On the bright side, the incidence of prosthetic valve endocarditis (PVE) post TAVR is not higher than post SAVR, according to this study recently presented at EuroPCR 2019, held in Paris. There is plenty of evidence describing PVE incidence, prognosis, risk factors, etc. after surgical valve replacement surgery (SAVR). However, we know little about the<a href="https://solaci.org/en/2019/06/23/prosthetic-valve-endocarditis-and-tavr-though-rare-devastating/" title="Read more" >...</a>
Degenerated surgical bioprostheses can be safely treated with CoreValve or CoreValve Evolut using the valve-in-valve procedure. Excellent 1-year clinical and hemodynamic outcomes were achieved in a non-selected regular population, i.e., “real-world” patients. The VIVA (Valve in Valve) registry, conducted at 23 sites, was a prospective study designed to systematically collect data from patients with degenerated<a href="https://solaci.org/en/2019/06/18/valve-in-valve-with-self-expanding-prosthesis-what-happens-with-gradients-at-one-year/" title="Read more" >...</a>
In this new era, the paradigm to treat the whole spectrum of transcatheter aortic valve replacement (TAVR) patients has started to shift beyond risk. However, broadening the spectrum raises the question of durability, which is why any long-term TAVR outcomes in any context are welcome. This specific study studied TAVR durability in the treatment of<a href="https://solaci.org/en/2019/06/03/good-news-at-3-years-for-valve-in-valve/" title="Read more" >...</a>
The CHOICE trial included 241 patients with severe aortic stenosis and high surgical risk who underwent transcatheter aortic valve replacement (TAVR) using transfemoral access. These patients were randomized to balloon-expandable valve (Edwards Sapien XT) vs. self-expanding valve (Medtronic CoreValve). The endpoints were all-cause mortality, stroke, readmission, valve function parameters as measured through an ultrasound, and<a href="https://solaci.org/en/2019/05/23/europcr-2019-choice-balloon-expandable-valves-vs-self-expanding-valves-in-high-risk-patients/" title="Read more" >...</a>
After reports of some serious adverse events with first-generation Lotus, the device was pulled off the market—but it was not meant to be left in oblivion. Now, it is back, renewed and with the approval of the United States Food and Drug Administration (FDA), to compete directly with the two market leaders (Sapien and CoreValve),<a href="https://solaci.org/en/2019/04/29/lotus-returns-with-new-strength-and-the-fda-approval-to-compete-with-sapien3-and-corevalve-evolut-r/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons. The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with<a href="https://solaci.org/en/2019/04/12/modern-valves-reduce-the-need-for-a-pacemaker/" title="Read more" >...</a>
For the first time, this long term observational study on a large cohort of contemporary patients with aortic stenosis (AS), has shown syncope is an underestimated threat, associated with worse prognosis after surgical aortic valve replacement (SAVR). It is interesting to note that other symptoms or early signs of AS that will normally indicate SAVR<a href="https://solaci.org/en/2019/02/11/un-underestimated-symptom-of-aortic-stenosis/" title="Read more" >...</a>
The former generation of valves, the balloon expandable (Sapien XT), was associated to less paravalvular leak than the self-expanding valves only in patients with larger annuli. The new generation of self-expanding valves (Evolut R) has managed to significantly improve sealing in patients with larger annuli and still holds potential benefits for smaller annuli. The aim<a href="https://solaci.org/en/2018/12/28/balloon-expandable-vs-self-expanding-to-each-valve-its-own-annulus/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration. This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events. For some time, we have been using an<a href="https://solaci.org/en/2018/12/03/aortic-stenosis-and-dialysis-is-tavr-the-strategy-of-choice/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. We are well aware of transcatheter aortic valve replacement’s (TAVR) effect in high-risk or inoperable patients at 5 years, even more after the PARTNER 1 trial. Yet, the outcomes of another relevant randomized study remained pending: el CoreValve US Pivotal High-Risk Trial. The CoreValve US Pivotal High-Risk Trial looked at the<a href="https://solaci.org/en/2018/11/21/corevalve-us-pivotal-high-risk-trial-at-5-years-similar-results/" title="Read more" >...</a>