The frequency of bicuspid aortic valves (BcAV) are around 1%, but in 60+ patients it is associated to severe aortic stenosis. Even though surgery is the standard treatment, TAVR is the “off label” indication in high risk patients. BcAV presents differences with tricuspids given that it is more elliptic, has asymmetric calcification and more...
At 5 years, there were no differences in all-cause death, stroke, acute myocardial infarction, or all of these combined between low-risk, elderly patients who underwent transcatheter aortic valve replacement (TAVR) or conventional surgery. Taking into account reports from previous years, these results are not at all surprising. NOTION enrolled an all-comers population that was 70 years old...
TAVR has shown benefits in high risk patients (prohibitive) and in intermediate risk patients, but the need for permanent pacemaker implantation (PPI) continues to be a soft spot (especially in younger patients) given time of use, eventual replacement and associated complications. Even though there is little information on PPI, pacemakers are not associated with higher mortality, but they...
1) The CULPRIT-SHOCK Study Is Finally Published in NEJM and It Is Bound to Change Guidelines During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked...
Edwards Lifesciences could have been satisfied after the success of the PARTNER trials and the improvements to its balloon-expandable valve (mainly as regards the delivery system profile and paravalvular leak reduction) in its last model, SAPIEN 3. However, it was not. The company decided to keep going, developing a valve that is radically different from its...
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...
The main advantage of transcatheter aortic valve replacement (TAVR) has always been its less invasive nature, compared against surgery. Many of the advances in this technique revolve around making it even less invasive, increasing the gap between the two. The kind of anesthesia has been one of these many advances. There are several reports (in general from...
Both balloon-expandable and self-expanding valves have been tested in randomized studies, with excellent outcomes. While both technologies have advantages, the chance to reposition or re-steer the sheath is only offered by self-expanding valves, which also adjust better to patient anatomy. The CHOICE trial, published in 2014 in JAMA, was one of the few randomized studies...
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,...
Transcatheter aortic valve replacement (TAVR) was developed as a strategy to treat non-surgical aortic stenosis, and was later expanded to elderly patients at intermediate risk, because of increased operator experience (overcoming the learning curve) and improved devices. The present study presents the one year outcomes of the SOURCE 3 trial, the multicenter European registry of the...