DKCRUSH-V: lo más simple no siempre es lo mejor en el tronco de la coronaria izquierda

DKCRUSH-V: What Is Simple Is Not Always Best for the Left Main Coronary Artery

Courtesy of the SBHCI. Angioplasty of true distal left main bifurcation lesions with a double-kissing (DK) crush two-stent strategy, compared with provisional stenting, results in lower rates of target lesion failure at 1 year. These findings were largely driven by lower rates of target vessel infarction and definite/probable stent thrombosis. Read also: “EXCEL-QOL Substudy: Similar Quality<a href="https://solaci.org/en/2017/11/01/dkcrush-v-what-is-simple-is-not-always-best-for-the-left-main-coronary-artery/" title="Read more" >...</a>

El Impella otorga seguridad en la ATC del TCI no protegido de alto riesgo

Impella Improves Safety in High Risk Unprotected Left Main PCI

Courtesy of Dr. Carlos Fava. The incidence of unprotected left main severe stenosis ranges between 4 and 8%, and it’s mostly associated with multivessel disease. The use of left ventricular support devices in high risk unprotected left main PCI is on the rise, but not much information available in this regard. Read also: “Prior assistance<a href="https://solaci.org/en/2017/10/18/impella-improves-safety-in-high-risk-unprotected-left-main-pci/" title="Read more" >...</a>

Introducing the number one enemy of PCI: diabetes

About 25% of patients with multivessel disease undergoing myocardial revascularization surgery or PCI have diabetes.   In this subgroup, the benefit of surgery in terms of mortality has long been shown: in the BARI study (Bypass Angioplasty Revascularization Investigation) patients undergoing PCI had close to double the mortality rate at 5 years compared to those<a href="https://solaci.org/en/2017/09/22/introducing-the-number-one-enemy-of-pci-diabetes/" title="Read more" >...</a>

Comienza a surgir evidencia positiva para la “válvula olvidada”

New Light on the ‘Forsaken Valve’

Tricuspid regurgitation is frequent and mostly secondary to right ventricle and tricuspid annulus dilation. Tricuspid regurgitation has been associated to mortality increase, even though historically the importance of this valve has been disregarded compared to the other three. Tricuspid surgical repair has seen good results, but it is mostly done in the context of another valve repair. Isolated<a href="https://solaci.org/en/2017/08/28/new-light-on-the-forsaken-valve/" title="Read more" >...</a>

¿Debemos comenzar a utilizar IVUS en las CTO?

Should We Begin to Use IVUS in CTO?

Courtesy of Dr. Carlos Fava. Currently, chronic total occlusions (CTO) are one of the obstacles that coronary angioplasties must overcome, particularly with the development of drug-eluting stents (DES) and new devices and strategies for these challenging lesions. However, there is little information on the safety, efficacy, and real clinical benefit of implanting stents of over 60 mm (known as full metal jackets, FMJ).<a href="https://solaci.org/en/2017/08/28/should-we-begin-to-use-ivus-in-cto/" title="Read more" >...</a>

Risk of Thrombosis and Bleeding with Peripheral Artery Disease and Concomitants

Peripheral artery disease (PAD) is no longer a systemic manifestation of atherosclerosis. In fact, 2 in 3 people with PAD have concomitant heart disease, and 1 in 3 people has concomitant PAD.   To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction<a href="https://solaci.org/en/2017/08/22/risk-of-thrombosis-and-bleeding-with-peripheral-artery-disease-and-concomitants/" title="Read more" >...</a>

MitraClip: ¿debemos intervenir antes a nuestros pacientes?

MitraClip: Should We Intervene Earlier?

Courtesy of Dr. Carlos Fava. Repairing the mitral valve with Mitraclip has become an alternative for high risk or inoperable symptomatic patients, but its long term evolution has only been tested by the EVEREST II, which had not taken into account 5 year mortality outcomes. Therefore, to better study its evolution, we need to carry out different randomized studies<a href="https://solaci.org/en/2017/07/11/mitraclip-should-we-intervene-earlier/" title="Read more" >...</a>

La asistencia previa con Impella 2.5 disminuye la mortalidad a 30 días en el shock cardiogénico por tronco de coronaria izquierda no protegido

Prior assistance with Impella 2.5 lowers 30-day mortality in cardiogenic shock due to unprotected left main coronary artery lesion

Courtesy of Dr. Carlos Fava. The prevalence of cardiogenic shock in acute myocardial infarction (MI) is 7%-10%, and it is associated with high mortality rates. Unfortunately, 0.7% of these cases are a consequence of unprotected left main coronary artery (ULMCA) as MI-culprit lesion. Its evolution is generally disastrous.   Ventricular assist device support and its implementation time may<a href="https://solaci.org/en/2017/07/05/prior-assistance-with-impella-2-5-lowers-30-day-mortality-in-cardiogenic-shock-due-to-unprotected-left-main-coronary-artery-lesion/" title="Read more" >...</a>

Las CTO en el infarto agudo de miocardio aumentan la mortalidad

CTO in patients with acute myocardial infarction increases long term mortality

Courtesy of Dr. Carlos Fava. It has been proved that in a setting of acute myocardial infarction with multivessel lesions, only the culprit vessel must be treated (if there is no hemodynamic compromise) at first, and other severe lesions are to be treated during a second session. However, proper conduct in cases with presence of chronic<a href="https://solaci.org/en/2017/06/29/cto-in-patients-with-acute-myocardial-infarction-increases-long-term-mortality/" title="Read more" >...</a>

El uso del ultrasonido intravascular en la angioplastia de tronco no protegido se asocia con mejores resultados en comparación con la angioplastia guiada solo por angiografía.

The use of IVUS in unprotected left main PCI associated to better outcomes, compared to angiography guided PCI

Courtesy of Dr. Gustavo Leiva. Coronary Artery Bypass Graft (CABG) has traditionally been the procedure of choice in patients with left main coronary artery disease. However, the use of percutaneous techniques in this kind of lesions has been on the rise, partly due to recent research showing similar outcomes with both procedures.   Unprotected left main<a href="https://solaci.org/en/2017/06/26/the-use-of-ivus-in-unprotected-left-main-pci-associated-to-better-outcomes-compared-to-angiography-guided-pci/" title="Read more" >...</a>

cardiac failure