Introduction From the earliest days of the heart surgery, the valves, when the reparation was not possible, were replaced by prosthetics using cardiopulmonary bypass. The good results of these procedures are well known. In the recent years, minimally invasive alternatives have been developed, aiming to make possible the treatment of individuals under high risk of complications and death caused by the conventional procedure. In 2002, the first transcatheter valvar implantation was made, which revolutionized the treatment of severe aortic stenosis. […]

A 68-year-old woman was admitted in our acute cardiac care unit due to cardiogenic shock. The transthoracic echocardiography (TTE) showed severe aortic stenosis, severe left ventricle (LV) systolic dysfunction (ejection fraction 20%) and a large apical thrombus (). We performed an emergent percutaneous aortic balloon valvuloplasty (). During the procedure, the coronary angiography revealed no epicardial coronary disease (). Despite some mild clinical and hemodynamic improvement (mean gradient reduced from 40 to 30 mmHg), she remained in New York Heart […]

Abstract Background: The impact of paravalvular regurgitation (PVR) following transcatheter aortic valve implantation (TAVI) remains uncertain. Objective: To evaluate the impact of PVR on mortality and hospital readmission one year after TAVI. Methods: Between January 2009 and June 2015, a total of 251 patients underwent TAVI with three different prostheses at two cardiology centers. Patients were assessed according to PVR severity after the procedure. Results: PVR was classified as absent/trace or mild in 92.0% (n = 242) and moderate/severe in […]

Abstract Background: Due to the nature of the percutaneous prosthesis deployment process, a variation in its final position is expected. Prosthetic valve placement will define the spatial location of its effective orifice in relation to the aortic annulus. The blood flow pattern in the ascending aorta is related to the aortic remodeling process, and depends on the spatial location of the effective orifice. The hemodynamic effect of small variations in the angle of inclination of the effective orifice has not […]