Letter from Dr. José Armando Mangione, President of SOLACI. Dear Colleagues, We kindly request you to take part in our survey about cotemporary TAVI practices in Latin American (LATAM) centers. It has been developed for the WRITTEN study, which assessed TAVI practices in 250 centers around the world (29 in LATAM) between March and September 2015.<a href="https://solaci.org/en/2019/09/26/the-written-worlwide-tavi-experience-survey-2/" title="Read more" >...</a>
Both studies followed beyond 5 years patients with severe aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR). Findings included low rates of significant valve degeneration and failure, in both cases. While data on the long-term degeneration of transcatheter-implanted valves are scarce, follow-up from the NOTION trial of low-risk patients and from the UK TAVI<a href="https://solaci.org/en/2019/02/12/notion-and-uk-tavi-report-good-long-term-outcomes/" title="Read more" >...</a>
Taking into account a simple 12-lead electrocardiography performed immediately after transcatheter aortic valve implantation (TAVI), removing the temporary pacemaker immediately is safe in patients without right bundle branch block who are in sinus rhythm with PR interval <240 ms and QRS interval <150 ms. In cases of atrial fibrillation, a QRS interval <140 ms also reassures the decision<a href="https://solaci.org/en/2018/10/23/immediate-electrocardiography-after-tavi-the-simplest-way-to-predict-conduction-disorders/" title="Read more" >...</a>
The incidence of arrhythmic events up to a year after implantation is high and involves almost half the patients with complete left bundle branch block following the procedure. Significant bradyarrhythmias occur in up to one-fifth of the patients, half of whom ultimately require a pacemaker. These data support the idea of a cardiac monitoring device<a href="https://solaci.org/en/2018/10/18/ambulatory-continuous-monitoring-in-patients-with-left-bundle-branch-block-after-tavi/" title="Read more" >...</a>
This prospective, randomized, multicenter study included 447 patients with severe aortic stenosis and intermediate or high surgical risk randomized in a 2×2 factorial design to general vs. conscious sedation with local anesthesia and also to receiving the Sapien 3 valve (balloon-expandable) vs. CoreValve Evolut R (self-expandable). Primary end point was a composite of all-cause mortality,<a href="https://solaci.org/en/2018/10/08/tct-2018-solve-tavi-self-expandable-vs-balloon-expandable-valves-and-general-vs-local-anesthesia-in-one-study/" title="Read more" >...</a>
Read articles on the main presentations of the first day of SOLACI-SOCIME 2018 Congress. See the presentation by Dr. José María Hernández, entitled “TAVI in a low risk patients”. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
Some of the many ongoing randomized studies including patients with atrial fibrillation (AF) might finally answer the question on the best antithrombotic scheme post TAVR. According to this registry, in patients undergoing transcatheter aortic valve replacement, independent predictors of death at 3 years are being a man, having moderate to severe kidney failure, and having<a href="https://solaci.org/en/2018/08/28/esc-2018-france-tavi-atrial-fibrillation-and-anticoagulation-associated-to-mortality-in-tavr/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. In most randomized or observational studies, women comprise more than 50% of patients undergoing TAVR, and they have showed better evolution, compared against surgery. The main differences between men and women with severe aortic stenosis are that women have smaller annular dimension, shorter distance to coronary ostia, smaller peripheral arteries, and<a href="https://solaci.org/en/2018/01/24/win-tavi-the-largest-female-tavr-registry-so-far/" title="Read more" >...</a>
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>
Durability ─or better yet, lack of deterioration─ is still a matter of debate when considering transcatheter aortic valve intervention (TAVI), especially now that it is being explored as a real alternative for younger patients. A recently published meta-analysis offers more evidence and suggests TAVI deterioration is mostly rare within the first 5 years. According to<a href="https://solaci.org/en/2017/08/14/valve-deterioration-after-tavi-is-rare-and-should-not-prevent-advancement-to-younger-populations/" title="Read more" >...</a>