Courtesy of Dr. Carlos Fava. While the benefits of TAVR are well-known, the need for a permanent pacemaker after implantation is still an issue to solve, even though new valves have reduced it. This study enrolled 175 patients who underwent TAVR with an ACURATE neo TF valve. In this population, 58% of patients were women and the...
Courtesy of Dr. Carlos Fava. The current recommendation for aortic valve replacement is based on stenosis severity based on valvular criteria (mean transvalvular gradient, peak aortic velocity and valve index area) and the presence of symptoms, in addition to comorbidities, mainly for risk stratification. However, ventricular damage and/or its effect on cardiovascular hemodynamics are not regarded...
Courtesy of Dr. Carlos Fava. The incidence of peripheral vascular disease (PVD) is increasing and associated with negative outcomes when overlapping with cardiovascular disease. In patients undergoing TAVR, its prevalence varies between 28% and 42%, according to different studies. However, its real impact on the rate of survival is still unclear. This study analyzed 27,440 patients >65 years...
Courtesy of SBHCI. Hybrid revascularization, which combines CABG with PCI, failed to reduce myocardial ischemia and major cardiac and cerebrovascular events, compared to cardiac artery bypass graft or PCI separately. However, this small study does not provide conclusive evidence, which calls for further randomized studies with enough statistical power to answer this question. Fortunately, we won’t have...
The reference vessel diameter is a fundamental factor for restenosis after coronary angioplasty even with drug-eluting stents. The smallest sized stents available are 2.25 mm in diameter, but even smaller vessels can be symptomatic. This was a prospective multicenter trial of the Resolute Onyx 2.0-mm zotarolimus-eluting stent. The primary endpoint was target lesion failure. Read also: “Effects...
Diabetes mellitus patients generally present more diffuse coronary disease, faster lesion progression and higher risk of restenosis after PCI. The way these anatomical differences translate into in a different clinical practice, compared to non-diabetic patients, remains unclear. Prior studies comparing the frequency of angina symptoms in diabetic vs. non-diabetic patients have arrived to contradicting outcomes,...
The fundamental advantage offered by transcatheter aortic valve replacement (TAVR) has always been the fact that it is less invasive than surgical valve replacement. So far, most improvements for these devices have derived in less invasiveness (e.g., by improving the profile of the eluting system). However, there are also cases of “deployment” reduction during the...
Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal...
Courtesy of Dr. Carlos Fava. Stage III or higher renal impairment is frequent before TAVR, and the need for new dialysis after the procedure may reach up to 20%. Within that percentage, 5% may require permanent dialysis, which increases mortality up to 9 times at one year. In that sense, factors leading to that complication have not...
Courtesy of Dr. Carlos Fava. Severe atherosclerotic disease in iliac arteries is experienced by 15% of all men and 5% of all women. TAC II recommends angioplasty for type-A, -B, and -C lesions. As regards stent type, self-expanding stent (SE, more elasticity) vs. balloon-expandable stent (SB, more radial strength), Reekers indicates superior target lesion revascularization (TLR) with SE. However, there...