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>
Bundle Branch Block and Need for Permanent Pacemaker, a Major Challenge after TAVR
Courtesy of Dr. Carlos Fava. The development of new valves for TAVR and the increased experienced of operators have significantly decreased paravalvular leak. However, new bundle Branch block (BBB) and the need for permanent pacemaker (PPM) are still relatively high, and their impact and evolution remain controversial. The study looked at 816 patients, 437<a href="https://solaci.org/en/2019/01/17/bundle-branch-block-and-need-for-permanent-pacemaker-a-major-challenge-after-tavr/" title="Read more" >...</a>
TAVR Is Feasible and Offers Good Outcomes in Patients with Cancer
Courtesy of Dr. Carlos Fava. Oncology patients have been excluded from all studies, but many of them have a life expectancy of over a year or two, and aortic stenosis can pose a problem as regards their treatment. This study analyzed 2744 patients who underwent TAVR. Among them, 222 presented cancer (8.1%). Patients with cancer were younger,<a href="https://solaci.org/en/2019/01/16/tavr-is-feasible-and-offers-good-outcomes-in-patients-with-cancer/" title="Read more" >...</a>
Percutaneous Closure Systems Are Safe in TAVR and Aneurysms
Courtesy of Dr. Carlos Fava. Currently, one of our medical challenges is to conduct procedures requiring access with large introducer sheaths in a simpler way, without requiring surgical intervention and closing with percutaneous devices while maintaining procedural quality and safety. There are several devices, but they require a learning curve and the only information available comes<a href="https://solaci.org/en/2019/01/15/percutaneous-closure-systems-are-safe-in-tavr-and-aneurysms/" title="Read more" >...</a>
Is Individual Operator Experience Important in TAVR?
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as a successful alternative for inoperable patients and a non-inferior alternative for high- and intermediate-risk patients. While its evolution depending on site experience has been analyzed, there is currently very little information regarding the impact of operator individual experience. This study analyzed 8771 procedures performed<a href="https://solaci.org/en/2019/01/09/is-individual-operator-experience-important-in-tavr/" title="Read more" >...</a>
Acute Coronary Syndromes After TAVR: Frequent and Not All Undergo Coronary Angiography
Approximately 10% of patients who undergo transcatheter aortic valve replacement (TAVR) are readmitted for an acute coronary syndrome after a mean follow-up of 25 months. Male sex, prior coronary artery disease, and (surprisingly and hard to explain) nontransfemoral approach were independent predictors of acute coronary syndrome after TAVR, an event associated with high midterm mortality. While<a href="https://solaci.org/en/2019/01/04/acute-coronary-syndromes-after-tavr-frequent-and-not-all-undergo-coronary-angiography/" title="Read more" >...</a>
Is TAVR at Hospitals Without Backup Cardiovascular Surgery Feasible?
Patients undergoing transcatheter aortic valve replacement (TAVR) at hospitals without cardiovascular surgery available are at significantly higher risk. That in itself is a call for attention; however, a propensity-matched analysis shows that the short- and long-term mortality rates are similar among patients treated at hospitals with and without cardiovascular surgery backup. This debate emerged a<a href="https://solaci.org/en/2018/12/03/is-tavr-at-hospitals-without-backup-cardiovascular-surgery-feasible/" title="Read more" >...</a>
Aortic Stenosis and Dialysis: Is TAVR the Strategy of Choice?
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration. This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events. For some time, we have been using an<a href="https://solaci.org/en/2018/12/03/aortic-stenosis-and-dialysis-is-tavr-the-strategy-of-choice/" title="Read more" >...</a>
Differences in Stroke between TAVR and SAVR in Intermediate Risk Patients
Transcatheter aortic valve replacement (TAVR) is more and more frequent in lower risk populations that had previously been treated with surgical valve replacement (SAVR). A small difference in neurological events could have significant consequences when it comes to deciding a course of action. This study is a sub-analysis of the randomized study SURTAVI (Surgical Replacement<a href="https://solaci.org/en/2018/11/09/differences-in-stroke-between-tavr-and-savr-in-intermediate-risk-patients/" title="Read more" >...</a>
TAVR in Low-Risk Patients with “Zero” Mortality and “Zero” Stroke
Transcatheter aortic valve replacement (TAVR) is now the standard of care for patients with symptomatic severe aortic stenosis who are at extreme, high, or intermediate risk for surgery. This multicenter, prospective study (Feasibility of Transcatheter Aortic Valve Replacement in Low-Risk Patients With Symptomatic, Severe Aortic Stenosis) included low-risk patients and was approved by the United<a href="https://solaci.org/en/2018/11/09/tavr-in-low-risk-patients-with-zero-mortality-and-zero-stroke/" title="Read more" >...</a>