This work studies cognitive evolution after transcatheter aortic valve implantation (TAVI). Previous smaller studies reported conflicting results on cognitive function after TAVI. This study prospectively included 229 patients who were ≥70 years old, had undergone TAVI and were assessed using the Mini Mental State Examination before and 6 months after the procedure. Cognitive deterioration or improvement was…
Cerebral Protection in TAVR: Studies Presented at London Valves
SENTINEL One of the new devices assessed at London Valves was Sentinel, which is made up of two independent filters. The larger filter is deployed in the brachiocephalic trunk, and the smaller filter is deployed in the left common carotid artery. The study included 22 patients and the device was deployed successfully in 20 of them…
Late Mortality in TAVR Is Mainly Due to Non-Cardiac Causes
Transcatheter aortic valve replacement (TAVR) has revolutionized the management of high-risk patients with severe aortic stenosis. However, survival after the procedure and severe complications have been assessed in relatively small populations with limited follow-up. This article reports long-term clinical results in the FRANCE-2 (FRench Aortic National CoreValve and Edwards) registry. The FRANCE-2 registry…
Stroke Predictors in TAVR: CoreValve vs. Sapien
A comprehensive analyzis of cerebrovascular events in major randomized controlled studies on transcatheter aortic valve replacement (TAVR) has shown some interesting data on both risks and timing of stroke in this setting. The study carried out by Dr. Neal Kleiman, reviewed data on stroke and stroke predictors among 3,687 patients included in the CoreValve…
Paravalvular Insufficiency After TAVR: A Better Predictor of Endocarditis
Data from this large international registry associate endocarditis after a transcatheter aortic valve replacement (TAVR) with high rates of early and late mortality, and might help find predictors identifying patients with the highest risk of developing this rare but dangerous complication. So far, information on endocarditis after TAVR was limited to small populations. In…
New TAVR Devices: Better Results in Bicuspids
Courtesy of del Dr. Carlos Fava. The bicuspid aortic valve is highly anatomically challenging because of valve asymmetric calcification, increased annulus diameter, raphe calcification and ascending aorta dilation. The new valves have shown to improve results, but we still lack data on this group. 301 patients presenting bicuspid aortic valve undergoing transcatheter aortic…
A Study on Valve Thrombosis After TAVI
This study, presented in Rome at the European Society of Cardiology Congress 2016 and published simultaneously online in the Journal of the American College of Cardiology (JACC), has identified a post-TAVI valve thrombosis rate of 7% using multidetector computerized tomography (CT). However, the vast majority of cases were completely asymptomatic. Previous studies had shown…
SAPIEN 3: Low One-Year-Mortality in High Risk or Inoperable Patients
In the first PARTNER trial (Placement of Aortic Transcatheter Valves), mortality at one year was 24% for high risk patients and 31% for inoperable patients. A recent report on SAPIEN 3 outcomes at 30 days ─ the last generation balloon expandable valve ─ showed a rather lower adverse events rate. However, additional information at longer…
Bivalirudin or Heparin to Decrease Cerebral Embolization Post TAVI?
Cerebral embolization is a relatively frequent complication during transcatheter aortic valve replacement (TAVR). The hypothesis behind this study is that the incidence of cerebral embolization might be decreased by anticoagulation with bivalirudin, instead of heparin. The first study objective was to determine the proportion of patients with new cerebral embolus after TAVI and…
Pre-TAVI Mitral Regurgitation Is Associated with Higher Mortality
Courtesy of Dr. Carlos Fava. This study sought to analyze the clinical impact and the level of improvement of mitral regurgitation (MR) in patients who receive a transcatheter aortic valve replacement (TAVR), and to find potential candidates for double valve repair with percutaneous techniques. Of 1.110 patients included, 177 (15.9%) suffered from severe pre-TAVR mitral…