Lately, the complexity of percutaneous coronary artery interventions (PCI) has seen an increase, mainly driven by the increasing prevalence of coronary lesion calcification, which represents a significant challenge for interventionists. Untreated calcification might result in insufficient stent expansion, a high risk factor of thrombosis and instent restenosis. Historically, several devices have been used to treat...
Percutaneous coronary intervention (PCI) with drug coated balloons (DCB) is a viable alternative, especially in patients at high risk of bleeding, side-branch lesions in coronary bifurcation, or in small coronary segments. De novo heart disease treated with DCB has been shown non-inferior to conventional DES stenting, according to the PICCOLETO-II trial. However, these interventions are...
Timely percutaneous intervention of STEMI patients effectively reduces MI size and mortality, which currently makes it the first line of treatment. A fundamental aspect is activation and platelet aggregation, which is why, in addition to creating networks to optimize STEMI treatment, prehospital drug treatments have been implemented. The COMPARECrush looked at whether early and powerful...
Untreated tricuspid regurgitation (TR) has been associated to high morbimortality. Surgical treatment of isolated severe TR is complex and carries a high mortality rate. A transcatheter treatment of this valve is currently being developed, and different concepts are being applied to the new devices. Even though most TR is secondary, atrial functional tricuspid regurgitation (A-FTR)...
While transcatheter aortic valve replacement (TAVR) has shown benefits, significant coronary artery disease affects 50% or more of patients who undergo such procedure. However, it is still unclear which is the best treatment strategy or how to handle this condition. Quantitative flow ratio (QFR) could be a non-invasive option to assess the severity of coronary...
When deciding on the optimal coronary artery revascularization treatment of coronary artery disease (CAD) patients, physicians normally assessed clinical presentation, surgical risk, survival expectation, and the likelihood of a better quality of life. Decisions are made after careful consideration, by the Heart Team, who will ponder options such as coronary artery bypass graft (CABG), percutaneous...
There are controversies regarding transcatheter aortic valve implantation (TAVI) in cases of challenging anatomical complexity, such as horizontal aorta (HA). This is primarily because aortic angulation (AA) impacts the procedure differently depending on the valve type used. As previously studied, angulation complicates crossing, implantation, and coaxial positioning with commissural alignment. In the study presented by...
The octogenarian population has already reached 137 million and continues to grow. It is estimated to triple by 2050. This increase represents a big challenge, seeing as these patients are often more fragile, present more complex coronary artery disease and multiple comorbidities. This generally requires two or more procedures and more experience both from operators...
One of the limitations of aortic bioprostheses is their durability. When these devices fail, percutaneous valve implantation is a valid strategy. However, it has been shown that there may be high gradients involved. This gradient increase has been associated with worse outcomes and higher mortality rates, as observed in the PARTNER 2 study at 12 months....
Achieving rapid and maximum inhibition of platelet aggregation can reduce complications related to scheduled percutaneous coronary intervention (PCI) in chronic coronary syndromes (CCS). Over the last few decades, the optimal timing for initiating P2Y12 inhibitors and their appropriate dosage have been the subject of numerous studies; however, they have not been clearly established yet. Higher...