Courtesy of the SBHCI. There is little data about the use of transcatheter aortic valve replacement (TAVR) to treat patients with severe aortic stenosis at low surgical risk. Many of the questions involve long term duration of valves (over 10 years) when treating younger patients with longer life expectancy. The NOTION study aims at comparing<a href="https://solaci.org/en/2017/05/30/notion-tavi-with-low-risk-at-4-year-follow-up/" title="Read more" >...</a>
This new device offers the advantage of a lower frame height, which reduces the chance of coronary occlusion. The delivery system is totally motorized and the valve can be repositioned. In addition, the sheath is “14 F” for all valve sizes (23, 26 and 29mm). 203 patients were included, all with severe aortic stenosis<a href="https://solaci.org/en/2017/05/25/centera-results-of-the-new-self-expandable-valve/" title="Read more" >...</a>
The efficacy of transcatheter aortic valve replacement (TAVR) has been well-established. However, its limitations include suboptimal deployment and paravalvular leak. The Lotus system is a fully repositionable and retrievable device with controlled mechanical expansion. It features an adaptive seal to minimize paravalvular leak, it does not require early pacing during deployment, and, given its early<a href="https://solaci.org/en/2017/05/23/reprise-iii-lotus-and-corevalve-compared-in-high-risk-or-inoperable-patients/" title="Read more" >...</a>
Early experience with the valve-in-valve technique in the treatment of failed bioprosthetic surgical valves in transcatheter aortic valve replacement (TAVR) has yielded acceptable acute procedural results. This turned the technique into another therapeutic option, one that could even cause the reassessment of the age limit for the surgical implantation of a mechanical or bioprosthesis valve.<a href="https://solaci.org/en/2017/05/17/further-evidence-on-managing-dysfunctioning-bioprostheses-with-balloon-expandable-prostheses/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has proven to be beneficial for extreme- and high-risk patients. It is also increasingly used in intermediate-risk patients, and it has been hinted at for low-risk patients. However, different sectors in the medical community still challenge the existence of real TAVR benefit. This assessment consisted<a href="https://solaci.org/en/2017/05/03/tavr-in-intermediate-risk-patients-is-it-as-effective-as-surgical-aortic-valve-replacement/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava One of the present challenges of TAVR is bicuspid aortic valve stenosis (AS), since it presents a different distribution and structure, associated to greater and more irregular calcification. There are only small series of devices and their use is still controversial. The study analyzed 561 patients with severe bicuspid<a href="https://solaci.org/en/2017/04/27/bicuspid-aortic-valve-stenosis-still-challenging-for-tavr/" title="Read more" >...</a>
Courtesy of Dr. Gustavo Leiva. Transcatheter aortic-valve replacement (TAVR) with the use of a self-expanding prosthesis is superior to medical therapy in patients with severe, symptomatic aortic stenosis in whom surgical aortic-valve replacement has been associated with prohibitive risk. Among patients considered at high risk, TAVR may be an alternative to surgery. The comparative<a href="https://solaci.org/en/2017/04/06/surgery-or-tavr-in-intermediate-risk-results-of-the-surtavi-study/" title="Read more" >...</a>
Courtesy of Dr. Agustín Vecchia. In the last few years, new percutaneous treatment options for mitral regurgitation have emerged. Transcatheter mitral annuloplasty with various devices is a relatively simple procedure that could compress the origin of circumflex artery branches due to the different orientation of mitral corners and the coronary sinus. The following work by Park<a href="https://solaci.org/en/2017/03/27/percutaneous-mitral-annuloplasty-first-results-in-humans/" title="Read more" >...</a>
This study seeks to prove the safety and efficacy of rapid left ventricular pacing through a 0.035” guidewire during aortic valvuloplasty and transcatheter aortic valve replacement (TAVR). Right ventricular temporary pacing placed through venous access during aortic valvuloplasty or during TAVR is time-consuming and, above all, associated with cardiac perforation and tamponade. Since<a href="https://solaci.org/en/2017/03/06/pacing-with-a-0-035-guidewire-an-old-technique-coming-back-to-simplify-tavr/" title="Read more" >...</a>
Two recent articles featured in JACC Cardiovascular Interventions showed that short term (at 30 days) outcomes of patients treated with the next-generation self-expanding Medtronic Evolut R valves could present several advantages compared to the original CoreValve, including recapturability. Both analyses reported similar rates of all-cause mortality and stroke. The study carried out by Dr. Jeffrey Popma as<a href="https://solaci.org/en/2017/02/23/evolut-r-clinical-results-might-be-better-than-those-for-first-generation-corevalve/" title="Read more" >...</a>