Patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) can safely undergo the procedure under conscious sedation. Conscious sedation has been adopted in clinical practice as a natural way of simplifying and conducting the procedure in the least invasive way possible. Currently, up to 50% of patients undergo TAVR under conscious sedation, but<a href="https://solaci.org/en/2020/10/28/conscious-versus-general-anesthesia-in-tavr/" title="Read more" >...</a>
The benefits of intravascular ultrasound (IVUS) guidance in all angioplasties with second-generation drug-eluting stents (DES) persist through 3 years of follow-up. These data derive from the extended follow-up of the ULTIMATE study, presented virtually at TCT 2020 and published simultaneously in JACC Intv. At 3 years, target-vessel failure remained lower in patients whose angioplasty was guided by<a href="https://solaci.org/en/2020/10/22/tct-2020-our-next-goal-should-be-using-ivus-guidance-in-every-angioplasty/" title="Read more" >...</a>
One-year outcomes of the head to head trial between CoreValve Evolut R vs Sapien 3 showed a significantly higher difference in stroke vs. patients receiving the self-expanding valve (Sapien 3 6.9% vs Evolut R 1%; p=0.002). The SOLVE-TAVI randomized 2×2 patients with severe aortic stenosis and high surgical risk to Sapien 3 or Evolut R and<a href="https://solaci.org/en/2020/10/21/tct-2020-surprising-differences-in-stroke-between-sapien-3-and-evolut-r/" title="Read more" >...</a>
Cerebral protection device TriGUARD 3, designed to cover all supra-aortic vessels during transcatheter aortic valve replacement (TAVR), is safe to use, according to the outcomes of the REFLECT II study. The technical feasibility of the device, which requires transfemoral access, does not seem to have an impact over clinical events. The primary safety endpoint was a VARC-2-defined<a href="https://solaci.org/en/2020/10/21/tct-2020-efficacy-of-cerebral-protection-device-triguard-3-during-tavr/" title="Read more" >...</a>
The TARGET FFR and DEFINE-FLOW studies were presented at TCT 2020 which have offer a deeper perspective on the value of FFR, not only before but also after PCI. TARGET FFR The TARGET FFR included 260 patients randomized after angiographically successful PCI to an FFR guided optimization vs. blinded FFR assessment strategies. In the guided<a href="https://solaci.org/en/2020/10/21/tct-2020-new-information-about-pre-and-post-pci-ffr-value/" title="Read more" >...</a>
Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding. This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk. The XIENCE Short<a href="https://solaci.org/en/2020/10/21/tct-2020-xience-in-favor-of-short-dual-antiaggregation-therapy-with-high-bleeding-risk/" title="Read more" >...</a>
01- ESC 2020 | New European Guidelines on Non-ST-Segment Elevation Acute Coronary Syndromes: What’s New? The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. Read more HERE 02- Ticagrelor to Improve Venous Graft Patency Saphenous<a href="https://solaci.org/en/2020/10/09/the-most-read-articles-of-september-in-interventional-cardiology/" title="Read more" >...</a>
The consequences of deferring transcatheter aortic valve replacement (TAVR) procedures because of the COVID 19 pandemic are piling up. Untreated severe aortic stenosis patients who had been scheduled for TAVR are seeing increased risk of all events, even mortality. According to recent studies published in JAMA, deferring TAVR in patients with symptomatic aortic stenosis is<a href="https://solaci.org/en/2020/10/08/death-stroke-and-hospitalization-while-waiting-for-tavr/" title="Read more" >...</a>
This meta-analysis to be published in J Am Cardiol supports the use of aspirin monotherapy (ASA) after transcatheter aortic valve replacement (TAVR). The use of aspirin alone is associated to less bleeding without increased ischemic events such as strokes or mortality. The combined outcomes of four studies, including the recently published POPular TAVI (cohort A),<a href="https://solaci.org/en/2020/10/07/post-tavr-asa-monotherapy-consolidates/" title="Read more" >...</a>
Transcatheter aortic valve replacement (TAVR) is increasingly being performed under conscious sedation, which is associated with a multi-point benefit (including mortality). This paper, recently published in JACC Intv., shows that general anesthesia is becoming obsolete, although the magnitude the benefit derived from conscious sedation appears to be lower than in previous studies. The aim of<a href="https://solaci.org/en/2020/10/02/minimalist-tavr-to-the-max/" title="Read more" >...</a>