There has been a significant decline in vascular complications in the last few years due to improvements in device profiles and operator experience on transcatheter aortic valve replacement (TAVR). Unilateral vascular access for transfemoral TAVR is as safe as bilateral access and it could be more comfortable for patients according to this study recently published...
In patients undergoing transcatheter aortic valve replacement (TAVR), fractional flow reserve (FFR) guided revascularization is associated with favorable results compared against the traditional angiography guided revascularization. Given the complete lack of randomized studies, this observational study is the best we have to decide how to guide revascularization in patients with symptomatic severe aortic stenosis undergoing...
Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality. The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both...
This study recently published in JACC paves the way to identifying higher risk patients among those with no epicardial coronary artery disease (CAD) that present angina symptoms. Evidence of coronary spasm and increased microcirculation resistance in patients with angina (but with no epicardial obstructive CAD) is associated with increased risk of adverse cardiac events. AT...
This sub study of the GALILEO specifically looked at valve thickening and reduced leaflet motion after TAVR documented with 4D CT. Whether anticoagulation with rivaroxaban might reduce or prevent this phenomenon remained unanswered. Patients receiving the same anticoagulation scheme than the general study’s (rivaroxaban + aspirin vs. aspirin + clopidogrel) were assessed by 4D CT...
The balloon-expandable valve has been granted approval in Europe for treatment of the complete risk spectrum of symptomatic severe aortic stenosis. Europe has recently approved an expanded indication for the Sapien 3 system for use in low-risk patients, as reported by Edward Lifesciences. Sapien 3, which includes the next-generation Sapien 3 Ultra, is the first transcatheter heart valve...
The XXXVIII Regional SOLACI Sessions in Bolivia were an extremely successful scientific event. Renowned specialists in hemodynamics from all over Latin America presented their works and shared their knowledge in an event characterized by the utmost respect and comradeship. That is the reason why we share below those presentations, thanking these professionals for their contribution to...
The aim of revascularization, whether through angioplasty or surgery, is to restore adequate flow to the myocardium; that much is obvious. However, after millions of “successful” procedures with the best technology applied to drug-eluting stents and optimal medical treatment, we still have a high ratio of patients who experience new events. Could an optimal angiographical...
Elevated markers after PCI in stable patients treated with the latest generation stents continues to happen. However, only the association between biomarker elevation with creatine kinase-myocardial band (CK-MB) should be of concern, sin it was associated with mortality at one year. Post procedural cardiac troponin (cTn) elevation was not associated to future events, according to...
According to the post hoc analysis of the DEFINE-FLAIR, patient sex seems to affect instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) guided revascularization outcomes. Even though this is not specified in the study protocols, it might affect the gold standard for functional lesion assessment. However, clinical outcomes are similar with both strategies. Therefore,...