Los marcapasos post TAVI aumentan los costos pero no los eventos adversos

Pacemaker Implantation After TAVI Raises Costs But Not the Incidence of Adverse Events

This new meta-analysis did not manage to prove whether permanent pacemaker implantation after transcatheter aortic valve replacement (TAVR) raises the rates of mortality, infarction, or stroke. Implantation could only be associated to a lesser recovery of ventricular function after the procedure, something that had already been observed in previous studies. Patients who required a pacemaker undoubtedly<a href="https://solaci.org/en/2017/09/07/pacemaker-implantation-after-tavi-raises-costs-but-not-the-incidence-of-adverse-events/" title="Read more" >...</a>

La angioplastia “ad hoc” durante el TAVI no impacta en su seguridad ni en resultados a largo plazo

“Ad Hoc” PCI during TAVR: No Impact on Safety or Long Term Outcomes

According to a recent study published in Circulation Cardiovascular Interventions, screening for coronary artery disease (CAD) with an invasive coronary angiography  (as part of the protocol prior TAVR)  and performing PCI and TAVR in the same session, has no impact on periprocedural safety or on long term outcomes. Study outcomes offer new hope, especially as regards using TAVR<a href="https://solaci.org/en/2017/09/06/ad-hoc-pci-during-tavr-no-impact-on-safety-or-long-term-outcomes/" title="Read more" >...</a>

La estrategia invasiva precoz beneficia a los pacientes de alto riesgo

Early Invasive Strategy Benefits High-Risk Patients

Early angiography is not associated with a reduction in mortality compared with a more delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). However, a new meta-analysis published by The Lancet supports the idea that certain high-risk patients would benefit from it. Patients with elevated cardiac biomarkers, a high GRACE score, diabetes, or advanced<a href="https://solaci.org/en/2017/09/01/early-invasive-strategy-benefits-high-risk-patients/" title="Read more" >...</a>

Sorpresivo hallazgo en diabetes y permeabilidad de los bypass

Striking Finding on Diabetes and Bypass Graft Patency

The higher rate of restenosis in the diabetic population is historic and has been reproduced in all studies and with all kinds of stents, but it was only after the FREEDOM trial when we found out about the higher infarction rate with PCI compared to surgery. This is why 50% of patients undergoing CABG are diabetic. Apart from the above<a href="https://solaci.org/en/2017/09/01/striking-finding-on-diabetes-and-bypass-graft-patency/" title="Read more" >...</a>

La revascularización incompleta se asocia a mortalidad en el TAVI

Incomplete Revascularization Is Associated with Mortality in TAVR

Courtesy of Dr. Carlos Fava. TAVR has proven to be beneficial for inoperable and high-risk patients, as well as for intermediate-risk patients. However, while many comorbidities have been analyzed, the presence, severity, and impact of coronary disease has not been well studied yet. This study analyzed 1270 patients who underwent TAVR. They presented >50% lesions in a major epicardial<a href="https://solaci.org/en/2017/08/15/incomplete-revascularization-is-associated-with-mortality-in-tavr/" title="Read more" >...</a>

NOTION: TAVI with Low Risk at 4 Year Follow Up

Post-dilation in TAVI associated to more stroke and more paravalvular regurgitation

Courtesy of Dr. Carlos Fava. Moderate/severe paravalvular regurgitation (PVR) after TAVR is present in 10%-14% of all cases, according to different series. The treatment of choice is post-dilation, generally effective in most cases. However, this strategy carries a risk of stroke. The true impact of this conduct is still unclear.   This review analyzed 6 studies that included 5007 patients; 889 of<a href="https://solaci.org/en/2017/07/10/post-dilation-in-tavi-associated-to-more-stroke-and-more-paravalvular-regurgitation/" title="Read more" >...</a>

La protección cerebral en TAVI continúa con evidencia débil pero con esperanzas

Cerebral protection during TAVI still offers weak evidence, but there is hope

Silent ischemic embolic lesions are common after transcatheter aortic valve implantation (TAVI). The use of cerebral protection devices might reduce the occurrence of these embolic lesions. Multiple studies with different devices, designs, and outcomes challenge the usefulness of cerebral protection during TAVI.   A comprehensive analysis of the literature was necessary to obtain a more<a href="https://solaci.org/en/2017/05/28/cerebral-protection-during-tavi-still-offers-weak-evidence-but-there-is-hope/" title="Read more" >...</a>

Post TAVR thrombosis, is it more common than we know?

Courtesy of Dr. Carlos Fava Few post TAVR scenarios remain to be analyzed. One of them is post TAVR valve thrombosis. This event has been reported in around 0.5% of cases, but its incidence, consequences and adequate treatment remain unclear.   The study analyzed 642 patients undergoing TAVR. Patients were followed up with Doppler Echocardiography<a href="https://solaci.org/en/2017/04/25/post-tavr-thrombosis-is-it-more-common-than-we-know/" title="Read more" >...</a>

Percutaneous Device Closure of PVL: An Alternative to Surgery

Paravalvular Leak (PVL) occurs in 5 to 17% of patients undergoing surgical valve replacement. Percutaneous device closure of PVL represents an alternative to repeat surgery.   All centers in UK and Ireland performing percutaneous PVL closure delivered their data to the UK PVL registry. Data were analyzed for factors associated with mortality and major cardiovascular<a href="https://solaci.org/en/2016/10/06/percutaneous-device-closure-of-pvl-an-alternative-to-surgery/" title="Read more" >...</a>

Mismatch protésico en válvulas supra anulares y en válvulas intra anulares

Low BMI Is a Predictor of Death for TAVI

Courtesy of Dr. Carlos Fava.     Body mass index (BMI) has always played an important role in heart surgery. However, there is little evidence on BMI effects on TAVI. This study included 491 patients, which were divided according to BMI into:   low (<20 Kg/m2 ) normal (20-24.9 Kg/m2 ) overweight (25-30 Kg/m2 ) obese<a href="https://solaci.org/en/2016/08/03/low-bmi-is-a-predictor-of-death-for-tavi/" title="Read more" >...</a>