Coronary revascularization with drug-eluting stents (DES) is very frequent, especially in acute coronary syndromes, but these metallic stents are permanent foreign bodies that activate the entire inflammatory system. Using bioresorbable stents (BRS) emerged as an alternative to this challenge. Although the initial results of the ABSORB study were not as expected (probably due to a...
The EVEREST II trial has shown the MitraClip has similar mortality rate to that of surgery and, on the other hand, we are well aware that residual mitral regurgitation (MR) is associated with a strong negative impact. However, research has shown little about transvalvular gradient after MitraClip and what it entails. 268 patients receiving MitraClip were...
Transcatheter aortic valve replacement (TAVR) is a therapeutical option for patients with symptomatic severe aortic stenosis. Current guidelines recommend TAVR in patients ≥75 years with intermediate risk. One of the most frequent complications of this procedure is moderate or greater aortic regurgitation (AR) after implantation. Consequently, new valves have been developed to try and reduce...
Severe mitral regurgitation is associated to cardiac failure and hospitalization and over time is accompanied by kidney failure, which leads to higher mortality. In the COAPT study, in patients with low ejection fraction, MitraClip showed benefits over medical treatment, but there was an important group of people with kidney function deterioration. The evolution and benefit...
Transcatheter aortic valve replacement (TAVR) through transfemoral access has already proven its great benefits, but this access cannot be used in certain patients, and alternative accesses need to be considered for such cases. One of the most commonly used accesses is the transaxillary or transubclavian access (AX), which, however, is associated with more complications (especially...
Tricuspid regurgitation (TR) is difficult to manage and is a mortality predictor. At present, surgery is recommended, even though its mortality rate is not low. Endovascular intervention of this entity is currently being developed and according to the European guidelines, it has evidence level IIb C in symptomatic inoperable patients. The TriCLASP included 74 patients...
Currently, the American and European guidelines recommend coronary angioplasty in patients with severe aortic stenosis with lesions >70% (Class IIa) who will undergo transcatheter aortic valve replacement (TAVR). However, the benefit of performing a revascularization in these patients is still uncertain. This prospective multicenter study included 2025 patients divided into two groups: complete revascularization (N = 1310)...
Though the different percutaneous valves have been designed and authorized for aortic stenosis with tricuspid valve, they have often been used to treat aortic regurgitation as an off-label indication. The Jenavalve Trilogy valve has recently received the CE Mark for aortic regurgitation and aortic stenosis. This study included 45 patients with severe AR. Primary end...
TAVR is a valid alternative to treat failed surgical bioprosthetic valves, but one of its biggest challenges is patients with a small annulus. When using self-expanding valves, supra-annular implantation is recommended. However, at present, we only have retrospective, observational studies, not large enough. The LYTEN Trial is a randomized study in patients presenting failed bioprosthetic...
Patients undergoing TAVR are mostly older and more fragile, with comorbidities both cardiovascular and non-cardiovascular. Therefore, they are associated with thromboembolic and bleeding risk. This study looked mortality predictors after successful TAVR in the Galileo trial. Mortality at 248 days was 9.2%, 5.5% being of cardiovascular cause and 3.9% non-cardiovascular. Mortality predictors were age >85,...