Estudios en cardiologia intervencionista desde el ultimo congresoque han tenido un impacto en nuestra practica diaria

Cardiopatia EstructuralEduardo Infante de Oliveira

H. Santa Maria, Lisboa, Portugal

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI superiority vs. SAVR

US Corevalve Implication:

TAVI should be the preferred treatment for

patients with symptomatic severe AS at

increased risk for surgery

And what about intermediate risk patients?

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVITAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVITAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVITAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVITAVI in intermediate risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVITAVI in lower risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI in lower risk patients

NOTION trial:

First trial to randomize lower risk patients

TAVI was safe and effective

TAVI was comparable to SAVR (death, stroke, MI)

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

TAVI - summary

Preferable to surgery in high risk patients (2-years FU)

Low mortality / complications rate in intermediate and low risk patients

Seems to be as safe and effective as SAVR in lower risk patients

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

LAAOne-sided 95% upper CI bound for

success

2.0% 2.5% 3.0%Percent of patients experiencing an event

2.2%2.618%

2.67%

Early Safety

95% upper CI bound for non-inferiority

0.5 1.0 1.518-month Rate Ratio

2.0

1.07

0.57 1.89

1.75

Primary Efficacy95% upper CI bound for non-inferiority

-0.01 0 0.01

18-month Rate Difference

0.02

0.0053

-0.02 0.03-0.03

-0.0190 0.0273

0.0275

Late Ischemic Efficacy

Holmes, DR et al. JACC VOL. 64, NO. 1, 2014

PREVAIL trial

Left Atrial Appendage Occlusion

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

Left Atrial Appendage Occlusion

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

LAAO – ESC guidelines 2012 – Can we aspect changes?

Cardiopatia Estructural Eduardo Infante de Oliveira, H. Santa Maria, Lisboa, Portugal

LAAO – ESC guidelines 2012 – Can we aspect changes?

IIa A

Estudios en cardiologia intervencionista desde el ultimo congresoque han tenido un impacto en nuestra practica diaria

Cardiopatia EstructuralEduardo Infante de Oliveira

H. Santa Maria, Lisboa, Portugal