Courtesy of Dr. Brian Nazareth Donato. The conventional treatment for patients with pulmonary embolism (PE) has traditionally been anticoagulation plus systemic thrombolytics, or surgical embolectomy, reserved for high risk patients. Even though it has been shown systemic thrombolytics reduce mortality in PE patients at high or intermediate risk, its use has been limited given the...
Operators: Renata Mattos, Luiz Carlos Simões, Vitor Hugo. Chairpersons: Luiz Alberto Christiani, Roberto Max Lopes. Debaters: Pedro Augusto Abujamra, Fabio Augusto Selig, Adriano Dias Dourado Oliveira, Salvador Andre Bavaresco Cristovão, Marco Antonio Perin, Mauricio Jaramillo Hincapie, Fabricio Leite. Broadcasted on June 8th, 2016 by TBR Productions.
Original Title: Hemodynamic. Functional and Clinical Responses to Pulmonary Artery Denervation with Pulmonary Artery Hypertension of Different Causes. Phase II Results from the Pulmonary Artery Denervation 1 study. Reference: Circ Cardiovasc Interv. 2015;8 Courtesy of Dr. Guillermo Migliaro. Hospital Alemán, Buenos Aires, Argentina. The mechanisms responsible for pulmonary artery hypertension (PAH) are multifactorial. PAH reduces...
Atrial fibrillation is initiated by focal triggers and maintained by an atrial substrate called fractioned complex of atrial electrograms. Isolating the pulmonary veins (triggers) through a circumferential ablation is the choice treatment in refractory atrial fibrillation but with suboptimal results. This work tested the hypothesis that don’t only isolate the pulmonary veins but also the...
Original title: Clinical and Hemodynamic Outcomes Up to 7 Years After Transcatheter Pulmonary Valve Replacement in the US Melody Valve Investigational Device Exemption Trial. Reference: Circulation. 2015 May 5. [Epub ahead of print]. Published studies on transcatheter pulmonary valve replacement with the Melody valve have shown good short term outcomes but there is no information of long term...
Original title: Vena cava filters in unstable elderly patients with acute pulmonary embolism Reference: Stein PD et al. Am J Med. 2014 Mar;127(3):222-5. Filters in inferior vena cava may reduce mortality in patients with severe pulmonary embolism (PE) who are hemodynamically unstable. This has not been demonstrated in elderly patients, a growing demographic group where the...
Original title: The effectiveness of prophylactic inferior vena cava filters in trauma patients: a systematic review and meta-analysis. Reference: Haut ER et al. JAMA Surg. 2014;149:194-202. Trauma is one of the strongest risk factors for pulmonary embolism (PE). Current guidelines recommend low molecular weight heparin therapy which have been proved effective; however, trauma patients often present high risk...
Título original: Riociguat for the Treatment of Pulmonary Arterial Hypertension. Referencia: Hossein-Ardeschir Ghofrani et al. N Engl J Med 2013;369:330-40. Many drugs have been tested for pulmonary arterial hypertension (PAH) including PDE5 inhibitors, prostanoids and endothelin receptor antagonists, however there are still missed targets in the treatment of this disease. Riociguat is a drug belonging to a...
Original title: Pulmonary artery denervation to treat pulmonary arterial hypertension: a single center, prospective, first-in-man PADN-1 study. Reference: Shao-Liang Chen et al. J Am Coll Cardiol. Article in press. Idiopathic pulmonary hypertension is characterized by elevated mean pressure and resistance due to an imbalance between local vasodilator and vasoconstrictor added to the vascular wall renovation. Based on animal...
Original title: Refined Balloon Pulmonary Angioplasty for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension. Reference: Hiroki Mizoguchi et al. Circ Cardiovasc Interv. 2012;5:748-755. Patients with Chronic Thromboembolic Pulmonary Hypertension (CTE-PH) have bad prognosis. Pulmonary thromboendarterectomy can significantly reduce pulmonary pressure but, due to comorbidity or technical matters (very peripheral thrombi), not all patients are good candidates for this...