Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. However, surgeons argue that these cases fail to consider patients from daily clinical practice, but rather include a population that has been carefully selected for randomized trials. Patients with non-tricuspid aortic stenosis, with severe<a href="https://solaci.org/en/2021/03/25/surgeons-claim-on-low-risk-patients-with-aortic-stenosis/" title="Read more" >...</a>
TAVR in Low-Risk Patients: Though still Superior, with Diminished Advantage after 2 Years.
At two-year followup, primary end point continued to be significantly lower with Sapien 3 vs. conventional surgery, but the initial difference in death and stroke in favor of TAVR started to shrink. In addition, there was higher risk of valve thrombosis in TAVR patients. The PARTNER 3 (Safety and Effectiveness of the SAPIEN 3 Transcatheter<a href="https://solaci.org/en/2021/03/16/tavr-in-low-risk-patients-though-still-superior-with-diminished-advantage-after-2-years/" title="Read more" >...</a>
AAS vs Warfarin in Low Risk TAVR
We are still discussing the adequate antithrombotic scheme after transcatheter aortic valve replacement (TAVR). Additionally, we are treating a much wider array of patients ranging from low risk to inoperable. And there is yet one more important point: hypo-attenuated leaflet thickening diagnosed by CT. We are still unaware of the impact they have on device<a href="https://solaci.org/en/2021/03/15/aas-vs-warfarin-in-low-risk-tavr/" title="Read more" >...</a>
Improvements in COAPT Trial for Functional Mitral Regurgitation
Patients with heart failure and moderate-to-severe secondary mitral regurgitation may benefit from transcatheter mitral valve repair. There are benefits at 3 years, even in hard points such as mortality rate. The COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) trial showed fewer heart failure hospitalizations and<a href="https://solaci.org/en/2021/03/15/improvements-in-coapt-trial-for-functional-mitral-regurgitation/" title="Read more" >...</a>
Revascularization Is Needed Before TAVR
Disease prevalence in patients with severe aortic stenosis is highly variable: from 80% in inoperable patients to only 15% according to the most recent research including low-risk patients. Given the high mortality observed in patients with heart disease, guidelines suggest considering coronary bypass revascularization in those in need of a valve replacement. This experience with<a href="https://solaci.org/en/2021/03/08/revascularization-is-needed-before-tavr/" title="Read more" >...</a>
Data that Can Change TAVR and SAVR Strategy
In many relatively young patients with severe aortic stenosis, we rule out the idea of a mechanical valve, opting for a surgical aortic valve replacement (SAVR) with a bioprosthesis; we bet once the surgical bioprosthesis deteriorates, we will be able to solve it with transcatheter aortic valve replacement (TAVR) of the failed surgical valve: TAV-in-SAV. <a href="https://solaci.org/en/2021/03/04/data-that-can-change-tavr-and-savr-strategy/" title="Read more" >...</a>
Predilation in TAVR and Myocardial Injury
Performing balloon predilation or valvuloplasty before a transcatheter aortic valve replacement (TAVR) may increase the incidence and magnitude of myocardial injury with new-generation balloon-expandable valves. Some papers argue in favor or against direct implantation, others remain neutral, but this research is the first one to express a different point of view. Historically, the biggest fear<a href="https://solaci.org/en/2021/03/03/predilation-in-tavr-and-myocardial-injury/" title="Read more" >...</a>
The Most Read Articles in Interventional Cardiology during February
01- Efficacy of AstraZeneca’s Vaccine against COVID-19 This study, published in the Lancet, looks into the vaccine resulting from the collaboration of the Oxford University and AstraZeneca, among others. Read more HERE 02- Findings on Sputnik V Vaccine Against COVID-19 The Sputnik V vaccine was developed by Gamaleya NRCEM. Similarly to the Oxford-AstraZeneca vaccine, it is based on a viral vector,<a href="https://solaci.org/en/2021/03/03/the-most-read-articles-in-interventional-cardiology-during-february/" title="Read more" >...</a>
Diastolic Dysfunction and TAVR: Prognosis before and after Procedure
The PARTNER 2 SAPIEN 3 showed baseline diastolic dysfunction is a predictor of clinical events after 2 years of TAVR. As expected, improved diastolic function after procedure immediately changes prognosis. Though these outcomes did meet our expectations, very few studies have shown hard evidence linking diastolic dysfunction and aortic stenosis. All patients included in the<a href="https://solaci.org/en/2021/03/02/diastolic-dysfunction-and-tavr-prognosis-before-and-after-procedure/" title="Read more" >...</a>
Coronary Access After TAVR: A Potential Problem Ahead
Coronary cannulation after transcatheter aortic valve replacement (TAVR) was unsuccessful in almost 10% of patients. This problem occurred almost exclusively in those who received a self-expanding valve. This study, recently published in JACC Cardiovasc Interv., was sought to investigate the feasibility of coronary ostia access after TAVR and describe potential predictors of coronary access impairment.<a href="https://solaci.org/en/2021/02/05/coronary-access-after-tavr-a-potential-problem-ahead/" title="Read more" >...</a>