aortic stenosis

EuroPCR 2019 | CHOICE: válvula balón expandible vs autoexpandibles en pacientes de alto riesgo

EuroPCR 2019 | CHOICE: Balloon-Expandable Valves vs. Self-Expanding Valves in High-Risk Patients

The CHOICE trial included 241 patients with severe aortic stenosis and high surgical risk who underwent transcatheter aortic valve replacement (TAVR) using transfemoral access. These patients were randomized to balloon-expandable valve (Edwards Sapien XT) vs. self-expanding valve (Medtronic CoreValve). The endpoints were all-cause mortality, stroke, readmission, valve function parameters as measured through an ultrasound, and<a href="https://solaci.org/en/2019/05/23/europcr-2019-choice-balloon-expandable-valves-vs-self-expanding-valves-in-high-risk-patients/" title="Read more" >...</a>

TAVR Still Gaining Ground Among Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has become the standard of care for patients with severe aortic stenosis and high surgical risk, and it should be considered as an option for intermediate-risk patients. In recent years, the number of low-risk patients treated with TAVR has increased. This study analyzes low-risk patients from the German Aortic Valve<a href="https://solaci.org/en/2019/05/14/tavr-still-gaining-ground-among-low-risk-patients/" title="Read more" >...</a>

¿Qué pacientes con bajo flujo y bajo gradiente se benefician del recambio valvular?

Would TAVR Have a Similar Benefit in Patients with Low Flow, Low Gradient, and Preserved Ejection Fraction?

Courtesy of Dr. Carlos Fava. Patients with low-flow low-gradient severe aortic stenosis are at higher risk, but there is a low-flow low-gradient group with preserved ejection fraction. These patients present systolic and diastolic ventricular dysfunction and their progress is different than that of the high-flow high-gradient normal ventricular function group. This study analyzed 1462 patients. Among them,<a href="https://solaci.org/en/2019/05/07/would-tavr-have-a-similar-benefit-in-patients-with-low-flow-low-gradient-and-preserved-ejection-fraction/" title="Read more" >...</a>

Cirugía para mejorar la sobrevida en insuficiencia tricuspidea aislada

Is Tricuspid Regurgitation after TAVR Significant?

Courtesy of Dr. Carlos Fava. Severe or moderate mitral regurgitation is associated to worse evolution after TAVR. However, we should not forget the tricuspid valve that, even though not extensively researched, is also associated to a negative impact in its evolution. A meta-analysis of 12 studies with a total 41485 patients was carried out.  <a href="https://solaci.org/en/2019/04/16/is-tricuspid-regurgitation-after-tavr-significant/" title="Read more" >...</a>

Pacing with a 0.035” Guidewire

Modern Valves Reduce the Need for a Pacemaker

Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons. The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with<a href="https://solaci.org/en/2019/04/12/modern-valves-reduce-the-need-for-a-pacemaker/" title="Read more" >...</a>

La diálisis nueva post TAVI aumenta la mortalidad.

After 100,000+ Patients, TAVR Becomes the New Standard of Care

Eighty years did the trick for one the countries with more experience in transcatheter aortic valve replacement (TAVR), which made it the new “standard of care” to treat elderly patients. Following in the footsteps of pioneer Alain Cribier, Germany has led the adoption of TAVR in Europe and the rest of the world. Since 2008,<a href="https://solaci.org/en/2019/03/26/after-100000-patients-tavr-becomes-the-new-standard-of-care/" title="Read more" >...</a>

ACC 2019 | PARTNER 3: TAVI en bajo riesgo con menos eventos al año que la cirugía

ACC 2019 | PARTNER 3: Low Risk TAVR vs. Surgery, Fewer Events per Year

Courtesy of Dr. Carlos Fava. TAVR has largely been shown superior or non-inferior in high or intermediate risk patients.  Indeed, the development of new technologies, the more simplified procedure and the increased experience of operators and team have allowed these groups to benefit from this strategy. However, there is little evidence available on low risk<a href="https://solaci.org/en/2019/03/19/acc-2019-partner-3-low-risk-tavr-vs-surgery-fewer-events-per-year/" title="Read more" >...</a>

ACC 2019 | Prometedores resultados para el TAVI en bajo riesgo

ACC 2019 | TAVR in Low-Risk Patients Is Noninferior

Courtesy of Dr. Carlos Fava. Self-expanding supraannular aortic valves have proved to be superior to surgery in high-risk patients and noninferior in intermediate-risk patients. However, the current challenge is posed by low-risk, generally younger, patients. In that sense, our purpose is to determine device effectiveness and safety in terms of mortality and stroke rates (which are<a href="https://solaci.org/en/2019/03/19/acc-2019-tavr-in-low-risk-patients-is-noninferior/" title="Read more" >...</a>

Es posible realizar MitraClip sin anestesia general

Cost-Effectiveness of TAVR in Intermediate-Risk Patients

Prior economic analyses had shown that transcatheter aortic valve replacement (TAVR) is cost-effective (which does not mean that it saves money) in high-risk patients compared with surgical replacement. In intermediate-risk patients, this equation was mere speculation until this work recently published in Circulation came along. Physicians started wondering about costs and durability after PARTNER 2 showed<a href="https://solaci.org/en/2019/03/08/cost-effectiveness-of-tavr-in-intermediate-risk-patients/" title="Read more" >...</a>

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

NOTION and UK TAVI Report Good Long-Term Outcomes

Both studies followed beyond 5 years patients with severe aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR). Findings included low rates of significant valve degeneration and failure, in both cases. While data on the long-term degeneration of transcatheter-implanted valves are scarce, follow-up from the NOTION trial of low-risk patients and from the UK TAVI<a href="https://solaci.org/en/2019/02/12/notion-and-uk-tavi-report-good-long-term-outcomes/" title="Read more" >...</a>

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