Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical...
Transcatheter aortic valve intervention (TAVI) has been shown beneficial over the years. However, a significant subgroup of patients with small aortic annulus, which make approximately one third of cases and have a higher incidence in women, face additional challenge, such as higher incidence of mismatch, reduced exercise capacity and shorter durability. Self-expanding and balloon expandable...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....
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...
Patients with severe aortic stenosis and a small aortic annulus face an increased risk of deteriorated valvular hemodynamic performance and adverse cardiovascular clinical outcomes after undergoing transcatheter aortic valve replacement (TAVR). This study, a prospective multicenter randomized trial, aimed to compare the efficacy and safety of two types of valves: the supra-annular self-expanding EVOLUT (SEV)...
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...
Cardiogenic shock will develop in approximately 10% of patients with ST elevated acute MI (STEMI), and unfortunately, only half of these patients will survive. Researchers have been looking into the Impella system to manage this severe complication. It consists of an aortic transvalvular pump designed to deliver blood from the left ventricle into the systemic...
The international guidelines recommend the use of dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor during 12 months in patients receiving percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), to prevent events such as MI and stent thrombosis. This was a multicenter, placebo controlled, double blind study to determine whether ticagrelor alone,...
Heart failure is characterized by increased left atrial filling pressure and venous congestion which intensify with exercise and volume burden, and makes conventional medical management hard. In this context, interatrial shunting might offer a self-regulating mechanism, as shown by the Ventura IAS study. The aim of this study was to assess the safety and efficacy...
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...