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>
Transcatheter mitral valve repair (TMVR) with MitraClip was shown feasible and safe, and therefore a viable option for symptomatic patients with severe mitral valve regurgitation of prohibitive risk. In this regard, the procedure alleviates symptoms, cardiac regurgitation and has a potential benefit on ventricular remodeling. However, many patients presented atrial fibrillation (AF) and mitral valve<a href="https://solaci.org/en/2019/04/10/mitral-valve-repair-with-mirtaclip-was-feasible-and-safe/" title="Read more" >...</a>
The degeneration of transcatheter biological valves clearly depends on time and starts with thrombus generation and subsequent histological changes resulting in valve failure (due to regurgitation, stenosis, or both). Thrombus formation is the first change, observed early in computerized tomography (CT) scans after implantation. Most times it is completely asymptomatic, which leaves many of us<a href="https://solaci.org/en/2019/01/18/the-physiopathology-behind-valve-degeneration-in-tavr/" title="Read more" >...</a>
Transcatheter tricuspid valve replacement is feasible with different devices, with a reasonable procedural success rate, and is associated with low peri-procedural mortality and significant clinical improvement. Mid-term survival was favorable in this high-risk population. Greater leaflet coaptation depth was associated with reduced procedural success, which, unsurprisingly, turned out to be an independent predictor of mortality.<a href="https://solaci.org/en/2019/01/07/more-evidence-for-the-forgotten-valve-results-from-the-trivalve-registry/" 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. 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>
The TriValve is a multicenter, international and retrospective study of multiple devices for percutaneous intervention to treat cardiac failure. This is a sub-analysis of patients receiving the most conventional of these devices: the MitraClip. The main points assessed by this study were all cause mortality, unplanned hospitalizations, functional class, the presence of peripheral edema, and<a href="https://solaci.org/en/2018/10/08/tct-2018-trivalve-mitraclip-for-the-tricuspid-valve/" title="Read more" >...</a>
This prospective, randomized, multicenter study included 447 patients with severe aortic stenosis and intermediate or high surgical risk randomized in a 2×2 factorial design to general vs. conscious sedation with local anesthesia and also to receiving the Sapien 3 valve (balloon-expandable) vs. CoreValve Evolut R (self-expandable). Primary end point was a composite of all-cause mortality,<a href="https://solaci.org/en/2018/10/08/tct-2018-solve-tavi-self-expandable-vs-balloon-expandable-valves-and-general-vs-local-anesthesia-in-one-study/" title="Read more" >...</a>
This study was simultaneously presented at TCT and published at JACCE, and it aims at showing the one-year outcomes of this new TAVR device, though follow-up is at 5 years. Primary end point was all cause mortality and secondary end points included clinical and echocardiographic events. With a total 941 patients (82,4 ± 5,9<a href="https://solaci.org/en/2018/10/05/tct-2018-portico-i-one-year-follow-up-for-the-self-expandable-reposisionable-valve/" title="Read more" >...</a>
The 1-year follow-up for this study was published last year in JACC, and it showed that transcatheter aortic valve replacement (TAVR) in failed bioprosthetic valves has low rates of complications, boosts significant hemodynamic improvement, and results in relatively low mortality. Now, the 3-year results are presented at TCT 2018. The study followed 365 patients who underwent valve-in-valve<a href="https://solaci.org/en/2018/10/04/tct-2018-partner-2-valve-in-valve-clinical-and-hemodynamic-results-maintained-in-the-long-term/" title="Read more" >...</a>