Doing a balloon aortic valvuloplasty can be a good way to “buy” time before a transcatheter aortic valve replacement (TAVR), according to a registry to be published this week in J Am Coll Cardiol Intv. This study analyzed the database of a whole country to find out the incidence, predictors and outcomes of balloon aortic<a href="https://solaci.org/en/2020/04/13/aortic-valvuloplasty-as-a-bridge-to-tavr-are-we-wasting-our-time/" title="Read more" >...</a>
Three generations of self-expanding valves, three different prognoses for our patients. Design improvements and better materials in self-expanding, supra-annular aortic valves, and their better results, have allowed for the expansion of the indication for transcatheter aortic valve replacement (TAVR). Particularly, the addition of a pericardial skirt improves annular sealing and results in a significantly low<a href="https://solaci.org/en/2020/04/08/technological-improvements-in-valves-translate-into-clinical-results/" title="Read more" >...</a>
The initial results of this study presented “virtually” at the American College of Cardiology (ACC) 2020 Scientific Session suggest that patients with severe bicuspid aortic stenosis can be treated with self-expandable valve Evolut. This is a small study presenting its 30-day outcomes. There is still a long way to go. The rate of all-cause mortality<a href="https://solaci.org/en/2020/04/02/virtual-acc-2020-first-results-of-evolut-in-low-risk-bicuspid-valves/" title="Read more" >...</a>
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.<a href="https://solaci.org/en/2020/03/25/virtual-acc-2020-unlike-in-tavr-the-number-of-mitral-valve-surgeries-does-not-improve-the-outcomes-of-transcatheter-mitral-valve-repairs/" title="Read more" >...</a>
Transcatheter aortic valve replacement with the self-expandable valves has shown optimal clinical and electrocardiographic results in patients with small annuli. These supra-annular prosthetic valves seem somewhat better than the intra-annular balloon expandable. TAVR in general has better functional results in terms of patient/prosthesis mismatch. This seems especially true for patients with a small annulus. The<a href="https://solaci.org/en/2020/03/20/tavr-in-small-annuli-is-there-a-better-valve/" title="Read more" >...</a>
Prosthesis mismatch (PPM) was introduced by Rahimtoola in 1978 and happens when the effective orifice area of a heart valve prosthesis is too small in relation to patient body size. Surgical valves have been well documented, but there is little information on percutaneous valves. The study looked at 757 patients undergoing TAVR with pre and post procedural eco-Doppler<a href="https://solaci.org/en/2019/11/25/lower-mismatch-rate-with-the-new-self-expandable-valves/" title="Read more" >...</a>
This small randomized study heated the debate about when to intervene aortic stenosis (AS). Putting off surgical valve replacement (SAVR) in patients with asymptomatic AS and waiting for symptom onset with conservative care increased periprocedural risk and all cause cardiovascular death. This study presented by Dr Duk-Hyun Kang during AHA 2019 scientific sessions (simultaneously published<a href="https://solaci.org/en/2019/11/20/aha-2019-recovery-early-surgery-in-asymptomatic-severe-aortic-stenosis/" title="Read more" >...</a>
This sub study of the GALILEO specifically looked at valve thickening and reduced leaflet motion after TAVR documented with 4D CT. Whether anticoagulation with rivaroxaban might reduce or prevent this phenomenon remained unanswered. Patients receiving the same anticoagulation scheme than the general study’s (rivaroxaban + aspirin vs. aspirin + clopidogrel) were assessed by 4D CT<a href="https://solaci.org/en/2019/11/20/aha-2019-galileo-4d-rivaroxaban-in-the-prevention-of-post-tavr-valve-thickening-and-thrombosis/" title="Read more" >...</a>
The balloon-expandable valve has been granted approval in Europe for treatment of the complete risk spectrum of symptomatic severe aortic stenosis. Europe has recently approved an expanded indication for the Sapien 3 system for use in low-risk patients, as reported by Edward Lifesciences. Sapien 3, which includes the next-generation Sapien 3 Ultra, is the first transcatheter heart valve<a href="https://solaci.org/en/2019/11/15/europe-grants-approval-to-balloon-expandable-valve-in-low-risk-patients-self-expanding-valve-still-waiting-for-it/" title="Read more" >...</a>
The self-expandable valve was associated to lower prosthesis-patient mismatch (PPM) compared against the balloon expandable valve regardless annular area, according to this study soon to be published in J Am Coll Cardiol Intv. This difference was basically driven by patients with larger body surface area (>1.83m²). Prosthesis mismatch has been associated to increased mortality after transcatheter<a href="https://solaci.org/en/2019/10/30/prosthesis-mismatch-in-supra-and-intra-annular-valves/" title="Read more" >...</a>