Original title: Multicenter Evaluation of a Next-Generation Balloon-Expandable Transcatheter Aortic Valve. Reference: John Webb, et al. J Am Coll Cardiol 2014;64:2235-43 Percutaneous aortic valve replacement is starting to be a reasonable alternative in patients at intermediate risk. One hundred and fifty patients who received SAPIEN 3rd generation percutaneous aortic valve implantation were analyzed prospectively. The STS score of…
Long-term septal ablation in hypertrophic cardiomyopathy
Original title: Periprocedural Complication and Long-Term Outcome After Alcohol Septal ablation in hypertrofic Obstructive cardiomyopathy. A Single-Center Experience. Reference: Robbert Steggerda, et al. J Am Coll Cardiol Intv 2014;7:1227-34. Septal ablation is an alternative to surgery in hypertrophic cardiomyopathy (HCM), but indications and evolution are not fully established.161 patients who received septal ablation (SA) and 102 who received…
Stress echocardiography in low flow, low gradient aortic stenosis with deteriorated systolic function
Echocardiography Favaloro Foundation. Buenos Aires, Argentina. JACC Cardiovascular Imaging has recently published a retrospective analysis including severe aortic stenosis patients (< 1 cm²), with low gradient (mean aortic gradient Patients that had undergone dobutamine stress echocardiography (DSE) to distinguish pseudo aortic stenosis (n=49) were selected. These results were used to determine flow reserve (FR). The…
Hybrid Revascularization in Multiple Vessels
Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83 According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications. This study randomized 102…
Thienopyridine Pretreatment in Non ST Elevation ACS syndrome
Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:…
Complications of peripheral angioplasty access
Original title: Access Site Complications After Peripheral Vascular Interventions. Incidence, Predictors, and Outcomes. Reference: Daniel Ortiz et al. Circ Cardiovasc Interv. 2014 Nov 11. Epub ahead of print. Hematomas and pseudoaneurysms are the most common complications of peripheral angioplasty, though its incidence and risk factors are unclear. A retrospective analysis was performed in 22226 patients receiving peripheral…
The SYNTAX Score II: a tool that should be used
Original title: Validation and Comparison of the Long-Term Prognostic Capability of SYNTAX Store-II Among 1528 Consecutive Patients Who Underwent Left Main Percutaneous Coronary Intervention. Reference: Bo Xu, et al. JACC Cardiovascular Intervention 2014;7:1128-37. The SYNTAX angiography score is useful when deciding revascularization in multivessel, but with the addition of clinical variables in the second version, SYNTAX score…
FFR results could change over the years
Original title: The impact of age flow reserve-guided percutaneous coronary intervention: A FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) trial substudy. Reference: Hong-Seok Lim et al. International Journal of Cardiology 2014; 177:66-70 The FAME study has shown the benefit of FFR guided PCI, but the question as to whether age affects lesion evaluation remains unclear. A…
Despite the evidence, visual estimation continues to dominate the decision on intermediate lesions
Original title: Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions. Results of the International Survey on Interventional Strategy. Reference: Gabor G. Toth et al. CircCardiovascInterv. 2014. Epubahead of print. Measurement of fractional flow reserve (FFR) is recommended by the guidelines and supported by evidence in intermediate lesions when not any proof of ischemia is available…
Transfemoral TAVI under local anesthesia with similar results to general anesthesia
Original title: Clinical outcomes and safety of transfemoral aortic valve implantation under general versus local anesthesia: subanalysis of the French Aortic National CoreValve and Edwards 2 registry. Reference: Oguri A et al. CircCardiovascInterv. 2014; 7:602-610. Transcatheter aortic valve replacement (TAVI) performed under local anesthesia is becoming an increasingly common procedure. This study compared clinical outcomes in patients…
TAVI, also a promising option for severe aortic regurgitation
Original title: Initial German Experience With Tranapical Implantation of a Second-Generation Trascatheter heart Valve for the Treatment of Aortic Regurgitation. Reference: Moritz Seiffert, et al. JACC Cardiovasc Interv. 2014 Oct;7(10):1168-74. There is a group of patients with severe aortic regurgitation and they are not candidates for surgery; percutaneous implant is an option, but until now, there is little…