Drug eluting stent (DES) in-stent restenosis (ISR) is currently a challenging, seeing as it often requires repeat revascularization. The use of drug coated balloons (DCB) offers the advantage of delivering the drug without the need for re-stenting. This highlights the importance of the technological development of DCB, with diverse drug formulations and coating technologies. As…
2 Year Outcomes of Transcatheter Mitral Valve Replacement with Intrepid
Severe mitral valve insufficiency (MI) has been associated to the progressive deterioration of left ventricular function, cardiac and kidney failure, and increased mortality. Complete medical treatment at maximal doses and surgery are indicated. For those at high risk or those with ventricular function deterioration, edge-to-edge repair has been shown an excellent alternative. The use of…
Non-ST-Segment Elevation Myocardial Infarction in Elderly Patients
The world population is aging, and cardiovascular diseases are the leading cause of death in Western countries. It is increasingly common to find patients aged 70 or older with non-ST-segment elevation acute myocardial infarction (NSTEMI). However, this group has been excluded from most studies, and there is not enough information to determine whether a conservative…
QFR Analysis of Coronary Lesions with TAVR
While transcatheter aortic valve replacement (TAVR) has shown benefits, significant coronary artery disease affects 50% or more of patients who undergo such procedure. However, it is still unclear which is the best treatment strategy or how to handle this condition. Quantitative flow ratio (QFR) could be a non-invasive option to assess the severity of coronary…
Age and Microvascular Function in Patients without Obstructive Coronary Artery Disease
At present, there is increasing interest in the microvascular function of patients with and without obstructive coronary artery disease of different ages. However, these “physiological” effects of age on microvascular function have never been directly quantified on patients without obstructive CAD. Prior studies have focused on patients with angina and obstructive CAD, and the effects…
Invasive Correlation (CFR – IMR) with Coronary Slow Flow
Prior registries have shown that 65% of patients with chronic coronary syndrome (CSS) and angina do not present obstructive atherosclerosis. This phenomenon, called myocardial ischemia with no obstructive coronary arteries (INOCA) is more common in women and has been associated with high hospitalization costs and diminished quality of life. INOCA patients can present microvascular dysfunction…
Events in CAD Patients Who Refused or Were Ineligible for CABG
When deciding on the optimal coronary artery revascularization treatment of coronary artery disease (CAD) patients, physicians normally assessed clinical presentation, surgical risk, survival expectation, and the likelihood of a better quality of life. Decisions are made after careful consideration, by the Heart Team, who will ponder options such as coronary artery bypass graft (CABG), percutaneous…
TAVI in Horizontal Aorta: Neo2 vs. Sapien Ultra
There are controversies regarding transcatheter aortic valve implantation (TAVI) in cases of challenging anatomical complexity, such as horizontal aorta (HA). This is primarily because aortic angulation (AA) impacts the procedure differently depending on the valve type used. As previously studied, angulation complicates crossing, implantation, and coaxial positioning with commissural alignment. In the study presented by…
Complex PCI in Octogenarian
The octogenarian population has already reached 137 million and continues to grow. It is estimated to triple by 2050. This increase represents a big challenge, seeing as these patients are often more fragile, present more complex coronary artery disease and multiple comorbidities. This generally requires two or more procedures and more experience both from operators…
High Gradients After Valve-in-Valve
One of the limitations of aortic bioprostheses is their durability. When these devices fail, percutaneous valve implantation is a valid strategy. However, it has been shown that there may be high gradients involved. This gradient increase has been associated with worse outcomes and higher mortality rates, as observed in the PARTNER 2 study at 12 months.…