The objective of this paper recently published in J Am Coll Cardiol Intv was to compare the outcomes of transcatheter aortic valve replacement (TAVR) with the new Sapien 3 Ultra vs. Sapien 3. Successful implantation was extremely high with both balloon-expandable devices, which also had a very low adverse event rates. However, Sapien Ultra was significantly better<a href="https://solaci.org/en/2020/11/30/balloon-expandable-valve-outdoes-itself/" title="Read more" >...</a>
Rivaroxaban seems to be a reasonable alternative to warfarin in patients with atrial fibrillation and bioprosthetic mitral valve. These results arise from the RIVER Study presented at the American Heart Association (AHA) 2020 Congress and simultaneously published in the New England Journal of Medicine (NEJM). After 5 years of follow-up, rivaroxaban reached the non-inferiority criterion<a href="https://solaci.org/en/2020/11/20/aha-2020-river-rivaroxaban-as-alternative-to-warfarin-in-patients-with-atrial-fibrillation-and-bioprosthetic-mitral-valve/" title="Read more" >...</a>
Transcatheter aortic valve replacement (TAVR) results durable at 5 years to treat failed surgical bioprosthetic valves and at one year to treat valves percutaneously. Regardless the type of the failed valve, the solution is TAVR. The 5 year follow up of the PARTNER 2 valve-in-valve (ViV) showed that TAVR as treatment for failed surgical bioprosthetic<a href="https://solaci.org/en/2020/10/21/tct-2020-tavr-appears-to-be-the-solution-for-all-dysfunctional-biological-valves/" title="Read more" >...</a>
The self-expanding Acurate Neo (Boston Scientific) did not meet non-inferiority vs. the self-expanding CoreValve Evolut (Medtronic) in the SCOPE 2 study published in Circulation simultaneously and presented at the virtual TCT 2020. These are bad news for the Acurate Neo, that had already failed to show non-inferiority vs. the Sapien 3 in the SCOPE 1<a href="https://solaci.org/en/2020/10/21/tct-2020-acurate-neo-does-not-meet-non-inferiority-vs-corevalve-evolut/" title="Read more" >...</a>
Moderate or severe left ventricle outflow tract calcification increases the risk of annulus rupture, residual aortic regurgitation and the need for a second valve. This recent study analyzed the performance of different contemporary prosthetic valves in patients with this particular anatomy. Since the early days of transcatheter aortic valve replacement (TAVR) outflow tract calcification has<a href="https://solaci.org/en/2020/09/10/outflow-tract-calcification-and-the-best-valve-in-this-context/" title="Read more" >...</a>
In patients with large and extra-large annuli, transcatheter aortic valve replacement (TAVR) is safe and feasible with 3rd generation valves: the 29mm balloon expandable valve Sapien-3, and their competitor, the self-expandable 34mm Evolut R. The largest size of both devices was designed specifically for patients with large or extra-large annuli. However, one of them seems<a href="https://solaci.org/en/2020/09/01/3rd-generation-valves-in-large-and-x-large-annuli/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. TAVR has matured over time and has advanced onto low risk patients, but one of its greatest challenges continues to be bicuspid valve patients. These represent between 1% and 2% of the population and over 20% of young adults requiring surgical valve replacement (SAVR). The study looked at 27,086 patients<a href="https://solaci.org/en/2020/08/28/good-evolution-of-bicuspid-valves-with-evolute-or-evolute-pro/" title="Read more" >...</a>
Patients with dysfunctional biological prosthetic valves have better outcomes with TAVR vs. surgical reintervention, beyond surgical risk. This study outcomes might even call into question the age cutoff to consider a mechanical vs. a biological prosthesis at first surgery. This analysis recently published in JACC looked at the outcomes of both possible strategies to treat<a href="https://solaci.org/en/2020/08/26/surgical-valve-replacement-might-soon-be-history/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. In the last decades, there has been a marked increase in the use bioprosthetic valves in aortic position given their benefits over mechanical valves. However, long term follow-up has shown structural valve degeneration (SVD). Given the risk of a second surgery after TAVR, valve-in-valve (ViV) has been on the rise,<a href="https://solaci.org/en/2020/08/19/valve-in-valve-good-evolution-at-long-term/" title="Read more" >...</a>
Watch again our “2nd ProEducar Educational Meeting on “Transcatheter Aortic Valve Implantation” on our Youtube account. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.