When operators decide to proceed with PCI despite a negative FFR (fairly frequent in the daily practice) outcomes at 5 years are far worse. This information comes from a large Canadian register presented at AHA 2020 Scientific Sessions, simultaneously published in JAMA. PCI to a non-ischemic lesion results in increased events risk at long term,<a href="https://solaci.org/en/2020/11/20/aha-2020-the-more-operators-listen-to-ffr-the-lower-the-risk/" title="Read more" >...</a>
Data from recent observational randomized studies suggest that most patients with asymptomatic severe aortic stenosis will eventually receive an indication for valve replacement. Mortality in this “asymptomatic” population is caused not only by sudden death, but also by cardiac death. Early intervention may prevent these deaths as a consequence of aortic stenosis symptoms. Researchers<a href="https://solaci.org/en/2020/10/30/asymptomatic-severe-aortic-stenosis-when-should-we-intervene/" title="Read more" >...</a>
The self-expanding Acurate Neo (Boston Scientific) did not meet non-inferiority vs. the self-expanding CoreValve Evolut (Medtronic) in the SCOPE 2 study published in Circulation simultaneously and presented at the virtual TCT 2020. These are bad news for the Acurate Neo, that had already failed to show non-inferiority vs. the Sapien 3 in the SCOPE 1<a href="https://solaci.org/en/2020/10/21/tct-2020-acurate-neo-does-not-meet-non-inferiority-vs-corevalve-evolut/" title="Read more" >...</a>
Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events. It is important to see past the obvious anatomical challenges (bifurcations, calcification,<a href="https://solaci.org/en/2020/10/14/complex-pci-complex-characteristics-impact-results/" title="Read more" >...</a>
The consequences of deferring transcatheter aortic valve replacement (TAVR) procedures because of the COVID 19 pandemic are piling up. Untreated severe aortic stenosis patients who had been scheduled for TAVR are seeing increased risk of all events, even mortality. According to recent studies published in JAMA, deferring TAVR in patients with symptomatic aortic stenosis is<a href="https://solaci.org/en/2020/10/08/death-stroke-and-hospitalization-while-waiting-for-tavr/" title="Read more" >...</a>
Read the case presentation and join the conversation through the comments in this post! Case Introduction: An Explosive Mission! 56-year-old male patient Severe smoker Hypertension Dyslipidemia Sedentary lifestyle and stress A sibling suffered from an acute myocardial infraction Cardiac markers: Standard angina, intensity of 8-9/10, 3-to-4-h long, and dyspnea (on and off for the past<a href="https://solaci.org/en/2020/09/17/the-fellows-corner-2nd-clinical-case-an-explosive-mission/" title="Read more" >...</a>
The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. This document includes news regarding a more agile infarction diagnosis, the use of non-invasive imaging, the simplification of anticoagulant therapy, infarction with normal coronary arteries,<a href="https://solaci.org/en/2020/09/11/esc-2020-new-european-guidelines-on-non-st-segment-elevation-acute-coronary-syndromes-whats-new/" title="Read more" >...</a>
After TAVR, patients with no anticoagulation indication are favored by monotherapy with aspirin (ASA) vs. dual antiaggregation therapy (DAPT). This study presented at ESC 2020, simultaneously published in NEJM, seems to go against the latest “fashion” (P2Y12 inhibitor monotherapy) and randomized patients to ASA monotherapy vs. DAPT with clopidogrel for 3 months. Unlike with the<a href="https://solaci.org/en/2020/09/03/esc-2020-against-the-grain-asa-monotherapy-appears-superior-after-tavr/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement with bioprosthesis has proved its benefits, but it fails after 10 to 15 years. Transcatheter aortic valve replacement has been shown valid, especially in high risk patients, but we still have little information and no “head to head” studies to know what is best in this<a href="https://solaci.org/en/2020/08/04/valve-in-valve-presents-better-evolution-than-re-sarv/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Chronic total occlusions (CTO) are still one of the greatest challenges in our field, thus forcing the development of different complex strategies to resolve them. Additionally, the use of imaging techniques during these procedures has improved long-term results. The CONSISTENT CTO (Conventional Antegrade Versus Sub-Intimal Synergy Stenting in Chronic Total Occlusions)<a href="https://solaci.org/en/2020/07/17/subintimal-re-entry-in-cto-improves-outcomes/" title="Read more" >...</a>