The randomized controlled study SCOPE 1 failed to show significant differences at one year between the self-expandable Acurate neo and the balloon expandable Sapien 3. The SCOPE 1 (Safety and Efficacy of the Symetis ACURATE neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis) compared the balloon expandable Sapien 3 (which has probably more data) against...
At two-year followup, primary end point continued to be significantly lower with Sapien 3 vs. conventional surgery, but the initial difference in death and stroke in favor of TAVR started to shrink. In addition, there was higher risk of valve thrombosis in TAVR patients. The PARTNER 3 (Safety and Effectiveness of the SAPIEN 3 Transcatheter...
We are still discussing the adequate antithrombotic scheme after transcatheter aortic valve replacement (TAVR). Additionally, we are treating a much wider array of patients ranging from low risk to inoperable. And there is yet one more important point: hypo-attenuated leaflet thickening diagnosed by CT. We are still unaware of the impact they have on device...
Disease prevalence in patients with severe aortic stenosis is highly variable: from 80% in inoperable patients to only 15% according to the most recent research including low-risk patients. Given the high mortality observed in patients with heart disease, guidelines suggest considering coronary bypass revascularization in those in need of a valve replacement. This experience with...
In many relatively young patients with severe aortic stenosis, we rule out the idea of a mechanical valve, opting for a surgical aortic valve replacement (SAVR) with a bioprosthesis; we bet once the surgical bioprosthesis deteriorates, we will be able to solve it with transcatheter aortic valve replacement (TAVR) of the failed surgical valve: TAV-in-SAV. ...
Performing balloon predilation or valvuloplasty before a transcatheter aortic valve replacement (TAVR) may increase the incidence and magnitude of myocardial injury with new-generation balloon-expandable valves. Some papers argue in favor or against direct implantation, others remain neutral, but this research is the first one to express a different point of view. Historically, the biggest fear...
The PARTNER 2 SAPIEN 3 showed baseline diastolic dysfunction is a predictor of clinical events after 2 years of TAVR. As expected, improved diastolic function after procedure immediately changes prognosis. Though these outcomes did meet our expectations, very few studies have shown hard evidence linking diastolic dysfunction and aortic stenosis. All patients included in the...
Thrombectomy with stent retriever and direct aspiration have been considered equally effective in the treatment of anterior circulation acute ischemic stroke. But are they really? This study recently published in Stroke compares the safety and efficacy of both techniques per occlusion segment. This study analyzed data from the MR CLEAN registry at every endovascular therapy...
Coronary cannulation after transcatheter aortic valve replacement (TAVR) was unsuccessful in almost 10% of patients. This problem occurred almost exclusively in those who received a self-expanding valve. This study, recently published in JACC Cardiovasc Interv., was sought to investigate the feasibility of coronary ostia access after TAVR and describe potential predictors of coronary access impairment....
01- New Valvular Heart Disease Guidelines with Key TAVI and Mitral Regurgitation Updates Valvular heart disease management guidelines were updated last week by the AHA and the ACC. Read more HERE 02- High Risk Anatomy Challenges ISCHEMIA Outcomes According to this recent analysis published in JAHA, patients with stable Ischemic heart disease and high-risk anatomy benefit from revascularization...