TAVR has been reported beneficial in the treatment of high and intermediate risk patients but, initially, randomized clinical trials have shown vascular complication and pacemaker implantation rates higher than SAVR in low-risk patients. This will most certainly improve as operator experience and device development advance. This is a randomized 1:1 study including 458 patients receiving...
TAVR: If Not Transfemoral, We Should Consider Transcaval Access
Transcatheter aortic valve replacement (TAVR) through transfemoral access has already proven its great benefits, but this access cannot be used in certain patients, and alternative accesses need to be considered for such cases. One of the most commonly used accesses is the transaxillary or transubclavian access (AX), which, however, is associated with more complications (especially...
EuroPCR 2022 | Should Revascularization Be Performed Before TAVR in Patients with Stable Coronary Disease?
Currently, the American and European guidelines recommend coronary angioplasty in patients with severe aortic stenosis with lesions >70% (Class IIa) who will undergo transcatheter aortic valve replacement (TAVR). However, the benefit of performing a revascularization in these patients is still uncertain. This prospective multicenter study included 2025 patients divided into two groups: complete revascularization (N = 1310)...
EuroPCR 2022 | Galileo Trial: Mortality Predictors after Successful TAVR
Patients undergoing TAVR are mostly older and more fragile, with comorbidities both cardiovascular and non-cardiovascular. Therefore, they are associated with thromboembolic and bleeding risk. This study looked mortality predictors after successful TAVR in the Galileo trial. Mortality at 248 days was 9.2%, 5.5% being of cardiovascular cause and 3.9% non-cardiovascular. Mortality predictors were age >85,...
EuroPCR 2022 | ASTRO TAVR: Should we treat post TAVR Strokes with Neurointervention?
The presence of stroke after TAVR has dropped and is currently at 2%; however, it is 5 times more deadly, has negatively affected quality of life and has increased healthcare costs. The ASTRO TAVI registry included 14 centers and 16615 TAVR procedures between 2006 y 2021. In this period, there were 484 neurological events within...
ACC 2022 | ADAPT-TAVR: Endoxaban Is Not Superior to DAPT After TAVR
DAPT-TAVR is a randomized trial that tested endoxaban in patients with no indication for anticoagulation who underwent successful transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis. This study included 229 patients whose mean age was 80 years; 42% of them were male. Patients were randomized to either endoxaban 60 mg or 30 mg every 24 h or...
Same-Day Discharger After TAVR: Are We There Yet?
Same-day discharge (SDD) has been shown to be effective in angioplasties and some peripheral procedures, but the pandemic—because of the burden it caused on the healthcare system—has forced the optimization of hospitalization times for other pathologies and procedures. This strategy is yet to be tested in transcatheter aortic valve replacement (TAVR) due to the possible...
Webinar SOLACI – Medtronic | Impossible Cases! Review of Complex and Controversial TAVR Cases
We invite the entire Latin American community to analyze challenging TAVR cases together with a panel of Latin American experts. We will be looking at vascular access sites, aortic anatomy, potential coronary compromise, Valve-in-Valve, and more! Date: March 24, 2022, at 07.30 PM (Argentinian/ Brazil time; UTC-3). The event will feature renowned experts from across...
Low Risk Patients: TAVR with Self-Expanding Valves Offers Similar Outcomes to Surgery Based on a Bayesian Analysis?
When compared against surgical valve replacement (SAVR) transcatheter aortic valve replacement (TAVR) has shown benefits across different risk groups, not only in events as death and stroke, but also in quality of life (especially in the first months post procedure) and improved symptoms. However, a catch-up phenomenon was observed in low-risk patients between the first...
Infective Endocarditis in TAVR: What’s the Best Treatment?
Infective Endocarditis (IE) rate after TAVR ranges from 0.7% to 3.4%, depending on the different analyses, and is comparable to that after SAVR. Close to 50% of patients treated with surgery received a prosthetic valve; in TAVR, the figure is lower, possibly due to the characteristics of patients (even though it remains unclear). Researchers looked...