Luis Nombela Franco

TCT-81 Clinical and hemodynamic results after direct transcatheter aortic valve replacement versus pre-implantation balloon aortic valvuloplasty. A case-matched analysis

nos: 81 84 TCT-81 Clinical and hemodynamic results after direct transcatheter aortic valve replacement versus pre-implantation balloon aortic valvuloplasty. A case-matched analysis Luis Nombela Franco, Carlos Ferrera, Eulogio Garcia, Pilar Jimenez, Corina Biagioni, Nieves Gonzalo, Ivan Nuñez-Gil, Ana Viana, Pablo Salinas, Javier Escaned, Antonio Fernandez-Ortiz, Carlos Macaya Hospital Clínico San Carlos, Madrid, Spain; Hospital Clínico San Carlos; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clinico San Carlos, Madrid, Spain; Hospital Clínico San Carlos; Unknown, Madrid, Spain; Hospital Clínico San Carlos; Unknown, Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain; Hospital Clínico San Carlos; Hospital Clinico de San Carlos, Madrid, Spain BACKGROUND Balloon aortic valvuloplasty (BAV) was considered a routine previous step in transcatheter aortic valve implantation (TAVI). Our aim was to evaluate the feasibility, safety and midterm hemodynamic results of direct TAVI without pre-implantation BAV. METHODS A total of 339 consecutive patients who underwent transfemoral TAVR were prospectively selected. A 1:1 matching was conducted, pairing age, prosthesis type (self-expandable or balloon expandable) and size, and valve calcification grade (48% with moderate to severe valve calcification). Finally, 102 pairs (102 patients with previous BAV and 102 without BAV) were obtained. RESULTS Direct TAVR was feasible in all patients without any crossover to BAV group. Device success was achieved in 91.2% and 90.2% of cases in direct TAVR and pre-BAV groups (p1⁄40.810), respectively, without any differences in balloon postdilation rate and residual aortic regurgitation. The amount of contrast agent, acute kidney injury and myocardial injury was significantly lower in the direct implantation group (p<0.05). No differences were found in 30-day and 1-year mortality between both groups (4.9% versus 9.8%, p1⁄40.177 and 14.0% versus 23.8%, p1⁄40.771, respectively). Hemodynamic parameters remained stable after 1-year follow-up in both groups. CONCLUSION Direct transfemoral TAVR without prior BAV was safe in patients with calcified severe aortic stenosis. Pre-implantation BAV could be omitted in patients undergoing TAVR, without influence in procedure success rate, and subsequent patients’ clinical course and valve hemodynamic performance. CATEGORIES STRUCTURAL: Valvular Disease: Aortic TCT-82 Evaluation of Current Practices in Transcatheter Aortic Valve Replacement: The WRITTEN (WoRldwIde TAVR ExperieNce) Survey Luis Nombela-Franco, Enrico Cerrato, Tamim Nazif, Helene Eltchaninoff, Lars Sondergaard, Henrique Ribeiro, Marco Barbanti, Fabian Nietlispach, Pierfrancesco Agostoni,

TCT-25 Efficacy and Safety of Left Atrial Appendage Closure Versus Medical Treatment in Atrial Fibrillation: A Network Metaanalysis From Randomized Trials

The effectiveness of vitamin K antagonist (VKA) versus placebo and antiplatelet treatment (APT) is well stablished for stroke prevention in atrial fibrillation (AF). Non-vitamin K antagonist oral anticoagulants (NOAC) are mostly superior to VKA in stroke and intracranial bleeding prevention. Recent

TCT-50 Impact of a bifurcation culprit lesion in ST elevation myocardial infarction: procedural success, clinical outcome and 5-year follow-up.

Coronary artery bifurcation is a challenging scenario for percutaneous coronary intervention (PCI). We aimed to assess the impact of a bifurcation culprit lesion in the setting of primary PCI for ST elevation myocardial infarction (STEMI). From 2747 STEMI patients (January 2004 to January 2015)

CORONARY OBSTRUCTION FOLLOWING TRANSCATHETER AORTIC VALVE IMPLANTATION: INSIGHTS ON BASELINE PATIENTS’ CHARACTERISCTICS, MANAGEMENT AND CLINICAL OUTCOMES

Very few data exist on coronary obstruction following transcatheter aortic valve implantation (TAVI). The objective of this study was to evaluate, through a systematic review of the literature, the main baseline characteristics, management and clinical outcomes of patients suffering coronary