This study explores the impact of balloon post-dilation on studies conducted in the United States assessing the CoreValve self-expandable valve. Procedural details of 3532 patients were examined to determine whether post-dilation was performed after valve implantation. Best practice guidelines recommend post-dilation to improve suboptimal outcomes, being the most frequent alternative for treating moderate or severe...
Courtesy of Dr. Carlos Fava. The prevalence of atrial fibrillation in patients undergoing transcatheter aortic valve replacement (TAVR) is high (32.9%, according to the PARTNER Trial, and 46.8%, according to the CoreValve High-Risk Study), and is associated with thromboembolic events (as in all other populations). Apixaban has shown to benefit patients with nonvalvular atrial fibrillation,...
Courtesy of Dr. Agustín Vecchia. Surgery is the treatment of choice for patients with symptomatic aortic insufficiency and/or ventricular dilatation or decreased ventricular function. The broad implementation of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis, the emergence of new devices, and the experience acquired by operators have brought this treatment to off-label indications such...
Courtesy of Dr. Carlos Fava. Transfemoral access is the first choice for transcatheter aortic valve replacement (TAVR). However, this approach is not feasible for a progressively larger number of patients, which establishes the need to search for alternative accesses. Between 2009 and 2014, this study enrolled 174 patients who underwent TAVR and were unsuitable for transfemoral...
Courtesy of Dr. Carlos Fava. After a transcatheter aortic valve replacement (TAVR), the incidence of permanent pacemaker (PPM) implantation ranges from 6% to 30% in different studies, depending on the valve type used. This is due to trauma, ischemia, haemorrhage, and atrioventricular node and infranodal tissue oedema, provoking ventricular dyssynchrony similar to that caused by...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has shown ample benefit in different groups, but one of its drawbacks continues to be the need for permanent pacemaker (PPM), which ranges between 5 and 30%. Its long term impact in terms of mortality is still controversial, since some studies associate it with...
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of high-risk patients with severe aortic stenosis. However, survival after the procedure and severe complications have been assessed in relatively small populations with limited follow-up. This article reports long-term clinical results in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. The FRANCE-2 registry...
Courtesy of del Dr. Carlos Fava. The bicuspid aortic valve is highly anatomically challenging because of valve asymmetric calcification, increased annulus diameter, raphe calcification and ascending aorta dilation. The new valves have shown to improve results, but we still lack data on this group. 301 patients presenting bicuspid aortic valve undergoing transcatheter aortic...
Courtesy of Dr. Carlos Fava. The benefits of transcatheter aortic valve implantation (TAVI) have been widely shown, but there is no evidence on sex-specific outcomes. Some studies have shown lower mortality and better evolution of the ventricular function in women, yet with more bleeding and stroke; however, it remains unclear. This study included 1,019 patients...
Few studies have evaluated the impact of new comorbidities, fragility and disability indices on transcatheter aortic valve replacement (TAVI) outcomes. This study analyzes Medtronic CoreValve U.S. Pivotal patients to develop a new, simpler scoring system to use in addition to the standard assessment of TAVI patients. A multidisciplinary heart team used objective criteria, the...