In the context of TAVR, one of the current challenges is the need for permanent pacemaker implantation (PPM), especially when using self-expanding valves (SEV). The information available in this regard remains controversial; while some studies suggest new PPM implantation will have no significant effect on clinical evolution, others have associated them with worse prognosis. As…
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…
High Implantation of Self-Expanding Valves in the Aortic Position or Cusp Overlapping: Should It Be the New “Gold Standard”?
Transcatheter aortic valve replacement (TAVR) has been proving its benefit in different scenarios for two decades now. However, in the field of self-expanding valves, one challenge has always been its high rate of pacemaker implantation compared with balloon-expandable devices and valvular replacement surgery. For this reason, the high implantation or Cusp Overlapping strategy was developed.…
Balloon expandable vs Self-Expanding Valves: The Best Option for ViV-TAVR in Small Annuli
TAVR has consolidated as an increasingly valid alternative to treat failed surgical aortic valve bioprostheses. One of the major challenges it presents is patients with small annuli treated with a surgical bioprosthesis. There is little data available about this scenario. A few observational studies have shown what appears to be a hemodynamic advantage of…
Low Risk Patients: TAVR with Self-Expanding Valves Offers Similar Outcomes to Surgery Based on a Bayesian Analysis?
When compared against surgical valve replacement (SAVR) transcatheter aortic valve replacement (TAVR) has shown benefits across different risk groups, not only in events as death and stroke, but also in quality of life (especially in the first months post procedure) and improved symptoms. However, a catch-up phenomenon was observed in low-risk patients between the first…