Original title: Invasive Hemodynamic Characteristics of Low Gradient Severe Aortic Stenosis Despite Preserved Ejection Fraction. Reference: Juliane Lauten et al. J Am Coll Cardiol 2013;61:1799–808. Although the pathophysiology, clinical features, and natural course of severe aortic stenosis have been extensively described, management recommendations are still evolving. The current European and American guidelines recommend a valve area cutoff of...
Patients with low-flow, low-gradient severe symptomatic aortic stenosis associated with severe impairment of the left ventricular systolic function have shown acceptable outcomes after transcatheter aortic valve replacement (TAVR), according to the multicenter TOPAS-TAVI registry, which demonstrated a relatively low 30-day mortality rate. Considering the very high risk presented by this population involved, a 30-day...
Patients with severe aortic stenosis and a small aortic annulus face an increased risk of deteriorated valvular hemodynamic performance and adverse cardiovascular clinical outcomes after undergoing transcatheter aortic valve replacement (TAVR). This study, a prospective multicenter randomized trial, aimed to compare the efficacy and safety of two types of valves: the supra-annular self-expanding EVOLUT (SEV)...
In recent years, TAVR has been increasingly used; however, when it comes to younger, lower risk patients, its use is still challenged. In this context, there is limited information and we lack randomized studies on “real world” cohorts. The DEDICATE randomized 1.414 patients over 65 with severe symptomatic aortic stenosis. 701 of these patients received...
Severe calcified aortic stenosis is a common condition that can currently be effectively treated with SAVR or TAVR. However, some patients, given comorbidities or anatomical characteristics, are not good candidates for these therapeutic alternatives. The non-invasive ultrasound therapy (NIUT) has surged as viable alternative. It claims ultrasound might act on calcified valves, and mobilize tissue...
Aortic stenosis (AS) is a progressive disease associated with morbidity and mortality, especially in severe cases. However, recent studies have revealed that moderate stenosis can also have unfavorable consequences in the course of the disease. One of the challenges lies in that determining its severity is sometimes difficult due to discrepancies between valve area, gradient,...
There is no question as regards the recommended treatment for symptomatic severe aortic stenosis, seeing as both transcatheter and surgical aortic valve replacement (TAVR and SAVR) have shown to significantly improve prognosis. This is despite the fact that there is still certain ambiguity around its characterization, which looks to define it according to hemodynamic severity...
The progression of aortic stenosis has been extensively studied and is well-known. As observed, in its advanced stages, this condition entails high morbidity and a marked decrease in survival. Both North American and European guidelines recommend treatment when faced with severe valve disease. However, true severity can be difficult to determine due to discordant data,...
Due to the proven long-term results and substantial increase in the number of transcatheter aortic valve implantation (TAVI) procedures conducted, the application of TAVI has been extended to clinical situations outside the original scope, such as non-calcified aortic regurgitation (NCAR). Device placement in these new scenarios entails a technical challenge due to the absence of...
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...