Guidelines recommend oral anticoagulation for all ≥ 75-year-old patients with atrial fibrillation. However, there is little evidence as to its net clinical benefit in the elderly population. This study looked at the life net clinical benefit in atrial fibrillation patients over 75 years of age treated with warfarin or apixaban vs. no treatment. Researchers observed...
Courtesy of Dr. Carlos Fava. The MitraClip has been shown to benefit a certain group of patients and it is a well-known fact that a ≥5 mmHg is associated to a more torpid evolution. However, there is little evidence when it comes to venous pulmonary waves, changes in left atrial pressure and V wave. 121...
In September 2008, interventional physicians at the Heart and Vascular Centre Hamburg conducted the first MitraClip implantation after its Conformité Européenne (CE)-marking approval. In July 2019, the same site reached an amazing milestone, 1000 MitraClips implanted, and in doing so it became the most experienced site in the world. Those 1000 patients treated had an average logistic...
While still lacking large-scale randomized trials, evidence is slowly building for transcatheter tricuspid valve repair. This work, presented at the TCT 2019 Congress and simultaneously published in JACC, shows that transcatheter tricuspid valve repair is not only feasible, but also likely to reduce the rates of mortality and heart failure rehospitalization compared with medical therapy alone....
Courtesy of SBHCI. The COAPT showed transcatheter repair of the mitral valve using the MitraClip resulted in reduced mortality and hospitalization for cardiac failure and improved quality of life, compared against optimal medical treatment in patients with cardiac failure and moderate to severe functional mitral regurgitation. The cost-effectiveness of this procedure has not been analyzed...
Courtesy of SBHCI. Mitral valve repair with a MitraClip device is a complex procedure that requires that operators develop a series of skills that may be unusual for them, such as analyzing an echocardiography. In this registry, researchers assessed the relationship between operator experience and procedural outcome. Operators were classified into 3 groups: 1 to 25 procedures...
Courtesy of Dr. Carlos Fava. The fact that the outcomes of edge-to-edge repair with MitraClip have improved, particularly in the immediate and short term, is widely known. Such improvement is basically a result of more operator experience and the arrival of 3-D echocardiography. However, there are no mid-term follow-up studies available, except for the EVEREST...
Negative one-year outcomes of Mitra-FR led to several discussions and hypothesis, especially after the COAPT was published only a few weeks later. According to the COAPT study, the MitraClip was able to reduce hospitalization rate for cardiac failure and also all-cause mortality, compared against optimal medical treatment alone. When comparing the COAPT to the Mitra-FR,...
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the...
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though...