Pure aortic regurgitation has historically been considered a contraindication for transcatheter aortic valve replacement (TAVR) due to the absence of calcification and subsequent device anchoring problems it poses. Initial reports on first-generation self-expanding valves for the treatment of pure regurgitation were somewhat discouraging, but devices evolved, adding repositioning capacity, different external skirts (pericardial, PET, urethane,...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has been proven to reduce mortality and improve the quality of life of patients with pure severe aortic stenosis (PAS). However, there is a significant number of patients who experience mixed aortic stenosis associated with moderate/severe aortic regurgitation (MAS). These subjects were excluded from the PARTNER...
Courtesy of Dr. Carlos Fava. The incidence of peripheral vascular disease (PVD) is increasing and associated with negative outcomes when overlapping with cardiovascular disease. In patients undergoing TAVR, its prevalence varies between 28% and 42%, according to different studies. However, its real impact on the rate of survival is still unclear. This study analyzed 27,440 patients >65 years...
Courtesy of Dr. Carlos Fava Surgical aortic valve replacement in a small annulus (<400 mm2) is associated with shorter duration, higher valve deterioration and patient prosthesis mismatch (PPM). They present a negative impact as regards duration and evolution. TAVR might be an option, with superior hemodynamic outcome and lower PPM. Read also: “Patients and Healthcare...
Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B, such as balloon pulmonary angioplasty. The percentage of patients with chronic...
Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may...
Chronic Lung Disease often affects patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) or surgery. In fact, this is why patients with lung disease are often deemed inoperable and prescribed TAVR. This is the first time the benefit of TAVR has been assessed in this group of patients, for symptoms of these conditions can...
From November 9th to November 11th, Punta del Este received the best cardiologists in Latin America. These 3 days of intense scientific activity included the SOLACI-SUC Joint Symposium, which was composed of a structural module (with presentations on TAVI, Mitraclip, paravalvular leaks, and clinical cases) and a coronary module (with activities centered on coronary bifurcation lesions,...
The discussion about the best anti-thrombotic strategy for patients with atrial fibrillation undergoing PCI seemed never-ending until the RE-DUAL PCI trial was published in the New England Journal of Medicine (NEJM). This study has arrived to simplify the tough choice between the risk of a thrombotic event vs. the risk of bleeding with a simpler scheme, without...
Courtesy of Dr. Carlos Fava. Avoiding general anesthesia in intervention procedures has the benefits of faster recovery and shorter hospitalization. This has been already analyzed in the context of TAVR, but not in MitraClip procedures. The present study analyzed 232 patients receiving the MitraClip. 76 of these procedures were done under general anesthesia (32.7%) and...