Nutritional status is associated with higher mortality in elderly patients with severe aortic stenosis who require valve replacement, whether through conventional surgical strategy or transcatheter aortic valve replacement (TAVR). Malnutrition is obviously associated with frailty. As an advantage, it can be quite evident to our clinical eye and weighing scales are enough to define it.<a href="https://solaci.org/en/2018/07/23/far-from-a-being-a-pun-malnutrition-tips-the-scales-in-tavr/" title="Read more" >...</a>
Are the Rates of Stroke Similar in TAVR and Surgery?
Courtesy of Dr. Carlos Fava. Stroke is one of the most undesirable complications we can face and, regarding transcatheter aortic valve replacement (TAVR), major studies presented have rates of stroke of about 4%. In others, rates have been slightly higher. This meta-analysis included 5 randomized studies between 2011 and 2017: PARTNER, CoreVALVE, NOTION, PARTNER 2, and SURTAVI.<a href="https://solaci.org/en/2018/06/12/are-the-rates-of-stroke-similar-in-tavr-and-surgery/" title="Read more" >...</a>
EuroPCR 2018 Highlights | The Best of a Congress that Left Plenty of News
A new edition of EuroPCR has come and gone. Now is the time to make a balance and review the main presentations at one of the most important European congresses on cardiovascular interventions. Thus, we have selected the six most relevant studies presented at the event. In our opinion, you cannot afford to miss them!<a href="https://solaci.org/en/2018/06/07/europcr-2018-highlights-the-best-of-a-congress-that-left-plenty-of-news/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2018/06/04/leaflet-laceration-an-extreme-measure-to-avoid-coronary-occlusion-after-tavr/" title="Read more" >...</a>
Is TAVR Durable Beyond 5 Years?
Courtesy of Dr. Carlos Fava. The benefits derived from transcatheter aortic valve replacement (TAVR) are clear and self-evident, and its progressively better outcomes are due to better patient selection, greater operator experience, and the development of new valves that enhance procedural safety and complexity. However, the question of durability remains a major unresolved issue, particularly now<a href="https://solaci.org/en/2018/05/22/is-tavr-durable-beyond-5-years/" title="Read more" >...</a>
Baseline Pulmonary Hypertension Should Not Preclude TAVR
Pulmonary hypertension (PH) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) should not preclude this procedure. In fact, TAVR will resolve this condition in most cases. More than three quarters of patients undergoing TAVR have some level of PH, though this has not been associated to increased mortality, according to this<a href="https://solaci.org/en/2018/05/04/baseline-pulmonary-hypertension-should-not-preclude-tavr/" title="Read more" >...</a>
Liver Failure as a Challenge for TAVR
Although surgical risk scores do not include liver failure (LF), patients who suffer from it and undergo cardiovascular surgery present high rates of morbidity and mortality. This is due to alteration of cardiac function, increased infection susceptibility, gastrointestinal complications, and increased bleeding. As regards transcatheter aortic valve replacement (TAVR), these patients have not been included<a href="https://solaci.org/en/2018/05/03/liver-failure-as-a-challenge-for-tavr/" title="Read more" >...</a>
TAVR with Prior MRS: A New Challenge
The benefits of transcatheter aortic valve replacement (TAVR) for high-risk, prohibitive-risk (class I) or intermediate-risk (class IIa) patients have already been proven, but there is a growing population of patients with a history of myocardial revascularization surgery (MRS) who experience severe aortic stenosis. Decision-making in these cases is anything but simple, mainly due to the presence of<a href="https://solaci.org/en/2018/05/02/tavr-with-prior-mrs-a-new-challenge/" title="Read more" >...</a>
Constrictive Pericarditis After Pericardiocentesis
All interventional cardiologists must be able to perform a pericardiocentesis. Whether we deal with a chronic total occlusion, a supposedly simple coronary angioplasty (we all have witnessed the perforation of a supposedly risk-free coronary artery), or a transcatheter aortic valve replacement (whose rise gave us another significant source of tamponades), we must all be ready<a href="https://solaci.org/en/2018/04/25/constrictive-pericarditis-after-pericardiocentesis/" title="Read more" >...</a>
Morbidity and Mortality During Authorization Wait-Times for TAVR
For this Canada-based study, the increased number of patients who required a transcatheter aortic valve replacement (TAVR) may have come hand in hand with an equal increase in healthcare financing, so as to cover procedural costs. In spite of that, the wait-time between the formal request for authorization and the actual procedure was 3 months, and<a href="https://solaci.org/en/2018/04/21/morbidity-and-mortality-during-authorization-wait-times-for-tavr/" title="Read more" >...</a>