Tag Archives: severe aortic stenosis

Death, Stroke, and Hospitalization while Waiting for TAVR

Death, Stroke, and Hospitalization while Waiting for TAVR

The consequences of deferring transcatheter aortic valve replacement (TAVR) procedures because of the COVID 19 pandemic are piling up. Untreated severe aortic stenosis patients who had been scheduled for TAVR are seeing increased risk of all events, even mortality.  According to recent studies published in JAMA, deferring TAVR in patients with symptomatic aortic stenosis is

TAVI bajo riesgo

TAVR as Anti-Inflammatory? An effect few imagined

We never saw it coming, such a pleiotropic effect: who would have though a mechanical device could have such a systemic anti-inflammatory effect? Transcatheter aortic valve replacement (TAVR) does in fact have it.  The shear stress aortic stenosis produces activates multiple inflammatory responses mediated by monocytes. This study identified the most important mechanoreceptor, involved in

Válvula Bicúspide

Good Evolution of Bicuspid Valves with EVOLUTE or EVOLUTE PRO

Courtesy of Dr. Carlos Fava. TAVR has matured over time and has advanced onto low risk patients, but one of its greatest challenges continues to be bicuspid valve patients. These represent between 1% and 2% of the population and over 20% of young adults requiring surgical valve replacement (SAVR).  The study looked at 27,086 patients

Enfermedades malignas y estenosis aórtica ¿Se justifica el TAVI?

Malignancies and Aortic Stenosis: Is TAVR Warranted?

This meta-analysis tells us that patients with active malignancies and severe aortic stenosis have a good evolution after transcatheter aortic valve replacement (TAVR), except for a higher rate of pacemaker implantation in the general population. These patients must not be limited to respite care only, at least as far as aortic stenosis is concerned. Short-term

¿Se debe tener en cuenta el género para revascularizar el tronco?

Myocardial Fibrosis in Severe Aortic Stenosis: A Matter of Sex?

Courtesy of Dr. Carlos Fava. Aortic valve calcification and its resulting stenosis leads to changes in left ventricle hemodynamics, producing diffuse ischemia followed by inflammation, increased extracellular matrix, necrosis, and later, diffuse fibrosis.  At present, with magnetic resonance imaging (MRI) we can analyze ventricular architecture and its function by detecting fibrosis (LGE) and its volume

Recomendaciones de la ACC con el nuevo coronavirus

Procedural Rescheduling Criteria in the Pandemic Era

Patients with structural heart disease are at higher risk in the face of the new coronavirus infection due to both advanced age and numerous comorbidities. All variables must be taken into account when deciding whether a patient can wait (so as to minimize the risk of exposure to the virus) or their pathology must be

Virtual ACC 2020 | First Results of Evolut in Low-Risk Bicuspid Valves

The initial results of this study presented “virtually” at the American College of Cardiology (ACC) 2020 Scientific Session suggest that patients with severe bicuspid aortic stenosis can be treated with self-expandable valve Evolut. This is a small study presenting its 30-day outcomes. There is still a long way to go. The rate of all-cause mortality

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

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