Researchers behind this small study believe that fracturing the rigid calcium deposits on leaflets with this new device could delay the need for transcatheter aortic valve replacement (TAVR) or facilitate it. This device showed actual improvement of leaflet mobility together with mean gradient reduction. The Leaflex Performer system (Pi-Cardia) was used in 16 patients with…
EuroPCR 2019 | TAVR Durability Offers Certain Guarantees at 8 and 10 Years
It has been 3 years since EuroPCR 2016 and the presentation of the first data on possible transcatheter valve degeneration, which sparked fear regarding the possibility that transcatherter aortic valve replacement (TAVR) devices might degrade earlier than expected due to the pressure put on them to introduce them into the delivery catheter. At EuroPCR 2019,…
EuroPCR 2019 | Long-Term Follow-Up for New Left Bundle Branch Block After TAVR Is Reassuring with Certain Precautions
Long-term follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and developed left bundle branch block (LBBB) after the procedure seems reassuring. Although it is not benign, it is associated with more conduction defects, more pacemakers, and worsening ventricular function. Long-term follow-up “partially reassures” the concerns of many physicians about new LBBB after TAVR.…
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…
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,…
Is Hybrid Operating Room Necessary for Safe TAVR
According to this sub-study of the FRANCE TAVI registry, mortality is similar for transcatheter aortic valve replacement in hybrid operating rooms vs. conventional catheterization labs. These findings support performing TAVR in conventional cath labs, which goes hand in hand with TAVR expansion, with improved logistics and organization costs. This study compared outcomes of patients undergoing…
Lotus Returns with New Strength and the FDA Approval to Compete with Sapien3 and CoreValve Evolut R
After reports of some serious adverse events with first-generation Lotus, the device was pulled off the market—but it was not meant to be left in oblivion. Now, it is back, renewed and with the approval of the United States Food and Drug Administration (FDA), to compete directly with the two market leaders (Sapien and CoreValve),…
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…
Is Tricuspid Regurgitation after TAVR Significant?
Courtesy of Dr. Carlos Fava. Severe or moderate mitral regurgitation is associated to worse evolution after TAVR. However, we should not forget the tricuspid valve that, even though not extensively researched, is also associated to a negative impact in its evolution. A meta-analysis of 12 studies with a total 41485 patients was carried out. …
Modern Valves Reduce the Need for a Pacemaker
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons. The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with…