PCR Perspectives

Fabien Praz and Neil Fam talk about the management of patients with combined mitral and tricuspid regurgitation, who are often elderly with heart failure and multiple comorbidities. Careful assessment—including echocardiography, hemodynamics, and sometimes CT—is crucial to identify the dominant lesion. Surgery is preferred if feasible, but for high-risk patients, transcatheter repair or replacement is considered. Hosted on Acast. See acast.com/privacy for more information.

Bernard Prendergast and Fabien Praz discuss updates from the new ESC/EACTS guidelines on aortic stenosis. Key changes include expanding TAVI to patients aged 70 and older, supporting early intervention in asymptomatic patients, and providing guidance for bicuspid aortic valves. These updates emphasise shared decision-making, careful patient selection, and lifetime management strategies. Hosted on Acast. See acast.com/privacy for more information.

Lukas Stolz and Rebecca Hahn discuss advances in transcatheter tricuspid valve intervention, emphasising that reducing tricuspid regurgitation (TR) to mild levels is key for improving patient outcomes, including mortality and heart failure hospitalisations. Decision-making between transcatheter edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR) depends on anatomy, imaging, and patient factors like pacemakers or bleeding risk. Hosted on Acast. See acast.com/privacy for more information.

Philipp Lurz and Saibal Kar discuss iatrogenic atrial septal defects from transseptal procedures. Small ones usually close on their own, while large defects causing significant shunting need closure to prevent right heart overload. Some moderate defects may be beneficial by decompressing the left atrium, so closure isn’t always needed. With the increasing amount of procedures, understanding the hemodynamics is also key to safe management. Hosted on Acast. See acast.com/privacy for more information.

Tiffany Patterson and Davide Capodanno address the increasingly common scenario of managing coronary artery disease (CAD) in patients undergoing TAVI. With up to half of TAVI candidates presenting with CAD, they highlight new evidence from NOTION-3 showing that revascularization reduces major adverse cardiac events. The takeaway: CAD in TAVI patients matters, should be assessed thoughtfully, and evidence is evolving to guide both lesion selection and timing. Hosted on Acast. See acast.com/privacy for more information.