Unlike degenerative mitral insufficiency, ischemic failure is due to an increase in the left ventricular cavity, the loss of its elliptical form, ring dilation and displacement of the papillary muscles leading to the loss of coaptation the leaflets. European and American guidelines suggest the intervention on the mitral valve in patients with ischemic mitral regurgitation...
ASCERT: Cirugia versus angioplastia en pacientes añosos con enfermedad coronaria de múltiples vasos: comparación de dos registros norteamericanos.
Editorial Read article William Weintraub.2012-03-26
GOPCABE: similar results for in-pump or off-pump surgery in elderly patients
Background: There is much debate about a possible benefit of coronary artery bypass grafting (CABG) without cardiopulmonary bypass (CPB) compared with on-pump surgery. However, a randomized study could not confirm this benefit. The objective of these studies was to compare the MACCE, (death, MI, stroke, revascularization repeated and a new dialysis), of surgical revascularization with...
FREEDOM: Insulin dependent versus non-insulin dependent with multivessel disease
From the total of 1900 patients in the FREEDOM study, 1248 did not require insulin (631 received angioplasty and 617 received CABG) and 602 if required (325 received angioplasty and 277 received CABG). Insulin dependent patients were more obese, with higher glycosylated hemoglobin, increased incidence of heart failure and increased incidence of acute coronary syndromes....
BIC 8: Copetin associated with troponin can rule out acute myocardial infarction in the emergency room.
The acute chest pain is responsible for more than 11 % of queries to an emergency service . Only 10% of these patients really have an acute myocardial infarction. The standard protocol for managing these patients includes serial electrocardiogram, dosage of biomarkers and an observation time of 6-12 hours. This overloads the emergency services and...
Is the 2nd generation DES an alternative to surgery in multivessel coronary disease?
The benefits of 2nd generation drug-eluting stents (DES) are being compared with Coronary artery bypass graft surgery (CABG), looking to achieve a safe, effective, less invasive and as complete as possible revascularization. As background of SYNTAX, the stent thrombosis (ST) with Taxus, reached 25% of the events in the group of intervention (PCI), so that...
Shall we change our daily practice to introduce complete revascularization during AMI? Another study contributes for preventive PCI in AMI.
Original title: Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease: The CvLPRIT Trial. Reference: Gershlick AH et al. J Am Coll Cardiol. 2015 Mar 17;65(10):963-72. Recent studies such as the PRAMI and the one we summarize here show complete revascularization of AMI patients before discharge...
CTO revascularization is beneficial
Título original: Long-Term Survival Benefit of Revascularization Compared UIT Medical Therapy in Practice UIT Coronary Chronic Total Occlusion and Well-Developed Collateral Circulation. Reference: Woo Jin Jan, el at. J Am Coll Cardiol Interv 2015;8:271-9 Multiple studies have shown the benefit of chronic total occlusion (CTO) revascularization, but for patients presenting Rentrop 3 grade collateral circulation (CC), such benefit...
Chronic total occlusions, a true challenge
Original title: Procedural Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention. A Report From the NCDR (National Cardiovascular Data Registry). Reference: Emanuel S. Brilakis, et al. JACC Cardiovascular Intervention 2015;8:245-53 Chronic total occlusions (CTO) are present in 20% to 50% of pathological coronary angiograms but, even though this percentage has increased in the past years, PCI is performed...
Hybrid Revascularization in Multiple Vessels
Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83 According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications. This study randomized 102...