Courtesy of Dr. Carlos Fava. While the benefits of TAVR are well-known, the need for a permanent pacemaker after implantation is still an issue to solve, even though new valves have reduced it. This study enrolled 175 patients who underwent TAVR with an ACURATE neo TF valve. In this population, 58% of patients were women and the...
Pure aortic regurgitation has historically been considered a contraindication for transcatheter aortic valve replacement (TAVR) due to the absence of calcification and subsequent device anchoring problems it poses. Initial reports on first-generation self-expanding valves for the treatment of pure regurgitation were somewhat discouraging, but devices evolved, adding repositioning capacity, different external skirts (pericardial, PET, urethane,...
Courtesy of Dr. Carlos Fava. The incidence of peripheral vascular disease (PVD) is increasing and associated with negative outcomes when overlapping with cardiovascular disease. In patients undergoing TAVR, its prevalence varies between 28% and 42%, according to different studies. However, its real impact on the rate of survival is still unclear. This study analyzed 27,440 patients >65 years...
1) New Study Confirms TAVR Durability at 5 Years The ADVANCE study was designed to evaluate the safety and effectiveness of transcatheter aortic valve replacement (TAVR) with self-expanding prosthesis CoreValve in “real world” patients with symptomatic, severe aortic stenosis at high surgical risk. Read the conclusions of this study 2) An Important Study Shows That Renal Function Must Be Cared for in...
Courtesy of Dr. Carlos Fava. The presence of renal dysfunction in the “real world” is over 25% in patients who undergo transcatheter aortic valve implantation (TAVI). The evolution of this disease among patients who are subjected to a replacement is well known, but evidence for patients who undergo TAVI is still limited, particularly for those who...
Cerebral ischemic events after transcatheter aortic valve replacement (TAVR) have been identified as independent predictors of morbidity and mortality. New-generation devices have managed to partially reduce the rate of cerebral events, but it still is around 5.5% at 30 days for patients undergoing TAVR through transfemoral access. First data on cerebral protection devices had only shown...
Courtesy of Dr. Carlos Fava. Stage III or higher renal impairment is frequent before TAVR, and the need for new dialysis after the procedure may reach up to 20%. Within that percentage, 5% may require permanent dialysis, which increases mortality up to 9 times at one year. In that sense, factors leading to that complication have not...
Courtesy of Dr. Carlos Fava. Nowadays, chronic total occlusions (CTO) due to in-stent restenosis (ISR) represent 5%-25% of all coronary angioplasties. These lesions pose a new and true challenge, since CTOs are often associated with stent-related problems (fractures, lack of expansion, overlapping, deformation), extreme tortuosity, severe calcification, tandem lesions after CTO, and aorto-ostial lesions, with little...
It remains unclear whether transradial access, compared with transfemoral access, presents a different risk of post-procedural kidney injury for patients admitted with acute coronary syndrome. Historically, it has been considered (without any evidence) that, given the higher difficulty associated with transradial access, it would require longer fluoroscopy time and higher contrast volume, which would eventually...
Courtesy of Dr. Carlos Fava. The association between diastolic dysfunction (DD) and aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) has not been studied yet, but the presence of aortic regurgitation has proved to be associated with worse outcomes. A total of 144 out of 195 patients who underwent TAVR with balloon-expandable SAPIENS or SAPIENS XT...