This study presented at EuroPCR 2022 analyzed the PARTNER study pool and included 1974 patients with a complete echocardiogram. Surgical risk was 17.3% extreme/inoperable, 54.3% intermediate and 28.4% low. 60% received transcatheter aortic valve replacement (TAVR) and the rest surgical aortic valve replacement (SAVR). 6.1% of patients were in stage 0 (no damage), 14.5% were…
Is High Mean Gradient After Edge-to-Edge Strategy Important?
Edge-to-edge treatment of the mitral valve is currently a valid alternative to surgery in cases of mitral regurgitation. Different studies have taken residual mitral regurgitation as a parameter of success, but little research has been conducted on the residual gradient once the procedure has been completed. What has been published is that a mean gradient…
Transfemoral vs Transradial Approach in the Percutaneous Treatment of CTO
Percutaneous treatment of chronic total occlusion (CTO) has traditionally been via the transfemoral approach (TFA). The use of the transradial approach (TRA) in complex coronary interventions has been increasing. A randomized study assessed the use of TRA vs TFA in complex PCI (58% CTO) and TRA saw favorable outcomes. The aim of this prospective, randomized,…
Improved Ventricular Function Post Revascularization: Fewer Events across Subgroups?
According to the STITCH and STITCHES trials, in patients with coronary artery disease and deteriorated left ventricular ejection fraction (EF), revascularization of a viable heart might reverse left ventricular systolic dysfunction. In these patients, improved EF after coronary revascularization appears to increase long term survival, particularly after cardiac artery bypass grafting (CABG), compared against medical…
Should We Worry about Non-Ischemic Lesions?
In the last decade, the interest in atheroma plaque morphology and its role in clinical events has been on the rise. Several studies have shown the use of IVUS to sort out plaque into lipidic rich (LRP) and thin cap fibroatheromas (TCFA). These morphologies have been associated with major cardiovascular events at followup. At…
Transcatheter Edge-To-Edge Repair Is Favorable for Elderly Patients at High Surgical Risk
Mitral valve prolapse is the most frequent cause of mitral valve regurgitation and is associated to hospitalization for cardiac failure and mortality. At present, the preferred treatment for operable patients is mitral valve surgical repair. Transcatheter edge to edge repair (TEER) has shown great benefit patients at high surgical risk; however, it has not been…
Coronary Flow Reserve in Patients with Intermediate FFR: Should We Use This Tool to Define When to Perform Coronary Angioplasty?
Current guidelines recommend using fractional flow reserve (FFR) to guide coronary angioplasty. However, intermediate FFR values (0.75-0.80) generate uncertainty about the prognostic value of performing coronary angioplasty over optimal medical treatment. The use of coronary flow reserve (CFR) together with FFR provides further insight into coronary circulation because CFR is an index that also includes…
Should We Start Using OCT in Myocardial Infarction with Non-Obstructive Lesions?
In ST elevation MI, the common assessment methodology continues to the angiography; however, we all know it has certain limitations, especially when it comes to intermediate lesions or coronary dissections. Using imaging, especially high resolution such as OCT, has been looked into by some studies, but never randomized studies. The EROSION III is a randomized…
Is Increased Mitral Valve Gradient After MitraClip a Long-Term Prognostic Factor?
Transcatheter mitral valve repair using the edge-to-edge strategy has become a therapeutic alternative for patients with severe primary mitral valve regurgitation (MVG) who are at high or extreme surgical risk. However, both degree of residual regurgitation and gradient after the procedure should be taken into account, as in previous studies the latter was associated with…
Hypertrophic Cardiomyopathy: Analyzing a Historical Series
75% of patients with hypertrophic Cardiomyopathy present symptoms. An important group responds very well to pharmacological treatment with betablockers and calcium antagonists, and those who do not respond, or do not tolerate these drugs, receive, at present, surgery as elective treatment. There is also alcohol septal ablation as an alternative strategy, which different studies have…