DES

Lithotripsy in the “Real World”: REPLICA EPIC-18 Study

Severe persistent calcification of the coronary arteries has been associated with different factors, such as advanced age, hypertension, dyslipidemia, smoking, and kidney failure, among others, and continues to be one of the challenges to stent implantation because of it impact on device advancing, drug release and adequate positioning.  Intravascular lithotripsy (IVL) is a technique that...

Nuevas guías de valvulopatías con actualizaciones clave en TAVI e insuficiencia mitral

TAVR in the Different Types of Aortic Stenosis

Aortic stenosis (AS) is classified according to gradient into high flow and high gradient (D1), low flow-low gradient with reduced ejection fraction (D2), and paradoxical low flow-low gradient with conserved ejection fraction (D3). D3 AS is characterized by ≥50% ejection fraction, but with systolic volume index ≤35 ml/min. Post TAVR evolution of D2 and D3...

La ATC es una alternativa válida en el TCI

Physiologically Significant Obstructions in the Left Main Coronary Artery: Revascularizing vs. Deferring

Most randomized studies on revascularization in stable coronary artery disease exclude left main coronary artery disease (LMCAD). One example of this was the ISCHEMIA study. However, the benefits of functional lesion assessment, as demonstrated in the FAME studies, highlight the importance of this tool in guiding decisions regarding revascularization. Nevertheless, the clinical outcomes of patients...

FFR Post Angioplastia

Virtual Flow Reserve (VFR): Virtual Physiological Test with OCT

Assessing intermediate coronary lesions with intracoronary physiology tests such as fractional flow reserve (FFR) or other non-hyperemic indices is considered the standard of care by both American and European societies. Likewise, intravascular imaging techniques (IVI), be it IVUS or optical coherence tomography (OCT), are of great use in assessing and guiding complex coronary lesions and...

Transcatheter Myotomy for the Treatment of the Dynamic Obstruction of the Left Ventricular Outflow Tract

Septal reduction therapies are used to mitigate the symptoms caused by dynamic left ventricular outflow tract (LVOT) obstruction and the associated mitral regurgitation (MR) that can surge in hypertrophic cardiomyopathy (HCM).  Alternative therapies to treat LVOT obstruction include surgical procedures, i.e. surgical myotomy or myomectomy, or alcohol and radiofrequency septal ablation (intracardiac, transthoracic and endocardial,...

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

NOTION Trial: 10 Year Outcomes, TAVR vs. SAVR in Low Risk Patients

Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of patients with severe aortic stenosis (AS). Randomized studies have shown the benefits of TAVR for treating inoperable patients, as well as high and intermediate risk patients.  The NOTION (Nordic Aortic Valve Intervention Trial) randomized patients with low risk severe AS to TAVR or SAVR (surgical...

AGENT-IDE: Drug Coated Balloons for Instent Restenosis

Drug eluting stents (DES) have improved considerably over the years, reducing the initial indices of instent restenosis (ISR) by roughly 5-10% a year in USA. However, DES failure might lead to neointimal hyperplasia and neoatherosclerosis, which increases the chance of developing chronic and acute coronary syndromes.  Drug coated balloons (DCB), which administer anti-proliferative agents with...

¿Es seguro utilizar iFR para diferir lesiones del tronco de la coronaria izquierda?

Rehospitalization After Treatment of Left Main Coronary Artery Disease and Its Prognosis: Sub-Analysis of the EXCEL Study

Individual randomized studies have shown variable results regarding the mortality risk following treatment of left main coronary artery disease (LMCAD), either through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). However, upon assessment of the latest meta-analyses (with matched data), similar risks of all-cause and cardiovascular mortality have been reported for both groups....

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