Several studies (some of them recent, some of them not so much so) have compared left main coronary artery angioplasty and myocardial revascularization surgery. Combined, these works compose a large corpus of evidence, but follow-up has not gone beyond 5 years in any case. The main aim of this study (presented at TCT 2018 and published simultaneously...
Mitral Valve Repair in Patients with Cardiac Failure
The mitral valve is a complex apparatus dependent on left atrium and left ventricle functionality. Dilation of these cavities might affect mitral annulus morphology and lead to valve dysfunction, generating mitral regurgitation (MR). This type of MR has been called functional, since leaflets and tendinous chordae do not present lesions themselves; instead, they malfunction ‘secondary’...
MITRA-FR: Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation
Courtesy of Dr. Adolfo Ferrero. INTRODUCCION: In patients with chronic heart failure and reduced left ventricular ejection fraction, severe secondary mitral valve regurgitation is associated with bad prognosis. Whether percutaneous mitral valve repair improves clinical results in this patient population, remains unclear, despite prior multicenter studies supporting this view. METHODS: Patients with severe secondary mitral...
Balloon Mitral Valvuloplasty at Very Long Term
With a mean follow up of 15 years, and some patients that survived over 20 years, this study shows that more than 75% of patients with rheumatic mitral stenosis show sustained results with balloon valvuloplasty. Predictors of this excellent long-term outcome are many, but they are determined mainly by age, prior symptoms and valve area...
How to Predict Events in Order to Decide Whether to Revascularize Symptomatic Carotid Artery Stenosis
Current models are not reliable when it comes to predicting events after carotid revascularization in acute patients. Peri-procedural events seem to be particularly hard to predict. The development of models that can be externally validated is essential for the decision-making process in patients with high event rates, both during the procedure or while the case...
Should Sex Be Taken into Account with Left Main Coronary Artery Revascularization?
The EXCEL trial did not find the sex of patients with left main coronary artery disease to be an independent predictor of adverse events after revascularization. However, women who underwent angioplasty had a trend towards worse outcomes, a finding that might be related to comorbidities and somewhat increased chances of peri-procedural complications. In its formal...
Differences in Debris Captured According to Valve Type
During valve replacement, cerebral protection systems may capture debris in up to 99% of all patients. In over half of them, these particles are >1 mm. The particles captured during procedures in which Evolut R or Lotus valves were used were more and larger compared with those captured with the Sapien balloon-expandable valve. Beyond differences among valves,...
Endovascular Therapy in Stroke: Much Evidence and Few Trained Operators
Endovascular therapy is now considered as the standard of care for acute ischemic stroke caused by large vessel occlusion. The time between symptoms onset and reperfusion emerges as the most determinant factor for good clinical outcomes, much more strongly than even in acute myocardial infarction. The saying “time is brain” is even more relevant than...
New Ultra-Thin-Strut DES: Do They Outperform Second-Generation DES?
The new drug-eluting stents (DES) equipped with ultra-thin struts are showing a lower risk of target lesion failure as a result of lower rates of acute myocardial infarction and similar rates of revascularization, according to this meta-analysis soon to be published in Circulation. Such a difference is evidenced at a 1-year follow-up when compared with...
SOLACI Symposium at the Chilean Society of Cardiology Congress
This week is the 54th Chilean Congress of Cardiology and Cardiovascular Surgery. This event will take place from November 30th to December 3rd, 2017, in Santiago de Chile. The 2nd Latin American Symposium of Cardiovascular Disease in Women, the 2017 Course for Non-Specialist Physicians, and the Module on Ecocardiography for Anesthesiologists are among the highlights...