Severely calcified lesions currently pose a significant challenge, as they require adequate preparation through non-compliant balloons or cutting balloons to achieve effective stent expansion. Another option is the use of orbital or rotational atherectomy (RA), but this carries the risk of complications such as slow/no reflow, perforations, dissections, peri-procedural infarction, or guidewire rupture. Despite the...
Despite stroke rate has declined since the early days of transcatheter aortic valve replacement (TAVR), it remains significant, reaching 1% to 3% 30 days after procedure. Since TAVR has seen a progressive expansion to the low risk and young populations, identifying risk factors in patient selection and management is crucial for us to prevent stroke. ...
At present, severe calcified coronary stenosis poses a significant challenge for PCI. A successful intervention will require plaque modification prior stenting, seeing as sub-expansion has been associated with worse clinical outcomes at followup. The tools normally used to treat these complex lesions include specialized balloons such as cutting, scoring, and high pressure balloons, as well...
In the context of TAVR, one of the current challenges is the need for permanent pacemaker implantation (PPM), especially when using self-expanding valves (SEV). The information available in this regard remains controversial; while some studies suggest new PPM implantation will have no significant effect on clinical evolution, others have associated them with worse prognosis. As...
The OCTOBER Study randomized 1201 patients with bifurcation lesions in a 1:1 ratio to undergo percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) or by angiography. The primary endpoint (PEP) was major adverse cardiovascular events (MACE) over a 2-year period. Group characteristics were similar. The average patient age was 66 years, most...
Transcatheter aortic valve replacement (TAVR) has shown remarkable benefits and continues to advance towards lower-risk patients and younger ages. However, one of its limitations lies in the demand for a permanent pacemaker (PPM), which during TAVR early stages with self-expanding valves reached 30%. Uncertainty persists regarding the evolution of patients undergoing PPM implantation after TAVR,...
Read the most outstanding articles from SOLACI-SBHCI 2023 Congress. In this case, check the presentation by Dr. João Eduardo Tinoco, entitled “Optimizing CTO Procedures: Realworld Experiences from LATAM”
Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical...
Heart failure is strongly associated with malnutrition or poor nutrition, which has been linked to increased mortality during follow-up. We know that mitral regurgitation causes progressive heart failure and affects nutrition. The COAPT Study has demonstrated the benefits of edge-to-edge treatment in mitral regurgitation when combined with comprehensive medical treatment and maximum tolerated doses. However,...
Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor...