At 5 years, there were no differences in all-cause death, stroke, acute myocardial infarction, or all of these combined between low-risk, elderly patients who underwent transcatheter aortic valve replacement (TAVR) or conventional surgery. Taking into account reports from previous years, these results are not at all surprising. NOTION enrolled an all-comers population that was 70 years old...
These were the 5 most read scientific articles of February
1) The CULPRIT-SHOCK Study Is Finally Published in NEJM and It Is Bound to Change Guidelines During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked...
Leading Manufacturer of Balloon-Expandable Valves Launches Self-Expanding Device
Edwards Lifesciences could have been satisfied after the success of the PARTNER trials and the improvements to its balloon-expandable valve (mainly as regards the delivery system profile and paravalvular leak reduction) in its last model, SAPIEN 3. However, it was not. The company decided to keep going, developing a valve that is radically different from its...
Mild Leaks: TAVR’s Silent Enemies
Courtesy of Dr. Carlos Fava. Even though the presence of paravalvular regurgitation (PVR) has been reduced, thank to greater experience and new devices, it is still frequent and has an impact in survival (especially moderate and severe PVR). Recent research has shown that mild PVR also has a negative impact. However, these data were provided...
Transcatheter Mitral Valve Replacement Devices Multiply
The Transcatheter mitral valve replacement has been established as gold standard for patients with intermediate or high risk severe aortic stenosis. The supporting evidence was initially gathered with one or two safe and effective devices that worked really well, so that later on prosthetic valves multiplied, for competing companies wanted their share of the market. However,...
Development of New Valves Lowers Need for Pacemaker
Courtesy of Dr. Carlos Fava. While the benefits of TAVR are well-known, the need for a permanent pacemaker after implantation is still an issue to solve, even though new valves have reduced it. This study enrolled 175 patients who underwent TAVR with an ACURATE neo TF valve. In this population, 58% of patients were women and the...
Aspirin During Noncardiac Surgery: Only in Patients with Prior Angioplasty
A new analysis from the POISE-2 study suggests that aspirin should not be withheld prior to noncardiac surgery in patients with a history of coronary angioplasty, even if their coronary procedure occurred several years earlier. Patients with a history of coronary angioplasty who need cardiac surgery are more likely to benefit from continued aspirin therapy,...
Endovascular Strategy Seems Superior against Surgery in Ruptured Aneurysms
Compared to surgery, endovascular repair of ruptured abdominal aorta aneurysms has better clinical results, survival and quality of life for patients (in addition to being cost-effective), according to mid-term outcomes of the IMPROVE study, recently published in the British Medical Journal. Even though the initial outcomes had not shown differences between both strategies in terms of...
Closure of Patent Foramen Ovale for the Treatment of Migraine
Migraine is one of the more frequent disabling disorders worldwide, but its physiopathology remains unclear. Since migraine is quite heterogeneous, individual therapies may not be effective for all patients. We still lack strategies to help us predict which patient subset might respond best to certain therapies. Read also: “Amplatzer and Figulla Devices Prove to Be...
Cardiac Damage: Should we start to assess it?
Courtesy of Dr. Carlos Fava. The current recommendation for aortic valve replacement is based on stenosis severity based on valvular criteria (mean transvalvular gradient, peak aortic velocity and valve index area) and the presence of symptoms, in addition to comorbidities, mainly for risk stratification. However, ventricular damage and/or its effect on cardiovascular hemodynamics are not regarded...