The efficacy of transcatheter aortic valve replacement (TAVR) has been well-established. However, its limitations include suboptimal deployment and paravalvular leak. The Lotus system is a fully repositionable and retrievable device with controlled mechanical expansion. It features an adaptive seal to minimize paravalvular leak, it does not require early pacing during deployment, and, given its early...
Courtesy of Dr. Carlos Fava. The presence of chronic obstructive pulmonary disease (COPD) is a criterion for which patients are ruled out for surgery and proposed as candidates for its current alternative, transcatheter aortic valve replacement (TAVR). A minimalist strategy could benefit this patient group, given the use of conscious sedation instead of general anesthesia. ...
Courtesy of Dr. Carlos Fava One of the present challenges of TAVR is bicuspid aortic valve stenosis (AS), since it presents a different distribution and structure, associated to greater and more irregular calcification. There are only small series of devices and their use is still controversial. The study analyzed 561 patients with severe bicuspid...
Two recent articles featured in JACC Cardiovascular Interventions showed that short term (at 30 days) outcomes of patients treated with the next-generation self-expanding Medtronic Evolut R valves could present several advantages compared to the original CoreValve, including recapturability. Both analyses reported similar rates of all-cause mortality and stroke. The study carried out by Dr. Jeffrey Popma as...
The aim of this study was to identify permanent pacemaker (PPM) predictors after transcatheter aortic valve replacement (TAVR) with last generation balloon expandable valve Edwards SAPIEN 3. The new conduction disturbances requiring PPM are one of the biggest concerns after TAVR, and their predictors have not yet been defined. 229 patients undergoing TAVR...
Paravalvular Leak (PVL) occurs in 5 to 17% of patients undergoing surgical valve replacement. Percutaneous device closure of PVL represents an alternative to repeat surgery. All centers in UK and Ireland performing percutaneous PVL closure delivered their data to the UK PVL registry. Data were analyzed for factors associated with mortality and major cardiovascular...
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...
In the first PARTNER trial (Placement of Aortic Transcatheter Valves), mortality at one year was 24% for high risk patients and 31% for inoperable patients. A recent report on SAPIEN 3 outcomes at 30 days ─ the last generation balloon expandable valve ─ showed a rather lower adverse events rate. However, additional information at longer...
Original Title: Transcatheter Mitral Valve Replacement in Native Mitral Valve Disease With Severe Mitral Annular Calcification: Results From the First Multicenter Global Registry Reference: J Am Coll Cardiol Intv. 2016;9(13):1361-1371. doi:10.1016/j.jcin.2016.04.022 Gentileza del Dr. Agustín Vecchia. The risk underlying the surgical approach to mitral valve replacement in patients with severe mitral annular calcification is high. A...
Original Title: Treatment of Symptomatic Severe Aortic Stenosis with a Novel Resheathable Supra-Annular Self-Expanding Transcatheter Aortic Valve System. Reference: Ganesh Manoharan et al. J Am Coll Cardiol Intv. 2015; 8(10):1359-1367. Courtesy of Dr. Agustín Vecchia. Despite the rapid growth and evolution of transcatheter aortic valve replacement devices (TAVR), vascular access complications, paravalvular leak, stroke...