This study was simultaneously presented at TCT and published at JACCE, and it aims at showing the one-year outcomes of this new TAVR device, though follow-up is at 5 years. Primary end point was all cause mortality and secondary end points included clinical and echocardiographic events. With a total 941 patients (82,4 ± 5,9…
TCT 2018 | NEOPRO: A Registry for Acurate neo and Evolut PRO
The purpose of this registry was to compare short-term clinical events and echocardiographic findings in two self-expanding valves used with transfemoral access, Acurate neo and Evolut PRO. The registry included a retrospective follow-up of 1551 patients, among whom 1263 received an Acurate neo valve and 288 received an Evolut Pro valve. The procedural success rates according to VARC-2 criteria were…
TCT 2018 | PARTNER 2 Valve-in-Valve: Clinical and Hemodynamic Results Maintained in the Long Term
The 1-year follow-up for this study was published last year in JACC, and it showed that transcatheter aortic valve replacement (TAVR) in failed bioprosthetic valves has low rates of complications, boosts significant hemodynamic improvement, and results in relatively low mortality. Now, the 3-year results are presented at TCT 2018. The study followed 365 patients who underwent valve-in-valve…
New Atrial Fibrillation After TAVR Indicates Prognosis
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has emerged as an important treatment alternative for intermediate- and high-risk patients. In that sense, the presence of atrial fibrillation (AF) before TAVR is high and it has been associated with worse outcomes and higher mortality. However, there is not much evidence available regarding new-onset atrial…
TAVR Post-dilation Is Safe
Courtesy of Dr. Carlos Fava. Numerous studies have shown that the presence of aortic regurgitation after TAVR is associated with worse evolution, and that balloon post-dilation (BPD) is the adequate strategy to correct this. However, a few reports using first generation valves have associated BPD to complications such as stroke, annulus rupture and valve displacement,…
Debris Captured by SENTINEL Devices Result Different across Different Valves
The idea behind this study is that debris can be captured in all patients during TAVR, even though we still ignore which patients would benefit more from this device. Tissue particles captured by the SENTINEL during TAVR vary from valve to valve, according to this new analysis. There are differences in size and number of…
ESC 2018 | FRANCE-TAVI: Atrial Fibrillation and Anticoagulation Associated to Mortality in TAVR
Some of the many ongoing randomized studies including patients with atrial fibrillation (AF) might finally answer the question on the best antithrombotic scheme post TAVR. According to this registry, in patients undergoing transcatheter aortic valve replacement, independent predictors of death at 3 years are being a man, having moderate to severe kidney failure, and having…
Gradient vs. Flow to Determine Aortic Valve Stenosis Severity before and after TAVR
Pressure loss vs. flow curves offer a fundamental synthesis of fluids dynamics in describing aortic valve physiopathology. Severe aortic stenosis is not just an orifice (as suggested by Gorlin) or a segment that offers dynamic resistance. However, once a new transcatheter valve has been implanted, it will behave purely as a resistor. At dobutamine dose,…
More Favorable Evidence for TAVR in Severe Aortic Regurgitation
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) was developed for aortic stenosis, but there is a significant number of patients with severe aortic regurgitation who still undergo this procedure as an off-label indication. Current evidence for this procedure in relation with this disease is growing, mainly due to good results obtained by different…
Far from a Being a Pun, Malnutrition Tips the Scales in TAVR
Nutritional status is associated with higher mortality in elderly patients with severe aortic stenosis who require valve replacement, whether through conventional surgical strategy or transcatheter aortic valve replacement (TAVR). Malnutrition is obviously associated with frailty. As an advantage, it can be quite evident to our clinical eye and weighing scales are enough to define it.…