aortic valve replacement

ESC 2018 | FRANCE-TAVI: Atrial Fibrillation and Anticoagulation Associated to Mortality in TAVR

Some of the many ongoing randomized studies including patients with atrial fibrillation (AF) might finally answer the question on the best antithrombotic scheme post TAVR. According to this registry, in patients undergoing transcatheter aortic valve replacement, independent predictors of death at 3 years are being a man, having moderate to severe kidney failure, and having<a href="https://solaci.org/en/2018/08/28/esc-2018-france-tavi-atrial-fibrillation-and-anticoagulation-associated-to-mortality-in-tavr/" title="Read more" >...</a>

Urgent/Emergent TAVR: A Valid Option

Courtesy of Dr. Carlos Fava. Aortic stenosis with cardiac failure or cardiogenic shock involves high mortality risk at short term. Surgery in these conditions is often unsafe, which leaves us with valvuloplasty, but only as a bridge to some other procedure, seeing as it is effective only for a short time. Few studies have looked into patients undergoing<a href="https://solaci.org/en/2018/06/20/urgent-emergent-tavr-a-valid-option/" title="Read more" >...</a>

Estenosis-aórtica-severa2-compressor

We Should Consider Mitral Stenosis Before TAVR

The association between aortic stenosis and some degree of mitral stenosis (MS) is around 10% (depending on the series), and it is related with negative outcomes. In high-risk and inoperable patients who underwent TAVR, that association and its significance have not been studied yet. &nbsp; The study analyzed data from the Society of Thoracic Surgeons/American<a href="https://solaci.org/en/2018/04/21/we-should-consider-mitral-stenosis-before-tavr/" title="Read more" >...</a>

Debemos hacer la mejor revasculirazión coronaria previo al TAVI

Do the Best Coronary Revascularization Prior TAVR

The presence of coronary artery disease (CAD) in patients with aortic stenosis is high, reaching 50% to70% of cases. This poses a great challenge as to what strategy to use and the things we can do. Even though it has been shown complete revascularization is beneficial, it is often difficult to achieve. Instead, reasonable incomplete<a href="https://solaci.org/en/2018/04/18/do-the-best-coronary-revascularization-prior-tavr/" title="Read more" >...</a>

TAVI en bajo riesgo con “cero” mortalidad y “cero” stroke

Diastolic Dysfunction Should Be Considered in TAVR

Aortic stenosis increases afterload creating hypertrophy as a compensation mechanism to maintain minute volume. This leads to left ventricular diastolic dysfunction (LVDD). More than half of patients presenting aortic stenosis have LVDD and myocardial fibrosis, which is a mortality predictor in surgery. &nbsp; At present, there is contradicting evidence in TAVR. &nbsp; The study looked<a href="https://solaci.org/en/2018/04/12/diastolic-dysfunction-should-be-considered-in-tavr/" title="Read more" >...</a>

Transcatheter Valve Replacement in the Bicuspid Valve Is Increasingly Performed, but Challenges Remain

Delayed Coronary Obstruction After TAVR: A Complication We Had Not Considered

Delayed coronary obstruction (after TAVR, outside the cath lab) is a rare complication with high mortality rates, not unlike acute obstruction. Cardiologists should be expectant and, upon the slightest suspicion of this complication, patients should be brought back to the cath lab for a coronary angiography. Occlusion immediately after implant release has been well-studied and<a href="https://solaci.org/en/2018/04/11/delayed-coronary-obstruction-after-tavr-a-complication-we-had-not-considered/" title="Read more" >...</a>

Permanent Pacemaker: still TAVR’s Aquila’s Heel

TAVR has shown benefits in high risk patients (prohibitive) and in intermediate risk patients, but the need for permanent pacemaker implantation (PPI) continues to be a soft spot (especially in younger patients) given time of use, eventual replacement and associated complications. Even though there is little information on PPI, pacemakers are not associated with higher mortality, but they<a href="https://solaci.org/en/2018/04/04/permanent-pacemaker-still-tavrs-aquilas-heel/" title="Read more" >...</a>

Leaks leves: los enemigos silenciosos en el TAVI

Mild Leaks: TAVR’s Silent Enemies

Courtesy of Dr. Carlos Fava. Even though the presence of paravalvular regurgitation (PVR) has been reduced, thank to greater experience and new devices, it is still frequent and has an impact in survival (especially moderate and severe PVR). Recent research has shown that mild PVR also has a negative impact. However, these data were provided<a href="https://solaci.org/en/2018/02/15/mild-leaks-tavrs-silent-enemies/" title="Read more" >...</a>

Cardiac Damage: Should we start to assess it?

Courtesy of Dr. Carlos Fava. The current recommendation for  aortic valve replacement is based on stenosis severity based on valvular criteria (mean transvalvular gradient, peak aortic velocity and valve index area) and the presence of symptoms, in addition to comorbidities, mainly for risk stratification. However, ventricular damage and/or its effect on cardiovascular hemodynamics are not regarded<a href="https://solaci.org/en/2017/12/20/cardiac-damage-should-we-start-to-assess-it/" title="Read more" >...</a>

¿Cateterismo o cirugía para el cierre del leak paravalvular?

Transcatheter Reduction or Surgery for Paravalvular Leak Repair?

Paravalvular leak is complication derived from incomplete sealing between the implanted prosthesis and the native annulus, which occurs in 5% of all patients who undergo mitral valve replacement and 10% of those who undergo transcatheter aortic valve replacement. This is the most frequent non-structural valve dysfunction. While mild leaks can be asymptomatic, moderate to severe<a href="https://solaci.org/en/2017/10/12/transcatheter-reduction-or-surgery-for-paravalvular-leak-repair/" title="Read more" >...</a>

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