Treating tricuspid regurgitation (TR) has gained increasing importance in interventionism. There is abundant literature on the negative natural evolution of this condition and its unfavorable prognosis, as well as the clinical challenges associated to optimal medical treatment. Among its percutaneous treatment options, both edge-to-edge repair devices (TEER), as showed in TriValve and TRILUMINATE trials, and...
Severe tricuspid regurgitation (TR) presents a reserved prognosis when not treated in time, seeing as systemic venous congestion might significantly limit quality of life in these patients. For many years it was thought diuretic therapy was the only option to treat these patients, since the surgical alternative offered suboptimal results and many patients were deemed...
Approximately 30% of patients undergoing percutaneous coronary intervention (PCI) present moderate to severe calcified lesions, which presents a significant challenge involving a high incidence of major adverse cardiovascular events (MACE). Rotational atherectomy (RA) is used to modify these calcified lesions and facilitate balloon angioplasty followed by stent implantation. The combination of RA with other plaque...
In patients with peripheral vascular disease (PVD), the presence of diabetes has been significantly associated with increased failure of critical lower limb ischemia (CLI) treatment, and higher incidence of amputation. This relationship has been attributed mainly to comorbidities and patient characteristics, concomitant peripheral neuropathy and marked microvascular alteration. Also, a high proportion of these patients...
While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when...
The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to...
The incidence of stroke after TAVR ranges between 2 and 5%, depending on the series, which has been associated with higher morbimortality, affecting patient quality of life and their psycho-social environment. Many cerebral embolic protection systems have been developed in response, and even though they have been shown beneficial in many studies, their role in...
Subclinical atrial fibrillation (AF), generally asymptomatic and of short duration, often requires continuous long-term monitoring using pacemakers or defibrillators for its detection. While subclinical AF is linked to an increased risk of stroke, the usefulness of oral anticoagulation as a treatment remains uncertain. In a double-blind randomized trial, one group received apixaban and the other...
During TAVR, we often fear the possibility of a stroke, which occurs in approximately 1 – 2% of cases. In general, this phenomenon is caused by thrombi stemming from atherosclerotic or calcified plaque, depending on the etiology. Even though its incidence has declined with technology development and the increasing expertise of operators, it is still...
The presence of cardiogenic shock (CS) in a setting of aortic stenosis ranges from 1% to 4%. The prognosis for this scenario is ominous due to subendocardial ischemia, which presents as a decrease in ventricular preload and an increase in afterload. Aortic valvuloplasty has been used in this context, but, unfortunately, it has been associated...