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...
A study by the Northern New England Cardiovascular Disease Group Consortium recently published online identified all patients with aortic valve stenosis treated with surgical or transcatheter aortic valve replacement between 2016 and 2022 in Maine, New Hampshire, and Vermont (USA). These patients were divided for analysis into three age groups: under 65 years old, 65...
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...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is currently under development, with an increasing number of conducted procedures. While the TRILUMINATE Study did not reveal benefit regarding major events, it did show improvements in quality of life. In the real world, we encounter numerous patients who do not meet the study criteria but still experience symptoms...
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,...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access fails. The introduction of ultrasound (US) to guide access has emerged as a technique that allows for precise channeling, avoiding accesses above or below the inguinal ligament. However, evidence regarding the use of this tool has shown diverse results. Two surveys conducted...
Aortic valve replacement (AVR) is indicated for symptomatic aortic stenosis (AS), while close follow-up is recommended for asymptomatic patients, unless they have elevated aortic gradients, low ejection fraction, or abnormal stress tests. However, the optimal timing to perform AVR is uncertain, especially with recent evidence suggesting that patients with AS associated with signs of myocardial...
The purpose of myocardial viability testing is to identify patients that might benefit from revascularization by diagnosing three types of myocardium: normal, viable or hibernating, and scarred (non-viable). Non-randomized studies have shown recovery of a viable ventricle after myocardial revascularization surgery (CABG) and improved survival. However, a sub-analysis of the main study on viability testing,...