Courtesy of SBHCI. Angioplasty in patients with chronic stable angina and functionally significant lesions improves clinical outcomes and quality of life over the long term, as compared with optimal medical therapy alone. Furthermore, the invasive approach becomes more cost-effective as the years go by. Previously, FAME 2 had shown that angioplasty was initially more expensive, but...
Courtesy of the SBHCI. Angioplasty of true distal left main bifurcation lesions with a double-kissing (DK) crush two-stent strategy, compared with provisional stenting, results in lower rates of target lesion failure at 1 year. These findings were largely driven by lower rates of target vessel infarction and definite/probable stent thrombosis. Read also: “EXCEL-QOL Substudy: Similar Quality...
Courtesy of Dr. Carlos Fava. Avoiding general anesthesia in intervention procedures has the benefits of faster recovery and shorter hospitalization. This has been already analyzed in the context of TAVR, but not in MitraClip procedures. The present study analyzed 232 patients receiving the MitraClip. 76 of these procedures were done under general anesthesia (32.7%) and...
A recent presentation at London Valves took a closer look at the REPRISE III trial as regards two points that generated much discussion, such as need for a pacemaker and paravalvular leak. REPRISE III had previously demonstrated that the Lotus is noninferior to first-generation CoreValve and Evolut R in terms of safety. Additionally, it proved to be superior...
Frailty is the patient’s diminished capacity to recover after pathological or iatrogenic processes. It has a fundamental role when considering valve replacement, be it surgical (SAVR) or transcatheter (TAVR). This was clearly observed in the PARTNER I and Core-Valve Pivotal trials, which showed that despite a 95% technical success, 2 in 5 patients showed poor quality...
Courtesy of Dr. Carlos Fava. The presence of Chronic Total Occlusion (CTO) is about 30%, with an ischemic threshold between 10% and 12.5% to justify rechannelization. Using the new devices, the new guidelines and with more experience operators, these procedures are successful in 10% to 30% of cases. More often than not these patients are not treated...
Courtesy of the SBHCI. Chronic total occlusions represent around 18% of all coronary lesions. However, they account for just 5% of all interventions, which means that many patients only receive medical treatment. This prospective, open, multicenter study randomized patients with multivessel lesions in whom at least one of these was a chronic total occlusion. Patients...
Early experience with the valve-in-valve technique in the treatment of failed bioprosthetic surgical valves in transcatheter aortic valve replacement (TAVR) has yielded acceptable acute procedural results. This turned the technique into another therapeutic option, one that could even cause the reassessment of the age limit for the surgical implantation of a mechanical or bioprosthesis valve....
Courtesy of Dr. Brian Nazareth Donato. The conventional treatment for patients with pulmonary embolism (PE) has traditionally been anticoagulation plus systemic thrombolytics, or surgical embolectomy, reserved for high risk patients. Even though it has been shown systemic thrombolytics reduce mortality in PE patients at high or intermediate risk, its use has been limited given the...
The first and only randomized trial on chronic total occlusion (CTO) revascularization versus optimal medical therapy in stable patients has disappointed interventional cardiologists. According to Dr. Seung-Jung Park, who presented the study, evidence suggests that optimal medical therapy is a reasonable initial treatment strategy for chronic total occlusion, when compared with angioplasty. Critics...