Single antiplatelet therapy (SAPT) is the standard treatment after transcatheter aortic valve replacement (TAVR). However, valve-in-valve TAVR to treat surgical bioprosthesis dysfunction carries an increased thrombotic risk and may benefit from more intensive antithrombotic treatment.

The Valve Academic Research Consortium recently expanded its bleeding endpoint definition, recommending that any procedure-related blood loss should be classified as bleeding, even in the absence of a clinically evident source. However, the lack of specific reference thresholds for hemoglobin decline limits the ability to discriminate clinically relevant events and the prognostic utility of these criteria.

Inflammation is common in response to transcatheter aortic valve replacement (TAVR), resulting from endothelial damage, procedure-related hypoperfusion, and immunogenicity against the bioprosthesis. The systemic inflammatory response after TAVR comprises a spectrum ranging from asymptomatic biomarker elevation to dramatic clinical manifestations. Although local inflammation post-TAVR is part of physiological healing, a hyperinflammatory response increases the risk for conduction disturbances, new-onset atrial fibrillation, acute kidney injury, prolonged hospitalization, mortality, and subclinical leaflet thrombosis. Unfavorable monocyte and T helper cell signatures can predispose to worse outcomes in connection with hyperinflammation. Strategies are needed to control key drivers of hyperinflammation after TAVR (eg, avoiding prolonged hypotension during transcatheter aortic valve deployment, periprocedural colchicine or glucocorticoids, targeted monoclonal antibodies, a healthy gut microbiome) and to identify patients in whom modulation of inflammatory pathways may optimize outcomes. This review provides a detailed description of the epidemiology, pathophysiology, and consequences of the inflammatory response to TAVR and discusses emerging treatment pathways.

The ACURATE IDE trial demonstrated increased death, stroke, and rehospitalization at 1 year with ACURATE neo2 transcatheter aortic valve replacement (TAVR) devices compared with control devices, possibly caused by suboptimal pre- and postdilatation.

Public reporting of transcatheter aortic valve replacement (TAVR) outcomes by U.S. News & World Report (USNWR) began in August 2020. The impact of these ratings on case selection has not been studied.

Diabetes mellitus (DM) is associated with suboptimal clopidogrel response and elevated thrombotic risk. The benefit of early de-escalation of dual antiplatelet therapy (DAPT) in DM patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) remains uncertain.

Treatment of small vessel (SV) coronary artery disease is associated with higher restenosis rates. Drug-coated balloons offer a promising treatment option for stent failure by delivering an antiproliferative drug and avoiding an additional metal implant. However, evidence supporting the use of paclitaxel-coated balloons (PCBs) for in-stent restenosis (ISR) in SVs is limited.

For patients with asymptomatic, severe aortic stenosis (AS), the EARLY TAVR (Evaluation of TAVR Compared to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis) trial demonstrated that early transcatheter aortic valve replacement (TAVR) was superior to clinical surveillance (CS) with respect to the primary endpoint in the intention-to-treat population.

The authors report the intention-to-treat results for the C-GUARDIANS (Safety and Efficacy of the CGuard™ Carotid Stent System in Carotid Artery Stenting) pivotal trial in carotid artery stenting patients considered high risk for carotid endarterectomy, treated with this novel stent and followed for 1 year.