The natural history of tricuspid regurgitation is associated to hospitalization for cardiac failure and mortality. This is why the AHA/ACC guidelines recommend surgery when the tricuspid fails during left valve surgical repair, because its slow progression is associated with high mortality (35%). Many of these patients are high risk and percutaneous intervention has surged as...
Low Gradient Aortic Stenosis: Is Invasive Assessment Viable?
There is an important group of patients presenting low flow, low-gradient severe aortic stenosis (defined as mean gradient <40 mmHg). This is why we do dobutamine stress echocardiogram (DSE), to confirm whether we are dealing with truly severe aortic stenosis. However, it might not be well tolerated and a CT angiography will be done to...
MitraScore: What Does the Final Result of Edge-to-Edge Treatment of Mitral Regurgitation Provide?
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
TriClip: Tricuspid Regurgitation Dedicated Device
Severe tricuspid regurgitation (TR) is difficult to manage and is associated to high morbimortality. Surgical repair is complex and not free from complications: its mortality rate ranges from 5 to 20% and depends on series, surgeon and center expertise. Edge-to-edge repair with clips has become a valid alternative to treat this disease, but most data...
Left Main Revascularization: 12 Year Registry in Canada
The current indication for severe left main lesion continues to be coronary artery bypass graft surgery (CABG) but percutaneous coronary intervention (PCI) has come far in this territory thanks to increasing operator experienced and the use of IVUS during procedures. At present, left main disease have a Class IIa indication in the American guidelines when...
Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis
3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR...
The most read articles of january in solaci.org
These were the most read articles of interventional cardiology in solaci.org. Real-World Revascularization Strategy for Left Main Coronary Artery: Surgery or PCI? There are many current randomized trials comparing percutaneous coronary intervention (PCI) with myocardial revascularization surgery (MRS) for the treatment of left main coronary artery disease (LMCAD). Real-World Results of Different Devices for TAVR Transcatheter aortic valve replacement (TAVR) keeps...
Resistant Obstructive Hypertrophic Cardiomyopathy: Myomectomy or Septal Ablation?
Approximately 70% of hypertrophic cardiomyopathies (HCM) are associated to a left ventricular outflow tract (LVOT) obstruction and mitral valve failure leading to dyspnea and cardiac failure in a high number of patients. Even though at present there are effective drug treatments combined with pacemaker implantation, surgery (septal myomectomy (SM) continues to be the first choice...
Long-Term Evolution of Hybrid Coronary Revascularization
Currently, myocardial revascularization surgery (MRS) and percutaneous coronary intervention (PCI) are the available strategies for multivessel coronary artery disease. However, an alternative strategy has long been developed, called hybrid coronary revascularization (HCR), where the anterior descending artery is bypassed with a graft from the mammary artery and the rest of the lesions are treated by...
The Most Important Articles of 2022 in Structural Heart Disease
Discover the most read scientific articles on interventional cardiology of 2022 in our website. We Should Treat Significant Stable CAD in Patients Undergoing TAVR Aortic stenosis is associated to significant coronary artery disease (CAD) in nearly 50% of cases. When we decide to treat aortic disease using surgery, it has been established we should also treat...