Thomas Pilgrim

Stefan Stortecky

Interventional / Structural Cardiology · University of Bern

10d

“

Based on the observed differences in the spectrum of pathogens between surgical and transcatheter heart valve interventions, a change in antibiotic prophylaxis for transcatheter heart valve interventions to an intravenous dose of amoxicillin/clavulanic acid, ampicillin/sulbactam, or vancomycin in patients allergic to penicillin may be reasonable... it remains to be demonstrated whether a change in antibiotic prophylaxis is effective to mitigate the risk of periprocedural endocarditis.

“

Among chronic coronary syndrome patients undergoing PCI, the frequency and prognostic value of periprocedural MI varies considerably based on definitions. Periprocedural MI defined by the ARC-2 and SCAI occurred 3-6 times less frequently and were prognostically more relevant as compared with the UDMI. Clinically relevant definitions should be used in daily practice and clinical trials.

Thomas Pilgrim

Interventional / Structural Cardiology · University of Bern

2w

“

In a patient population with minimum exclusion criteria and high adherence to dual antiplatelet therapy, biodegradable polymer sirolimus-eluting stents were non-inferior to durable polymer everolimus-eluting stents for the combined safety and efficacy outcome target lesion failure at 12 months. The noted benefit in the subgroup of patients with ST-segment elevation myocardial infarction needs further study.

“

I was troubled to publish these data given the potential confusion it can create, but we must understand that in the Registry, redo-TAVR for probable device failure constituted only 0.22% of the overall 63,876 TAVR procedures. This low rate reflects the relative durability of the valves and also the competing risk of mortality in the elderly and high-risk patients undergoing TAVR so far.

“

If you're just looking at short-term follow-up, 1 year or even 2 years, valve-in-valve is going to look better [because it's] not a reop, it's a stick in the groin. But when you follow out to 5 years, then you'll see a survival benefit for surgery.

Annette Maznyczka

Interventional / Structural Cardiology · Leeds General Infirmary

6w

“

We found that asymmetrical expansion of the THV was associated with hemodynamic valve performance. Patients with high degrees of prosthetic valve asymmetry had a higher risk for increased residual transvalvular gradients … moreover, our analysis suggests that patients with valve asymmetry have a higher risk for relevant paravalvular aortic regurgitation. Hemodynamic valve performance may be a surrogate marker for long-term clinical outcomes.

John Webb

Interventional / Structural Cardiology · Valve (United States)

2mo

“

We would hope that TAVR valves would last an average of 10 years, but in these patients, the average time that the valve lasted was just 2-and-a-half years. So this says something about this patient population. It's difficult to apply it to patients who have late failure.

“

PVL manifests through diverse aetiologies, encompassing mal positioning, under-expansion, and uneven calcium distribution. The choice of remedy should align with the specific aetiology. Redo-TAV implantation (TAVI), for instance, holds promise in cases of mal positioning, potentially enhancing annular sealing, whereas balloon valvuloplasty may rectify under-expansion of the TAV.