Surgery or TAVR in intermediate risk? Results of the SURTAVI Study

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<a href="https://solaci.org/en/2017/04/06/surgery-or-tavr-in-intermediate-risk-results-of-the-surtavi-study/" title="Read more" >...</a>

Percutaneous Repair of Paravalvular Leaks After TAVR: The Challenge of Identifying Eligible Subjects

Courtesy of Dr. Carlos Fava. This study enrolled 72 patients who underwent transcatheter aortic valve replacement with an Edwards Sapiens valve, and then experienced a leak of at least moderate severity.   Fifteen of them underwent a percutaneous leak repair after identification of the leak mostly through the presence of symptoms.   Both groups were similar. Patients who<a href="https://solaci.org/en/2017/04/06/percutaneous-repair-of-paravalvular-leaks-after-tavr-the-challenge-of-identifying-eligible-subjects/" title="Read more" >...</a>

dispositivo de cierre manta en acceso femoral

MANTA Closure Device for large-bore arteriotomy closure: Is It Safe?

 Courtesy of Dr. Agustín Vecchia.  The number of transcatheter aortic valve replacements (TAVR) and the placement of aortic endoprosthesis and ventricular assist devices, among others, have grown exponentially worldwide in the last few years. In a short time, many of these procedures will surely become the new standard of care. Logically, this growth comes hand in hand<a href="https://solaci.org/en/2017/03/27/manta-closure-device-for-large-bore-arteriotomy-closure-is-it-safe/" title="Read more" >...</a>

Pacing with a 0.035” Guidewire, an Old Technique Coming Back to Simplify TAVR

This study seeks to prove the safety and efficacy of rapid left ventricular pacing through a 0.035” guidewire during aortic valvuloplasty and transcatheter aortic valve replacement (TAVR).   Right ventricular temporary pacing placed through venous access during aortic valvuloplasty or during TAVR is time-consuming and, above all, associated with cardiac perforation and tamponade.   Since<a href="https://solaci.org/en/2017/03/06/pacing-with-a-0-035-guidewire-an-old-technique-coming-back-to-simplify-tavr/" title="Read more" >...</a>

Cerebral Protection in TAVR: Does It Improve Cognitive Function?

Neurological complications during transcatheter aortic valve replacement (TAVR) may be reduced with cerebral protection devices; this study was designed to explore that hypothesis.   The study enrolled 363 patients undergoing TAVR in 19 sites and divided them in three arms: a safety arm (n = 123), a device imaging arm (n = 121), and a non-device imaging arm (n = 119).   The<a href="https://solaci.org/en/2017/03/02/cerebral-protection-in-tavr-does-it-improve-cognitive-function/" title="Read more" >...</a>

Meta-analysis on Cerebral Embolic Protection in TAVR

Cerebral embolic protection is a strategy to prevent embolization of thrombotic or calcific debris during transcatheter aortic valve replacement (TAVR). A number of randomized and controlled studies have tested the safety and efficacy of various devices, though none of them have enough statistical power to show significant differences in end points.     While preliminary<a href="https://solaci.org/en/2017/03/02/meta-analysis-on-cerebral-embolic-protection-in-tavr/" title="Read more" >...</a>

TAVR: Reasons to Consider Mitral Annular Calcification

Courtesy of Dr. Carlos Fava. Aortic valve calcification and mitral annular calcification have the same etiology and are frequently present in high-risk patients undergoing transcatheter aortic valve replacement (TAVR). The implications of mitral annular calcification for patients undergoing TAVR has not been entirely clarified yet.   The study examined 782 patients with severe aortic stenosis who underwent<a href="https://solaci.org/en/2017/02/14/tavr-reasons-to-consider-mitral-annular-calcification/" title="Read more" >...</a>

4 Readmission Predictors after Successful TAVR

Readmissions are frequent after cardiovascular procedures and they significantly increase healthcare costs. Data on readmission need within the first month after successful transcatheter aortic valve replacement (TAVR) are limited.   The registry included all TAVR patients surviving index hospitalization between January and February 2013 for readmission incidence, predictors, causes and costs within 30 days.  <a href="https://solaci.org/en/2017/01/28/4-readmission-predictors-after-successful-tavr/" title="Read more" >...</a>

Post TAVR Cognitive Function at Short Term: Better or Worse?

There is little information on the short and mid-term evolution of cognitive function after transcatheter aortic valve replacement (TAVR).   The aim of this study was to describe global changes in cognitive function and changes in specific cognitive domains one year after TAVR.   Fifty one patients undergoing TAVR, median age 80, were prospectively followed<a href="https://solaci.org/en/2017/01/11/post-tavr-cognitive-function-at-short-term-better-or-worse/" title="Read more" >...</a>

Apixaban: An Alternative for Patients with Atrial Fibrillation Undergoing TAVR?

Courtesy of Dr. Carlos Fava. The prevalence of atrial fibrillation in patients undergoing transcatheter aortic valve replacement (TAVR) is high (32.9%, according to the PARTNER Trial, and 46.8%, according to the CoreValve High-Risk Study), and is associated with thromboembolic events (as in all other populations).   Apixaban has shown to benefit patients with nonvalvular atrial fibrillation,<a href="https://solaci.org/en/2017/01/11/apixaban-an-alternative-for-patients-with-atrial-fibrillation-undergoing-tavr/" title="Read more" >...</a>