One of the first statements in this document points out these are not “regular guidelines” developed after thorough analysis of all the available evidence published since the last update. Instead, they are meant to provide temporary basic management pointers on how to handle different scenarios of cardiac patients in the context of the COVID-19 pandemic....
Lotus Returns with New Strength and the FDA Approval to Compete with Sapien3 and CoreValve Evolut R
After reports of some serious adverse events with first-generation Lotus, the device was pulled off the market—but it was not meant to be left in oblivion. Now, it is back, renewed and with the approval of the United States Food and Drug Administration (FDA), to compete directly with the two market leaders (Sapien and CoreValve),...
We Must Still Fear the “Big Five Complications” After TAVR
Surgical risk scores cannot be used for transcatheter aortic valve replacement (TAVR) and they usually overestimate procedural risk. There are 5 big complications after TAVR, specifically, that cannot be predicted by conventional surgical scores. These 5 peri-procedural complications are considered important because they have a somewhat significant impact on survival after TAVR. They are: 1)...
MR CLEAN Registry: “Time is Brain” is a Far More Accurate than “Time is Heart”
Time to endovascular treatment after ischemic stroke is strongly associated to functional outcomes. This association could be even stronger than previously suggested in more select populations of controlled studies. These findings emphasize that functional outcomes after endovascular treatment could be improved significantly by reducing onset to treatment times. Randomized studies in select acute...
NSAIDs and Risk of Bleeding in Patients with Atrial Fibrillation
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is very frequent and many of these medications are sold over-the-counter, but they can expose patients with atrial fibrillation using warfarin or dabigatran to potentially dangerous bleeding. Such a combination is a “perfect storm” of sorts, since atrial fibrillation is the most frequent type of arrhythmia and its...
Leaflet Laceration, an Extreme Measure to Avoid Coronary Occlusion After TAVR
Intentional leaflet laceration before mounting the prosthesis on the release system, so as to reduce the risk of acute coronary occlusion, seems a desperate maneuver to force transcatheter aortic valve replacement (TAVR). Unfortunately, we will always encounter patients without other real choice; in those cases, creativity may start as compassionate treatment and then be upgraded...
EuroPCR 2018 | SAPIEN 3 in bicuspids
First generation TAVR procedures performed on patients with bicuspid aortic valve stenosis have rendered suboptimal outcomes. In addition, studies on new generation devices, such as the SAPIEN 3, have systematically excluded these patients from their protocols. Therefore, we are missing information about TAVR on bicuspid aortic valve stenosis patients. This study compared SAPIEN 3 TAVR...