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…
Is TAVR Beneficial in Cardiogenic Shock?
The presence of cardiogenic shock (CS) in a setting of aortic stenosis ranges from 1% to 4%. The prognosis for this scenario is ominous due to subendocardial ischemia, which presents as a decrease in ventricular preload and an increase in afterload. Aortic valvuloplasty has been used in this context, but, unfortunately, it has been associated…
Impella in High Risk Coronary Angioplasty before TAVR
The population is aging, which is closely related with the presence of aortic stenosis. This condition, as we know, is associated with coronary artery disease (CAD) approximately in 50% of cases. In high risk surgical patients, this calls for procedures such as percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). PCI with ventricular…
TCT 2023 | EVOLUT Low Risk: 4-Year Follow-up
In recent years, there has been a steady increase in the use of transcatheter aortic valve replacement (TAVR) in younger patients, with an average age of 74 years, as observed in US medical records. This trend goes alongside encouraging durability results, as demonstrated in the 10-year NOTION study, where structural valve degeneration (SVD) with first-generation…
TCT 2023 | The WATCH-TAVR Study
In the TVT registry, around 40% of the patients eligible for transcatheter aortic valve replacement (TAVR) had atrial fibrillation, and there were high levels of adverse events after starting anticoagulant treatment, especially with oral anticoagulants (VKAs), primarily due to bleeding. The purpose of this study was to assess the feasibility, safety, and efficacy of combined…
Cause of Cardiac Death after TAVR at Present
Cardiac failure (CF) and sudden cardiac death (SCD) stand out as two of the main causes of death in patients with aortic stenosis. Although transcatheter aortic valve intervention has shown higher survival, these two continue to be the main conditions leading to patient death at followup. In its early days, TAVR also showed benefits, but…
Predictors and Evolution of Need for PPM after TAVR with Self-Expanding Valves
In the context of TAVR, one of the current challenges is the need for permanent pacemaker implantation (PPM), especially when using self-expanding valves (SEV). The information available in this regard remains controversial; while some studies suggest new PPM implantation will have no significant effect on clinical evolution, others have associated them with worse prognosis. As…