions themselves; instead, they malfunction ‘secondary’…
Aortic Stenosis with Normal Flow Low Gradient: Should We Intervene or Wait?
Symptomatic patients with <1 cm² aortic valve area will benefit from an intervention regardless parameters such as flow and gradient, even if these are normal (or at least not severe). A valve replacement will be indicated without question (either surgical or percutaneous) in patients with >40 mHg mean gradient or low gradient justified by low…
TAVR Post-dilation Is Safe
Courtesy of Dr. Carlos Fava. Numerous studies have shown that the presence of aortic regurgitation after TAVR is associated with worse evolution, and that balloon post-dilation (BPD) is the adequate strategy to correct this. However, a few reports using first generation valves have associated BPD to complications such as stroke, annulus rupture and valve displacement,…
Debris Captured by SENTINEL Devices Result Different across Different Valves
The idea behind this study is that debris can be captured in all patients during TAVR, even though we still ignore which patients would benefit more from this device. Tissue particles captured by the SENTINEL during TAVR vary from valve to valve, according to this new analysis. There are differences in size and number of…
Surgical Redo Mitral Valve Replacement vs. Valve-in-Valve in Failed Bioprosthetic Valves
Despite their higher surgical risk, patients who underwent transcatheter mitral valve replacement (TMVR) presented 1-year mortality rates similar to those of patients who had redo surgical mitral valve replacement for bioprosthetic valve failure. At one month, echocardiographic findings were similar; however, at one year, patients who underwent TMVR presented a gradient increase that had no…
Simple Lab Tests to Better Stratify Low Flow and Low Gradient AS Patients
Combining B-type natriuretic peptide (BNP) and high-sensitive cardiac troponin T measures undeniably helps to better stratify severe aortic stenosis patients with low flow and low gradient. Many patients in these conditions clearly benefit from a transcatheter aortic valve replacement (TAVR) procedure, and for others it is simply useless, and given its high cost, better stratification…
MITRA-FR: Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Courtesy of Dr. Adolfo Ferrero. INTRODUCCION: In patients with chronic heart failure and reduced left ventricular ejection fraction, severe secondary mitral valve regurgitation is associated with bad prognosis. Whether percutaneous mitral valve repair improves clinical results in this patient population, remains unclear, despite prior multicenter studies supporting this view. METHODS: Patients with severe secondary mitral…