Courtesy of Dr. Carlos Fava. Bicuspid aortic valves are found in approximately 2% of patients and represent the most frequent cause of aortic stenosis in young adults requiring valve replacement. Though TAVR has advanced significantly, this entity has not yet been included in the different randomized studies. At present, we have data from different reports,...
The Most Read Scientific Articles of March
01- Coronavirus and the Heart: How Should Cardiologists Prepare? As the number of confirmed cases increases throughout the globe, a picture is emerging as to what the direct cardiovascular effects of this pandemic may be. Read more HERE 02- TAVR: Should Transradial Approach be the Second Access Site? Courtesy of Dr. Carlos Fava. One of...
Technological Improvements in Valves Translate into Clinical Results
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...
ESC 2019 | COMPLETE: Definitive Evidence for Infarction with Multivessel Disease
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the...
ESC 2019 | POPULAR AGE: Good Old Clopidogrel Still Valid
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though...
EuroPCR 2019 | Long-Term Follow-Up for New Left Bundle Branch Block After TAVR Is Reassuring with Certain Precautions
Long-term follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and developed left bundle branch block (LBBB) after the procedure seems reassuring. Although it is not benign, it is associated with more conduction defects, more pacemakers, and worsening ventricular function. Long-term follow-up “partially reassures” the concerns of many physicians about new LBBB after TAVR....
EuroPCR 2019 | BASKET-SMALL 2: Drug-Coated Balloons vs. DES in Small Vessels
This angiographic substudy supports the safety of drug-coated balloons in small vessels. Despite better angiographic outcomes, there were eight cases of stent thrombosis among drug-eluting stent (DES) patients, while there was none with drug-coated balloons. In patients with small vessels, using a drug-coated balloon appears safe and comparable to DES, with favorable angiographic outcomes at...
Continuous Monitoring of Left Atrial Pressure during MitraClip, Regardless Echocardiography
The aim of this study was to assess the use of measuring left atrial pressure to complement transesophageal echocardiography and doppler imaging. Procedure efficacy is measured in the cath lab by echocardiography. However, these measurements are operator dependent and might be influenced by left ventricular function and changes in left atrial compliance. The study...
Further Evidence on Managing Dysfunctioning Bioprostheses with Balloon-Expandable Prostheses
Early experience with the valve-in-valve technique in the treatment of failed bioprosthetic surgical valves in transcatheter aortic valve replacement (TAVR) has yielded acceptable acute procedural results. This turned the technique into another therapeutic option, one that could even cause the reassessment of the age limit for the surgical implantation of a mechanical or bioprosthesis valve....
TAVR in Pure Aortic Insufficiency: Yes or No?
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...