Publications by authors named "Marina Urena"
Introduction And Objectives: The Valve Academic Research Consortium (VARC)-3 definition of the early safety (ES) composite endpoint after transcatheter aortic valve replacement (TAVR) lacks clinical validation. The aim of this study was to determine the incidence, predictors, and clinical impact of ES after TAVR as defined by VARC-3 criteria.
Methods: We performed a multicenter study including 10 078 patients with severe aortic stenosis undergoing transarterial TAVR.
Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. This study aimed to determine the rate, factors associated with, and prognostic value of poor functional status (NYHA class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
Methods: This multicenter study included 6,363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I-II vs.
Background: Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in aortic stenosis patients. However, the factors associated with poorer outcomes among AF patients in contemporary TAVR practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.
Methods: Multicenter study including consecutive patients with a history of AF, evaluating the clinical outcomes and predictors of mortality, and HF-related hospitalization, who underwent TAVR with newer-generation devices using balloon or self-expandable valves.
Background: In patients with significant tricuspid regurgitation, cardiac magnetic resonance imaging (CMR) is the preferred method for the evaluation of right ventricular function and volumes. However validated thresholds are lacking.
Aim: The aim of this study was to evaluate CMR assessment of right ventricular volumes in patients with significant (moderate or severe) tricuspid regurgitation, and to define its association with outcomes.
The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) has recently introduced a consensus document that outlines risk factors to identify high bleeding risk (HBR) in patients undergoing transcatheter aortic valve replacement (TAVR). The objective of the present study was to evaluate the prevalence and predictive value of the VARC-HBR definition in a contemporary, large-scale TAVR population. Multicenter study including 10,449 patients undergoing TAVR.
View Article and Find Full Text PDFIntroduction And Objectives: In patients undergoing percutaneous coronary intervention (PCI) in the workup pre-transcatheter aortic valve replacement (TAVR), the clinical impact of coronary revascularization complexity remains unknown. This study sought to examine the impact of PCI complexity on clinical outcomes after TAVR in patients undergoing PCI in the preprocedural workup.
Methods: This was a multicenter study including consecutive patients scheduled for TAVR with concomitant significant coronary artery disease.
Background: Cardiac surgery for infective endocarditis (IE) is associated with significant hospital mortality, and female sex may be associated with worse outcomes. However, the impact of sex on the presenting characteristics, management, and outcomes of patients operated on for acute infective endocarditis (IE) has not been adequately studied.
Objectives: The goal of our study was to analyse differences in management and outcome of IE between women and men who undergo surgery.
Background: There is currently no established recommendation for antithrombotic treatment following transcatheter mitral valve replacement (TMVR). However, based on the analogy with surgical mitral bioprosthesis, vitamin K antagonists (VKAs) are predominantly used.
Objectives: The purpose of this study was to compare bleeding and thrombotic events associated with direct oral anticoagulants (DOACs) or VKAs in a prospective cohort of TMVR patients.
Mitral regurgitation is the second most frequent heart valve disease in Europe and the most frequent in the US. Although surgery is the therapy of choice when intervention is indicated, transcatheter mitral valve repair or replacement are alternatives for patients who are not eligible for surgery. However, the development of transcatheter mitral valves is slower than expected.
View Article and Find Full Text PDFBackground: The optimal treatment in patients with severe aortic stenosis and small aortic annulus (SAA) remains to be determined. This study aimed to compare the hemodynamic and clinical outcomes between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) in patients with a SAA.
Methods: This prospective multicenter international randomized trial was performed in 15 university hospitals.
Cardiac Death After Transcatheter Aortic Valve Replacement With Contemporary Devices.
JACC Cardiovasc Interv
September 2023
Article Synopsis
- This study examined the rates and causes of sudden cardiac death (SCD) and heart failure (HF)-related deaths in 5,421 patients who underwent transcatheter aortic valve replacement (TAVR) using newer devices.
- Findings revealed that 18% of patients died within two years, with over half of those deaths attributed to cardiovascular issues, notably advanced HF and SCD.
- Key predictors for HF-related death included atrial fibrillation and reduced heart function, while factors linked to increased SCD risk included certain procedural complications like periprocedural ventricular arrhythmias.*
Article Synopsis
- Paravalvular leak (PVL), conduction disturbances, and vascular complications are key issues following Transcatheter Aortic Valve Replacement (TAVR), leading to the development of third-generation heart valves like SAPIEN 3 and EVOLUT PRO to reduce these problems.
- A study involving 1,481 patients from six European centers found that SAPIEN 3 showed lower rates of PVL compared to EVOLUT PRO at various follow-up points, especially for low-grade PVL.
- However, no significant difference in severe PVL or 1-year survival rates was observed between the two devices, indicating that while PVL detection is high, both devices have similar outcomes in terms of serious complications and survival.
Article Synopsis
- This study investigates the incidence and effects of late bleeding events (LBEs) in patients who undergo percutaneous coronary intervention (PCI) before transcatheter aortic valve replacement (TAVR).
- Among 1,457 patients analyzed, 7.9% experienced LBEs after TAVR, with various severities impacting long-term mortality rates.
- It concludes that LBEs significantly heighten the risk of death after TAVR and highlights the need for effective strategies to prevent these events and optimize antithrombotic treatments.
Article Synopsis
- The study compares infective endocarditis (IE) outcomes in patients after surgical aortic valve replacement (SAVR) versus transcatheter aortic valve replacement (TAVR), aiming to identify differences in clinical presentation, microbiological profiles, management, and outcomes.
- Data was gathered from two international registries, focusing on patients with IE affecting aortic valve prostheses, and included a matched comparison of TAVR and SAVR patients.
- The findings revealed that patients with surgical bioprostheses had higher rates of complications but similar one-year mortality rates compared to those with TAVR, indicating important differences in infection characteristics and treatment but comparable long-term outcomes.
Background: Transcatheter mitral valve implantation (TMVI) may be attractive to treat high-risk patients with mitral bioprosthesis or annuloplasty ring failure or severe mitral annular calcification.
Aim: To report the outcomes of patients after valve-in-valve/ring/mitral annular calcification TMVI using balloon expandable transcatheter aortic valves, according to the degree of urgency of the procedure.
Methods: All patients who underwent TMVI in our centre from 2010 to 2021 were classified into three groups: elective, urgent or emergent/salvage TMVI.
Background: The potential benefit of transcatheter aortic valve replacement (TAVR) in patients with nonsevere aortic stenosis (AS) and heart failure is controversial. This study aimed to assess outcomes of patients with nonsevere low-gradient AS (LGAS) and reduced left ventricular ejection fraction undergoing TAVR or medical management.
Methods: Patients undergoing TAVR for LGAS and reduced left ventricular ejection fraction (<50%) were included in a multinational registry.
Background: The potential benefit of using larger or smaller transcatheter heart valves (THV) in patients with borderline aortic annulus measurement (BAM) remains uncertain. The objective of this study was to evaluate the clinical outcomes associated with the selection of larger or smaller THV in the context of BAM.
Methods: This was a multicenter observational study including patients who underwent transcatheter aortic valve replacement with the SAPIEN 3 or SAPIEN 3 Ultra-valve systems (Edwards Lifesciences, Irvine, CA) from April 2014 to June 2021.
Background: Transcatheter aortic valve implantation now has a major role in the treatment of patients with severe aortic stenosis. However, evidence is scarce on its feasibility and safety to treat patients with pure aortic regurgitation.
Aims: We sought to evaluate the results of transcatheter aortic valve implantation using the balloon-expandable SAPIEN 3 transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA) in patients with pure aortic regurgitation on native non-calcified valves.