Courtesy of Dr. Carlos Fava. Transfemoral access is the first choice for transcatheter aortic valve replacement (TAVR). However, this approach is not feasible for a progressively larger number of patients, which establishes the need to search for alternative accesses. Between 2009 and 2014, this study enrolled 174 patients who underwent TAVR and were unsuitable for transfemoral...
Courtesy of Dr. Carlos Fava. Left main coronary artery disease (LMD), has historically been treated with myocardial revascularization surgery (CABG), but for some years now, and with the development of new drug eluting stents (DES), percutaneous coronary intervention (PCI) has been gathering support in this challenging territory. The study analyzed the SYNTAX and PRECOMBAT...
Courtesy of Dr. Agustín Vecchia. Nearly 10% of patients with acute coronary syndrome (ACS) require surgery. Managing periprocedural dual antiplatelet therapy (DAPT) in ACS patients is controversial and, to date, there are no randomized trials in this regard. Guidelines recommend ticagrelor discontinuation five days prior surgery and in the most emblematic work on this drug...
The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute Myocardial Infarction 2015 suggest that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PCI). This study compared the impact of pharmacoinvasive strategy with the impact of primary angioplasty in real-world patients admitted with acute coronary syndrome with ST-segment elevation. The...
Courtesy of Dr. Guillermo Migliaro. Coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) with an estimated incidence of 0.5%. Arterial blood entering the pericardium may cause a rapid elevation of intrapericardial pressure and collapse the right cavities (tamponade) creating hemodynamic compromise. Historically, surgical drainage has been the...
Courtesy of Dr. Carlos Fava. The benefits of transcatheter aortic valve implantation (TAVI) have been widely shown, but there is no evidence on sex-specific outcomes. Some studies have shown lower mortality and better evolution of the ventricular function in women, yet with more bleeding and stroke; however, it remains unclear. This study included 1,019 patients...
Original Title: Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence. Reference: North Noelck et al. Circ Cardiovasc Qual Outcomes. July 2016. Published ahead of print. Atrial fibrillation is an important cause of stroke. Oral anticoagulation reduces the risk of stroke but, on the...
Original Title: Transcatheter Mitral Valve Replacement in Native Mitral Valve Disease With Severe Mitral Annular Calcification: Results From the First Multicenter Global Registry Reference: J Am Coll Cardiol Intv. 2016;9(13):1361-1371. doi:10.1016/j.jcin.2016.04.022 Gentileza del Dr. Agustín Vecchia. The risk underlying the surgical approach to mitral valve replacement in patients with severe mitral annular calcification is high. A...
Original Title: Transcatheter Aortic Valve Implantation Compared With Surgical Aortic Valve Replacement in Low-Risk Patients. Reference: Stefano Rosato et al. Circ Cardiovasc Interv. 2016 May;9(5):e003326. The proved efficacy of transcatheter aortic valve implantation (TAVI) in high risk patients is leading the expansion of its indication for lower risk patients. All the same, compared to the...
Original Title: Natural history, diagnostic approaches, and therapeutic strategies for patients with asymptomatic severe aortic stenosis. Reference: Généreux P et al. J Am Coll Cardiol. 2016; Epub ahead of print. Given that transcatheter aortic valve replacement (TAVI) is now being prescribed to lower risk patients, some wonder whether it is time to study the benefit...