This meta-analysis which included the 4 large randomized studies on transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) in low-risk patients recently published in JACC, showed TAVR is associated with significant lower mortality compared against SAVR at one year follow up. These results add to the mounting evidence showing that when it...
Acute kidney injury is a common complication after transcatheter aortic valve replacement (TAVR) and is associated to increased mortality both short and long-term. In patients undergoing percutaneous coronary intervention (PCI) forcing diuresis with controlled hydration has shown to reduce the incidence of acute kidney injury in nearly 50%. However, this has not been tested in...
Permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) continues to be one of the most frequent complications. Even though its real impact on prognosis continues to be controversial, its impact on healthcare cost is out of the question, in addition to being uncomfortable for patients. This study, soon to be published in J Am...
Courtesy of Dr. Carlos Fava. As we all know, TAVR is gaining ground fast in the lower risk patient population, but in addition to analyzing the most important events, researchers are increasingly looking at health status, not only at hospital level, but also after one year. This study looked into PARTNER 3 patient health status...
Courtesy of Dr. Carlos Fava. About 12% of patients >75 years old have aortic stenosis. In 3%-4% of them, such disease is severe. Transcatheter aortic valve replacement (TAVR) has already proven to be beneficial for extreme-, high-, and intermediate-risk patients. Regarding low-risk patients, we currently have different analyses; two of them are randomized and their results are...
Myocardial revascularization surgery is still one of the most effective treatment strategies against coronary disease. One of the most important advantages of surgery over angioplasty is the chance to reach complete revascularization. This has proven to improve the survival of patients and to reduce the number of cardiovascular events. The choice of conduit for the...
Courtesy of Dr. Carlos Fava. Bicuspid aortic stenosis patients (bicuspid AS) represent a small group and have not been included in the larger transcatheter aortic valve replacement (TAVR) studies, since they present different morphology and asymmetric calcification, which might come along with more paravalvular leak and less accurate positioning. Between 2012 and 2016, 475,315 patients...
Spontaneous coronary artery dissection is an increasing cause of acute myocardial infarction, particularly in younger women. These infarctions are frequently treated conservatively given the risks entailed by revascularization, due to the possibility of causing an antegrade or retrograde expansion of the dissection. The uncertainty around treatment for these patients gave way to this study (recently...
This population study has found all-cause mortality is lower the lower body mass index (BMI) is, but lower BMI is not necessarily better. In fact, the lowest mortality in this global analysis was found in patients with medium BMI. Other anthropometric measurements such as hip/waist ratio and strength/weight ratio are better predictors of events and...
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...