Courtesy of Dr. Carlos Fava. Mitral regurgitation is the most frequent type of valve disease, accounting for >6% of patients over 65 years old. Surgery is currently the strategy of choice, but percutaneous treatment is a valid alternative. The long-term progress of symptomatic patients at high surgical risk who do not meet the formal indications for<a href="https://solaci.org/en/2019/02/01/good-outcomes-for-mitraclip-off-label/" title="Read more" >...</a>
Anticoagulation Plays a Controversial Role in TAVR
Men gender, kidney failure and atrial fibrillation are the factors that most affect 3-year mortality after transcatheter aortic valve replacement. On the other hand, surprisingly enough, anticoagulation (mostly indicated for atrial fibrillation) reduces mortality risk – especially the risk of valve deterioration – after TAVR. Should anticoagulation be included in post TAVR protocols? This question<a href="https://solaci.org/en/2019/01/21/anticoagulation-plays-a-controversial-role-in-tavr/" title="Read more" >...</a>
“Troponinitis” or “Troponinemia”: Terms that Trivialize Troponin Elevation Without a Specified Diagnosis
Troponin elevation is a common finding in acute patients admitted by an emergency service, even in the absence of an acute coronary event. There are patients in whom we simply cannot identify the origin of such troponin elevation. Initially, we relied on this marker as an exclusive marker of acute coronary syndrome. In consequence, many<a href="https://solaci.org/en/2019/01/21/troponinitis-or-troponinemia-terms-that-trivialize-troponin-elevation-without-a-specified-diagnosis/" title="Read more" >...</a>
The Most Important Articles of 2018 in Structural Heart Diseases
1- ESC 2018 | MITRA FR: Testing MitraClip for Secondary Mitral Regurgitation In secondary mitral regurgitation, mitral-valve leaflets and chordae are structurally normal and mitral regurgitation results from alterations in left ventricular geometry and function. Read more 2- TCT 2018 | COAPT: MitraClip in Patients with Secondary Mitral Regurgitation The prognosis of patients with<a href="https://solaci.org/en/2019/01/18/the-most-important-articles-of-2018-in-structural-heart-diseases/" title="Read more" >...</a>
Bundle Branch Block and Need for Permanent Pacemaker, a Major Challenge after TAVR
Courtesy of Dr. Carlos Fava. The development of new valves for TAVR and the increased experienced of operators have significantly decreased paravalvular leak. However, new bundle Branch block (BBB) and the need for permanent pacemaker (PPM) are still relatively high, and their impact and evolution remain controversial. The study looked at 816 patients, 437<a href="https://solaci.org/en/2019/01/17/bundle-branch-block-and-need-for-permanent-pacemaker-a-major-challenge-after-tavr/" title="Read more" >...</a>
TAVR Is Feasible and Offers Good Outcomes in Patients with Cancer
Courtesy of Dr. Carlos Fava. Oncology patients have been excluded from all studies, but many of them have a life expectancy of over a year or two, and aortic stenosis can pose a problem as regards their treatment. This study analyzed 2744 patients who underwent TAVR. Among them, 222 presented cancer (8.1%). Patients with cancer were younger,<a href="https://solaci.org/en/2019/01/16/tavr-is-feasible-and-offers-good-outcomes-in-patients-with-cancer/" title="Read more" >...</a>
Percutaneous Closure Systems Are Safe in TAVR and Aneurysms
Courtesy of Dr. Carlos Fava. Currently, one of our medical challenges is to conduct procedures requiring access with large introducer sheaths in a simpler way, without requiring surgical intervention and closing with percutaneous devices while maintaining procedural quality and safety. There are several devices, but they require a learning curve and the only information available comes<a href="https://solaci.org/en/2019/01/15/percutaneous-closure-systems-are-safe-in-tavr-and-aneurysms/" title="Read more" >...</a>
Is Individual Operator Experience Important in TAVR?
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as a successful alternative for inoperable patients and a non-inferior alternative for high- and intermediate-risk patients. While its evolution depending on site experience has been analyzed, there is currently very little information regarding the impact of operator individual experience. This study analyzed 8771 procedures performed<a href="https://solaci.org/en/2019/01/09/is-individual-operator-experience-important-in-tavr/" title="Read more" >...</a>
What is the best antiplatelet in PCI to vein grafts?
Courtesy of Dr. Carlos Fava. PCI to saphenous vein grafts is one the greatest challenges these days because, as opposed to native arteries, they present important thrombolytic material, diffuse and long lesions, and abundant macrophage and inflammatory cells, which makes the procedure more complex. At present, we have not yet agreed on the best antiplatelet<a href="https://solaci.org/en/2019/01/07/what-is-the-best-antiplatelet-in-pci-to-vein-grafts/" title="Read more" >...</a>
Acute Coronary Syndromes After TAVR: Frequent and Not All Undergo Coronary Angiography
Approximately 10% of patients who undergo transcatheter aortic valve replacement (TAVR) are readmitted for an acute coronary syndrome after a mean follow-up of 25 months. Male sex, prior coronary artery disease, and (surprisingly and hard to explain) nontransfemoral approach were independent predictors of acute coronary syndrome after TAVR, an event associated with high midterm mortality. While<a href="https://solaci.org/en/2019/01/04/acute-coronary-syndromes-after-tavr-frequent-and-not-all-undergo-coronary-angiography/" title="Read more" >...</a>