The optimal anti-thrombotic therapy after transcatheter aortic valve implantation is unknown. Patients using oral anticoagulation have lover incidence of early valve degeneration than patients using antiplatelet drugs, but these strategy have never previously been tested head-to-head in a randomized controlled trial. The pragmatic randomized controlled trial “anticoagulation versus acetylsalicylic acid after transcatheter aortic valve implantation / ACASA-TAVI” will randomize 360 patients to one of the two strategies, and systematically assess their safety and efficacy. Read more at https://www.clinicaltrials.gov
Patients with coronary artery disease and refractory angina pain have very few viable treatment options. One proposed therapy is the implantation of a device in the coronary sinus which aims to reduce the diameter of the vessel and increase the venous pressure. Whether this method reduces the ischemia associated with angina is unknown. In “myocardial ischemia with coronary sinus reducing stent implantation / MICS-REDUCE”, we will systematically and blindly assess ischemia in these patients using the gold standard method of oxygen-tagged H2O PET. Read more at https://www.clinicaltrials.gov
Gradient discordance during transcatheter aortic valve implantation
The success of a transcatheter aortic valve implantation relies heavily on the estimation of pressure gradients between the left ventricle and the aorta. We frequently observe a substantial discrepancy between the measured invasive gradients and the estimated pressure difference from echocardiography. To understand this phenomenon, and hopefully better inform the recognition of procedural success, we are conducting a study using stress assessments at the end of the TAVI procedures. The observed differences may be caused by different loading and contractile conditions.
TAV-in-TAV: An experimental model
As the population treated with TAVI grows older, we are seeing an increasing demand for a new implantation in a failing valve. How these second valves behave and perform in situ is not well described. We study technical aspects and mechanical/hemodynamic consequences in a comprehensive experimental model to increase knowledge of the optimal management of this emerging clinical challenge.