La cirugía parece superior a la angioplastia en pacientes jóvenes

Complete Revascularization Improves Long-Term Prognosis in Acute Coronary Syndromes

Going beyond the culprit artery during angioplasty was associated with lower mortality, although this was a cohort study that should be confirmed through randomized trials. According to this new observational study, patients experiencing non-ST-segment elevation myocardial infarction with multivessel disease seem to benefit from complete revascularization during initial angioplasty.   This study, published online before<a href="https://solaci.org/en/2018/11/01/complete-revascularization-improves-long-term-prognosis-in-acute-coronary-syndromes/" title="Read more" >...</a>

TCT 2018 | SOLVE-TAVI: autoexpandible vs balón expandible y anestesia general vs local en un mismo estudio

TCT 2018 | SOLVE-TAVI: Self-Expandable vs. Balloon-Expandable Valves and General vs. Local Anesthesia in One Study

This prospective, randomized, multicenter study included 447 patients with severe aortic stenosis and intermediate or high surgical risk randomized in a 2×2 factorial design to general vs. conscious sedation with local anesthesia and also to receiving the Sapien 3 valve (balloon-expandable) vs. CoreValve Evolut R (self-expandable). Primary end point was a composite of all-cause mortality,<a href="https://solaci.org/en/2018/10/08/tct-2018-solve-tavi-self-expandable-vs-balloon-expandable-valves-and-general-vs-local-anesthesia-in-one-study/" title="Read more" >...</a>

TCT 2018 | PORTICO-I: un año de seguimiento para la válvula auto-expandible y reposicionable

TCT 2018 | PORTICO-I: One Year Follow-Up for the Self-Expandable Reposisionable Valve

This study was simultaneously presented at TCT and published at JACCE, and it aims at showing the one-year outcomes of this new TAVR device, though follow-up is at 5 years. Primary end point was all cause mortality and secondary end points included clinical and echocardiographic events.   With a total 941 patients (82,4 ± 5,9<a href="https://solaci.org/en/2018/10/05/tct-2018-portico-i-one-year-follow-up-for-the-self-expandable-reposisionable-valve/" title="Read more" >...</a>

New Atrial Fibrillation After TAVR Indicates Prognosis

Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as an important treatment alternative for intermediate- and high-risk patients. In that sense, the presence of atrial fibrillation (AF) before TAVR is high and it has been associated with worse outcomes and higher mortality. However, there is not much evidence available regarding new-onset atrial<a href="https://solaci.org/en/2018/10/01/new-atrial-fibrillation-after-tavr-indicates-prognosis/" title="Read more" >...</a>

La reparación de la válvula mitral con Mitraclip es segura en pacientes de alto riesgo

Mitral Valve Repair in Patients with Cardiac Failure

The mitral valve is a complex apparatus dependent on left atrium and left ventricle functionality. Dilation of these cavities might affect mitral annulus morphology and lead to valve dysfunction, generating mitral regurgitation (MR). This type of MR has been called functional, since leaflets and tendinous chordae do not present lesions themselves; instead, they malfunction ‘secondary’<a href="https://solaci.org/en/2018/10/01/mitral-valve-repair-in-patients-with-cardiac-failure/" title="Read more" >...</a>

Análisis de laboratorio sencillos para estratificar mejor el bajo flujo y bajo gradiente

Simple Lab Tests to Better Stratify Low Flow and Low Gradient AS Patients

Combining B-type natriuretic peptide (BNP) and high-sensitive cardiac troponin T measures undeniably helps to better stratify severe aortic stenosis patients with low flow and low gradient. Many patients in these conditions clearly benefit from a transcatheter aortic valve replacement (TAVR) procedure, and for others it is simply useless, and given its high cost, better stratification<a href="https://solaci.org/en/2018/09/17/simple-lab-tests-to-better-stratify-low-flow-and-low-gradient-as-patients/" title="Read more" >...</a>

Far from a Being a Pun, Malnutrition Tips the Scales in TAVR

Nutritional status is associated with higher mortality in elderly patients with severe aortic stenosis who require valve replacement, whether through conventional surgical strategy or transcatheter aortic valve replacement (TAVR). Malnutrition is obviously associated with frailty. As an advantage, it can be quite evident to our clinical eye and weighing scales are enough to define it.<a href="https://solaci.org/en/2018/07/23/far-from-a-being-a-pun-malnutrition-tips-the-scales-in-tavr/" title="Read more" >...</a>

La post-dilatación en el Valve in Valve presenta mejoría hemodinámica

Post-Dilation in Valve-in-Valve Implantation Offers Hemodynamic Improvement

Courtesy of Dr. Carlos Fava. A significant number of patients present severe aortic stenosis and undergo surgery with 19-to-21-mm bioprostheses. These patients frequently evolve with high gradients and receive Valve-in-Valve (ViV) implantation. In about a third of patients with high post-procedural gradient (≥20 mmHg), this has been associated with poor outcomes. This study analyzed 30 patients who underwent<a href="https://solaci.org/en/2018/07/16/post-dilation-in-valve-in-valve-implantation-offers-hemodynamic-improvement/" title="Read more" >...</a>

Urgent/Emergent TAVR: A Valid Option

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>

EuroPCR 2018 | NOTION: Good TAVR Durability Compared with Surgically-Implanted Valve in Low-Risk Patients

Several studies are defining the role of transcatheter aortic valve replacement (TAVR) in patients with low surgical risk. One of the main concerns for this population, whose life expectancy is much longer, has to do with TAVR durability compared with a surgically-implanted biological valves. The Nordic Aortic Valve Intervention (NOTION) trial was the first study<a href="https://solaci.org/en/2018/05/29/europcr-2018-notion-good-tavr-durability-compared-with-surgically-implanted-valve-in-low-risk-patients/" title="Read more" >...</a>