At present, severe calcified coronary stenosis poses a significant challenge for PCI. A successful intervention will require plaque modification prior stenting, seeing as sub-expansion has been associated with worse clinical outcomes at followup. The tools normally used to treat these complex lesions include specialized balloons such as cutting, scoring, and high pressure balloons, as well...
In the context of TAVR, one of the current challenges is the need for permanent pacemaker implantation (PPM), especially when using self-expanding valves (SEV). The information available in this regard remains controversial; while some studies suggest new PPM implantation will have no significant effect on clinical evolution, others have associated them with worse prognosis. As...
Researchers conducted a multicenter randomized study involving 2008 patients undergoing coronary angioplasty (PCI). In this group, 1005 patients underwent a procedure guided by OCT, and 1003 patients by IVUS. The average age of participants was 65 years, 21% of subjects were women, and there were no significant differences between both groups. The primary endpoint was...
Researchers conducted a randomized study involving 827 patients who experienced out-of-hospital cardiac arrest without ST-segment elevation myocardial infarction, and then underwent percutaneous coronary intervention. In this group, 414 patients were transferred to a specialized cardiac arrest center (CAC), while 413 were taken to the geographically closest hospital (closest emergency department, CED). The primary endpoint (PEP)...
Though rare, spontaneous coronary artery dissection (SCAD) might lead to MI, most commonly affecting young middle aged women. In these cases, the angiographic image will present a characteristic double lumen, and an intramural hematoma in the coronary artery wall. Normally, it will be treated medically. However, a small number of cases presenting STEMI will require...
The OCTOBER Study randomized 1201 patients with bifurcation lesions in a 1:1 ratio to undergo percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) or by angiography. The primary endpoint (PEP) was major adverse cardiovascular events (MACE) over a 2-year period. Group characteristics were similar. The average patient age was 66 years, most...
Researchers conducted a randomized study that included a total of 1233 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) and 1254 patients who underwent the same procedure but were guided by angiography. The latter had complex lesions. The initial groups were similar. The average age was 65 years, most...
Primary or degenerative mitral regurgitation (MR) occurs frequently. Even though surgery continues to be the standard treatment at present, it remains risky for one group of patients, which makes edge-to-edge mitral valve repair (MV-TEER) a viable alternative. We are well aware that moderate to severe MR is associated with worse prognosis. However, post procedural mean...
Due to the proven long-term results and substantial increase in the number of transcatheter aortic valve implantation (TAVI) procedures conducted, the application of TAVI has been extended to clinical situations outside the original scope, such as non-calcified aortic regurgitation (NCAR). Device placement in these new scenarios entails a technical challenge due to the absence of...
Atrial fibrillation is the most prevalent arrhythmia and to prevent its potential complications, we should administer anticoagulants (OACs), either warfarin or the new direct oral anticoagulants (DOACs). Even though these drugs have been shown effective, they still involve the risk of bleeding, especially gastrointestinal bleeding, which in turn leads to numerous hospitalizations. Left atrial appendage occlusion...