transcatheter aortic valve replacement

¿Fin de la discusión sobre el impacto del marcapaso post TAVI?

End of Discussion on the Impact of Pacemaker After TAVR?

Transcatheter aortic valve replacement (TAVR) is often associated with conduction abnormalities, which usually end with permanent pacemaker (PPM) implantation in 10-40% of patients. Factors predisposing to PPM after TAVR have been studied in great detail, but their short- and long-term clinical impact is still controversial. &nbsp; Recently, outcomes from a large cohort of patients were<a href="https://solaci.org/en/2017/10/10/end-of-discussion-on-the-impact-of-pacemaker-after-tavr/" title="Read more" >...</a>

Sedación consciente en TAVI: ¿Es recomendable?

Conscious Sedation in TAVR: Is It Advisable?

The fundamental advantage offered by transcatheter aortic valve replacement (TAVR) has always been the fact that it is less invasive than surgical valve replacement. So far, most improvements for these devices have derived in less invasiveness (e.g., by improving the profile of the eluting system). However, there are also cases of “deployment” reduction during the<a href="https://solaci.org/en/2017/09/25/conscious-sedation-in-tavr-is-it-advisable/" title="Read more" >...</a>

Los marcapasos post TAVI aumentan los costos pero no los eventos adversos

Pacemaker Implantation After TAVI Raises Costs But Not the Incidence of Adverse Events

This new meta-analysis did not manage to prove whether permanent pacemaker implantation after transcatheter aortic valve replacement&nbsp;(TAVR) raises the rates of mortality, infarction, or stroke. Implantation could only be associated to a lesser recovery of ventricular function after the procedure, something that had already been observed in previous studies. Patients who required a pacemaker undoubtedly<a href="https://solaci.org/en/2017/09/07/pacemaker-implantation-after-tavi-raises-costs-but-not-the-incidence-of-adverse-events/" title="Read more" >...</a>

La angioplastia “ad hoc” durante el TAVI no impacta en su seguridad ni en resultados a largo plazo

“Ad Hoc” PCI during TAVR: No Impact on Safety or Long Term Outcomes

According to a recent study published in&nbsp;Circulation Cardiovascular Interventions, screening for coronary artery disease&nbsp;(CAD) with an invasive coronary angiography&nbsp; (as part of the protocol prior TAVR) &nbsp;and performing PCI and TAVR&nbsp;in the same session, has no impact on periprocedural safety or on long term outcomes. Study outcomes offer new hope, especially as regards using TAVR<a href="https://solaci.org/en/2017/09/06/ad-hoc-pci-during-tavr-no-impact-on-safety-or-long-term-outcomes/" title="Read more" >...</a>

Predicción de mortalidad en TAVI - Marcapaso

A Simple Electrocardiography to Predict Mortality in TAVR

Conduction abnormalities, such as new left bundle branch block, atrioventricular block, and need for a pacemaker, are still among the most frequent complications in transcatheter aortic valve replacement (TAVR). New valve generations have (mostly) not managed to reduce significantly electrical abnormalities; furthermore, some modifications such as external skirts, which are extremely effective for the reduction<a href="https://solaci.org/en/2017/08/29/a-simple-electrocardiography-to-predict-mortality-in-tavr/" title="Read more" >...</a>

La revascularización incompleta se asocia a mortalidad en el TAVI

Incomplete Revascularization Is Associated with Mortality in TAVR

Courtesy of Dr. Carlos Fava. TAVR&nbsp;has proven to be beneficial for inoperable and high-risk patients, as well as for intermediate-risk patients. However, while many comorbidities have been analyzed, the presence, severity, and impact of&nbsp;coronary disease&nbsp;has not been well studied yet. This study analyzed 1270&nbsp;patients who underwent TAVR. They presented &gt;50% lesions in a major epicardial<a href="https://solaci.org/en/2017/08/15/incomplete-revascularization-is-associated-with-mortality-in-tavr/" title="Read more" >...</a>

Doble antiagregación en TAVI, simple es mejor?

Dual Antiplatelet in TAVR: Is Single Better?

Courtesy of Dr. Agustín Vecchia. As TAVR&nbsp;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<a href="https://solaci.org/en/2017/08/02/dual-antiplatelet-in-tavr-is-single-better/" title="Read more" >...</a>

El aumento de la experiencia de los operadores mejora los resultados en el TAVI

Increasing operator experience improves TAVR outcomes

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<a href="https://solaci.org/en/2017/07/26/increasing-operator-experience-improves-tavr-outcomes/" title="Read more" >...</a>

NOTION: TAVI with Low Risk at 4 Year Follow Up

Post-dilation in TAVI associated to more stroke and more paravalvular regurgitation

Courtesy of Dr. Carlos&nbsp;Fava. Moderate/severe paravalvular regurgitation (PVR) after&nbsp;TAVR&nbsp;is present in 10%-14% of all cases, according to different series. The treatment of choice is post-dilation, generally effective in most cases. However, this strategy carries a risk of&nbsp;stroke.&nbsp;The true impact of this conduct is still unclear. &nbsp; This review analyzed 6&nbsp;studies that included 5007&nbsp;patients; 889 of<a href="https://solaci.org/en/2017/07/10/post-dilation-in-tavi-associated-to-more-stroke-and-more-paravalvular-regurgitation/" title="Read more" >...</a>

SENTINEL: Protección cerebral en TAVI

SENTINEL study: cerebral protection during TAVR

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). &nbsp; Aside from the potential seriousness of this clinical event, the risk of embolism is particularly worrisome because,<a href="https://solaci.org/en/2017/06/15/sentinel-study-cerebral-protection-during-tavr/" title="Read more" >...</a>

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