Abstract Background: Transcatheter aortic valve replacement (TAVR) is a worldwide adopted procedure with rapidly evolving practices. Regional and temporal variations are expected to be found. Objective: To compare TAVR practice in Latin America with that around the world and to assess its changes in Latin America from 2015 to 2020. Methods: A survey was applied to global TAVR centers between March and September 2015, and again to Latin-American centers between July 2019 and January 2020. The survey consisted of questions […]

Abstract Background The bicuspid aortic valve (BAV) affects 0.5 to 2% of the population and is associated with valve and aortic alterations. There is a lack of studies on the profile of these patients in the Brazilian population. Objective To describe the profile of patients with BAV undergoing valve and/or aortic surgery in a tertiary cardiology center, in addition to the outcomes related to the intervention. Methods Retrospective cohort including 195 patients (mean age 54±14 years, 73.8% male) diagnosed with […]

Abstract Background: C-reactive protein (CRP) is an inflammation biomarker that can be a predictor of adverse events in cardiovascular procedures. Its use in the assessment of long-term prognosis of transcatheter aortic valve implantation (TAVI) is still incipient. Objective: To evaluate CRP as a prognostic marker in the first year after TAVI in aortic stenosis (AoS). Methods: CRP was assessed on the first postoperative week in a retrospective cohort of patients with AoS. Pre- and post- CRP levels were correlated with […]

Introduction Aortic stenosis is a common heart valve disease, mostly caused by degenerative aortic valve disease in the elderly. Aortic stenosis obstructs the forward flow of the left ventricle to the aorta, leading to a pressure differential between the left ventricle and the aorta and increased left ventricular pressure secondary to left ventricular hypertrophy. As the disease progresses, it leads to left ventricular systolic and diastolic dysfunction and myocardial ischemia due to decreased coronary blood flow. However, cardiogenic shock secondary […]

Abstract Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS) in patients with elevated surgical risk. Concomitant coronary artery disease affects 55-70% of patients with severe AS. Percutaneous coronary intervention in patients with TAVI can be challenging. We report a case of acute coronary obstruction immediately following transapical TAVI deployment requiring emergent rotational atherectomy.

Severe aortic stenosis (AS) is defined as a significant reduction of the aortic valve area (aortic valve area [AVA] ≤ 1.0 cm2) associated with evidence of left ventricular hypertrophic response (aortic jet velocity > 4 m/s or mean gradient between the left ventricle and the aorta > 40 mmHg).–3 However, as Minners et al. have demonstrated, inconsistencies in echocardiographic measurements are extremely frequent in daily clinical practice. In about 30% of the cases evaluated by AS, we found AVA ≤ […]

Abstract Background: Transcatheter aortic valve implantation (TAVI) is a well-established procedure; however, atrioventricular block requiring permanent pacemaker implantation (PPI) is a common complication. Objectives: To determine the incidence, predictors and clinical outcomes of PPI after TAVI, focusing on how PPI affects left ventricular ejection fraction (LVEF) after TAVI. Methods: The Brazilian Multicenter TAVI Registry included 819 patients submitted to TAVI due to severe aortic stenosis from 22 centers from January/2008 to January/2015. After exclusions, the predictors of PPI were assessed […]

Abstract Background: Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature. Objective: To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors. Methods: Observational study of patients with symptomatic severe […]

Clinical aspects The 56-year-old male patient, who smoked and had arterial hypertension and hypertriglyceridemia, developed heart failure with dilatation of heart chambers and severe systolic dysfunction. His echocardiography showed low-gradient aortic stenosis. According to the Brazilian Society of Cardiology III Guideline on Heart Failure, a patient with signs and symptoms of heart failure should undergo some tests to characterize the heart failure, such as resting electrocardiography, chest X ray, echocardiography and BNP measurement. Then, laboratory and invasive tests, such as […]