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La trascendental importancia de los cambios en el estilo de vida

The Crucial Significance of Lifestyle Changes

The Crucial Significance of Lifestyle Changes

Any change towards a healthier lifestyle, even if it seems small, can have a great impact, particularly in patients with diabetes. These changes are never too late. In consequence, as physicians, we should always be attentive and never stop encouraging patients to adopt them. Patients with diabetes who make changes to their lifestyle, such as

Are Abdominal Aortic Aneurysm Screening Programs Overstated?

With the remarkable drop in tobacco use across the world, also dropped mortality associated to abdominal aorta aneurysm rupture (AAA). All AAA screening programs have been designed decades ago, when the risk was higher. This is why we might need to rethink these programs, or at least design new randomized controlled studies to pave the

Urgent/Emergent TAVR: A Valid Option

Courtesy of Dr. Carlos Fava. Aortic stenosis with cardiac failure or cardiogenic shock involves high mortality risk at short term. Surgery in these conditions is often unsafe, which leaves us with valvuloplasty, but only as a bridge to some other procedure, seeing as it is effective only for a short time. Few studies have looked into patients undergoing

Evaluación funcional de las estenosis coronarias en la vida real: todavía no hicimos el click.

Real-Life Functional Assessment of Coronary Stenosis: We Are Yet to Convert to It

The use of functional assessment of coronary stenosis (following the class IA recommendation in both American and European guidelines) is below 50% in daily clinical practice. Truth be told, most operators continue having blind faith in angiography. The inclusion of coronary physiology in the decision-making process has spread widely across countries, sites, and operators. The ERIS

The Largest Registry on the ACURATE neo Valve

Transcatheter aortic valve replacement (TAVR) using the ACURATE neo device depends, largely, on correct patient selection and appropriate oversizing. The individual anatomy of each patient, namely periannular and aortic root calcification, must be taken into account. The ACURATE neo valve (Symetis/Boston, Ecublens, Switzerland) is a new-generation self-expanding valve characterized by a stent design shaped as an X

Deterioro de la función renal: ¿Cómo impacta en la ATC y en la CRM?

Renal Impairment: How Does It Affect Angioplasty and Surgery?

Courtesy of Dr. Carlos Fava. The incidence of kidney disease is increasing. In its final stage, this pathology is related with coronary disease and increased mortality. Furthermore, we know that, in many occasions, it is associated with diabetes. Nowadays, the evidence comparing the progress of patients with impaired kidney function who have undergone left main

DEFENSE-PFO: el cierre FOP con ciertas características disminuye eventos combinados y stroke

DEFENSE-PFO: High Risk PFO Closure Reduces Combined Events and Stroke Risk

High risk patent foramen ovale closure PFO resulted in reduced stroke, vascular death and bleeding risk. Recent reports have shown a favorable role of PFO in patients with cryptogenic stroke, though with some unclear results, which immediately raised the questions: Who are the optimal candidates for this procedure, and who will see no benefit?  

Are the Rates of Stroke Similar in TAVR and Surgery?

Courtesy of Dr. Carlos Fava. Stroke is one of the most undesirable complications we can face and, regarding transcatheter aortic valve replacement (TAVR), major studies presented have rates of stroke of about 4%. In others, rates have been slightly higher. This meta-analysis included 5 randomized studies between 2011 and 2017: PARTNER, CoreVALVE, NOTION, PARTNER 2, and SURTAVI.

Angina Is as Subjective as Any Other Pain

Almost 80% of all patients randomized in this study reported Canadian Cardiovascular Society class II or III angina, and almost all of them (97%) had more than 1 positive non-invasive ischemia test that matched the area of their single diseased coronary vessel. Beyond fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), the study randomized patients to

La recanalización de las CTO mejora la calidad de vida

CTO Revascularization Improves Quality of Life

Courtesy of Dr. Carlos Fava. The presence of CTO hovers around 15, 20% in coronary angiographies of patients with chronic stable angina, but only 5% receive percutaneous coronary intervention (PCI). One of the obstacles to percutaneous revascularization is the lack of relevant studies justifying it, though we do have different comparative studies that improve symptoms, ventricular