Angina pectoris without stenosis in the epicardial coronary arteries is a common problem with several possible underlying causes. The main purpose of this work was to test the hypothesis that stratified medical therapy guided by an interventional diagnostic procedure might improve outcomes. Patients without coronary lesions and with angina were immediately randomized 1:1 to an...
Prosthesis-patient mismatch (i.e. a difference between the size of the implanted prosthetic valve and the patient body size) in patients who undergo surgery is associated with worse outcomes. This may also apply to percutaneous prostheses, although that has not been well-studied yet. This work, presented at TCT 2018 and published simultaneously in JACC, analyzes this problem...
This study was simultaneously presented at TCT and published at JACCE, and it aims at showing the one-year outcomes of this new TAVR device, though follow-up is at 5 years. Primary end point was all cause mortality and secondary end points included clinical and echocardiographic events. With a total 941 patients (82,4 ± 5,9...
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’...
Successful rechanneling of a chronic total occlusion (currently around 90%) leads to significant improvement in quality of life and symptom frequency in patients with stable chronic angina compared with optimal medical treatment alone. These results are promising and what we ultimately expected, although symptoms, as a primary endpoint in themselves, are in the eye of...
Courtesy of Dr. Carlos Fava. Tricuspid regurgitation (TR) has a negative impact in the long run. Several reports have shown that, in high risk inoperable patients, transcatheter edge-to-edge valve repair with MitraClip is feasible, safe and has good results, but there is still a long way to go. The present study looked at 24 consecutive...
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...
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...
The prognosis of patients with symptoms of angina (with all their subjectivity) in a setting of no significant coronary lesions is widely varied. It is not as benign as we initially thought and patients do not present as many events as “regular” patients with associated severe coronary lesions. The literature owed us data on the...
Courtesy of Dr. Carlos Fava. Aortic stenosis with cardiac failure or cardiogenic shock involves high mortality risk at short term. Surgery in these conditions is often unsafe, which leaves us with valvuloplasty, but only as a bridge to some other procedure, seeing as it is effective only for a short time. Few studies have looked into patients undergoing...