Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) was developed for aortic stenosis, but there is a significant number of patients with severe aortic regurgitation who still undergo this procedure as an off-label indication. Current evidence for this procedure in relation with this disease is growing, mainly due to good results obtained by different...
Courtesy of Dr. Carlos Fava. The benefits derived from transcatheter aortic valve replacement (TAVR) are clear and self-evident, and its progressively better outcomes are due to better patient selection, greater operator experience, and the development of new valves that enhance procedural safety and complexity. However, the question of durability remains a major unresolved issue, particularly now...
The new COMBO stent, comprised of thin struts plus a bioengineered layer of endothelial progenitor cells, is safe and effective at 1 year, according to this registry (the largest study on this device to date). This new stent could provide a better option for patients at high risk for bleeding who may not be able to...
The transradial access is the preferred access site for patients undergoing acute coronary syndrome. Compared to the transfemoral access site, it reduces the risk of all cause death, vascular complications and major bleeding. Radial artery occlusion is the most frequent vascular complication associated to this approach, though it rarely results in clinical consequences such as ischemia, given the...
The systematic reduction of inefficiencies in the catheterization laboratory (such as the improvement of lab room start times and room turnaround times) can definitely improve the productivity of a Department of Interventional Cardiology without forcing its members to stay in the facilities longer. As a matter of fact, work can be finished even faster with...
Life-threatening complications that require surgery during TAVR are infrequent. The proportion was originally thought to be between 1% and 2%. However, we now know that it is lower, even though we do not know how frequent it is or what are its most common causes. Its evolution, both in the short and in the long...
The association between aortic stenosis and coronary disease is common, since both conditions share pathogenesis, risk factors, and symptoms. Transcatheter aortic valve replacement (TAVR) is currently indicated for high-risk and inoperable patients. It also appears as a valid alternative for the treatment of intermediate-risk patients, and it could soon be indicated for low-risk patients. Coronary...
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. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men....
Courtesy of Dr. Carlos Fava. Peripheral vascular diseases (PVD) present the same risk factors as aortic stenosis. In consequence, these disorders usually coexist. The frequency and impact of their various stages on patients undergoing TAVR is yet to be thoroughly assessed. Read also: “Peripheral Vascular Disease Is Associated to More Events in TAVR”. This study analyzed...