Read articles on the main presentations of the first day of SOLACI-CACI 2017 Congress. Check the presentation of Dr. Andreas Baumbach, entitled “Role of general anesthesia compare to conscious sedation during TAVR”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Courtesy of Dr. Agustín Vecchia. As TAVR is expanded to lower risk patients, complications become more relevant. As regards stroke, the PARTNER 2 and SURTAVI one year outcomes are 8.0% and 8.2% respectively. The mechanisms behind this complication have not yet been clarified and, therefore, neither have guideline recommendations in this regard (as we can tell...
Courtesy of Dr. Carlos Fava. Aortic stenosis can present different hemodynamic patterns, such as low flow and low gradient with reduced or preserved ventricular function. However, evidence on the evolution of different hemodynamic patterns after transcatheter aortic valve replacement (TAVR) is limited. This study consisted in a retrospective analysis of 368 patients who underwent TAVR. The population was divided in...
The introduction of transcatheter aortic valve replacement (TAVR) into clinical practice in the United States has been a tightly controlled process aimed at optimizing patient outcomes and minimizing the learning curve. Many strategies have been used to reach a rational dispersion for this new technology, including choosing sites with enough volume, and adequate operator training...
Courtesy of Dr. Agustín Vecchia. Paravalvular leak was once considered the greatest disadvantage of TAVR when compared to conventional surgery. Nowadays, new devices and more-experienced operators have managed to “control” this phenomenon, keeping related statistics within acceptable ranges. Repositionable-valve Lotus may probably offer the most effective solution for this event; however, it is associated with high rates of...
Certain studies have carried out a tomographic follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and described the frequency of leaflet thrombosis; however, in most cases, it is unclear whether this finding requires some sort of intervention. The difference between this work and those previously published is that this study is not focused on imaging, it...
Neurological complications during and after transcatheter aortic valve replacement (TAVR) are probably the only event whose incidence has not been reduced by new valve designs (as opposed to paravalvular leak, vascular complications, or need for pacemaker implantation). Aside from the potential seriousness of this clinical event, the risk of embolism is particularly worrisome because,...
Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement (SAVR) continues to be elective, but the presence of post-procedural acute myocardial infarction (AMI) has been associated to bad evolution. Despite the proven benefits of TAVR for high risk patients and the progress shown by patients of intermediate risk, the incidence of post implantation MI has...
Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found...
Courtesy of SBHCI. The occurrence of a periprocedural neurological events is associated to an increased risk of death and morbidity at long term, both for transcatheter aortic valve replacement (TAVR) and for surgery. The SURTAVI study, recently presented at the ACC meeting and simultaneously published by NEJM, showed that TAVR with self-expandable CoreValve or Evolut...