1) Balloon Angioplasty: A Reasonable Plan B for Chronic Thromboembolic Hypertension Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B,...
Cardiac Artery Bypass Graft Surgery has been shown more effective than percutaneous coronary intervention (basically because it renders lower revascularization rate) in patients with severe left main bifurcation lesions receiving 1st generation drug eluting stents. This is why the 2014 American guidelines recommend CABG for most patients. But the EXCEL and the NOBLE trials brought back hope to...
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...
According to this Chinese study, dual antiplatelet therapy with ticagrelor and aspirin improves vein graft patency a year after surgery without increasing the risk for major bleeding. Treatment with the P2Y12 inhibitor ticagrelor in combination with aspirin has been widely accepted for patients with acute coronary syndrome undergoing angioplasty. However, there were no related data regarding surgical revascularization. Read also: “Ticagrelor...
From November 9th to November 11th, Punta del Este received the best cardiologists in Latin America. These 3 days of intense scientific activity included the SOLACI-SUC Joint Symposium, which was composed of a structural module (with presentations on TAVI, Mitraclip, paravalvular leaks, and clinical cases) and a coronary module (with activities centered on coronary bifurcation lesions,...
The recent publication of several reports on risk of cataract, left sided brain tumors, subclinical atherosclerosis and chromosome damage among interventional cardiologists has raised increasing concerns about radiation exposure in the cath lab. Recognizing these risks has created a demand of these new forms of protection. Unfortunately, these have mainly been focused on the main operator,...
The discussion about the best anti-thrombotic strategy for patients with atrial fibrillation undergoing PCI seemed never-ending until the RE-DUAL PCI trial was published in the New England Journal of Medicine (NEJM). This study has arrived to simplify the tough choice between the risk of a thrombotic event vs. the risk of bleeding with a simpler scheme, without...
Courtesy of SBHCI. The final 5-year outcomes of the PROTECT AF and PREVAIL studies (which assessed the left atrial appendage closure device Watchman) continues to show similar stroke prevention rate to that of warfarin, though with a clear reduction in bleeding. The meta-analysis showed a significant reduction in hemorrhagic stroke (0.17% vs 0.87%), non-procedure related...
Courtesy of SBHCI. Two new transcatheter treatments for severe or massive functional tricuspid regurgitation have showed good results at 30 days, according to their feasibility studies. The long-forgotten tricuspid valve has been gaining more attention with research linking tricuspid regurgitation to an increase in mortality. Early studies used devices originally designed for the mitral or...
Fentanyl is a potent opiate commonly administered in the cath lab. Recently, questions on its safety have been raised by research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The mechanism might be slowed gastric emptying. The Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial enrolled 212 patients undergoing indicated...