When scheduling a coronary angiography, patients are usually instructed to fast for at least 8 hours (no oral intake after dinner). However, this strategy can lead to negative effects such as discomfort, irritability, dehydration, and even hypoglycemia in some cases. Previous studies have not shown significant differences in gastric complications between patients fasting only 2 hours before...
Roughly 20% or coronary angiographies show some form of chronic total occlusion (CTO), and this figure is twice as high for diabetic patients or those with cardiac failure and reduced ejection fraction (EF). CTO percutaneous intervention (PCI) has experienced a significant growth thanks to the development of new techniques and dedicated material. However, a considerable...
Several scientific societies support performing left atrial appendage occlusion (LAAO) as a stand-alone procedure, even though it is often associated to other cardiomyopathies requiring transcatheter intervention. Though still controversial, combining LAAO and any other cardiac intervention might reduce hospitalizations, as well as the need for additional punctures, anesthesia, red tape, a longer stay and higher...
The need for permanent pacemaker implantation (PPM) continues to be one of the main challenges in TAVR, especially with self-expanding valves, with a pacemaker implantation rate that varies between 17.5% and 30% in large randomized studies, vs. 4% to 6.5% with self-expanding valves. Therefore, in an attempt to prevent the need for PPM implantation, the...
Transcatheter aortic valve replacement (TAVR) has widely demonstrated its significant benefits, both in high-risk and inoperable patients, as well as in those with intermediate and low risk. While paravalvular regurgitation has been a challenge, its management has improved with operator experience and a deeper understanding of CT angiographies. However, in cases of regurgitation, elevated gradient,...
Failure of a mitral bioprosthesis always poses a challenge regarding decision-making, especially when dealing with elderly patients with multiple risk factors. The scenario is worsened by the high risk associated with a new sternotomy and the significant impact of undergoing new surgery. Transcatheter mitral valve-in-valve (TMViV) replacement is emerging as a valid strategy in the...
The XLVI SOLACI Regional Sessions – 16th Central America and the Caribbean Region took place in Santo Domingo, Dominican Republic, between September 14 and 15, 2023. It was an extremely successful event that featured the participation of prestigious national and international guests and a high-level scientific program. Below, we share some of the presentations that...
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially...
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR...
TAVR can be associated to early valve thrombosis, characterized by thrombi formation near or attached to the prosthetic valve, with or without valve dysfunction. This dysfunction is associated with increased leaf thickening and reduced leaflet motion, as well as reduced orifice area or increased transvalvular gradient. Triggered multislice CT allows dynamic valve assessment and thrombosis...