Self-expanding TAVI using the cusp overlap technique versus the traditional technique: electrocardiogram changes and 1-year cardiovascular outcomes.

Introduction And Objectives: Transcatheter aortic valve implantation (TAVI) using the cusp overlap technique (COT) has shown a lower pacemaker implantation rate at 30 days. The objective of this study was to compare electrocardiogram changes and clinical outcomes between COT and the traditional technique (TT) at 1 year of follow-up.

Methods: Observational, retrospective, nonrandomized study of consecutive patients undergoing TAVI between January 2015 and January 2021.

Impact of operatoŕs experience on -procedural outcomes with Watchman FLX: Insights from the FLX-SPA registry.

Background: The Watchman FLX is a device upgrade of the Watchman 2.5 that incorporates several design enhancements intended to simplify left atrial appendage occlusion (LAAO) and improve procedural outcomes. This study compares -procedural results of LAAO with Watchman FLX (Boston Scientific, Marlborough, Massachusetts) in centers with varying degrees of experience with the Watchman 2.

Early clinical outcomes after transaxillary versus transfemoral TAVI. Data from the Spanish TAVI registry.

Introduction And Objectives: Transaxillary access (TXA) has become the most widely used alternative to transfemoral access (TFA) in patients undergoing transcatheter aortic valve implantation (TAVI). The aim of this study was to compare total in-hospital and 30-day mortality in patients included in the Spanish TAVI registry who were treated by TXA or TFA access.

Methods: We analyzed data from patients treated with TXA or TFA and who were included in the TAVI Spanish registry.

The impact of waiting for intervention on costs and effectiveness: the case of transcatheter aortic valve replacement.

Objectives: The economic crisis in Europe might have limited access to some innovative technologies implying an increase of waiting time. The purpose of the study is to evaluate the impact of waiting time on the costs and benefits of transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis.

Methods: This is a cost-utility analysis from the perspective of the Spanish National Health Service.

Anomalous right coronary artery origin with interarterial pathway-importance of morphological origin assessment and the role of percutaneous interventionism.

Anomalies in coronary arteries (CA) are an important issue in cardiology and cardiovascular surgery. Specifically the anomalous origin of the right coronary artery (RCA) is of special importance because it is the most frequent anomaly. Clinical practice guidelines recommend the revascularization treatment in cases of interarterial pathway and documented myocardial ischemia and when hypoplasia, compression or obstruction is evident.

Transfemoral transcatheter aortic valve replacement compared with surgical replacement in patients with severe aortic stenosis and comparable risk: cost-utility and its determinants.

Objective: To evaluate cost-effectiveness of transfemoral TAVR vs surgical replacement (SAVR) and its determinants in patients with severe symptomatic aortic stenosis and comparable risk.

Methods: Patients were prospectively recruited in 6 Spanish hospitals and followed up over one year. We estimated adjusted incremental cost-effectiveness ratio (ICER) (Euros per quality-adjusted life-year [QALY] gained) using a net-benefit approach and assessed the determinants of incremental net-benefit of TAVR vs SAVR.

Quantification of scientific output in cardiovascular medicine: a perspective based on global data.

Aims: We sought to explore whether global and regional scientific output in cardiovascular medicine is associated with economic variables and follows the same trend as medicine and as science overall.

Methods And Results: We registered the number of documents, number of citations, citations per document and the h-index for the first 50 countries according to the h-index (a measure to evaluate both the productivity and impact of the publications) in cardiovascular medicine. Economic variables (gross domestic product [GDP] per capita, % expenditure of the GDP in research and development [R&D] and health) were obtained from the World Bank, the UNESCO, and the World Health Organization.

Clinical outcomes in patients undergoing percutaneous closure of periprosthetic paravalvular leaks.

Objectives: The purpose of this study was to evaluate the feasibility and efficacy of the percutaneous device closure of a consecutive series of patients with periprosthetic paravalvular leaks referred to our structural heart disease center with congestive heart failure and hemolytic anemia.

Background: Clinically significant periprosthetic paravalvular leak is an uncommon but serious complication after surgical valve replacement. Percutaneous closure has been utilized as an alternative to surgical repair of this defect in high-risk surgical patients.

A method for standardized computed tomography angiography-based measurement of aortic valvar structures.

Aims: Reliable assessment of the aortic valvar apparatus (AVAp) is essential as it may facilitate consistent outcomes with percutaneous aortic valvar therapies. The commonly referenced aortic annulus is problematic since this measurement does not correspond to any actual anatomic structure. We aim to describe a reliable method of measuring relevant structures of the AVAp based on widely available computed tomography analyses.

Insight into the dynamics of the coronary sinus/great cardiac vein and the mitral annulus: implications for percutaneous mitral annuloplasty techniques.

Background: Implantation of devices into the coronary sinus (CS)/great cardiac vein (GCV) to reshape the mitral annulus (MA) is being investigated, despite these structures not being within the same plane and coronary arteries frequently traversing between them. Furthermore, dynamic changes in their relationship have never been studied. We analyzed the CS/GCV dimensions and its relationship with the MA and the coronary arteries.

Transcatheter aortic valve implantation.

In the 7 years since the first implant, more than 7000 transcatheter aortic valve implantations (TAVI) have been performed worldwide. This article describes the latest available information on this field and the upcoming technological expectations.

Development of personalized annuloplasty rings: combination of CT images and CAD-CAM tools.

Although the use of personalized annuloplasty rings manufactured for each patient according to the size and morphology of their valve complex could be beneficial for the treatment of mitral insufficiency, this possibility has been limited for reasons of time-lines and costs as well as for design and manufacturing difficulties, as has been the case with other personalized implant and prosthetic developments. However, the present quality of medical image capture equipment together with the benefits to be had from computer-aided design and manufacturing technologies (CAD-CAM) and the capabilities furnished by rapid prototyping technologies, present new opportunities for a personalized response to the development of implants and prostheses, the social impact of which could turn out to be highly positive. This paper sets out a personalized development of an annuloplasty ring based on the combined use of information from medical imaging, from CAD-CAM design programs and prototype manufacture using rapid prototyping technologies.

[Percutaneous transcatheter valve therapy].

Aortic stenosis (AS) and mitral regurgitation (MR) are currently the commonest valvular pathologies in developed society. The current standard of treatment of severe AS and severe MR has been surgical aortic valve replacement (AVR) and mitral valve (MV) surgery. In 2002, the first human percutaneous AVR (PAVR) was performed and in 2005, results of percutaneous MV repair were also reported.