The first experiences with distal radial access (DRA) have revealed significant benefits compared against the transradial approach (TRA), showing reduced bleeding events and better puncture site occlusion rate. Even the spectrum of diseases treated with DRA has grown, and now includes chronic total occlusion (CTO) though 7Fr inductors, such as Terumo’s Glidesheath Slender. The aim...
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...
Several scientific societies support performing left atrial appendage occlusion (LAAO) as a stand-alone procedure, even though it is often associated to other cardiomyopathies requiring transcatheter intervention. Though still controversial, combining LAAO and any other cardiac intervention might reduce hospitalizations, as well as the need for additional punctures, anesthesia, red tape, a longer stay and higher...
Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the...
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially...
Short dual antiplatelet therapy (DAPT) has shown benefits in patients receiving drug eluting stents (DES), reducing bleeding with no concomitant increase in major adverse cardiovascular events (MACE). Traditionally, the therapeutic window was limited to monotherapy with P2Y12 inhibitors during the first year and there are few data on short DAPT followed by long term monotherapy...
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR...
TAVR can be associated to early valve thrombosis, characterized by thrombi formation near or attached to the prosthetic valve, with or without valve dysfunction. This dysfunction is associated with increased leaf thickening and reduced leaflet motion, as well as reduced orifice area or increased transvalvular gradient. Triggered multislice CT allows dynamic valve assessment and thrombosis...
Tricuspid regurgitation has become increasingly common, and current pharmacological treatment options are limited. In turn, surgery, which is a complex alternative, carries considerable rates of complications and mortality. In response to this issue, various percutaneous systems are being developed, such as edge-to-edge treatment, percutaneous annuloplasty, and caval valve implantation (CAVI), among others. In the analysis...
TAVR has been shown beneficial over time, and with the development of new generation of prosthetic valves and implantation techniques, outcomes have been improved, reducing the incidence of leaks y and the need for definite pacemaker. This study looked at the evolution of 100 patients with symptomatic aortic stenosis treated with Myval THV from Meril...