Drug eluting stent (DES) in-stent restenosis (ISR) is currently a challenging, seeing as it often requires repeat revascularization. The use of drug coated balloons (DCB) offers the advantage of delivering the drug without the need for re-stenting. This highlights the importance of the technological development of DCB, with diverse drug formulations and coating technologies. As...
Aortic stenosis is an increasingly common valvulopathy because people are living longer now. A present, the main treatment consists of surgical (SAVR) or transcatheter aortic valve replacement. (TAVR). One of the main challenges of this disease is its progression. The European guidelines recommend Doppler echocardiograms every 2 to 3 years for mild cases, mildly calcified,...
Mitral regurgitation (MR) is the most frequent valve disease. Mitral transcatheter edge-to-edge repair (M-TEER) has been shown beneficial in high or prohibitive risk patients in cases of degenerative and functional MR. The PASCAL device has been shown safe and effective by the CLASP II, but we still need further research in clinical “real world” environments. ...
Aortic stenosis (AS) is classified according to gradient into high flow and high gradient (D1), low flow-low gradient with reduced ejection fraction (D2), and paradoxical low flow-low gradient with conserved ejection fraction (D3). D3 AS is characterized by ≥50% ejection fraction, but with systolic volume index ≤35 ml/min. Post TAVR evolution of D2 and D3...
Septal reduction therapies are used to mitigate the symptoms caused by dynamic left ventricular outflow tract (LVOT) obstruction and the associated mitral regurgitation (MR) that can surge in hypertrophic cardiomyopathy (HCM). Alternative therapies to treat LVOT obstruction include surgical procedures, i.e. surgical myotomy or myomectomy, or alcohol and radiofrequency septal ablation (intracardiac, transthoracic and endocardial,...
The use of transcatheter mitral valve intervention for the treatment of mitral valve regurgitation (MR) continues to evolve; at present guidelines only recommend it for inoperable or high surgical risk patients. So far, many devices have been assessed, some of which have shown promising results, but only for poor surgical candidates. Researchers looked into the...
The edge-to-edge approach with MitraClip has been established as a valid strategy for patients who experience severe symptomatic mitral regurgitation (MI) with high risk for surgery, currently with a IIa indication. MI complicated by cardiogenic shock, which results in a high risk for conventional valve surgery, is a particularly complex scenario. In such a case,...
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...
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...
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...