Publications by authors named "Lluis Asmarats"
Artificial intelligence for risk prediction in transcatheter heart valve interventions.
Expert Rev Cardiovasc Ther
July 2025
Background: Patients with pre-existing right bundle branch block (RBBB) undergoing transcatheter aortic valve replacement (TAVR) face a high risk of permanent pacemaker implantation (PPI). However, additional predictors of PPI in this subpopulation are unknown.
Methods: This retrospective, multicenter study enrolled 530 patients with baseline RBBB without pacemakers undergoing TAVR in native aortic valve stenosis.
Background: Pre-existing mitral prosthesis raises technical challenges for transcatheter aortic valve replacement (TAVR) but has been scarcely studied. In this work we sought to compare outcomes of patients with previous surgical mitral valve prostheses undergoing TAVR with balloon-expandable valve (BEV) or self-expanding valve (SEV) systems.
Methods: Patients from the Spanish TAVR registry with pre-existing surgical mitral prostheses were included in this investigation.
Background: Benchmark best practices have been shown to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI), but the impact in diverse health systems is unknown.
Aims: We evaluated the impact of Benchmark best practices implementation in Germany, Austria, France, Spain, and Italy.
Methods: International, multicentre registry of severe symptomatic aortic stenosis (AS) patients undergoing TAVI with a balloon-expandable valve, before and after Benchmark best practices implementation.
Background: Among patients undergoing transcatheter aortic valve replacement (TAVR), the risk of delayed atrioventricular block (AVB) in those without procedural conduction disturbances (CDs) remains largely unknown. This may affect hospital stay, particularly same- or next-day discharge after the procedure.
Objective: The purpose of this study was to evaluate the timing, type, and factors associated with delayed (up to 30 days) AVB in patients without procedural CDs.
Background: Vascular complications (VCs) remain a major concern after transcatheter aortic valve replacement (TAVR). However, their occurrence in patients treated with newer generation devices has been scarcely studied. Therefore, the aim of this study was to determine the incidence, management, predictors, and clinical impact of VCs in patients undergoing TAVR with contemporary devices.
View Article and Find Full Text PDF'Incidence and impact of structural valve deterioration following TAVI: a multicenter real-world study'.
Eur Heart J Cardiovasc Imaging
May 2025
Aims: Valve durability becomes a major issue as transcatheter aortic valve implantation (TAVI) is expanding to populations with longer life expectancy. We sought to (i) determine the incidence of structural valve deterioration (SVD), (ii) compare the incidence of SVD between balloon-expandable (BE) and self-expandable (SE) valves, and (iii) analyse the impact of SVD.
Methods And Results: 2040 patients who underwent TAVI (2007-2020) from 9 centres were included.
Predictability and device tilting in edge-to-edge mitral valve repair.
Rev Esp Cardiol (Engl Ed)
February 2025
Background: Patients with symptomatic aortic stenosis are a vulnerable population with associated cardiac damage and a significant comorbidity burden. In this study we aimed to determine the rate, factors associated with, and prognostic value of poor functional status (New York Heart Association [NYHA] class III-IV) in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR).
Methods: This multicenter study included 6363 transarterial TAVR patients, classified according to baseline functional status (NYHA class I or II vs III or IV).
Prospective validation of a prespecified algorithm for the management of conduction disturbances after transcatheter aortic valve replacement: The PROMOTE study.
Heart Rhythm
December 2024
Background: There is a large variability in the management of conduction disturbances (CDs) after transcatheter aortic valve replacement (TAVR).
Objective: This study aimed to validate a prespecified algorithm for managing CDs in patients undergoing TAVR.
Methods: This was a prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR.
Background: Atrial fibrillation (AF) has been identified as a marker of advanced cardiac damage in patients with aortic stenosis. However, the factors associated with poorer outcomes among AF patients in contemporary transcatheter aortic valve replacement (TAVR) practice, particularly regarding mortality and heart failure (HF)-related hospitalizations, remain largely unknown.
Methods: In this multicenter study, we assessed consecutive patients with a history of AF and evaluated the clinical outcomes of those who underwent TAVR with newer generation devices using either balloon- or self-expandable valves.
Aortic stenosis is the most [...
View Article and Find Full Text PDFValidation of the Valve Academic Research Consortium High Bleeding Risk Definition in Patients Undergoing TAVR.
Circ Cardiovasc Interv
January 2025
Background: The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) has recently introduced a consensus document that outlines risk factors to identify high bleeding risk in patients undergoing transcatheter aortic valve replacement. The objective of the present study was to evaluate the prevalence and predictive value of the VARC-HBR definition in a contemporary, large-scale transcatheter aortic valve replacement population.
Methods: Multicenter study including 10 449 patients undergoing transcatheter aortic valve replacement.
Initial experience on percutaneous tricuspid valve replacement using the EVOQUE prosthesis.
