Courtesy of Dr. Carlos Fava. Left main coronary artery (LMCA) lesions have always been defined as high-risk, with surgery as treatment of choice. Drug-eluting stents (DES) have slowly changed that, but their use still lacks strong supporting evidence. The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) study...
Courtesy of Dr. Guillermo Migliaro. Coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) with an estimated incidence of 0.5%. Arterial blood entering the pericardium may cause a rapid elevation of intrapericardial pressure and collapse the right cavities (tamponade) creating hemodynamic compromise. Historically, surgical drainage has been the...
Diabetic patients have an increased risk of future cardiovascular events after an ST elevation MI. Administration of an intracoronary abciximab bolus during primary PCI could be beneficial for this high risk subgroup of patients. This study reports one year clinical outcomes and CMR imaging of patients randomized to intracoronary vs. intravenous abciximab during primary...
He grew up in the 40s, surrounded by cap screws, dental crowns and damp from the Paraná River. His father, mother and two brothers, were dentists. Years later, his daughter and niece would also become dentists. But since his early years, Hugo Londero had known he would become a physician. He was certain his greatest...
Original Title: Revascularization in Patients with Multivessel Coronary Artery Disease and Severe Left Ventricular Systolic Dysfunction: Everolimus Eluting Stents vs Coronary Artery Bypass Graft Surgery Reference: Bangalore et al. Circulation. 2016 May 5. Epub ahead of print. Courtesy of Dr. Guillermo Migliaro. Guidelines recommend coronary artery bypass graft surgery (CABG) over percutaneous coronary...
Platelet inhibition is critical in reducing atherothrombotic risk in the short and long term after an acute coronary syndrome, especially if the patient has received coronary angioplasty. Few data are available in the real world in terms of safety and efficacy of prasugrel versus clopidogrel in this clinical context. This registry involved 12227 patients undergoing...
A total of 18,273 patients receiving angioplasty in hospitals with or without central vascular surgery were followed for 9 months and the costs were evaluated. Mortality and the occurrence of events were not different between the two groups. The cost of treatment was lower in the central vascular surgery centers (23,961 USD versus 25,540 USD,...
Original title: Everolimus-Eluting Stents or Bypass Surgery for Multivessel Coronary Disease. Reference: Sripal Bangalore, M.D. et al. N Engl J Med. 2015 Mar 26;372(13):1213-22. Coronary artery bypass grafting (CABG) have had better outcomes than percutaneous coronary intervention (PCI) in the treatment of multivessel coronary disease. However, this information comes from studies that do not include new generation stents....
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...
Original title: Five-year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial. Reference: Morice MC et al. Circulation. 2014 Jun 10;129(23):2388-94. Current guidelines recommend CABG as the strategy of choice for treating lesions of...