The aim of this study was to evaluate the long-term performance of transcatheter aortic valve replacement (TAVR) and surgically-implanted valves through longitudinal echocardiographic follow-up of the PARTNER I trial patients. The study included all patients receiving TAVR or undergoing surgery who had a post-implant echocardiogram at five years analyzed for peak systolic velocity, mean gradient,…
Post TAVR Cognitive Function at Short Term: Better or Worse?
There is little information on the short and mid-term evolution of cognitive function after transcatheter aortic valve replacement (TAVR). The aim of this study was to describe global changes in cognitive function and changes in specific cognitive domains one year after TAVR. Fifty one patients undergoing TAVR, median age 80, were prospectively followed…
Apixaban: An Alternative for Patients with Atrial Fibrillation Undergoing TAVR?
Courtesy of Dr. Carlos Fava. The prevalence of atrial fibrillation in patients undergoing transcatheter aortic valve replacement (TAVR) is high (32.9%, according to the PARTNER Trial, and 46.8%, according to the CoreValve High-Risk Study), and is associated with thromboembolic events (as in all other populations). Apixaban has shown to benefit patients with nonvalvular atrial fibrillation,…
TAVR in Low-Flow Low-Gradient Aortic Stenosis and Severe Impairment of Systolic Function
Patients with low-flow, low-gradient severe symptomatic aortic stenosis associated with severe impairment of the left ventricular systolic function have shown acceptable outcomes after transcatheter aortic valve replacement (TAVR), according to the multicenter TOPAS-TAVI registry, which demonstrated a relatively low 30-day mortality rate. Considering the very high risk presented by this population involved, a 30-day…
Permanent Pacemaker Predictors with SAPIEN 3
The aim of this study was to identify permanent pacemaker (PPM) predictors after transcatheter aortic valve replacement (TAVR) with last generation balloon expandable valve Edwards SAPIEN 3. The new conduction disturbances requiring PPM are one of the biggest concerns after TAVR, and their predictors have not yet been defined. 229 patients undergoing TAVR…
Transcaval Access: Another Alternative to Femoral Access Counterindication
For TAVR eligible patients (transcatheter aortic valve replacement) with femoral access counterindication, a new access site, extra thoracic yet percutaneous, may offer an alternative. This consists of reaching the abdominal aorta through the vena cava. With this technique the operator enters the abdominal aorta through the vena cava by electrifying a guidewire, advancing a…
Coronary Lesions After TAVR: Severity May Be Modified
Courtesy of Dr. Carlos Fava. Between 40% and 70% of patients undergoing transcatheter aortic valve replacement (TAVR) present coronary lesions. The fact that aortic stenosis affects how blockages act, and that, after stenosis correction, hemodynamic compromise for those same lesions may vary, has been consistently proven. Its management has not been determined yet. The study…
TAVR in Pure Aortic Insufficiency: Yes or No?
Courtesy of Dr. Agustín Vecchia. Surgery is the treatment of choice for patients with symptomatic aortic insufficiency and/or ventricular dilatation or decreased ventricular function. The broad implementation of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis, the emergence of new devices, and the experience acquired by operators have brought this treatment to off-label indications such…
TAVR: Transcarotid Access as a Valid Alternative
Courtesy of Dr. Carlos Fava. Transfemoral access is the first choice for transcatheter aortic valve replacement (TAVR). However, this approach is not feasible for a progressively larger number of patients, which establishes the need to search for alternative accesses. Between 2009 and 2014, this study enrolled 174 patients who underwent TAVR and were unsuitable for transfemoral…
TAVR: Pre-Existing Complete Right Bundle Branch Block Is Associated with Mortality
Courtesy of Dr. Carlos Fava. The fact that the presence of a complete right bundle branch block (RBBB) increases the risk of bradycardia, high-grade atrioventricular block, and need for a permanent pacemaker (PPM) after TAVR is well-known. The impact of pre-existing complete right bundle branch block has not been well-studied. This article analyses 749 patients enrolled in…