The aim of this study was to identify permanent pacemaker (PPM) predictors after transcatheter aortic valve replacement (TAVR) with last generation balloon expandable valve Edwards SAPIEN 3. The new conduction disturbances requiring PPM are one of the biggest concerns after TAVR, and their predictors have not yet been defined. 229 patients undergoing TAVR<a href="https://solaci.org/en/2017/01/03/permanent-pacemaker-predictors-with-sapien-3/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The presence of paravalvular leaks (PVL) after aortic valve replacement ranges between 5% and 20%. Percutaneous repair has emerged as a feasible alternative, effective and safe, to prevent new surgery. The study included 86 patients undergoing aortic valve replacement presenting PVL with cardiac failure CFIII or IV and/or anemia.<a href="https://solaci.org/en/2016/12/26/paravalvular-leak-in-surgical-prosthesis-how-to-treat-them/" title="Read more" >...</a>
For TAVR eligible patients (transcatheter aortic valve replacement) with femoral access counterindication, a new access site, extra thoracic yet percutaneous, may offer an alternative. This consists of reaching the abdominal aorta through the vena cava. With this technique the operator enters the abdominal aorta through the vena cava by electrifying a guidewire, advancing a<a href="https://solaci.org/en/2016/12/21/transcaval-access-another-alternative-to-femoral-access-counterindication/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Between 40% and 70% of patients undergoing transcatheter aortic valve replacement (TAVR) present coronary lesions. The fact that aortic stenosis affects how blockages act, and that, after stenosis correction, hemodynamic compromise for those same lesions may vary, has been consistently proven. Its management has not been determined yet. The study<a href="https://solaci.org/en/2016/12/13/coronary-lesions-after-tavr-severity-may-be-modified/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Transfemoral access is the first choice for transcatheter aortic valve replacement (TAVR). However, this approach is not feasible for a progressively larger number of patients, which establishes the need to search for alternative accesses. Between 2009 and 2014, this study enrolled 174 patients who underwent TAVR and were unsuitable for transfemoral<a href="https://solaci.org/en/2016/12/06/tavr-transcarotid-access-as-a-valid-alternative/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The fact that the presence of a complete right bundle branch block (RBBB) increases the risk of bradycardia, high-grade atrioventricular block, and need for a permanent pacemaker (PPM) after TAVR is well-known. The impact of pre-existing complete right bundle branch block has not been well-studied. This article analyses 749 patients enrolled in<a href="https://solaci.org/en/2016/12/05/tavr-pre-existing-complete-right-bundle-branch-block-is-associated-with-mortality/" title="Read more" >...</a>
A minimalist approach to transcatheter aortic valve replacement (TAVR) involving local anesthesia appears to have several advantages, according to this new meta-analysis. In addition to shortening times for procedures and lengths of stay in the critical care unit and hospital, lighter sedation may lower the need for transfusions or treatment with inotropes or vasopressors.<a href="https://solaci.org/en/2016/12/01/local-anesthesia-for-tavr-was-safe-and-reduced-hospital-stays/" title="Read more" >...</a>
New findings from the GARY (German Aortic Valve Registry) registry show that intermediate-risk patients with severe aortic stenosis presented significantly higher mortality at 1 year when treated with transcatheter aortic valve replacement (TAVR) rather than with conventional surgery. Results reflect everyday realities, which might include various bias tipping the scales towards one strategy or the<a href="https://solaci.org/en/2016/12/01/tavr-or-surgery-for-intermediate-risk-patients-gary-registry/" title="Read more" >...</a>
The introduction of transcatheter aortic valve replacement procedures (TAVR) seems to have increased the number of elderly patients hospitalized with severe aortic stenosis, as well as the number of interventions. However, less than one fifth of patients over 85 are intervened, according to a Canadian registry. Given the significant difference in mortality with TAVR,<a href="https://solaci.org/en/2016/11/30/less-than-20-of-patients-that-could-benefit-from-tavr-are-receiving-it/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. After a transcatheter aortic valve replacement (TAVR), the incidence of permanent pacemaker (PPM) implantation ranges from 6% to 30% in different studies, depending on the valve type used. This is due to trauma, ischemia, haemorrhage, and atrioventricular node and infranodal tissue oedema, provoking ventricular dyssynchrony similar to that caused by<a href="https://solaci.org/en/2016/11/18/tavr-the-need-for-a-pacemaker-is-associated-with-mortality/" title="Read more" >...</a>