This large registry has shown bicuspid aortic stenosis (AS) patients have similar mortality with transcatheter aortic valve replacement (TAVR) compared against surgical valve replacement (SAVR). TAVR outcomes in this population are not only similar to SAVR outcomes, but also to TAVR outcomes in patients with conventional aortic valve anatomy. Despite the good news, these outcomes…
Europe Grants Approval to Balloon-Expandable Valve in Low-Risk Patients; Self-Expanding Valve Still Waiting for It
The balloon-expandable valve has been granted approval in Europe for treatment of the complete risk spectrum of symptomatic severe aortic stenosis. Europe has recently approved an expanded indication for the Sapien 3 system for use in low-risk patients, as reported by Edward Lifesciences. Sapien 3, which includes the next-generation Sapien 3 Ultra, is the first transcatheter heart valve…
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…
Infective Endocarditis After TAVI
Infective endocarditis after transcatheter aortic valve implantation (TAVI) is one of the most feared complications due to its morbidity and mortality. With the expansion of TAVI into all risk groups, endocarditis might be a long-term concern. However, its long-term risk seems similar to that of endocarditis with surgically-implanted biological valves; consequently, it should not affect…
Prosthesis Mismatch in Supra and Intra Annular valves
The self-expandable valve was associated to lower prosthesis-patient mismatch (PPM) compared against the balloon expandable valve regardless annular area, according to this study soon to be published in J Am Coll Cardiol Intv. This difference was basically driven by patients with larger body surface area (>1.83m²). Prosthesis mismatch has been associated to increased mortality after transcatheter…
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…
Incidence and Prognosis of Heart Valve Embolization
The incidence of peri-procedural transcatheter heart valve embolization and migration (TVEM) is as low as 1%. However, it is associated with increased morbidity and mortality. Peri-procedural TVEM is one of the most feared complication given its potential to transform the procedure into a catastrophe, but little do we know about its incidence (except for a…
Trying to Reduce Post TAVR Kidney Injury
Acute kidney injury is a common complication after transcatheter aortic valve replacement (TAVR) and is associated to increased mortality both short and long-term. In patients undergoing percutaneous coronary intervention (PCI) forcing diuresis with controlled hydration has shown to reduce the incidence of acute kidney injury in nearly 50%. However, this has not been tested in…
MIDAS Strategy: Minimizing Implantat Depth According to Membranous Septum
Permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) continues to be one of the most frequent complications. Even though its real impact on prognosis continues to be controversial, its impact on healthcare cost is out of the question, in addition to being uncomfortable for patients. This study, soon to be published in J Am…
TAVR Offers Better Quality of Life to Low Risk Patients
Courtesy of Dr. Carlos Fava. As we all know, TAVR is gaining ground fast in the lower risk patient population, but in addition to analyzing the most important events, researchers are increasingly looking at health status, not only at hospital level, but also after one year. This study looked into PARTNER 3 patient health status…