A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Over time, percutaneous coronary intervention (PCI) with drug coated balloons (DCB) have been shown more beneficial than conventional PCI. However, in many cases, stenting is required to treat suboptimal results. Even though several studies have looked into this scenario, long term durability still calls for research. This was a 5 year thorough analysis of the...
Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is currently under development, with an increasing number of conducted procedures. While the TRILUMINATE Study did not reveal benefit regarding major events, it did show improvements in quality of life. In the real world, we encounter numerous patients who do not meet the study criteria but still experience symptoms...
Proximal optimization technique (POT) has been recommended as a standard strategy in bifurcation lesions because it facilitates proper stent implantation and apposition in the proximal main vessel, according to the European Bifurcation Club. Percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has specific characteristics, and the long-term impact of this strategy...
TAVR is a well-established course of treatment, increasingly indicated in lower risk populations. However, one of the challenges associated with self-expanding TAVR, compared against balloon expandable TAVR and SAVR, is the frequent need for definite permanent pacemaker implantation (PPI). High implantation, also known as cusp overlapping (COT), has been shown to reduce the need for...
Patients suffering from immune-mediated chronic inflammatory disease (CID) face a high risk of developing heart disease, including aortic valve disease. Inflammatory vascular disease when triggered by an autoimmune condition, can prompt a harmful response leading to valve degeneration, with increased calcification and fibrosis, and the associated progression of stenosis, failure or both. Prior research has...
The edge-to-edge approach with MitraClip has been established as a valid strategy for patients who experience severe symptomatic mitral regurgitation (MI) with high risk for surgery, currently with a IIa indication. MI complicated by cardiogenic shock, which results in a high risk for conventional valve surgery, is a particularly complex scenario. In such a case,...
Aortic valve replacement (AVR) is indicated for symptomatic aortic stenosis (AS), while close follow-up is recommended for asymptomatic patients, unless they have elevated aortic gradients, low ejection fraction, or abnormal stress tests. However, the optimal timing to perform AVR is uncertain, especially with recent evidence suggesting that patients with AS associated with signs of myocardial...
Infiltrative diseases (ID) consist of a heterogeneous series of genetic conditions that cause infiltration and extracellular deposits which alter the diverse systems and organs affected. Amyloidosis, sarcoidosis and hemochromatosis affect the heart, altering the myocardium and the conduction system. PCI is often used at present to treat heart disease, and some of these patients present...
The Treatment of severe aortic stenosis has experienced a significant revolution with TAVR, especially in high and intermediate risk patients, and it is now extending to low risk patients. In the US, nearly half of patients under 64 are being treated with TAVR. One of the fundamental questions that still remains unanswered revolves around device...