With the expansion of transcatheter aortic valve replacement (TAVR) use in the low-risk population, more patients will need repeat valve replacement in the future, making it paramount to understand the performance of repeat TAVR. Currently, this information is limited. The aim of this study was to analyze the real-world experience of performing a second TAVR...
Bicuspid aortic valve (BAV) stenosis is the most common congenital valve disease, affecting up to 2% of the population. Patients with BAV disease undergoing transcatheter aortic valve replacement (TAVR) account for 0.5%. In this context, TAVR data on BAV stenosis patients has been limited to observational studies on first generation valves that had resulted in...
Coronary obstruction is a complication from TAVR that can cause death (up to 50% mortality), even though its incidence is lower than 1%. One of the most frequent strategies used in the prevention of this complication is chimney stenting in patients at high anatomical risk (valve in valve, narrow sinotubular junction, short coronary ostium height)....
Patients presenting aortic stenosis with cardiogenic shock are at extreme risk, with 70% mortality until the aortic obstruction is resolved, and taking into account they make poor transplant candidates. Safety and efficacy of TAVR in patients with cardiogenic shock remains unclear. The aim of this study was to assess events in patients undergoing TAVR with...
With the treatment of aortic valve disease in younger patients, a significant number of them will need redo TAVR at some point in their life. However, to date there are few data on redo TAVR. The aims of this study was to look at real life experience on redo TAVR with balloon-expandable SAPIEN valves and...
Coronary artery disease (CAD) coexists with aortic stenosis in about half the patients who suffer the latter. These patients receiving antiplatelet therapy are at a higher risk of periprocedural bleeding—one of the most frequent complications in patients who undergo transcatheter aortic valve replacement (TAVR). One way of limiting the risk for bleeding is choosing the...
One of the challenges that transcatheter aortic valve replacement (TAVR) continues to face is percutaneous access closure with percutaneous closure systems (PCS). However, several systems have been developed, either by plug—such as the MANTA system—or by suture (SU)—such as the ProStar and ProGlide systems. Both of these have been tested in different analyses, but to...
Prosthesis-patient mismatch (PPM) was initially proposed by Rahimtoola and reintroduced by Pirabot. PPM is the indexed effective orifice area in relation to body surface area, cutoff value being 0.85 cm2/m2, and <0.70 cm2/m2for obese patients. PPM is considered moderate if indexed effective orifice area is 0.65-0.85 cm2/m2 and severe when <0.65 cm2/m2 Research studies on surgical prosthesis have...
Amyloidosis is a systemic disease that affects different organs and impairs their function. Recent studies with magnetic resonance imaging (MRI) have shown that between 13% and 16% of patients who undergo transcatheter aortic valve replacement (TAVR) have amyloidosis. A review of four studies showed that mortality at 20 months was twice as high when amyloidosis...
At present, surgical aortic valve replacement (SAVR) uses bioprostheses. However, when these fail, we are presented with a great challenge, seeing as repeat SAVR involves a higher risk. In this context, valve-in-valve (V-in-V TAVR) has surged as a very attractive alternative. Bioprosthesis fracture (BPF) is a new interesting strategy that has shown lower gradient and...