Courtesy of the SBHCI. The 2-year results of the PARTNER 2A trial showed that transcatheter aortic valve implantation has a result similar to that of surgery in patients with aortic stenosis and intermediate surgical risk. We lacked long-term data, both clinical and related to prosthesis function. Now, at TCT 2019, researchers presented the 5-year data for this...
TAVR in Bicuspid Has the Same Results in Surgery at Hospital Level
Courtesy of Dr. Carlos Fava. Bicuspid aortic stenosis patients (bicuspid AS) represent a small group and have not been included in the larger transcatheter aortic valve replacement (TAVR) studies, since they present different morphology and asymmetric calcification, which might come along with more paravalvular leak and less accurate positioning. Between 2012 and 2016, 475,315 patients...
Can We Treat Severe Residual Mitral Regurgitation after MitraClip without Surgery?
Courtesy of Dr. Carlos Fava. Edge to edge with MitraClip was shown effective and safe, and its outcomes have been improving over these past few years. However, one of its greatest challenges involves not being able to reduce mitral regurgitation (MR) after device implantation, resulting in the need for surgery, as some studies have shown...
Surgery to Improve Survival in Isolated Tricuspid Regurgitation
Patients with isolated tricuspid regurgitation (i.e., who have no associated left-sided valve disease) are frequently treated conservatively. In many cases, valve disease is highly symptomatic, even with the optimization of medical treatment; however, an invasive strategy is seldom proposed. The aim of this work was to measure the impact of surgery on isolated tricuspid regurgitation...
Angioplasty vs. Surgery in Lower Limb Ischemia
This analysis of data from an already published study, “Bypass Versus Angioplasty in Severe Ischemia of the Limb (BASIL-1),” confirms the superiority of bypass over balloon angioplasty, with or without stenting, in patients with chronic lower limb ischemia who require a femoropopliteal intervention. While analyzed interventions took place between 1999 and 2003 (a fact subject...
Peri-Procedural Infarction in Angioplasty vs. Surgery in the Left Main Coronary Artery
According to the EXCEL trial, peri-procedural infarction was more common after left main coronary artery surgery compared with angioplasty, and it was strongly associated with increased 3-year mortality after controlling all possible confounding variables. This increased mortality was only present in extensive infarctions with an increase in CK-MB ≥10×. The EXCEL trial seems to want...
Bariatric Surgery Associated with a Lower Rate of Mortality Due to Infarction and Stroke
Prior bariatric surgery in a patient with morbid obesity is associated with a significant effect on survival after infarction or stroke. While these are observational data, the significant metabolic improvement experienced after the surgery can explain perfectly such findings. This large nationwide registry of bariatric surgery found a 40% decrease in the risk of death,...
2019 World Heart and Cardiothoracic Surgery Conference (2019WHCS)
2019 World Heart and Cardiothoracic Surgery Conference (2019WHCS) is a premiere educational Heart Congress in the field of Cardiothoracic Surgery and Cardiology that rotate between continents and are organized in collaboration with national and international Cardiac societies and associations. This International Heart and Cardiothoracic Surgery Congress 2019WHCS is going to be held at Singapore during September 10-11, 2019 around the theme ‘Discovering the Science of...
ACC 2019 | PARTNER 3: Low Risk TAVR vs. Surgery, Fewer Events per Year
Courtesy of Dr. Carlos Fava. TAVR has largely been shown superior or non-inferior in high or intermediate risk patients. Indeed, the development of new technologies, the more simplified procedure and the increased experience of operators and team have allowed these groups to benefit from this strategy. However, there is little evidence available on low risk...
Is TAVR at Hospitals Without Backup Cardiovascular Surgery Feasible?
Patients undergoing transcatheter aortic valve replacement (TAVR) at hospitals without cardiovascular surgery available are at significantly higher risk. That in itself is a call for attention; however, a propensity-matched analysis shows that the short- and long-term mortality rates are similar among patients treated at hospitals with and without cardiovascular surgery backup. This debate emerged a...