Transcatheter aortic valve replacement (TAVR) keeps growing in terms of the development of new devices, more extensive operator experience, and enhanced procedure planning. Nowadays, there are multiple device options, which depend on patient characteristics and operator experience. Two-arm studies compared these devices, analyzing the potential benefits of a certain valve over the others. This multicenter…
Device Evolution Also Impacts on Valve in Valve
TAVR to treat dysfunctional biological prosthetics (ViV) with the last generation self-expandable supra-annular prosthetic offers excellent results both clinical and hemodynamic. In addition, there were additional reductions of paravalvular regurgitation compared against the original models. The present registry published in JAHA is the most extensive to treat this issue and replicate outcomes from the clinical…
SOLVE-TAVI after 12-month followup: self-expanding vs. balloon expandable and general vs. local anesthesia
The ambitious SOLVE-TAVI (soon to be published in JACC) is aimed at answering to of the most important questions we make when facing a TAVR procedure: What valve do we choose, a self-expanding or a balloon expandable? And once we have chosen our device, do we proceed with general anesthesia or conscious sedation? The…
The Most Read Articles in Structural Heart Disease of 2020
In this selection, we summarize for you the most important scientific news of 2020 in the field of structural heart disease. 01- Virtual ACC 2020 | COAPT: Better Quality of Life Translates into Harder End-Points After transcatheter mitral valve repair with MitraClip, the COAPT patients saw improved quality of life, better survival rate and fewer hospitalizations…
TCT 2020 | Surprising Differences in Stroke between SAPIEN 3 and Evolut R
One-year outcomes of the head to head trial between CoreValve Evolut R vs Sapien 3 showed a significantly higher difference in stroke vs. patients receiving the self-expanding valve (Sapien 3 6.9% vs Evolut R 1%; p=0.002). The SOLVE-TAVI randomized 2×2 patients with severe aortic stenosis and high surgical risk to Sapien 3 or Evolut R and…
3rd Generation Valves in Large and X-Large Annuli
In patients with large and extra-large annuli, transcatheter aortic valve replacement (TAVR) is safe and feasible with 3rd generation valves: the 29mm balloon expandable valve Sapien-3, and their competitor, the self-expandable 34mm Evolut R. The largest size of both devices was designed specifically for patients with large or extra-large annuli. However, one of them seems…
Self-Expanding Valve vs. Balloon-Expandable Valve, Randomized, Head to Head
The “arms race”among transcatheter valves has been vertiginous. By the time we received the mid- or long-term outcomes of studies focused on a given valve, we were already using its next generation in clinical practice. As a result, there is little information addressing which valve is the best. Nowadays, this “arms race” has reached a…