All interventional cardiologists must be able to perform a pericardiocentesis. Whether we deal with a chronic total occlusion, a supposedly simple coronary angioplasty (we all have witnessed the perforation of a supposedly risk-free coronary artery), or a transcatheter aortic valve replacement (whose rise gave us another significant source of tamponades), we must all be ready<a href="https://solaci.org/en/2018/04/25/constrictive-pericarditis-after-pericardiocentesis/" title="Read more" >...</a>
For this Canada-based study, the increased number of patients who required a transcatheter aortic valve replacement (TAVR) may have come hand in hand with an equal increase in healthcare financing, so as to cover procedural costs. In spite of that, the wait-time between the formal request for authorization and the actual procedure was 3 months, and<a href="https://solaci.org/en/2018/04/21/morbidity-and-mortality-during-authorization-wait-times-for-tavr/" title="Read more" >...</a>
Aortic stenosis increases afterload creating hypertrophy as a compensation mechanism to maintain minute volume. This leads to left ventricular diastolic dysfunction (LVDD). More than half of patients presenting aortic stenosis have LVDD and myocardial fibrosis, which is a mortality predictor in surgery. At present, there is contradicting evidence in TAVR. The study looked<a href="https://solaci.org/en/2018/04/12/diastolic-dysfunction-should-be-considered-in-tavr/" title="Read more" >...</a>
Using instantaneous wave-free ratio (iFR) to guide decisions on revascularization of intermediate lesions is cheaper than using fractional flow reserve (FFR). Based on costs from the DEFINE-FLAIR trial, researchers estimate the difference to be almost USD 1000. This should not be seen as good news for any given technology (iFR, in this case), but for physiologic<a href="https://solaci.org/en/2018/04/05/acc-2018-define-flair-sub-analysis-ifr-more-comfortable-faster-and-much-cheaper/" title="Read more" >...</a>
A new study raises an alarm against expanding transcatheter aortic valve replacement (TAVR) procedures to low surgical risk patients, since 2 year mortality seems higher in these patients with TAVR, compared to conventional surgery. This study will soon be published in Catheter Cardiovasc Interv. Expanding TAVR to low risk patients might involve risks we have not<a href="https://solaci.org/en/2018/03/14/red-light-for-tavr-in-low-surgical-risk-patients/" title="Read more" >...</a>
1) The CULPRIT-SHOCK Study Is Finally Published in NEJM and It Is Bound to Change Guidelines During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked<a href="https://solaci.org/en/2018/03/01/these-were-the-5-most-read-scientific-articles-of-february/" title="Read more" >...</a>
St elevation acute coronary syndromes are typically caused by thrombotic obstruction of a coronary artery due to ruptured atherosclerosis plaque. However, there is a significant number of patients with similar clinical presentations but no evidence of obstructive coronary artery disease (CAD). Read also: CTO in patients with acute myocardial infarction increases long term mortality. In general, patients without<a href="https://solaci.org/en/2018/03/01/surprising-prognosis-for-normal-acs/" title="Read more" >...</a>
Life-threatening complications that require surgery during TAVR are infrequent. The proportion was originally thought to be between 1% and 2%. However, we now know that it is lower, even though we do not know how frequent it is or what are its most common causes. Its evolution, both in the short and in the long<a href="https://solaci.org/en/2018/02/28/is-emergency-cardiac-surgery-necessary-in-tavr/" title="Read more" >...</a>
Several studies show that patients with multivessel lesions who undergo angioplasty with incomplete revascularization experience more events, including higher mortality, than a cohort of patients who have undergone complete revascularization. In most cases, the analysis was dichotomic (complete vs. incomplete revascularization), but more recent studies show that there may be a gradient, a continuum, in<a href="https://solaci.org/en/2018/02/14/incomplete-revascularization-does-not-mean-the-same-thing-for-all-patients/" title="Read more" >...</a>
1) The 10 Commandments of ESC’s New STEMI Guidelines The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. Read more 2) Burnout Syndrome among Cardiologists For the first time, the American College of Cardiology (ACC) has carried out a survey on this phenomenon,<a href="https://solaci.org/en/2018/02/01/these-were-the-5-most-read-scientific-articles-of-january/" title="Read more" >...</a>