Nominally deployed transcatheter heart valves SAPIEN 3 has shown excellent durability in accelerated testing to an equivalent 25 year-wear. S3 durability resulted comparable to surgical biological valve durability. Non-nominal implants (overexpansion, underexpansion, and elliptical) also showed excellent durability to an equivalent 5 year-wear. The aim of this study was to test nominally deployed S3 durability to 1 billion…
Cerebrovascular Events After TAVR May Be Especially Serious
Stroke events do not seem to be related to valve thrombosis or structural degeneration, but to a higher baseline risk in patients who undergo transcatheter aortic valve replacement (TAVR). About 1 in 20 patients who underwent TAVR experienced a stroke or transient ischemic attack during follow-up. According to this new analysis, the consequences of these events…
SURTAVI Follow-Up Completed with Good News
The assessment of all severe aortic stenosis patients at intermediate risk of the SURTAVI was finally completed, confirming inferiority against the traditional surgical replacement (SAVR) in hard points such as all-cause mortality and disabling stroke. The aim of this study was to report SURTAVI 2-year outcomes (Surgical Replacement and Transcatheter Aortic Valve Implantation) and confirm…
TAVR Reaches Low-Risk Patients with Bicuspid Valves
Transcatheter aortic valve replacement (TAVR) seems to be safe in low-risk patients with bicuspid aortic valve stenosis. Their hospital length of stay was very short, with zero mortality, and zero disabling stroke. Subclinical leaflet thrombosis and device durability are still unknown. The United States Food and Drug Administration (FDA) approved TAVR for low-risk patients. However,…
Aortic Valvuloplasty as a Bridge to TAVR: Are We Wasting Our Time?
Doing a balloon aortic valvuloplasty can be a good way to “buy” time before a transcatheter aortic valve replacement (TAVR), according to a registry to be published this week in J Am Coll Cardiol Intv. This study analyzed the database of a whole country to find out the incidence, predictors and outcomes of balloon aortic…
Technological Improvements in Valves Translate into Clinical Results
Three generations of self-expanding valves, three different prognoses for our patients. Design improvements and better materials in self-expanding, supra-annular aortic valves, and their better results, have allowed for the expansion of the indication for transcatheter aortic valve replacement (TAVR). Particularly, the addition of a pericardial skirt improves annular sealing and results in a significantly low…
Predilation in TAVR: Definitive Data for Easier Decision-Making?
Direct implantation (without predilation) resulted non-inferior vs. the conventional strategy with prior balloon aortic valvuloplasty using the S3 prosthesis (even though this did not translate into a simplified procedure). In a few patients, the prosthesis was not able to cross the native valve, which resulted in device retrieval and subsequent valvuloplasty. According to these data,…
Virtual ACC 2020 | POPULAR TAVR: Post TAVR Anticoagulation without Clopidogrel?
In patients undergoing transcatheter aortic valve replacement (TAVR) that also required anticoagulation for another indication (mostly atrial fibrillation), the incidence of major bleeding between month 1 and 12 was lower in those receiving only anticoagulation instead of anticoagulation + clopidogrel. The present study presented as part of the scientific sessions at the virtual ACC 2020,…
Virtual ACC 2020 | PARTNER 3: TAVR vs CABG in Low Risk at 2 Years
The 2-year outcomes in patients with severe aortic stenosis and low surgical risk continue to show a numerical benefit in favor of transcatheter aortic valve replacement (TAVR) vs. surgical replacement (CABG) for the primary end point of death, stroke or repeat hospitalization for cardiovascular reasons. However, the initially higher advantage of TAVR has been narrowing…
Virtual ACC 2020 | Conscious Sedation in TAVR
According to the TVT Registry, patients who undergo transcatheter aortic valve replacement (TAVR) with conscious sedation have better outcomes, including lower mortality rates. A minimalist strategy always (sooner or later) proves to be superior across our whole range of procedures, from a simple diagnostic study with local anesthesia and a 4-Fr transradial access, to a…