ACC 2017 HIGHLIGHTS articles

oclusion de orejuela durante cirugia

Closing off the Appendage While Performing Cardiac Surgery Results in a Reduction in Risk of Embolic Stroke

Closing off the Appendage While Performing Cardiac Surgery Results in a Reduction in Risk of Embolic Stroke

Closing off the left appendage as an add-on procedure while performing other cardiac surgery in patients with atrial fibrillation resulted in a reduction in risk of embolic stroke of nearly 40% over 12 months, according to an analysis carried out on the Society of Thoracic Surgeons (STS) database.   Patients who had surgical appendage occlusion had

impella_shock_cardiogenico

Infarction in Cariogenic Shock: Prioritizing the Use of Impella Could Improve Survival

This small study suggests the early use of Impella ventricular support device in patients undergoing AMI complicated by cardiogenic shock could help lower mortality rate in this population.   However, study design should moderate our enthusiasm, mainly because of the cost of this device.   Detroit Cardiogenic Shock Initiative has stressed early identification of cardiogenic

ffr para guiar revascularizacion en SCA

FFR-Guided ACS Revascularization Apparently Superior to Culprit Vessel Treatment

Using fractional flow reserve (FFR) to guide revascularization of all functionally significant lesions in the setting of acute coronary syndrome appears to improve outcomes over treating only the culprit artery, according to the Compare-Acute trial.   This study, conducted at 24 centers in Europe and Asia, enrolled 885 patients who were stable following successful primary angioplasty and

radiacion acceso radial

Higher Radiation Dose in Patients and Operators with Radial Approach (RAD-MATRIX Dosimeter)

Both physicians and patients are exposed to higher radiation doses during radial access PCI compared to femoral, according to this large contemporary study on high volume PCI operators of ACS patients.   Even though the difference in radiation exposure was relatively small for patients (approximately 10% higher for radial PCI) this translated into double the

recanalizacion cto

DECISION-CTO: Prevailing Questions on CTO Rechanneling

The first and only randomized trial on chronic total occlusion (CTO) revascularization versus optimal medical therapy in stable patients has disappointed interventional cardiologists.   According to Dr. Seung-Jung Park, who presented the study, evidence suggests that optimal medical therapy is a reasonable initial treatment strategy for chronic total occlusion, when compared with angioplasty.   Critics

absorv vs xience acc 2017

ABSORB III: More Events with Absorb Than With Xience at Two Years

The two year outcomes of ABSORB III, presented at the scientific sessions of the American College of Cardiology 2017, have shown the bioresorbable scaffold Absorb GT1 (BVS, Abbott Vascular) was associated with increased risk of target vessel failure, compared against the everolimus eluting stent Xience.   At 25 months, target vessel failure occurred in 11%

tavr_cirugia_surtavi

Surgery or TAVR in intermediate risk? Results of the SURTAVI Study

Courtesy of Dr. Gustavo Leiva. Transcatheter aortic-valve replacement (TAVR) with the use of a self-expanding prosthesis is superior to medical therapy in patients with severe, symptomatic aortic stenosis in whom surgical aortic-valve replacement has been associated with prohibitive risk. Among patients considered at high risk, TAVR may be an alternative to surgery.   The comparative

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