Among patients undergoing percutaneous coronary intervention (PCI), there is a need for risk stratification for successful planning and post procedural management. Risk stratification is paramount for effective decision making. For a long time, the SYNTAX score has been the preferred tool for complex PCI patient risk assessment. However, it has important limitations, such as inter-observer…
Abbreviated Therapy in Patients with Acute Coronary Syndrome: How Safe Is Conservative DAPT Treatment?
Abbreviated dual antiplatelet therapy in patients at high risk for bleeding and acute myocardial infarction. Patients with acute coronary syndrome (ACS) who undergo stent placement (percutaneous coronary intervention, PCI) conventionally require at least 12 months of dual antiplatelet therapy (DAPT) to reduce ischemic events. Patients with ACS who are also at high risk for bleeding…
Mitral Valve Surgery after Edge-to-Edge Repair
In last few years, transcatheter edge-to-edge repair (TEER) with MitraClip has been shown safe and effective, both for primary and secondary mitral valve regurgitation (MR), given the increasing interventionist and echocardiographer experience. However, there is a group of patients that require surgery after failed TEER, either because of bad evolution or because device implantation…
Provisional Stenting vs. Culotte: 5-Year Results of EBC TWO
The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the…
Impact of Right Ventricular Pacing in Patients with Permanent Pacemaker Implantation after TAVR
Permanent pacemaker implantation (PPI) is a relevant complication in patients undergoing transcatheter aortic valve replacement (TAVR) despite there being new devices. The current information on the long term impact of this complication remains unclear and recent evidence suggests post-TAVR ventricular pacing (VP) might be associated to higher risk of all-cause mortality and hospitalization for cardiac…
EuroPCR 2023 | TAVR in TAVR Results with Balloon-Expandable Valves
With the expansion of transcatheter aortic valve replacement (TAVR) use in the low-risk population, more patients will need repeat valve replacement in the future, making it paramount to understand the performance of repeat TAVR. Currently, this information is limited. The aim of this study was to analyze the real-world experience of performing a second TAVR…
Echo- Stress during Edge-to-Edge Mitral Valve Repair Can Be Useful
Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a…
EuroPCR 2023 | ACURATE Neo2: Results After 5 Years
The ACURATE Neo2 valve is an evolution of the first-generation ACURATE Neo valve with a low rate of pacemaker implantation and a decrease in paravalvular leak, also compatible with the 14F introducer. This prospective study included patients with symptomatic severe aortic stenosis at high surgical risk who underwent ACURATE Neo2 valve implantation. The primary endpoint…
EuroPCR 2023 | Intravascular Lithotripsy (IVL) Balloon in the Treatment of Underexpanded Stents
Calcified coronary plaque (CCP) is a challenge for interventional cardiology. Stent underexpansion (SU) commonly associated with CCP could predispose to stent thrombosis or restenosis. Currently, SU in severe CCP can be treated by rotational atherectomy, orbital atherectomy, balloon cutting/scoring, non-compliant high-pressure balloons, or intravascular lithotripsy (IVL). The aim of this meta-analysis was to determine the…
EuroPCR 2023 | TAVR in Patients with Bicuspid Aortic Valve Stenosis
Bicuspid aortic valve (BAV) stenosis is the most common congenital valve disease, affecting up to 2% of the population. Patients with BAV disease undergoing transcatheter aortic valve replacement (TAVR) account for 0.5%. In this context, TAVR data on BAV stenosis patients has been limited to observational studies on first generation valves that had resulted in…