Original title: Percutaneous Left Ventricular Assist Device with Tandem Heart for High-Risk Percutaneous Coronary Intervention: The Mayo Clinic Experience. Reference: Oluseun O Alli, et al. Catheterization and Cardiovascular Intervention 80:728:734 There is a small group of poor surgical patients admitted for surgery that due to complex comorbidity, coronary anatomy and compromised left ventricular function that can be treated...
Original title: Real-Word of the Impella 2.5 Circulatory Support System in Complex High-Risk Percutaneous Coronary Intervention: The USpella Registry Reference: Brijeshwar maini, et al. Catheterization and Cardiovscular Intervention For about a decade angioplasty has begun to be performed in increasingly complex patients (PE) such as those with left coronary trunk injury, 3-vessel injury, poor ventricular function and surgically...
Severe mitral valve insufficiency (MI) has been associated to the progressive deterioration of left ventricular function, cardiac and kidney failure, and increased mortality. Complete medical treatment at maximal doses and surgery are indicated. For those at high risk or those with ventricular function deterioration, edge-to-edge repair has been shown an excellent alternative. The use of...
Coronary sinus reduction (CSR) is a relevant area of study for the treatment of refractory angina, with hopes of improving myocardial perfusion. However, to date, there are no conclusive data. The ORBITA-COSMIC study is a randomized, double-blind, placebo-controlled trial conducted at six centers in the UK. Researchers recruited patients with angina and chronic ischemia who...
Most clinical trials have shown benefits of beta blockers after acute myocardial infraction, including patients with extensive AMI, and these were carried out in the era before AMI was diagnosed with biomarkers and prior to treatment with coronary angioplasty, use of antithrombotic agents and high intensity statins, and angiotensin-aldosterone system inhibitors. The aim of this...
In recent years, TAVR has been increasingly used; however, when it comes to younger, lower risk patients, its use is still challenged. In this context, there is limited information and we lack randomized studies on “real world” cohorts. The DEDICATE randomized 1.414 patients over 65 with severe symptomatic aortic stenosis. 701 of these patients received...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
The purpose of myocardial viability testing is to identify patients that might benefit from revascularization by diagnosing three types of myocardium: normal, viable or hibernating, and scarred (non-viable). Non-randomized studies have shown recovery of a viable ventricle after myocardial revascularization surgery (CABG) and improved survival. However, a sub-analysis of the main study on viability testing,...
Coronary artery disease, both obstructive and non-obstructive, often coexists with significant aortic stenosis. Therapeutic decision-making in this scenario remains controversial, not only regarding the need for treatment, but also about when it should be addressed, considering its pros and cons. Various analyses have yielded contradictory data, as most lesions are chronic and stable. Currently, the...