The transcatheter treatment of patent foramen ovale (PFO) has been shown to reduce thromboembolic events in patients with cryptogenic stroke. However, most of large randomized studies have failed to include patients with thrombophilia, either inherited or acquired. For instance, the RESPECT study excluded patients with antiphospholipid antibodies (AFA) or hyperhomocysteinemia, while the REDUCE screened for...
Aortic valve replacement (AVR) is recommended for symptomatic aortic stenosis (AS), while close monitoring is the advised strategy for asymptomatic patients, unless they have elevated aortic gradients, reduced ejection fraction, or abnormal stress tests. However, the optimal timing for AVR remains uncertain, especially in light of recent evidence suggesting that AS patients showing signs of...
Repeat mitral valve repair has been associated with increased mortality. Transcatheter mitral valve repair has surged as an alternative for patients treated with mitral valve-in-valve (MViV), valve-in-ring (MViR), or valve-in-mitral for annular calcification (ViMAC). Current data from the VIVID and the MAC Global Registry on 30-day evolution in these 3 scenarios show 7.4%, 11.4% and...
Severe tricuspid regurgitation (TR) is an underestimated condition in healthcare systems. However, it is more common than believed, especially in individuals over 65 years of age. This condition is linked to hospitalizations due to heart failure, mortality rates, and a progressive decline in quality of life. Surgery to treat TR on its own is complicated,...
According to several studies, in patients with high-risk atherosclerotic disease, such as those affected by coronary artery disease, achieving target LDL levels through high-intensity statin therapy has been shown to lead to a significant reduction in long-term cardiovascular events. Therefore, the management of dyslipidemia has become a fundamental pillar of secondary prevention. However, reaching such...
Drug-coated balloon (DCB) angioplasty is emerging as a novel treatment for coronary artery disease. Studies evaluating this strategy have demonstrated clinically non-inferior outcomes compared with those of drug-eluting stent (DES) implantation in patients with in-stent restenosis and de novo disease in small vessels. However, evidence for the use of DCBs in large coronary vessels is...
The preference for the use of potent P2Y12 inhibitors such as ticagrelor and prasugrel in patients with high risk of acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is based on randomized studies and current guideline recommendations. However, clopidogrel is still recommended for patients at high risk of bleeding. Several strategies have been looked...
Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery....
The impact of diabetes in patients with coronary artery disease (CAD) are well known, and after percutaneous coronary intervention (PCI), outcomes tend to be less favorable, with higher restenosis rate, repeat myocardial infarction (MI) and stent thrombosis. Despite the development of drug eluting stents, procedures and techniques, treating bifurcation lesions in diabetic patients still show...
The population over 75 is growing gradually, which entails an increase in acute myocardial infarction (AMI) in this group. As we all know, it is fairly common for AMI to present with multivessel disease. It has been shown that younger patients will benefit from complete revascularization vs. a simple resolution of the culprit vessel. However,...