Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may...
Courtesy of Dr. Carlos Fava. Transcatheter mitral valve repair with MitraClip has shown good results in symptomatic patients with extreme surgical risk in different studies. However, its “real world” benefits have not been studied in depth due to how complex this strategy is compared with other usual procedures. This study analyzed 2952 patients who underwent mitral...
Courtesy of SBHCI. Hybrid revascularization, which combines CABG with PCI, failed to reduce myocardial ischemia and major cardiac and cerebrovascular events, compared to cardiac artery bypass graft or PCI separately. However, this small study does not provide conclusive evidence, which calls for further randomized studies with enough statistical power to answer this question. Fortunately, we won’t have...
Courtesy of Dr. Carlos Fava. The incidence of unprotected left main severe stenosis ranges between 4 and 8%, and it’s mostly associated with multivessel disease. The use of left ventricular support devices in high risk unprotected left main PCI is on the rise, but not much information available in this regard. Read also: “Prior assistance...
The higher rate of restenosis in the diabetic population is historic and has been reproduced in all studies and with all kinds of stents, but it was only after the FREEDOM trial when we found out about the higher infarction rate with PCI compared to surgery. This is why 50% of patients undergoing CABG are diabetic. Apart from the above...
Tricuspid regurgitation is frequent and mostly secondary to right ventricle and tricuspid annulus dilation. Tricuspid regurgitation has been associated to mortality increase, even though historically the importance of this valve has been disregarded compared to the other three. Tricuspid surgical repair has seen good results, but it is mostly done in the context of another valve repair. Isolated...
Courtesy of Dr. Carlos Fava. Currently, chronic total occlusions (CTO) are one of the obstacles that coronary angioplasties must overcome, particularly with the development of drug-eluting stents (DES) and new devices and strategies for these challenging lesions. However, there is little information on the safety, efficacy, and real clinical benefit of implanting stents of over 60 mm (known as full metal jackets, FMJ)....
Courtesy of Dr. Carlos Fava. The prevalence of cardiogenic shock in acute myocardial infarction (MI) is 7%-10%, and it is associated with high mortality rates. Unfortunately, 0.7% of these cases are a consequence of unprotected left main coronary artery (ULMCA) as MI-culprit lesion. Its evolution is generally disastrous. Ventricular assist device support and its implementation time may...
Courtesy of Dr. Gustavo Leiva. Coronary Artery Bypass Graft (CABG) has traditionally been the procedure of choice in patients with left main coronary artery disease. However, the use of percutaneous techniques in this kind of lesions has been on the rise, partly due to recent research showing similar outcomes with both procedures. Unprotected left main...
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and...