After the recent announcement by the US Food and Drug Administration (FDA) green-lighting transcatheter aortic valve replacement (TAVR) in patients across the whole spectrum, and given the advancements regarding devices already in the market (such as MitraClip) and a variety of pulmonary valves, there is only one territory left to conquer: the long forgotten tricuspid...
Both the self-expandable valve Evolut R and its direct competitor, balloon-expandable valve Sapien 3, received the authorization to be indicated for low-risk patients in a long-awaited announcement made on August 16th, 2019. The US Food and Drug Administration (FDA) has approved and expanded the indication for the Evolut series (Medtronic) and the Sapien 3 and...
Most patients with atrial fibrillation require anticoagulation to reduce the risk of stroke or systemic embolization. Today, this is achieved with the new direct oral anticoagulants, which present lower intracranial bleeding risk compared against the old vitamin K antagonists. On the other hand, approximately between 5% to 10% of patients receiving PCI also present atrial...
The new ProEducar Educational Newsletter is out for all fellows, interventional trainees, and specialists in hemodynamics seeking to be up to date in their professional practice. This is a special issue on chronic total occlusion (CTO), one of the main current challenges for interventional cardiologists. This comprehensive, extensive work directed by Dr. Gustavo Pedernera includes...
On the bright side, the incidence of prosthetic valve endocarditis (PVE) post TAVR is not higher than post SAVR, according to this study recently presented at EuroPCR 2019, held in Paris. There is plenty of evidence describing PVE incidence, prognosis, risk factors, etc. after surgical valve replacement surgery (SAVR). However, we know little about the...
Evidently, we are still uncertain. The information goes both ways, even on our own web page, we have been coming and going just like any other publication around the world. After a 2-day debate, the Circulatory System Devices FDA panel has confirmed the tendency to higher mortality with paclitaxel-based devices and is expected to debate...
Transcatheter aortic valve replacement (TAVR) in low-risk patients with symptomatic severe aortic stenosis appears to be safe at one year. In a follow-up using computerized tomography (TC), hypoattenuated leaflet thickening was observed in a minority of patients, but it did not have a long-term hemodynamic impact. It should be noted that the management strategy for...
Delayed high-grade block after transcatheter aortic valve replacement (TAVR) goes unnoticed in patients undergoing TAVR without prior conduction disorders because, most times, it takes place during hospitalization or immediately after the procedure. Right bundle branch block is a risk factor, but it has poor sensitivity for the prediction of high-grade blocks, and there may be...
After post TAVR mean 3-year follow-up, a new onset persistent left bundle branch block (LBBB) was not associated with higher mortality or hospitalization for cardiac failure according to this study to be published soon in J Am Coll Cardiol Intv. Nevertheless, LBBB was associated to higher risk of definite pacemaker and a negative impact in...
This new meta-analysis combines all randomized transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement trials and expands the scope of TAVR. Evidence across the range of risk studied supports a paradigm shift in patients with symptomatic severe aortic stenosis. The clinical superiority of TAVR compared with surgery has been demonstrated across the spectrum...