Patients with severe aortic stenosis and a small aortic annulus face an increased risk of deteriorated valvular hemodynamic performance and adverse cardiovascular clinical outcomes after undergoing transcatheter aortic valve replacement (TAVR). This study, a prospective multicenter randomized trial, aimed to compare the efficacy and safety of two types of valves: the supra-annular self-expanding EVOLUT (SEV)…
TAVR in the Different Types of Aortic Stenosis
Aortic stenosis (AS) is classified according to gradient into high flow and high gradient (D1), low flow-low gradient with reduced ejection fraction (D2), and paradoxical low flow-low gradient with conserved ejection fraction (D3). D3 AS is characterized by ≥50% ejection fraction, but with systolic volume index ≤35 ml/min. Post TAVR evolution of D2 and D3…
Short-Term Outcomes of TAVR in Asymptomatic or Minimally Symptomatic Patients
Aortic valve replacement (AVR) is indicated for symptomatic aortic stenosis (AS), while close follow-up is recommended for asymptomatic patients, unless they have elevated aortic gradients, low ejection fraction, or abnormal stress tests. However, the optimal timing to perform AVR is uncertain, especially with recent evidence suggesting that patients with AS associated with signs of myocardial…
Does Post-Dilation in TAVR Affect its Long-Term Outcomes?
Transcatheter aortic valve replacement (TAVR) has widely demonstrated its significant benefits, both in high-risk and inoperable patients, as well as in those with intermediate and low risk. While paravalvular regurgitation has been a challenge, its management has improved with operator experience and a deeper understanding of CT angiographies. However, in cases of regurgitation, elevated gradient,…
Coronary Artery Disease in TAVR: Unsolved Dilemma
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially…
Use of Apixaban and Post TAVR Valve Thrombosis
TAVR can be associated to early valve thrombosis, characterized by thrombi formation near or attached to the prosthetic valve, with or without valve dysfunction. This dysfunction is associated with increased leaf thickening and reduced leaflet motion, as well as reduced orifice area or increased transvalvular gradient. Triggered multislice CT allows dynamic valve assessment and thrombosis…
TAVI for Pure Aortic Valve Regurgitation Using a Newself-Expanding Technology | SOLACI-SBHCI 2023
✔️ SOLACI-SBHCI 2023 – International Live Case | TAVI for Pure Aortic Valve Regurgitation Using a Newself-Expanding Technology ✔️ Site: Nanjing First Hospital, Nanjing, China ✔️ August 4, 2023, Copacabana Room, Windsor Oceánico
TAVR: High Implantation of Self-Expanding Valves Directly Impacts ECG
TAVR has been shown beneficial, especially in high risk or inoperable patients. However, there are limitations to its use, especially with self-expanding valves, which are the need for pacemaker implantation and ECG changes after procedure. To address this matter, researchers assessed the right and left cusp overlap effect on 254 patients undergoing TAVR with self-expanding…
MYVAL, a TAVR Balloon-Expandable Valve with Promising Results
TAVR has been shown beneficial over time, and with the development of new generation of prosthetic valves and implantation techniques, outcomes have been improved, reducing the incidence of leaks y and the need for definite pacemaker. This study looked at the evolution of 100 patients with symptomatic aortic stenosis treated with Myval THV from Meril…
Predictors of Stroke at 30 Days and 6 Months After TAVR
While the rate of stroke has decreased since the early days of transcatheter aortic valve replacement (TAVR), it remains non-negligible, reaching up to 1%-3% at 30 days. As TAVR progressively expands to low-risk populations and younger patients, identifying risk factors for patient selection and management in stroke prevention becomes crucial. While researchers have identified predictors…