Courtesy of Dr. Carlos Fava. Moderate/severe paravalvular regurgitation (PVR) after TAVR is present in 10%-14% of all cases, according to different series. The treatment of choice is post-dilation, generally effective in most cases. However, this strategy carries a risk of stroke. The true impact of this conduct is still unclear. This review analyzed 6 studies that included 5007 patients; 889 of…
Transcatheter valve replacement in the bicuspid valve is increasingly performed, but challenges remain
As experience increases, transcatheter aortic valve replacement (TAVR) has expanded to different populations and anatomies. This study sought to compare technical and clinical outcomes in patients with bicuspid versus tricuspid aortic stenosis from the Bicuspid AS TAVR Multicenter Registry. Outcomes of 561 patients with bicuspid valves and 4546 patients with tricuspid valves were compared. Propensity score matching was used…
Incidence, characteristics, and treatment of valve thrombosis after TAVR
Certain studies have carried out a tomographic follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and described the frequency of leaflet thrombosis; however, in most cases, it is unclear whether this finding requires some sort of intervention. The difference between this work and those previously published is that this study is not focused on imaging, it…
TAVI without predilation is feasible and safe
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve implantation has already proven to be beneficial for high-risk and inoperable patients. In that sense, it is also an increasingly frequent solid option for lower-risk patients. However, due to the presence of valve calcifications, it may occasionally be necessary to assess the benefits and risks of valve dilation…
SENTINEL study: cerebral protection during TAVR
Neurological complications during and after transcatheter aortic valve replacement (TAVR) are probably the only event whose incidence has not been reduced by new valve designs (as opposed to paravalvular leak, vascular complications, or need for pacemaker implantation). Aside from the potential seriousness of this clinical event, the risk of embolism is particularly worrisome because,…
TAVR presents less post-procedural MI than surgical aortic valve replacement
Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement (SAVR) continues to be elective, but the presence of post-procedural acute myocardial infarction (AMI) has been associated to bad evolution. Despite the proven benefits of TAVR for high risk patients and the progress shown by patients of intermediate risk, the incidence of post implantation MI has…
In-hospital morbid-mortality rates for balloon aortic valvuloplasty are similar to those for transcatheter aortic valve implantation
Courtesy of Dr. Carlos Fava. The balloon aortic valvuloplasty (BAV) was introduced by Dr. Cribier in 1986. However, given its poor results, soon after it fell into disuse. With the introduction of TAVR, it saw a revival as bridge for another intervention, even though it is still resisted in many places. The present study…
Low Gradient Aortic Stenosis Won’t Improve with TAVR
Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found…
[SURTAVI] Sub-study of neurological events: more evidence in favor of TAVR
Courtesy of SBHCI. The occurrence of a periprocedural neurological events is associated to an increased risk of death and morbidity at long term, both for transcatheter aortic valve replacement (TAVR) and for surgery. The SURTAVI study, recently presented at the ACC meeting and simultaneously published by NEJM, showed that TAVR with self-expandable CoreValve or Evolut…
NOTION: TAVI with low risk at 4 year follow up
Courtesy of the SBHCI. There is little data about the use of transcatheter aortic valve replacement (TAVR) to treat patients with severe aortic stenosis at low surgical risk. Many of the questions involve long term duration of valves (over 10 years) when treating younger patients with longer life expectancy. The NOTION study aims at comparing…