TAVR in Small Annuli: Is There a Better Valve?

Transcatheter aortic valve replacement with the self-expandable valves has shown optimal clinical and electrocardiographic results in patients with small annuli. These supra-annular prosthetic valves seem somewhat better than the intra-annular balloon expandable.  TAVR in general has better functional results in terms of patient/prosthesis mismatch. This seems especially true for patients with a small annulus.  The<a href="https://solaci.org/en/2020/03/20/tavr-in-small-annuli-is-there-a-better-valve/" title="Read more" >...</a>

Lower Mismatch Rate with the New Self-Expandable Valves

Prosthesis mismatch (PPM) was introduced by Rahimtoola in 1978 and happens when the effective orifice area of a heart valve prosthesis is too small in relation to patient body size. Surgical valves have been well documented, but there is little information on percutaneous valves. The study looked at 757 patients undergoing TAVR with pre and post procedural eco-Doppler<a href="https://solaci.org/en/2019/11/25/lower-mismatch-rate-with-the-new-self-expandable-valves/" title="Read more" >...</a>

AHA 2019 | GALILEO-4D: rivaroxabán y prevención de engrosamiento y trombosis de las valvas post TAVI

AHA 2019 | GALILEO-4D: Rivaroxaban in the Prevention of Post TAVR Valve Thickening and Thrombosis

This sub study of the GALILEO specifically looked at valve thickening and reduced leaflet motion after TAVR documented with 4D CT. Whether anticoagulation with rivaroxaban might reduce or prevent this phenomenon remained unanswered. Patients receiving the same anticoagulation scheme than the general study’s (rivaroxaban + aspirin vs. aspirin + clopidogrel) were assessed by 4D CT<a href="https://solaci.org/en/2019/11/20/aha-2019-galileo-4d-rivaroxaban-in-the-prevention-of-post-tavr-valve-thickening-and-thrombosis/" title="Read more" >...</a>

Europe Grants Approval to Balloon-Expandable Valve in Low-Risk Patients; Self-Expanding Valve Still Waiting for It

The balloon-expandable valve has been granted approval in Europe for treatment of the complete risk spectrum of symptomatic severe aortic stenosis. Europe has recently approved an expanded indication for the Sapien 3 system for use in low-risk patients, as reported by Edward Lifesciences. Sapien 3, which includes the next-generation Sapien 3 Ultra, is the first transcatheter heart valve<a href="https://solaci.org/en/2019/11/15/europe-grants-approval-to-balloon-expandable-valve-in-low-risk-patients-self-expanding-valve-still-waiting-for-it/" title="Read more" >...</a>

Mismatch protésico en válvulas supra anulares y en válvulas intra anulares

Prosthesis Mismatch in Supra and Intra Annular valves

The self-expandable valve was associated to lower prosthesis-patient mismatch (PPM) compared against the balloon expandable valve regardless annular area, according to this study soon to be published in J Am Coll Cardiol Intv. This difference was basically driven by patients with larger body surface area (>1.83m²). Prosthesis mismatch has been associated to increased mortality after transcatheter<a href="https://solaci.org/en/2019/10/30/prosthesis-mismatch-in-supra-and-intra-annular-valves/" title="Read more" >...</a>

Endocarditis y TAVI, una complicación rara pero devastadora

Prosthetic Valve Endocarditis and TAVR: though Rare, Devastating

On the bright side, the incidence of prosthetic valve endocarditis (PVE) post TAVR is not higher than post SAVR, according to this study recently presented at EuroPCR 2019, held in Paris. There is plenty of evidence describing PVE incidence, prognosis, risk factors, etc. after surgical valve replacement surgery (SAVR). However, we know little about the<a href="https://solaci.org/en/2019/06/23/prosthetic-valve-endocarditis-and-tavr-though-rare-devastating/" title="Read more" >...</a>

Valve-in-Valve with Self-Expanding Prosthesis: What Happens with Gradients at One Year?

Degenerated surgical bioprostheses can be safely treated with CoreValve or CoreValve Evolut using the valve-in-valve procedure. Excellent 1-year clinical and hemodynamic outcomes were achieved in a non-selected regular population, i.e., “real-world” patients. The VIVA (Valve in Valve) registry, conducted at 23 sites, was a prospective study designed to systematically collect data from patients with degenerated<a href="https://solaci.org/en/2019/06/18/valve-in-valve-with-self-expanding-prosthesis-what-happens-with-gradients-at-one-year/" title="Read more" >...</a>

Good News at 3 Years for “Valve-in-Valve”

In this new era, the paradigm to treat the whole spectrum of transcatheter aortic valve replacement (TAVR) patients has started to shift beyond risk. However, broadening the spectrum raises the question of durability, which is why any long-term TAVR outcomes in any context are welcome. This specific study studied TAVR durability in the treatment of<a href="https://solaci.org/en/2019/06/03/good-news-at-3-years-for-valve-in-valve/" title="Read more" >...</a>

EuroPCR 2019 | CHOICE: válvula balón expandible vs autoexpandibles en pacientes de alto riesgo

EuroPCR 2019 | CHOICE: Balloon-Expandable Valves vs. Self-Expanding Valves in High-Risk Patients

The CHOICE trial included 241 patients with severe aortic stenosis and high surgical risk who underwent transcatheter aortic valve replacement (TAVR) using transfemoral access. These patients were randomized to balloon-expandable valve (Edwards Sapien XT) vs. self-expanding valve (Medtronic CoreValve). The endpoints were all-cause mortality, stroke, readmission, valve function parameters as measured through an ultrasound, and<a href="https://solaci.org/en/2019/05/23/europcr-2019-choice-balloon-expandable-valves-vs-self-expanding-valves-in-high-risk-patients/" title="Read more" >...</a>

Lotus Returns with New Strength and the FDA Approval to Compete with Sapien3 and CoreValve Evolut R

After reports of some serious adverse events with first-generation Lotus, the device was pulled off the market—but it was not meant to be left in oblivion. Now, it is back, renewed and with the approval of the United States Food and Drug Administration (FDA), to compete directly with the two market leaders (Sapien and CoreValve),<a href="https://solaci.org/en/2019/04/29/lotus-returns-with-new-strength-and-the-fda-approval-to-compete-with-sapien3-and-corevalve-evolut-r/" title="Read more" >...</a>