Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement (SAVR) continues to be elective, but the presence of post-procedural acute myocardial infarction (AMI) has been associated to bad evolution. Despite the proven benefits of TAVR for high risk patients and the progress shown by patients of intermediate risk, the incidence of post implantation MI has…
Same-day discharge after coronary angioplasty is increasingly popular but still not the gold standard
The length of hospital stay after elective coronary angioplasty varies significantly among operators and hospitals, according to a recent survey of interventional cardiologists in the United States (US), Canada, and the United Kingdom (UK), published in Catherization and Cardiovascular Interventions. While same-day discharge is a routine proceeding in the UK, most interventional cardiologists surveyed mentioned…
Biodegradable-polymer stents are as safe as permanent-polymer stents in a 5-year follow-up
Courtesy of Dr. Carlos Fava. One of the questions around drug-eluting stents (DES) is whether the development of biodegradable polymers would derive in better outcomes than the performance of durable polymers as regards the presence of events. In consequence, the COMPARE II trial was carried out with the aim of testing them in “real-world” patients. This…
Mortality at one year in post PCI myocardial infarction
Courtesy of Dr. Brian Nazareth Donato. Multiple definitions with biomarkers and variable thresholds have been proposed to diagnose post procedural MI. The last update of the Third Universal Definition of Myocardial Infarction decided to use only troponin values with a threshold >5 over the normal value, on top of the clinical evidence by ECG, echocardiography…
Transseptal puncture for the treatment of structural heart disease: conventional needle or radiofrequency needle?
Courtesy of Dr. José Álvarez. This study sought to find differences in the transseptal puncture technique between the use of a conventional needle and the use of a radiofrequency-powered needle. A total of 52 patients who underwent transseptal puncture for the treatment of various types of heart disease (Mitraclip, Watchman, Lariat, and mitral valvuloplasty) were…
Angioplasty in lesions due to radiation treatment presents similar mortality rates
Courtesy of Dr. Carlos Fava. Thoracic radiation causes cardiac lesions, and coronary arteries are among the most affected structures. Furthermore, it provokes obstructive lesions due to wall fibrosis. Generally, patients with this background are not eligible for surgery and receive angioplasty, a seemingly great alternative. However, there is no clear information on outcomes yet. This…
In-hospital morbid-mortality rates for balloon aortic valvuloplasty are similar to those for transcatheter aortic valve implantation
Courtesy of Dr. Carlos Fava. The balloon aortic valvuloplasty (BAV) was introduced by Dr. Cribier in 1986. However, given its poor results, soon after it fell into disuse. With the introduction of TAVR, it saw a revival as bridge for another intervention, even though it is still resisted in many places. The present study…
Early Endarterectomy Seems Superior to Carotid Stenting in Symptomatic Patients
Patients with symptomatic stenosis of the internal carotid artery benefit from early intervention. The challenge lies in what intervention to choose. Most studies comparing endarterectomy to carotid stenting are fairly heterogeneous as regards timing of intervention. This element is key to comparing between procedures, since there is no doubt timing will directly affect results. …
EuroCTO: Rechanneling vs. Optimal Medical Treatment in Total Occlusions
Courtesy of the SBHCI. Chronic total occlusions represent around 18% of all coronary lesions. However, they account for just 5% of all interventions, which means that many patients only receive medical treatment. This prospective, open, multicenter study randomized patients with multivessel lesions in whom at least one of these was a chronic total occlusion. Patients…
Low Gradient Aortic Stenosis Won’t Improve with TAVR
Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found…