Tag Archives: severe aortic stenosis

Debemos tener en cuenta a la isquemia crítica de MM II en el TAVI

Pre-TAVR Revascularization: Angiographic or Physiological?

Pre-TAVR Revascularization: Angiographic or Physiological?

In patients undergoing transcatheter aortic valve replacement (TAVR), fractional flow reserve (FFR) guided revascularization is associated with favorable results compared against the traditional angiography guided revascularization.  Given the complete lack of randomized studies, this observational study is the best we have to decide how to guide revascularization in patients with symptomatic severe aortic stenosis undergoing

AHA 2019 | Sapien vs Evolut: A Head-to-Head Study Seems Mandatory

Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality.  The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both

Impacto negativo de la hipertensión pulmonar en el TAVI

Negative Impact of Pulmonary Hypertension in TAVR

Courtesy of Dr. Carlos Fava. The presence of pulmonary hypertension (PH) is frequent in severe aortic stenosis. This can be classified in: isolated pre-capillary PH, isolated post-capillary PH, and combined post-capillary and pre-capillary PH.  At present, little research has looked into the disease from this perspective.  The study looked at 1400 patients and divided them

Meta-Analysis of Large TAVR Studies on Low-Risk: Evidence is Consistent

This meta-analysis which included the 4 large randomized studies on transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) in low-risk patients recently published in JACC, showed TAVR is associated with significant lower mortality compared against SAVR at one year follow up.  These results add to the mounting evidence showing that when it

Remodelado miocárdico reverso luego del reemplazo valvular

Loss in Life Expectancy after Surgical Aortic Valve Replacement

This study found after surgical aortic valve replacement (SAVR) patients had shorter life expectancy, compared against the general population. This loss in life expectancy was significant, especially in young patients. These results provide essential information to advice patients before and after SAVR. This is an observational national cohort study to assess long term relative survival

Clinical Implications of the New Hypertension Guidelines

Hypertension is the first modifiable risk factor affecting morbidity and mortality in nearly half of the adults in the US. The new ACC/AHA guidelines have issued new standards for the detection assessment and management of high blood pressure. The major change compared against their prior version was stage 1 hypertension definition, defined as systolic blood

TAVR Still Gaining Ground Among Low-Risk Patients

Transcatheter aortic valve replacement (TAVR) has become the standard of care for patients with severe aortic stenosis and high surgical risk, and it should be considered as an option for intermediate-risk patients. In recent years, the number of low-risk patients treated with TAVR has increased. This study analyzes low-risk patients from the German Aortic Valve

¿Qué pacientes con bajo flujo y bajo gradiente se benefician del recambio valvular?

Would TAVR Have a Similar Benefit in Patients with Low Flow, Low Gradient, and Preserved Ejection Fraction?

Courtesy of Dr. Carlos Fava. Patients with low-flow low-gradient severe aortic stenosis are at higher risk, but there is a low-flow low-gradient group with preserved ejection fraction. These patients present systolic and diastolic ventricular dysfunction and their progress is different than that of the high-flow high-gradient normal ventricular function group. This study analyzed 1462 patients. Among them,

Terapia endovascular en stroke: mucha evidencia y pocos operadores entrenados

TAVR Learning Curve and Volume-Outcomes Relationship Plateau

Every operator keeps track of their cases. Have they reached their potential or are they still learning and improving their technique? After 1000 procedures, can we expect them to have better results than someone that has only done 500? Prior studies have reached conflictive results and consequently the relationship between learning curve and volume-outcomes remains

¿Qué usar para medir funcionalmente una lesión coronaria en el contexto de estenosis aórtica severa?

Un Underestimated Symptom of Aortic Stenosis

For the first time, this long term observational study on a large cohort of contemporary patients with aortic stenosis (AS), has shown syncope is an underestimated threat, associated with worse prognosis after surgical aortic valve replacement (SAVR). It is interesting to note that other symptoms or early signs of AS that will normally indicate SAVR

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