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Variable rate of stroke after transcatheter aortic valve replacement with self-expandable valves: more doubts than certainties
This commentary refers to ‘Comparison of newer generation self-expandable vs. balloon-expandable valves in transcatheter aortic valve implantation: the randomized SOLVE-TAVI trial’ by H. Thieleet al., 2020;41:1890 –1899.
Source: European Heart Journal - August 18, 2020 Category: Cardiology Source Type: research

Stroke rates after transcatheter aortic valve replacement: does valve choice play a role?
This commentary refers to ‘Comparison of newer generation self-expandable vs. balloon-expandable valves in transcatheter aortic valve implantation: the randomized SOLVE-TAVI trial’, by H. Thieleet al., 2020;41:1890 –1899.
Source: European Heart Journal - August 18, 2020 Category: Cardiology Source Type: research

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)
ConclusionTranscatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.
Source: European Heart Journal - June 23, 2019 Category: Cardiology Source Type: research

Transcatheter aortic valve implantation vs. surgical aortic valve replacement for treatment of symptomatic severe aortic stenosis: an updated meta-analysis
Conclusion  Compared with SAVR, TAVI is associated with reduction in all-cause mortality and stroke up to 2  years irrespective of baseline surgical risk and type of THV system.
Source: European Heart Journal - April 23, 2019 Category: Cardiology Source Type: research

Clinical and haemodynamic outcomes of balloon-expandable transcatheter mitral valve implantation: a 7-year experience
ConclusionTranscatheter mitral valve implantation using balloon-expandable valves in selected patients with bioprosthesis or annuloplasty failure or severe MAC was associated with a low rate of peri-procedural complications and acceptable long-term outcomes.
Source: European Heart Journal - May 19, 2018 Category: Cardiology Source Type: research

‘Ten Commandments’ of the EHRA Guide for the Use of NOACs in AF
Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain. In 2013, the first “EHRA Practical Guide” was published to provide practical guidance for situations; an update was published in 2015. Below ...
Source: European Heart Journal - April 21, 2018 Category: Cardiology Source Type: research

Impact of low stroke volume on mortality in patients with severe aortic stenosis and preserved left ventricular ejection fraction
ConclusionLow flow defined as SVi  <  30 mL/m2 or SV  <  55 mL is an important outcome predictor in severe AS with preserved LVEF under medical and surgical management. Further studies are needed to prospectively test these values for risk stratification and decision making.
Source: European Heart Journal - March 13, 2018 Category: Cardiology Source Type: research

Unveiling transthyretin cardiac amyloidosis and its predictors among elderly patients with severe aortic stenosis undergoing transcatheter aortic valve replacement
ConclusionsTransthyretin cardiac amyloidosis is prevalent in 16% of patients with severe calcific AS undergoing TAVR and is associated with a severe AS phenotype of low-flow low-gradient with mildly reduced ejection fraction. Average tissue Doppler mitral annular S ’ of <  6 cm/s may be a sensitive measure that should prompt a confirmatory99mTc-PYP scan and subsequent testing for ATTR-CA. Prospective assessment of outcomes after TAVR is needed in patients with and without ATTR-CA.
Source: European Heart Journal - August 1, 2017 Category: Cardiology Source Type: research

Final 5-year clinical and echocardiographic results for treatment of severe aortic stenosis with a self-expanding bioprosthesis from the ADVANCE Study
ConclusionFive-year results in real-world, elderly, high-risk patients undergoing TAVI with a self-expanding bioprosthesis provided evidence for continued valve durability with low rates of reinterventions and haemodynamic valve dysfunction.Trial registrationClinicalTrials.gov, NCT01074658.
Source: European Heart Journal - June 13, 2017 Category: Cardiology Source Type: research

SOURCE 3: 1-year outcomes post-transcatheter aortic valve implantation using the latest generation of the balloon-expandable transcatheter heart valve
ConclusionIn SOURCE 3, we observe a low complication rate and mortality at 1  year. Given the low incidence of higher degree paravalvular leakages, this variable did no longer affect outcome. Clinicaltrial.gov number: NCT02698956.
Source: European Heart Journal - June 12, 2017 Category: Cardiology Source Type: research

Transcatheter aortic valve thrombosis: the relation between hypo-attenuated leaflet thickening, abnormal valve haemodynamics, and stroke
Conclusion</div>On MDCT, 12.5% of patients showed HALT or reduced leaflet motion, whereas only one of these patients had abnormal valve haemodynamics on echocardiography. Neither HALT nor increased transvalvular gradient were associated with stroke/TIA.</span>
Source: European Heart Journal - March 27, 2017 Category: Cardiology Source Type: research

Aortic valve replacement with mechanical vs. biological prostheses in patients aged 50-69 years
Conclusion Patients aged 50–69 years who received mechanical valves had better long-term survival after AVR than those with bioprostheses. The risk of stroke was similar; however, patients with bioprostheses had a higher risk of aortic valve reoperation and a lower risk of major bleeding. Clinical Trial Registration http://clinicaltrials.gov/show/NCT02276950. ClinicalTrials.gov Identifier NCT02276950.
Source: European Heart Journal - September 20, 2016 Category: Cardiology Authors: Glaser, N., Jackson, V., Holzmann, M. J., Franco-Cereceda, A., Sartipy, U. Tags: Cardiovascular surgery Source Type: research

Early clinical and echocardiographic outcomes after SAPIEN 3 transcatheter aortic valve replacement in inoperable, high-risk and intermediate-risk patients with aortic stenosis
Conclusions The SAPIEN 3 THV system was associated with low rates of 30-day mortality and major/disabling stroke as well as low rates of moderate or severe paravalvular regurgitation. Trial Registration ClinicalTrials.gov #NCT01314313.
Source: European Heart Journal - July 20, 2016 Category: Cardiology Authors: Kodali, S., Thourani, V. H., White, J., Malaisrie, S. C., Lim, S., Greason, K. L., Williams, M., Guerrero, M., Eisenhauer, A. C., Kapadia, S., Kereiakes, D. J., Herrmann, H. C., Babaliaros, V., Szeto, W. Y., Hahn, R. T., Pibarot, P., Weissman, N. J., Leip Tags: TAVI Source Type: research

The future of transcatheter aortic valve implantation
Since the introduction of transcatheter aortic valve implantation (TAVI) into clinical practice, the treatment of aortic stenosis has changed dramatically. In the past, medical therapy with or without balloon aortic valvuloplasty was the only option for inoperable patients. More recently, TAVI has become the treatment of choice for these patients and the preferred alternative for high-risk operable patients. Surgical aortic valve replacement (SAVR) currently remains the gold standard for patients at low or intermediate operative risk. As randomized trials have demonstrated comparable results between TAVI and SAVR in the hi...
Source: European Heart Journal - March 7, 2016 Category: Cardiology Authors: Hamm, C. W., Arsalan, M., Mack, M. J. Tags: Frontiers in cardiovascular medicine Source Type: research

Transcatheter treatment of severe tricuspid regurgitation with the MitraClip system
Conclusions Transcatheter tricuspid valve repair by use of interventional edge-to-edge repair with the MitraClip system was feasible, and safe in three consecutive patients. Reduction of tricuspid insufficiency associates with relief of clinical symptoms for right heart failure. This strategy seems a promising treatment option for patients at prohibitive surgical risk.
Source: European Heart Journal - March 7, 2016 Category: Cardiology Authors: Hammerstingl, C., Schueler, R., Malasa, M., Werner, N., Nickenig, G. Tags: EHJ BRIEF COMMUNICATION Source Type: research

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