The new drug-eluting stents (DES) equipped with ultra-thin struts are showing a lower risk of target lesion failure as a result of lower rates of acute myocardial infarction and similar rates of revascularization, according to this meta-analysis soon to be published in Circulation. Such a difference is evidenced at a 1-year follow-up when compared with<a href="https://solaci.org/en/2018/07/04/new-ultra-thin-strut-des-do-they-outperform-second-generation-des/" title="Read more" >...</a>
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>
First generation TAVR procedures performed on patients with bicuspid aortic valve stenosis have rendered suboptimal outcomes. In addition, studies on new generation devices, such as the SAPIEN 3, have systematically excluded these patients from their protocols. Therefore, we are missing information about TAVR on bicuspid aortic valve stenosis patients. This study compared SAPIEN 3 TAVR<a href="https://solaci.org/en/2018/05/30/europcr-2018-sapien-3-in-bicuspids/" title="Read more" >...</a>
Pulmonary hypertension (PH) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) should not preclude this procedure. In fact, TAVR will resolve this condition in most cases. More than three quarters of patients undergoing TAVR have some level of PH, though this has not been associated to increased mortality, according to this<a href="https://solaci.org/en/2018/05/04/baseline-pulmonary-hypertension-should-not-preclude-tavr/" title="Read more" >...</a>
The frequency of bicuspid aortic valves (BcAV) are around 1%, but in 60+ patients it is associated to severe aortic stenosis. Even though surgery is the standard treatment, TAVR is the “off label” indication in high risk patients. BcAV presents differences with tricuspids given that it is more elliptic, has asymmetric calcification and more<a href="https://solaci.org/en/2018/05/02/bicuspid-valves-do-not-increase-mortality-in-tavr/" title="Read more" >...</a>
Aortic stenosis increases afterload creating hypertrophy as a compensation mechanism to maintain minute volume. This leads to left ventricular diastolic dysfunction (LVDD). More than half of patients presenting aortic stenosis have LVDD and myocardial fibrosis, which is a mortality predictor in surgery. At present, there is contradicting evidence in TAVR. The study looked<a href="https://solaci.org/en/2018/04/12/diastolic-dysfunction-should-be-considered-in-tavr/" 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. Transcatheter mitral valve repair with MitraClip has shown good results in symptomatic patients with extreme surgical risk in different studies. However, its “real world” benefits have not been studied in depth due to how complex this strategy is compared with other usual procedures. This study analyzed 2952 patients who underwent mitral<a href="https://solaci.org/en/2017/11/10/mitral-valve-repair-with-mitraclip-is-safe-in-high-risk-patients/" title="Read more" >...</a>
Courtesy of SBHCI. Two new transcatheter treatments for severe or massive functional tricuspid regurgitation have showed good results at 30 days, according to their feasibility studies. The long-forgotten tricuspid valve has been gaining more attention with research linking tricuspid regurgitation to an increase in mortality. Early studies used devices originally designed for the mitral or<a href="https://solaci.org/en/2017/11/06/tct-2017-the-tri-repair-and-the-forma-trials-new-devices-for-the-forgotten-valve/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. A small annulus in patients with Severe Aortic Stenosis is a real challenge, since it is associated with post-surgical prosthesis patient mismatch (PPM), which negatively affects prosthesis duration and evolution. TAVR has become a good alternative strategy, with better hemodynamic profile and lower PPM incidence in this group. The present study included 246<a href="https://solaci.org/en/2017/10/17/small-annulus-should-we-start-choosing-the-valve/" title="Read more" >...</a>