TAVR: Reasons to Consider Mitral Annular Calcification

Courtesy of Dr. Carlos Fava. Aortic valve calcification and mitral annular calcification have the same etiology and are frequently present in high-risk patients undergoing transcatheter aortic valve replacement (TAVR). The implications of mitral annular calcification for patients undergoing TAVR has not been entirely clarified yet.   The study examined 782 patients with severe aortic stenosis who underwent<a href="https://solaci.org/en/2017/02/14/tavr-reasons-to-consider-mitral-annular-calcification/" title="Read more" >...</a>

TAVR in Low-Flow Low-Gradient Aortic Stenosis and Severe Impairment of Systolic Function

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<a href="https://solaci.org/en/2017/01/06/tavr-in-low-flow-low-gradient-aortic-stenosis-and-severe-impairment-of-systolic-function/" title="Read more" >...</a>

Transcaval Access: Another Alternative to Femoral Access Counterindication

For TAVR eligible patients (transcatheter aortic valve replacement) with femoral access counterindication, a new access site, extra thoracic yet percutaneous, may offer an alternative. This consists of reaching the abdominal aorta through the vena cava.   With this technique the operator enters the abdominal aorta through the vena cava by electrifying a guidewire, advancing a<a href="https://solaci.org/en/2016/12/21/transcaval-access-another-alternative-to-femoral-access-counterindication/" title="Read more" >...</a>

TAVR in Pure Aortic Insufficiency: Yes or No?

Courtesy of Dr. Agustín Vecchia. Surgery is the treatment of choice for patients with symptomatic aortic insufficiency and/or ventricular dilatation or decreased ventricular function. The broad implementation of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis, the emergence of new devices, and the experience acquired by operators have brought this treatment to off-label indications such<a href="https://solaci.org/en/2016/12/13/tavr-in-pure-aortic-insufficiency-yes-or-no/" title="Read more" >...</a>

TAVR: Transcarotid Access as a Valid Alternative

Courtesy of Dr. Carlos Fava. Transfemoral access is the first choice for transcatheter aortic valve replacement (TAVR). However, this approach is not feasible for a progressively larger number of patients, which establishes the need to search for alternative accesses.   Between 2009 and 2014, this study enrolled 174 patients who underwent TAVR and were unsuitable for transfemoral<a href="https://solaci.org/en/2016/12/06/tavr-transcarotid-access-as-a-valid-alternative/" title="Read more" >...</a>

TAVR: Pre-Existing Complete Right Bundle Branch Block Is Associated with Mortality

Courtesy of Dr. Carlos Fava. The fact that the presence of a complete right bundle branch block (RBBB) increases the risk of bradycardia, high-grade atrioventricular block, and need for a permanent pacemaker (PPM) after TAVR is well-known.   The impact of pre-existing complete right bundle branch block has not been well-studied.    This article analyses 749 patients enrolled in<a href="https://solaci.org/en/2016/12/05/tavr-pre-existing-complete-right-bundle-branch-block-is-associated-with-mortality/" title="Read more" >...</a>

Local Anesthesia for TAVR Was Safe and Reduced Hospital Stays

A minimalist approach to transcatheter aortic valve replacement (TAVR) involving local anesthesia appears to have several advantages, according to this new meta-analysis.   In addition to shortening times for procedures and lengths of stay in the critical care unit and hospital, lighter sedation may lower the need for transfusions or treatment with inotropes or vasopressors.<a href="https://solaci.org/en/2016/12/01/local-anesthesia-for-tavr-was-safe-and-reduced-hospital-stays/" title="Read more" >...</a>

TAVR in Pure Aortic Regurgitation Is Associated with Lower Mortality Rates

This study summarizes all available evidence on transcatheter aortic valve replacement (TAVR) for the treatment of native pure aortic regurgitation.   Surgical replacement is the standard of care for pure aortic regurgitation. However, there are many reports of cases and small studies in which high-risk patients with pure aortic regurgitation were treated with TAVR.  <a href="https://solaci.org/en/2016/11/01/tavr-in-pure-aortic-regurgitation-is-associated-with-lower-mortality-rates/" title="Read more" >...</a>

Late Mortality in TAVR Is Mainly Due to Non-Cardiac Causes

Transcatheter aortic valve replacement (TAVR) has revolutionized the management of high-risk patients with severe aortic stenosis. However, survival after the procedure and severe complications have been assessed in relatively small populations with limited follow-up.   This article reports long-term clinical results in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry.   The FRANCE-2 registry<a href="https://solaci.org/en/2016/10/05/late-mortality-in-tavr-is-mainly-due-to-non-cardiac-causes/" title="Read more" >...</a>

Sex Specific Outcomes: Women after TAVI

Courtesy of Dr. Carlos Fava. The benefits of transcatheter aortic valve implantation (TAVI) have been widely shown, but there is no evidence on sex-specific outcomes. Some studies have shown lower mortality and better evolution of the ventricular function in women, yet with more bleeding and stroke; however, it remains unclear.   This study included 1,019 patients<a href="https://solaci.org/en/2016/08/10/sex-specific-outcomes-women-after-tavi/" title="Read more" >...</a>