1) The 10 Commandments of ESC’s New STEMI Guidelines The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. Read more 2) Burnout Syndrome among Cardiologists For the first time, the American College of Cardiology (ACC) has carried out a survey on this phenomenon,...
Even though the incidence of complications in transcatheter aortic valve replacement (TAVR) have significantly decreased, there is one in particular that remains a concern since, when mild, it is associated to increased events rate. This complication is prosthetic paravalvular leak , which happens between the native annulus and the stent. The Lotus valve, completely repositionable, uses a...
Intravascular imaging, which includes ultrasound intravascular (IVUS) and optical coherence tomography (OCT), shows live details that better characterize post stenting plaque, anatomy and outcomes. The already familiar limitations of the angiography has lead us to think that IVUS and OCT could improve clinical outcomes; however, we should still find the evidence to support this claim. To shed some...
During primary angioplasty, it is not uncommon to see several other lesions in coronary arteries. Current guidelines advise against the treatment of these lesions in the same primary angioplasty procedure, although there is evidence supporting such a course of action that may warrant changes in these recommendations. The functional assessment of these nonculprit lesions may...
Courtesy of Dr. Carlos Fava Surgical aortic valve replacement in a small annulus (<400 mm2) is associated with shorter duration, higher valve deterioration and patient prosthesis mismatch (PPM). They present a negative impact as regards duration and evolution. TAVR might be an option, with superior hemodynamic outcome and lower PPM. Read also: “Patients and Healthcare...
Courtesy of SBHCI. Angioplasty in patients with chronic stable angina and functionally significant lesions improves clinical outcomes and quality of life over the long term, as compared with optimal medical therapy alone. Furthermore, the invasive approach becomes more cost-effective as the years go by. Previously, FAME 2 had shown that angioplasty was initially more expensive, but...
Courtesy of the SBHCI. Chronic stable angina and severe coronary lesion patients who undergo angioplasty in a single vessel show no better outcomes than individuals who undergo a placebo sham procedure when it comes to exercise capacity and symptoms, according to this study presented at TCT and published simultaneously in the Lancet. The curious results...
Coronary angiography is essential for patients admitted with non-ST-elevation acute coronary syndrome, since it allows physicians to confirm the diagnosis, stratify the risk, and define the revascularization and antithrombotic management strategies. There is no doubt that these patients should be studied invasively, but the timing for that is still uncertain. Coronary catheterization within...
Overnight observation after coronary angioplasty has been the standard of care in the United States. The foundations for this practice go back to the early days of balloon angioplasty, when acute occlusion and access-site complications were frequent. There are several registries and randomized studies showing the clear safety of same-day discharge after coronary angioplasty. This practice...
Conduction abnormalities, such as new left bundle branch block, atrioventricular block, and need for a pacemaker, are still among the most frequent complications in transcatheter aortic valve replacement (TAVR). New valve generations have (mostly) not managed to reduce significantly electrical abnormalities; furthermore, some modifications such as external skirts, which are extremely effective for the reduction...