Courtesy of Dr. Carlos Fava. Repairing the mitral valve with Mitraclip has become an alternative for high risk or inoperable symptomatic patients, but its long term evolution has only been tested by the EVEREST II, which had not taken into account 5 year mortality outcomes. Therefore, to better study its evolution, we need to carry out different randomized studies<a href="https://solaci.org/en/2017/07/11/mitraclip-should-we-intervene-earlier/" title="Read more" >...</a>
Post-dilation in TAVI associated to more stroke and more paravalvular regurgitation
Courtesy of Dr. Carlos Fava. Moderate/severe paravalvular regurgitation (PVR) after TAVR is present in 10%-14% of all cases, according to different series. The treatment of choice is post-dilation, generally effective in most cases. However, this strategy carries a risk of stroke. The true impact of this conduct is still unclear. This review analyzed 6 studies that included 5007 patients; 889 of<a href="https://solaci.org/en/2017/07/10/post-dilation-in-tavi-associated-to-more-stroke-and-more-paravalvular-regurgitation/" title="Read more" >...</a>
TAVI without predilation is feasible and safe
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve implantation has already proven to be beneficial for high-risk and inoperable patients. In that sense, it is also an increasingly frequent solid option for lower-risk patients. However, due to the presence of valve calcifications, it may occasionally be necessary to assess the benefits and risks of valve dilation<a href="https://solaci.org/en/2017/06/26/tavi-without-predilation-is-feasible-and-safe/" title="Read more" >...</a>
SENTINEL study: cerebral protection during TAVR
Neurological complications during and after transcatheter aortic valve replacement (TAVR) are probably the only event whose incidence has not been reduced by new valve designs (as opposed to paravalvular leak, vascular complications, or need for pacemaker implantation). Aside from the potential seriousness of this clinical event, the risk of embolism is particularly worrisome because,<a href="https://solaci.org/en/2017/06/15/sentinel-study-cerebral-protection-during-tavr/" title="Read more" >...</a>
Low Gradient Aortic Stenosis Won’t Improve with TAVR
Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found<a href="https://solaci.org/en/2017/06/01/low-gradient-aortic-stenosis-wont-improve-with-tavr/" title="Read more" >...</a>
[SURTAVI] Sub-study of neurological events: more evidence in favor of TAVR
Courtesy of SBHCI. The occurrence of a periprocedural neurological events is associated to an increased risk of death and morbidity at long term, both for transcatheter aortic valve replacement (TAVR) and for surgery. The SURTAVI study, recently presented at the ACC meeting and simultaneously published by NEJM, showed that TAVR with self-expandable CoreValve or Evolut<a href="https://solaci.org/en/2017/05/30/surtavi-sub-study-of-neurological-events-more-evidence-in-favor-of-tavr/" title="Read more" >...</a>
NOTION: TAVI with low risk at 4 year follow up
Courtesy of the SBHCI. There is little data about the use of transcatheter aortic valve replacement (TAVR) to treat patients with severe aortic stenosis at low surgical risk. Many of the questions involve long term duration of valves (over 10 years) when treating younger patients with longer life expectancy. The NOTION study aims at comparing<a href="https://solaci.org/en/2017/05/30/notion-tavi-with-low-risk-at-4-year-follow-up/" title="Read more" >...</a>
Cerebral protection during TAVI still offers weak evidence, but there is hope
Silent ischemic embolic lesions are common after transcatheter aortic valve implantation (TAVI). The use of cerebral protection devices might reduce the occurrence of these embolic lesions. Multiple studies with different devices, designs, and outcomes challenge the usefulness of cerebral protection during TAVI. A comprehensive analysis of the literature was necessary to obtain a more<a href="https://solaci.org/en/2017/05/28/cerebral-protection-during-tavi-still-offers-weak-evidence-but-there-is-hope/" title="Read more" >...</a>
ARTE: Aspirin or Aspirin and Clopidogrel after TAVR?
Courtesy of SBHCI. This study presented at Euro PCR and simultaneously published by JACC Cardiovascular Interventions poses a question that has remained unanswered since the start of TAVR. There is little information on the optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR). In general, patients receive between 1 and 6 months of dual<a href="https://solaci.org/en/2017/05/25/arte-aspirin-or-aspirin-and-clopidogrel-after-tavr/" title="Read more" >...</a>
Further Evidence on Managing Dysfunctioning Bioprostheses with Balloon-Expandable Prostheses
Early experience with the valve-in-valve technique in the treatment of failed bioprosthetic surgical valves in transcatheter aortic valve replacement (TAVR) has yielded acceptable acute procedural results. This turned the technique into another therapeutic option, one that could even cause the reassessment of the age limit for the surgical implantation of a mechanical or bioprosthesis valve.<a href="https://solaci.org/en/2017/05/17/further-evidence-on-managing-dysfunctioning-bioprostheses-with-balloon-expandable-prostheses/" title="Read more" >...</a>