Severe aortic regurgitation (AR) may account for 20% to 30% of all surgical aortic valve replacements (SAVR) and is often associated with aortic stenosis (AS). Transcatheter treatment of these patients is limited due to anatomical factors such as root and annular dilation, large annular dimensions, and less calcification in the valve leaflets to serve as...
5 Year Evolution of PCI vs CABG in Large Randomized Studies on Acute and Chronic Coronary Syndrome
Left main lesions in acute coronary syndrome (ACS) represent a major risk and, at present, the best revascularization strategy is a matter of debate. Though many studies and registries have excluded this group of patients, there is data on the pros and cons of both percutaneous coronary intervention (PCI) and cardiac artery bypass graft (CABG). ...
Frequency and Causes of Mortality in Chronic Total Occlusion
In recent years, there has been an increase in the number of percutaneous coronary interventions (PCI) performed to treat chronic total occlusion (CTO). This increase is due to the availability of more advanced technology and greater experience of both operators and specialized centers. However, it is important to note that this technique is not free...
TAVR: Does HALT Affect Follow-Up?
Transcatheter aortic valve replacement (TAVR) in low-risk patients has been shown to be superior or noninferior in randomized studies, but the presence of valvular thrombosis, in its different forms, has not been well analyzed, nor is there much information on its impact on evolution. Researchers conducted an analysis of the LTR study that included 200...
Abbreviated Therapy in Patients with Acute Coronary Syndrome: How Safe Is Conservative DAPT Treatment?
Abbreviated dual antiplatelet therapy in patients at high risk for bleeding and acute myocardial infarction. Patients with acute coronary syndrome (ACS) who undergo stent placement (percutaneous coronary intervention, PCI) conventionally require at least 12 months of dual antiplatelet therapy (DAPT) to reduce ischemic events. Patients with ACS who are also at high risk for bleeding...
Echo- Stress during Edge-to-Edge Mitral Valve Repair Can Be Useful
Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a...
EuroPCR 2023 |TAVR in Cardiogenic Shock
Patients presenting aortic stenosis with cardiogenic shock are at extreme risk, with 70% mortality until the aortic obstruction is resolved, and taking into account they make poor transplant candidates. Safety and efficacy of TAVR in patients with cardiogenic shock remains unclear. The aim of this study was to assess events in patients undergoing TAVR with...
EuroPCR 2023 | Events after Redo TAVR in Balloon-Expandable Valves
With the treatment of aortic valve disease in younger patients, a significant number of them will need redo TAVR at some point in their life. However, to date there are few data on redo TAVR. The aims of this study was to look at real life experience on redo TAVR with balloon-expandable SAPIEN valves and...
Latest Developments in Tricuspid Regurgitation
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...