ESC 2020 | Against the Grain, ASA Monotherapy Appears Superior after TAVR

After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT).  This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the<a href="https://solaci.org/en/2020/09/03/esc-2020-against-the-grain-asa-monotherapy-appears-superior-after-tavr/" title="Read more" >...</a>

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

3rd Generation Valves in Large and X-Large Annuli

In patients with large and extra-large annuli, transcatheter aortic valve replacement (TAVR) is safe and feasible with 3rd generation valves: the 29mm balloon expandable valve Sapien-3, and their competitor, the self-expandable 34mm Evolut R.  The largest size of both devices was designed specifically for patients with large or extra-large annuli. However, one of them seems<a href="https://solaci.org/en/2020/09/01/3rd-generation-valves-in-large-and-x-large-annuli/" title="Read more" >...</a>

Incidencia, características y tratamiento de la trombosis valvular post TAVI

Arrhythmias Wrongfully Linked to TAVR?

Continuous electrocardiographic monitoring pre-transcatheter aortic valve replacement (TAVR) detected arrhythmic events in almost half the patients analyzed in this study (which will be published soon in JACC Interventions). A fourth of these patients needed urgent therapeutic actions before the procedure. Previous conduction disorders—particularly, right bundle branch block and chronic renal insufficiency—were linked to a higher<a href="https://solaci.org/en/2020/08/18/arrhythmias-wrongfully-linked-to-tavr/" title="Read more" >...</a>

Valve in Valve Presents Better Evolution than re-SARV

Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement with bioprosthesis has proved its benefits, but it fails after 10 to 15 years.  Transcatheter aortic valve replacement has been shown valid, especially in high risk patients, but we still have little information and no “head to head” studies to know what is best in this<a href="https://solaci.org/en/2020/08/04/valve-in-valve-presents-better-evolution-than-re-sarv/" title="Read more" >...</a>

High Mortality Rates for Redo Surgery After TAVR

Courtesy of Dr. Carlos Fava. Since the beginnings of transcatheter aortic valve replacement (TAVR) back in 2002, this strategy has gained considerable ground, encompassing not only inoperable or high-risk patients but also those at medium and low risk. Additionally, it came to include patients with failed bioprostheses. The most common reason for surgery was paravalvular leak,<a href="https://solaci.org/en/2020/08/03/high-mortality-rates-for-redo-surgery-after-tavr/" title="Read more" >...</a>

La revascularización incompleta se asocia a mortalidad en el TAVI

Post TAVR Regression of Ventricular Mass

This study looked at patients with moderate to severe left ventricular hypertrophy and aortic stenosis treated with transcatheter aortic valve replacement (TAVR). Patients with reduced hypertrophy had lower mortality and fewer hospitalizations at 5 years.  It included all moderate to severe risk patients with ventricular hypertrophy undergoing TAVR in the studies and registries PARTNER (I,<a href="https://solaci.org/en/2020/07/16/post-tavr-regression-of-ventricular-mass/" title="Read more" >...</a>

Contained Annulus Rupture after TAVR: What Should We Do?

Courtesy of Dr. Carlos Fava. Aortic annulus rupture is a catastrophic event that presents in nearly 0.9% of cases, but there is another entity called contained annulus rupture, associated to oversized devices and annulus calcification and diagnosed with CT angiography, with up to 5% frequency. 1602 patients from the ENCORE registry were analyzed. 21 of<a href="https://solaci.org/en/2020/06/30/contained-annulus-rupture-after-tavr-what-should-we-do/" title="Read more" >...</a>

TAVI: Balón expandible o autoexpandible ¿Cuál es la respuesta?

Self-Expanding Valve vs. Balloon-Expandable Valve, Randomized, Head to Head

The “arms race”among transcatheter valves has been vertiginous. By the time we received the mid- or long-term outcomes of studies focused on a given valve, we were already using its next generation in clinical practice. As a result, there is little information addressing which valve is the best. Nowadays, this “arms race” has reached a<a href="https://solaci.org/en/2020/06/24/self-expanding-valve-vs-balloon-expandable-valve-randomized-head-to-head/" title="Read more" >...</a>

SOLACI-CACI 2021 Preliminary Agenda

Check out the main topics of the upcoming SOLACI-CACI 2021 Congress. Save the Date!   Special Session About the COVID-19 Pandemic   Managing Cardiovascular disease and Cath Lab during the COVID-19 Pandemic Live Case Transmissions Coronary and Structural cases performed by distinguished international and national operators. Coronary Track   Myocardial Infarction, Left Main session, Complex<a href="https://solaci.org/en/2020/06/09/solaci-caci-2021-preliminary-agenda/" title="Read more" >...</a>

¿Fin de la discusión sobre el impacto del marcapaso post TAVI?

Should We Finalize TAVR with Atrial Pacing in Some Patients?

Courtesy of Dr. Carlos Fava. The benefits of transcatheter aortic valve replacement (TAVR) are undoubtedly clear, but implantation is performed near the atrioventricular (AV) node, the bundle of His, and the left bundle branch. Consequently, permanent pacemaker implantation (PPI) after TAVR or surgical aortic valve replacement becomes necessary. While researchers have recently developed strategies to reduce<a href="https://solaci.org/en/2020/06/01/should-we-finalize-tavr-with-atrial-pacing-in-some-patients/" title="Read more" >...</a>

TAVI