Moderate aortic stenosis (MAS) encompasses a broader spectrum than severe aortic stenosis. However, its progression has not yet been fully elucidated. While there are reports suggesting that this condition is not as benign as initially believed, there is a need to consider early interventions in certain instances. Researchers conducted an analysis from January 2016 to...
Mitral valve regurgitation (MR) is a common cause behind heart failure and is associated to hospitalization for heart failure and higher mortality. Transcatheter edge-to-edge repair (TEER), together with guideline-directed medical therapy (GDMT) has been shown beneficial in high risk patients, according to the COAPT study. However, there is a significant group of patients that make...
Cardiogenic shock (CS) in a setting of aortic stenosis is associated with high mortality rates. In consequence, surgery is generally not a possibility for this patient group, and they usually undergo aortic valvuloplasty, resulting in a mortality rate of 33%-50% at 30 days, 70% at one year, and 90% at two years. While transcatheter aortic...
In last few years, transcatheter edge-to-edge repair (TEER) with MitraClip has been shown safe and effective, both for primary and secondary mitral valve regurgitation (MR), given the increasing interventionist and echocardiographer experience. However, there is a group of patients that require surgery after failed TEER, either because of bad evolution or because device implantation...
Severe secondary mitral valve regurgitation is associated to hospitalization and mortality. The COAPT study has shown the superiority of guideline directed medical therapy at maximal tolerated doses according to guidelines (GDMT) plus edge-to-edge transcatheter repair (TEER) versus GMDT alone. However, at present there is no information on the impact of hospitalizations and their relationship to...
Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. However, surgeons argue that these cases fail to consider patients from daily clinical practice, but rather include a population that has been carefully selected for randomized trials. Patients with non-tricuspid aortic stenosis, with severe...
Valvular heart disease management guidelines were updated last week by the AHA and the ACC. The last complete version had been published in 2014; therefore many of its recommendations have become obsolete before the latest evidence. The studies that made the FDA approve TAVI for low-risk patients are probably the most important incorporations. They also...
In cases where it is difficult to demonstrate the improvement of a drug or a device in hard endpoints such as mortality, we should look for softer and easier to prove endpoints. The problem is that these soft endpoints are often subjective (such as sensation of shortness of breath or angina pectoris) and they could...
Courtesy of Dr. Carlos Fava. Edge to edge with MitraClip was shown effective and safe, and its outcomes have been improving over these past few years. However, one of its greatest challenges involves not being able to reduce mitral regurgitation (MR) after device implantation, resulting in the need for surgery, as some studies have shown...
This study especially designed to compare PCI vs. CABG in patients with left main coronary artery disease and low to intermediate Syntax score showed that 30-day and 3 -year outcomes of PCI with everolimus eluting stents vs CABG were consistent both in diabetic and non-diabetic patients. The randomized EXCEL trial (Evaluation of XIENCE versus Coronary...