Tricuspid regurgitation is frequent and mostly secondary to right ventricle and tricuspid annulus dilation. Tricuspid regurgitation has been associated to mortality increase, even though historically the importance of this valve has been disregarded compared to the other three. Tricuspid surgical repair has seen good results, but it is mostly done in the context of another valve repair. Isolated...
The prevalence of pre-procedural kidney failure in patients undergoing transcatheter aortic valve replacement (TAVR) can be as high as 50 – 60% (stage 3 kidney failure or worse); it has been strongly associated with acute kidney deterioration and, ultimately, an increase of post TAVR mortality. A recent meta-analyzis of several small studies carried out in a single...
The new generation devices for transfemoral transcatheter aortic valve replacement have been optimized to improve valve position and reduce residual aortic regurgitation. This study compared 30 day, 12 month and 24 month outcomes of the repositionable, Lotus valve, with controlled mechanical expansion, and the balloon-expandable valve Edwards Sapien 3. Primary end point was all cause mortality...
Courtesy of Dr. Carlos Fava. Repairing the mitral valve with Mitraclip has become an alternative for high risk or inoperable symptomatic patients, but its long term evolution has only been tested by the EVEREST II, which had not taken into account 5 year mortality outcomes. Therefore, to better study its evolution, we need to carry out different randomized studies...
Courtesy of Dr. Carlos Fava The EVEREST II trial showed the MitraClip had similar mortality rate to that of surgery but, even though residual mitral valve regurgitation (MR) is associated to a strong negative impact, little is known about post MitraClip increased transvalvular gradient and its implication. 268 patients undergoing MC implantation were analyzed....
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....
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...
Current surgical and medical treatment options for severe tricuspid regurgitation are extremely limited. However, this historically forgotten valve seems to have the option of transcatheter repair, nowadays. This observational study assessed the safety and feasibility of the MitraClip system for patients with severe chronic tricuspid regurgitation. All patients presented severe tricuspid regurgitation and...
Courtesy of Dr. Carlos Fava. The association between diastolic dysfunction (DD) and aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) has not been studied yet, but the presence of aortic regurgitation has proved to be associated with worse outcomes. A total of 144 out of 195 patients who underwent TAVR with balloon-expandable SAPIENS or SAPIENS XT...
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...