Several studies (some of them recent, some of them not so much so) have compared left main coronary artery angioplasty and myocardial revascularization surgery. Combined, these works compose a large corpus of evidence, but follow-up has not gone beyond 5 years in any case. The main aim of this study (presented at TCT 2018 and published simultaneously...
The TriValve is a multicenter, international and retrospective study of multiple devices for percutaneous intervention to treat cardiac failure. This is a sub-analysis of patients receiving the most conventional of these devices: the MitraClip. The main points assessed by this study were all cause mortality, unplanned hospitalizations, functional class, the presence of peripheral edema, and...
The purpose of this registry was to compare short-term clinical events and echocardiographic findings in two self-expanding valves used with transfemoral access, Acurate neo and Evolut PRO. The registry included a retrospective follow-up of 1551 patients, among whom 1263 received an Acurate neo valve and 288 received an Evolut Pro valve. The procedural success rates according to VARC-2 criteria were...
The mitral valve is a complex apparatus dependent on left atrium and left ventricle functionality. Dilation of these cavities might affect mitral annulus morphology and lead to valve dysfunction, generating mitral regurgitation (MR). This type of MR has been called functional, since leaflets and tendinous chordae do not present lesions themselves; instead, they malfunction ‘secondary’...
Courtesy of Dr. Carlos Fava. Numerous studies have shown that the presence of aortic regurgitation after TAVR is associated with worse evolution, and that balloon post-dilation (BPD) is the adequate strategy to correct this. However, a few reports using first generation valves have associated BPD to complications such as stroke, annulus rupture and valve displacement,...
Despite their higher surgical risk, patients who underwent transcatheter mitral valve replacement (TMVR) presented 1-year mortality rates similar to those of patients who had redo surgical mitral valve replacement for bioprosthetic valve failure. At one month, echocardiographic findings were similar; however, at one year, patients who underwent TMVR presented a gradient increase that had no...
This condition, now “trending” among patients undergoing transcatheter aortic valve replacement (TAVR), has expanded to almost all patients we treat, always with the same outcome: the prognosis is bad, so bad that it might warrant making the difficult decision of not going forward. The association between frailty and bad prognosis is easy to see and...
The role of human immunodeficiency virus (HIV) in the development of vascular disease (specifically peripheral artery disease) remains unclear. Is the virus per se the direct cause of this disease or is it a consequence of dyslipidemia, one of the adverse effects of antiretrovirals? This study looked into the effect of HIV infection on peripheral...
With a mean follow up of 15 years, and some patients that survived over 20 years, this study shows that more than 75% of patients with rheumatic mitral stenosis show sustained results with balloon valvuloplasty. Predictors of this excellent long-term outcome are many, but they are determined mainly by age, prior symptoms and valve area...
Current models are not reliable when it comes to predicting events after carotid revascularization in acute patients. Peri-procedural events seem to be particularly hard to predict. The development of models that can be externally validated is essential for the decision-making process in patients with high event rates, both during the procedure or while the case...