There is an important group of patients presenting low flow, low-gradient severe aortic stenosis (defined as mean gradient <40 mmHg). This is why we do dobutamine stress echocardiogram (DSE), to confirm whether we are dealing with truly severe aortic stenosis. However, it might not be well tolerated and a CT angiography will be done to…
Is There a Way to Reduce the Need for Permanent Pacemaker Implantation in Self-Expanding Valves?
We are well aware of the benefits of TAVR in different scenarios, but the need for permanent pacemaker implantation (PPI) in self-expandable valves is between 15% and 30% according to different randomized and non-randomized studies. This is why the higher implantation strategy or cusp overlap (COT) was developed and, though it has been shown to…
New-Generation ACURATE Neo2
Transcatheter aortic valve replacement (TAVR) is a therapeutical option for patients with symptomatic severe aortic stenosis. Current guidelines recommend TAVR in patients ≥75 years with intermediate risk. One of the most frequent complications of this procedure is moderate or greater aortic regurgitation (AR) after implantation. Consequently, new valves have been developed to try and reduce…
The Most Read Articles of 2021: Structural Heart Disease
A new year is coming to an end and at SOLACI we are going over the most read studies on our website, on a vital topic, peripheral vascular disease. Follow us to keep up to date. The Most Read Articles of 2021: Structural Heart Disease 01- Surgeons’ Claim on Low-Risk Patients with Aortic Stenosis Recent…
Ten Commandments for 2021 Guidelines on Valvular Heart Disease
Since the latest version to the Valvular Heart Disease Guidelines from the European Society of Cardiology, plenty of evidence has been accumulating, finally leading to this updated version. In this regard, below you will find what has been called “10 commandments” that sum up this new document, to keep you in the loop. The incidence…
More Keys to Define Moderate Aortic Stenosis
Amidst the current efforts to prove early intervention might have benefits in moderate aortic stenosis (AS), this trial comes along directing us back to basics. In patients with symptomatic aortic stenosis, peaking mortality will clearly justify intervention. But what is the case when there are no symptoms? According to this recent analysis published in JAMA,…
New Markers of Aortic Stenosis Define Asymptomatic Patients
Asymptomatic aortic stenosis has been keeping us in tense stillness. However, there are new markers capable of identifying patients that might benefit from earlier intervention. In this regard, cardiovascular magnetic resonance (CMR) has been gaining its well-deserved place in cardiology and now more specifically in aortic stenosis. This study sought to validate CMR markers of…
EuroPCR 2021 | Evolut Low Risk: Two-Year Results of The Self-Expanding Valve in Low-Risk Patients
Transcatheter aortic valve replacement (TAVR) with the Evolut self-expanding valve was non-inferior to surgery in patients with low surgical risk. After two years, the primary endpoint of death or disabling stroke was similar between both strategies. This presentation at EuroPCR 2021 reinforces the results presented during the American College of Cardiology (ACC) 2019 Congress and…
Surgeons’ Claim on Low-Risk Patients with Aortic Stenosis
Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. However, surgeons argue that these cases fail to consider patients from daily clinical practice, but rather include a population that has been carefully selected for randomized trials. Patients with non-tricuspid aortic stenosis, with severe…
Cusp Overlap for Higher CoreValve Implantation
Implant depth greater than the length of the membranous septum is an independent predictor of permanent pacemaker implantation. Valve implantation 3 to 5 mm below the aortic annulus in a projection coaxial to the device is recommended. The problem is this is rarely in the annular plane of the valve. Ideal annular plane projection is…