Currently, myocardial revascularization surgery (MRS) and percutaneous coronary intervention (PCI) are the available strategies for multivessel coronary artery disease. However, an alternative strategy has long been developed, called hybrid coronary revascularization (HCR), where the anterior descending artery is bypassed with a graft from the mammary artery and the rest of the lesions are treated byref="https://solaci.org/en/2023/01/23/long-term-evolution-of-hybrid-coronary-revascularization/" title="Read more" >...
Valve-in-Valve Shows Good Evolution after 2 Years
The degeneration of bioprostheses in aortic position occurs at approximately after 10 to 15 years. In this scenario, the treatment of choice used to be redo surgery, but with the evolution of transcatheter aortic valve replacement (TAVR), it became a valid alternative with a level IIa B evidence. While there are currently multiple analyses ofref="https://solaci.org/en/2022/12/02/valve-in-valve-shows-good-evolution-after-2-years/" title="Read more" >...
Do Men and Women Present the Same Evolution after Left Atrial Appendage Closure?
Atrial fibrillation is a very frequent type of arrythmia that affects both men and women alike. This entity is associated to higher mortality seeing as it favors stroke and hospitalization for cardiac failure. At present, one of its valid treatment strategies is left atrial appendage closure, to reduce or prevent stroke and anticoagulation driven bleeding. ref="https://solaci.org/en/2022/11/14/do-men-and-women-present-the-same-evolution-after-left-atrial-appendage-closure/" title="Read more" >...
SYMPLICITY HTN-3 Trial. Evolution at 3 Years
The SYMPLICITY 3-year outcomes are out. Bear in mind this is the largest study we have had so far. It included 535 patients. 364 received renal denervation (RDN) and 171 went to the control group. At 36-month followup, 101 patients crossed over. The procedure was safe at 36 months, both for patients receiving it atref="https://solaci.org/en/2022/09/21/symplicity-htn-3-trial-evolution-at-3-years/" title="Read more" >...
EuroPCR 2022 | TriCLASP, Evolution at 30 Days
Tricuspid regurgitation (TR) is difficult to manage and is a mortality predictor. At present, surgery is recommended, even though its mortality rate is not low. Endovascular intervention of this entity is currently being developed and according to the European guidelines, it has evidence level IIb C in symptomatic inoperable patients. The TriCLASP included 74 patientsref="https://solaci.org/en/2022/05/26/europcr-2022-triclasp-evolution-at-30-days/" title="Read more" >...
Coronary Angioplasty Evolution According to Syntax II: 5-Year Followup
It has been long since the SYNTAX (NEJM 2009) came out comparing percutaneous coronary intervention (PCI) against coronary artery bypass grafting (CABG). That emblematic study associated PCI with first generation drug eluting stents (Taxus) with increased major cardiac and cerebrovascular events (all-cause mortality, AMI, stroke, or any revascularization – MACCE) vs. CABG, at 5 years,ref="https://solaci.org/en/2022/05/05/coronary-angioplasty-evolution-according-to-syntax-ii-5-year-followup/" title="Read more" >...
Device Evolution Also Impacts on Valve in Valve
TAVR to treat dysfunctional biological prosthetics (ViV) with the last generation self-expandable supra-annular prosthetic offers excellent results both clinical and hemodynamic. In addition, there were additional reductions of paravalvular regurgitation compared against the original models. The present registry published in JAHA is the most extensive to treat this issue and replicate outcomes from the clinicalref="https://solaci.org/en/2021/10/21/device-evolution-also-impacts-on-valve-in-valve/" title="Read more" >...
EuroPCR 2021 | Evolut Low Risk: Two-Year Results of The Self-Expanding Valve in Low-Risk Patients
Transcatheter aortic valve replacement (TAVR) with the Evolut self-expanding valve was non-inferior to surgery in patients with low surgical risk. After two years, the primary endpoint of death or disabling stroke was similar between both strategies. This presentation at EuroPCR 2021 reinforces the results presented during the American College of Cardiology (ACC) 2019 Congress andref="https://solaci.org/en/2021/05/27/europcr-2021-evolut-low-risk-two-year-results-of-the-self-expanding-valve-in-low-risk-patients/" title="Read more" >...
TCT 2020 | Acurate Neo Does Not Meet Non-Inferiority vs. CoreValve Evolut
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 1ref="https://solaci.org/en/2020/10/21/tct-2020-acurate-neo-does-not-meet-non-inferiority-vs-corevalve-evolut/" title="Read more" >...
Good Evolution of Bicuspid Valves with EVOLUTE or EVOLUTE PRO
Courtesy of Dr. Carlos Fava. TAVR has matured over time and has advanced onto low risk patients, but one of its greatest challenges continues to be bicuspid valve patients. These represent between 1% and 2% of the population and over 20% of young adults requiring surgical valve replacement (SAVR). The study looked at 27,086 patientsref="https://solaci.org/en/2020/08/28/good-evolution-of-bicuspid-valves-with-evolute-or-evolute-pro/" title="Read more" >...