We never saw it coming, such a pleiotropic effect: who would have though a mechanical device could have such a systemic anti-inflammatory effect? Transcatheter aortic valve replacement (TAVR) does in fact have it. The shear stress aortic stenosis produces activates multiple inflammatory responses mediated by monocytes. This study identified the most important mechanoreceptor, involved in...
Many studies have tried to answer the question about whether there is a superior device in transcatheter aortic valve replacement (TAVR). Today, there is no evidence to support such claim, and most patients will likely find operator experience more beneficial than any device per se. However, there are certain patients with specific characteristics that might...
Transcatheter aortic valve replacement (TAVR) can be an alternative for aortic valves with endocarditis successfully treated with antibiotics, which no longer are severe valve lesions. At one year, the risk of endocarditis relapse was low and the mortality rate was similar to that of patients without a history of infection. This aim of this study...
After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT). This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the...
Continuous electrocardiographic monitoring pre-transcatheter aortic valve replacement (TAVR) detected arrhythmic events in almost half the patients analyzed in this study (which will be published soon in JACC Interventions). A fourth of these patients needed urgent therapeutic actions before the procedure. Previous conduction disorders—particularly, right bundle branch block and chronic renal insufficiency—were linked to a higher...
The Latin American Society of Interventional Cardiology, through the SOLACI Research Department, is conducting a survey to determine the reasons why transcatheter aortic valve replacement (TAVR) was NOT conducted in patients with severe aortic stenosis in Latin America (from January to December 2019). Dr. Ricardo Allende, from San Luis Potosí (Mexico), and Dr. Pablo Lamelas,...
Courtesy of Dr. Carlos Fava. Since the beginnings of transcatheter aortic valve replacement (TAVR) back in 2002, this strategy has gained considerable ground, encompassing not only inoperable or high-risk patients but also those at medium and low risk. Additionally, it came to include patients with failed bioprostheses. The most common reason for surgery was paravalvular leak,...
This study looked at patients with moderate to severe left ventricular hypertrophy and aortic stenosis treated with transcatheter aortic valve replacement (TAVR). Patients with reduced hypertrophy had lower mortality and fewer hospitalizations at 5 years. It included all moderate to severe risk patients with ventricular hypertrophy undergoing TAVR in the studies and registries PARTNER (I,...
Courtesy of Dr. Carlos Fava. Aortic annulus rupture is a catastrophic event that presents in nearly 0.9% of cases, but there is another entity called contained annulus rupture, associated to oversized devices and annulus calcification and diagnosed with CT angiography, with up to 5% frequency. 1602 patients from the ENCORE registry were analyzed. 21 of...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has shown benefit and is currently moving towards low-risk patients, as well as bicuspid aortic valves and (to a lower extent) aortic regurgitation. However, we must ponder on which valve should be used on each patient: balloon-expandable (BE) or self-expanding (SE) valve? They represent different technologies...