Rev Esp Cardiol (Engl Ed)
January 2025
Early and late hospital readmissions after percutaneous left atrial appendage closure.
Rev Esp Cardiol (Engl Ed)
April 2025
Article Synopsis
- Percutaneous left atrial appendage closure (LAAC) is a procedure to prevent blood clots in patients with nonvalvular atrial fibrillation, but there is limited information on readmission rates following the procedure.
- A study of 1419 patients found that 18.1% were readmitted within a year, primarily due to bleeding and heart failure, with specific health conditions increasing the likelihood of readmission.
- Both early and late readmissions were linked to a higher risk of mortality within two years, highlighting the importance of managing patient health before and after LAAC.
Article Synopsis
- The study aimed to determine the effectiveness and safety of low-dose direct oral anticoagulation (DOAC) compared to dual antiplatelet therapy (DAPT) in patients who underwent left atrial appendage occlusion (LAAO) for three months post-procedure.
- Conducted across three European sites, the ADALA trial faced challenges with participant recruitment due to the COVID-19 pandemic and was halted prematurely, involving only 90 patients.
- The main outcomes assessed included the rates of major bleeding and thromboembolic events, with the study analyzing patients who had a history of bleeding and various health profiles.
Article Synopsis
- Device-related thrombosis (DRT) occurs frequently after left atrial appendage closure (LAAC), with notable differences in diagnosis timing and outcomes between men and women.
- Women make up 34.7% of DRT patients in the study and tend to be older and have fewer comorbidities compared to men, but DRT in women is diagnosed significantly later.
- Both genders have similar treatment outcomes and overall mortality rates, indicating that treatment strategies are equally effective regardless of sex.
Early Nonprocedural Bleeding After Left Atrial Appendage Occlusion.
JACC Cardiovasc Interv
August 2024
Article Synopsis
- The study examined early nonprocedural bleeding in patients who underwent left atrial appendage occlusion (LAAO), finding that about 7% experienced bleeding unrelated to the procedure within three months, with more than half categorized as major bleeding.
- Key predictors for early bleeding included receiving dual antiplatelet therapy at discharge, a history of gastrointestinal bleeding, and multiple previous bleeding episodes.
- Furthermore, early nonprocedural bleeding was linked to a higher risk of all-cause mortality, emphasizing the serious implications of such events, regardless of their severity.
Impact of the use of plaque modification techniques on coronary microcirculation using an angiography-derived index of microcirculatory resistance.
Int J Cardiovasc Imaging
August 2024
Many lesions in patients undergoing percutaneous coronary intervention (PCI) exhibit significant calcification. Several techniques have been developed to improve outcomes in this setting. However, their impact on coronary microcirculation remains unknown.
View Article and Find Full Text PDFClinical impact of complex percutaneous coronary intervention in the pre-TAVR workup.
Rev Esp Cardiol (Engl Ed)
January 2025
Introduction And Objectives: In patients undergoing percutaneous coronary intervention (PCI) in the workup pre-transcatheter aortic valve replacement (TAVR), the clinical impact of coronary revascularization complexity remains unknown. This study sought to examine the impact of PCI complexity on clinical outcomes after TAVR in patients undergoing PCI in the preprocedural workup.
Methods: This was a multicenter study including consecutive patients scheduled for TAVR with concomitant significant coronary artery disease.
Background And Aims: There is significant potential to streamline the clinical pathway for patients undergoing transcatheter aortic valve implantation (TAVI). The purpose of this study was to evaluate the effect of implementing BENCHMARK best practices on the efficiency and safety of TAVI in 28 sites in 7 European countries.
Methods: This was a study of patients with severe symptomatic aortic stenosis (AS) undergoing TAVI with balloon-expandable valves before and after implementation of BENCHMARK best practices.
Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study.
JACC Cardiovasc Interv
February 2024
Article Synopsis
- The COVID-19 pandemic led to significant treatment delays for patients needing transcatheter aortic valve replacement (TAVR), with a marked decrease in procedure volumes during the first two waves of the pandemic.
- The study analyzed TAVR case data from 130 centers in 61 countries, finding a 15% drop in cases during the first wave and 7% in the second, particularly affecting regions like Africa, Central-South America, and Asia.
- Factors such as hospital type (private vs public), urban vs rural location, low procedure volumes, a country's socioeconomic status, and stringent public health measures contributed to these reductions, highlighting the need for improved public health policies for future health crises.
Introduction: Over the last two decades, mitral transcatheter edge-to-edge repair (M-TEER) has become a safe and effective therapy for severe mitral regurgitation in patients deemed at high surgical risk.
Areas Covered: This review aims to encompass the most relevant and updated evidence in the field of M-TEER from its inception, focusing on clinical and anatomical features for proper patient and device selection.
Expert Opinion: Growing operator experience and device iterations have resulted in improved clinical outcomes and an expansion of the therapy to patients with complex anatomies and clinical scenarios.