Sedación consciente vs anestesia general en el TAVI

SOLVE-TAVI after 12-month followup: self-expanding vs. balloon expandable and general vs. local anesthesia

The ambitious SOLVE-TAVI (soon to be published in JACC) is aimed at answering to of the most important questions we make when facing a TAVR procedure: What valve do we choose, a self-expanding or a balloon expandable? And once we have chosen our device, do we proceed with general anesthesia or conscious sedation?    The<a href="https://solaci.org/en/2021/05/04/solve-tavi-after-12-month-followup-self-expanding-vs-balloon-expandable-and-general-vs-local-anesthesia/" title="Read more" >...</a>

TAVR vs. the Least Invasive Surgically Implanted Valve

Rapid-deployment surgically implanted valves are designed to make a surgeons’ job faster and easier, compared with conventional bioprostheses, which require several stitches. These valves, which shorten surgical times, could compete with transcatheter-implanted valves (transcatheter aortic valve replacement, TAVR). The German Aortic Valve Registry analyzed 16,473 patients who underwent surgical aortic valve replacement with either a current-generation<a href="https://solaci.org/en/2021/04/19/tavr-vs-the-least-invasive-surgically-implanted-valve/" title="Read more" >...</a>

El estudio SOURCE 3 confirma los buenos resultados de la válvula SAPIEN 3 a un año de seguimiento

High Deployment: Also Trending with Balloon Expandable Valves

Conventional implantation of balloon expandable SAPIEN-3 results in a final 70:30 or 80:20 ratio of the valve in the aorta/left ventricular outflow tract. This comes with permanent pacemaker implantation rates of approximately 10%. Higher deployment might translate into lower rates of conduction abnormalities and pacemaker implantation.   The study compared a cohort of 1028 consecutive patients; 406<a href="https://solaci.org/en/2021/03/25/high-deployment-also-trending-with-balloon-expandable-valves/" title="Read more" >...</a>

Cirugía para mejorar la sobrevida en insuficiencia tricuspidea aislada

Cusp Overlap for Higher CoreValve Implantation

Implant depth greater than the length of the membranous septum is an independent predictor of permanent pacemaker implantation. Valve implantation 3 to 5 mm below the aortic annulus in a projection coaxial to the device is recommended. The problem is this is rarely in the annular plane of the valve. Ideal annular plane projection is<a href="https://solaci.org/en/2021/03/25/cusp-overlap-for-higher-corevalve-implantation/" title="Read more" >...</a>

Predilatación en TAVI ¿Datos definitivos para no complicarse tomando decisiones?

Predilation in TAVR and Myocardial Injury

Performing balloon predilation or valvuloplasty before a transcatheter aortic valve replacement (TAVR) may increase the incidence and magnitude of myocardial injury with new-generation balloon-expandable valves. Some papers argue in favor or against direct implantation, others remain neutral, but this research is the first one to express a different point of view. Historically, the biggest fear<a href="https://solaci.org/en/2021/03/03/predilation-in-tavr-and-myocardial-injury/" title="Read more" >...</a>

The Ten Commandments in Adult Congenital Heart Disease

Adult congenital heart disease is a life-long condition that requires appropriate follow-up by experts. Said follow-up is paramount to diagnosing specific and highly variable complications in a timely manner. The recently published European Society of Cardiology guidelines for the management of congenital heart disease calls for a summary of its most important aspects as “ten<a href="https://solaci.org/en/2020/12/15/the-ten-commandments-in-adult-congenital-heart-disease/" title="Read more" >...</a>

Balloon-Expandable Valve Outdoes Itself

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>

AHA 2020 | Aumenta el alta precoz en el TAVI con un costo esperado

AHA 2020 | Rise in Early Discharge After TAVR Has the Expected Cost

As hospitalization time after a transcatheter aortic valve replacement (TAVR) is reduced, we are observing a concomitant increase in re-hospitalizations due to conduction disorders. Early discharge is a great step, but it should be noted that conduction disorders can happen beyond 48 hours. A few years ago, pacemaker implantation rates after discharge were about 7%;<a href="https://solaci.org/en/2020/11/19/aha-2020-rise-in-early-discharge-after-tavr-has-the-expected-cost/" title="Read more" >...</a>

TCT 2020 | Diferencias en stroke entre SAPIEN 3 y Evolut R que generan sorpresa

TCT 2020 | Surprising Differences in Stroke between SAPIEN 3 and Evolut R

One-year outcomes of the head to head trial between CoreValve Evolut R vs Sapien 3 showed a significantly higher difference in stroke vs. patients receiving the self-expanding valve (Sapien 3 6.9% vs Evolut R 1%; p=0.002). The SOLVE-TAVI randomized 2×2 patients with severe aortic stenosis and high surgical risk to Sapien 3 or Evolut R and<a href="https://solaci.org/en/2020/10/21/tct-2020-surprising-differences-in-stroke-between-sapien-3-and-evolut-r/" title="Read more" >...</a>

TCT 2020 | La Acurate Neo no alcanza la no inferioridad vs la CoreValve Evolut

TCT 2020 | Acurate Neo Does Not Meet Non-Inferiority vs. CoreValve Evolut

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>