TAVR has been shown beneficial in patients across the risk spectrum. The PARTNER 2 SAPIEN 3 (P2S3i) study on intermediate risk patients was the first to show TAVR superiority vs SAVR when using the transfemoral approach. SAVR durability has been shown in different analysis but, except for a few reports, TAVR durability at long term…
Aortic Stenosis and Cardiogenic Shock: Is TAVR an Option?
Cardiogenic shock (CS) in a setting of aortic stenosis is associated with high mortality rates. In consequence, surgery is generally not a possibility for this patient group, and they usually undergo aortic valvuloplasty, resulting in a mortality rate of 33%-50% at 30 days, 70% at one year, and 90% at two years. While transcatheter aortic…
VASC-OBSERVANT II Substudy: Impact of Vascular Complications after TAVR
At present, transcatheter aortic valve replacement (TAVR) has become increasingly common to treat severe symptomatic aortic stenosis, with the transfemoral approach being the most common access strategy, associated to better outcomes vs. other access sites. Even though vascular complication rates (VC) have dropped given increased operation experience and improved devices, such as the use of…
TAVI in Moderate Aortic Stenosis with Low Ejection Fraction
The presence of aortic stenosis, heart failure, and decreased ventricular function is associated with poor prognosis and high mortality. For this reason, both European and American guidelines classify severe stenosis as a Class I indication. There are two retrospective analyses that demonstrate the benefits of transcatheter aortic valve implantation (TAVI) via transfemoral access. The TAVR…
TAVR: Does HALT Affect Follow-Up?
Transcatheter aortic valve replacement (TAVR) in low-risk patients has been shown to be superior or noninferior in randomized studies, but the presence of valvular thrombosis, in its different forms, has not been well analyzed, nor is there much information on its impact on evolution. Researchers conducted an analysis of the LTR study that included 200…
Impact of Right Ventricular Pacing in Patients with Permanent Pacemaker Implantation after TAVR
Permanent pacemaker implantation (PPI) is a relevant complication in patients undergoing transcatheter aortic valve replacement (TAVR) despite there being new devices. The current information on the long term impact of this complication remains unclear and recent evidence suggests post-TAVR ventricular pacing (VP) might be associated to higher risk of all-cause mortality and hospitalization for cardiac…
EuroPCR 2023 | TAVR in TAVR Results with Balloon-Expandable Valves
With the expansion of transcatheter aortic valve replacement (TAVR) use in the low-risk population, more patients will need repeat valve replacement in the future, making it paramount to understand the performance of repeat TAVR. Currently, this information is limited. The aim of this study was to analyze the real-world experience of performing a second TAVR…
Redo Surgical Aortic Valve Replacement after Prior Transcatheter vs Surgical Aortic Valve Replacement: A Growing Population
Transcatheter aortic valve replacement (TAVR) has evolved since it was first implemented, and it is now also used to treat low risk patients. One of the questions this has raised is whether patient life expectancy is higher than prosthesis life expectancy. The growing population in need for valve replacement also poses the question of how…
Is There a Way to Reduce the Need for Permanent Pacemaker Implantation in Self-Expanding Valves?
We are well aware of the benefits of TAVR in different scenarios, but the need for permanent pacemaker implantation (PPI) in self-expandable valves is between 15% and 30% according to different randomized and non-randomized studies. This is why the higher implantation strategy or cusp overlap (COT) was developed and, though it has been shown to…
High Implantation of Self-Expanding Valves in the Aortic Position or Cusp Overlapping: Should It Be the New “Gold Standard”?
Transcatheter aortic valve replacement (TAVR) has been proving its benefit in different scenarios for two decades now. However, in the field of self-expanding valves, one challenge has always been its high rate of pacemaker implantation compared with balloon-expandable devices and valvular replacement surgery. For this reason, the high implantation or Cusp Overlapping strategy was developed.…