Courtesy of Dr. Carlos Fava. Aortic stenosis with cardiac failure or cardiogenic shock involves high mortality risk at short term. Surgery in these conditions is often unsafe, which leaves us with valvuloplasty, but only as a bridge to some other procedure, seeing as it is effective only for a short time. Few studies have looked into patients undergoing<a href="https://solaci.org/en/2018/06/20/urgent-emergent-tavr-a-valid-option/" title="Read more" >...</a>
All interventional cardiologists must be able to perform a pericardiocentesis. Whether we deal with a chronic total occlusion, a supposedly simple coronary angioplasty (we all have witnessed the perforation of a supposedly risk-free coronary artery), or a transcatheter aortic valve replacement (whose rise gave us another significant source of tamponades), we must all be ready<a href="https://solaci.org/en/2018/04/25/constrictive-pericarditis-after-pericardiocentesis/" title="Read more" >...</a>
The association between aortic stenosis and coronary disease is common, since both conditions share pathogenesis, risk factors, and symptoms. Transcatheter aortic valve replacement (TAVR) is currently indicated for high-risk and inoperable patients. It also appears as a valid alternative for the treatment of intermediate-risk patients, and it could soon be indicated for low-risk patients. Coronary<a href="https://solaci.org/en/2018/02/20/coronary-disease-works-as-a-30-day-predictor-in-tavr/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Even though the presence of paravalvular regurgitation (PVR) has been reduced, thank to greater experience and new devices, it is still frequent and has an impact in survival (especially moderate and severe PVR). Recent research has shown that mild PVR also has a negative impact. However, these data were provided<a href="https://solaci.org/en/2018/02/15/mild-leaks-tavrs-silent-enemies/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men.<a href="https://solaci.org/en/2018/02/14/who-lives-longer-after-tavr-men-or-women/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The current recommendation for aortic valve replacement is based on stenosis severity based on valvular criteria (mean transvalvular gradient, peak aortic velocity and valve index area) and the presence of symptoms, in addition to comorbidities, mainly for risk stratification. However, ventricular damage and/or its effect on cardiovascular hemodynamics are not regarded<a href="https://solaci.org/en/2017/12/20/cardiac-damage-should-we-start-to-assess-it/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Repairing the mitral valve with Mitraclip has become an alternative for high risk or inoperable symptomatic patients, but its long term evolution has only been tested by the EVEREST II, which had not taken into account 5 year mortality outcomes. Therefore, to better study its evolution, we need to carry out different randomized studies<a href="https://solaci.org/en/2017/07/11/mitraclip-should-we-intervene-earlier/" title="Read more" >...</a>
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.<a href="https://solaci.org/en/2017/05/17/further-evidence-on-managing-dysfunctioning-bioprostheses-with-balloon-expandable-prostheses/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The association between diastolic dysfunction (DD) and aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) has not been studied yet, but the presence of aortic regurgitation has proved to be associated with worse outcomes. A total of 144 out of 195 patients who underwent TAVR with balloon-expandable SAPIENS or SAPIENS XT<a href="https://solaci.org/en/2017/04/19/diastolic-dysfunction-shall-we-begin-to-assess-it/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2016/12/13/tavr-in-pure-aortic-insufficiency-yes-or-no/" title="Read more" >...</a>