Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial and is constantly being advanced onto lower risk populations, but at present, it is limited (perhaps most importantly in aortic tricuspid valves) by the need for permanent pacemaker implantation (PPMI), especially when it comes to self-expandable valves, as the latest study on low risk populations<a href="https://solaci.org/en/2019/09/30/tavr-and-pacemakers-new-strategies/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The real incidence of peripheral artery (PAD) disease in TAVR remains unclear. Different reports still estimate it is between 10 and 46%, but they have shown it has a negative impact in evolution. 51,685 TAVR patients were analyzed. 12,740 of these patients presented PAD (24.6%). PAD patients tended to be<a href="https://solaci.org/en/2019/09/11/the-real-impact-of-peripheral-artery-disease-in-tavr/" title="Read more" >...</a>
This new consensus published this week in J Am Coll Cardiol has provided us with an algorithm to manage conduction disturbances after transcatheter aortic valve replacement. This consensus is intended to reduce potential deaths caused by conduction disturbances and, at the same time, reduce unnecessary definite pacemaker implantation. This document is a big step ahead<a href="https://solaci.org/en/2019/09/04/experts-reach-consensus-on-post-tavr-pacemaker-indication/" title="Read more" >...</a>
The ProEducar Fellow Course is a special event designed for fellows or interventional trainees seeking to update their knowledge and perfect their skills on interventional cardiology. This intensive and quality event introduces four interventional modules focused on practice rather than theory, with step-by-step demonstrations, tips and secrets of the trade, and educational cases. The course<a href="https://solaci.org/en/2019/07/21/proeducar-2019-we-celebrate-10-years-of-continuous-interventional-education/" title="Read more" >...</a>
Seeing as hypertension prevalence and incidence increases with age, treating elderly patients of paramount importance. The AHA/ACC guidelines have lowered cohort hypertension thresholds to >130/80 mmHg, whereas the European guidelines have kept the classic >140/90 mmHg, though recommending lower thresholds for most patients at the same time. Lower than 130/80 mmHg is recommended with the<a href="https://solaci.org/en/2019/07/19/many-guidelines-much-confusion-blood-pressure-targets-in-the-elderly/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. TAVR has largely been shown superior or non-inferior in high or intermediate risk patients. Indeed, the development of new technologies, the more simplified procedure and the increased experience of operators and team have allowed these groups to benefit from this strategy. However, there is little evidence available on low risk<a href="https://solaci.org/en/2019/03/19/acc-2019-partner-3-low-risk-tavr-vs-surgery-fewer-events-per-year/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Mitral regurgitation is the most frequent type of valve disease, accounting for >6% of patients over 65 years old. Surgery is currently the strategy of choice, but percutaneous treatment is a valid alternative. The long-term progress of symptomatic patients at high surgical risk who do not meet the formal indications for<a href="https://solaci.org/en/2019/02/01/good-outcomes-for-mitraclip-off-label/" title="Read more" >...</a>
Men gender, kidney failure and atrial fibrillation are the factors that most affect 3-year mortality after transcatheter aortic valve replacement. On the other hand, surprisingly enough, anticoagulation (mostly indicated for atrial fibrillation) reduces mortality risk – especially the risk of valve deterioration – after TAVR. Should anticoagulation be included in post TAVR protocols? This question<a href="https://solaci.org/en/2019/01/21/anticoagulation-plays-a-controversial-role-in-tavr/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. The development of new valves for TAVR and the increased experienced of operators have significantly decreased paravalvular leak. However, new bundle Branch block (BBB) and the need for permanent pacemaker (PPM) are still relatively high, and their impact and evolution remain controversial. The study looked at 816 patients, 437<a href="https://solaci.org/en/2019/01/17/bundle-branch-block-and-need-for-permanent-pacemaker-a-major-challenge-after-tavr/" title="Read more" >...</a>
Taking into account a simple 12-lead electrocardiography performed immediately after transcatheter aortic valve implantation (TAVI), removing the temporary pacemaker immediately is safe in patients without right bundle branch block who are in sinus rhythm with PR interval <240 ms and QRS interval <150 ms. In cases of atrial fibrillation, a QRS interval <140 ms also reassures the decision<a href="https://solaci.org/en/2018/10/23/immediate-electrocardiography-after-tavi-the-simplest-way-to-predict-conduction-disorders/" title="Read more" >...</a>