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…
ACURATE Neo2: One-Year Hemodynamic and Clinical Benefit Results
Both Acurate Neo2 and its predecessor, Acurate Neo, have proven their safety and efficacy in the percutaneous treatment of severe aortic stenosis. The Acurate platform offers a lower gradient and a larger effective orifice area, as well as a low risk of periprocedural complications, according to previous registries. However, the first-generation Acurate device had some…
Evolution of Bicuspid Valves at 12 Months
Severe aortic stenosis due to a bicuspid aortic valve (BAV) is uncommon, especially in individuals under 65 years of age. While there are usually no significant differences according to the type of valve when it comes to surgery, with transcatheter aortic valve replacement (TAVR) some may arise. TAVR has seen significant advancements in the treatment…
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…
Low Gradient, Normal Flow Aortic Stenosis: Changes in Quality of Life with TAVR
There is no question as regards the recommended treatment for symptomatic severe aortic stenosis, seeing as both transcatheter and surgical aortic valve replacement (TAVR and SAVR) have shown to significantly improve prognosis. This is despite the fact that there is still certain ambiguity around its characterization, which looks to define it according to hemodynamic severity…
CAPTIS, a Novel Cerebral Embolic Protection System in TAVR
The incidence of stroke after TAVR ranges between 2 and 5%, depending on the series, which has been associated with higher morbimortality, affecting patient quality of life and their psycho-social environment. Many cerebral embolic protection systems have been developed in response, and even though they have been shown beneficial in many studies, their role in…
Cerebral Embolic Protection Devices: How Useful are they in TAVR?
During TAVR, we often fear the possibility of a stroke, which occurs in approximately 1 – 2% of cases. In general, this phenomenon is caused by thrombi stemming from atherosclerotic or calcified plaque, depending on the etiology. Even though its incidence has declined with technology development and the increasing expertise of operators, it is still…