Courtesy of Dr. Carlos Fava. Nowadays, chronic total occlusions (CTO) due to in-stent restenosis (ISR) represent 5%-25% of all coronary angioplasties. These lesions pose a new and true challenge, since CTOs are often associated with stent-related problems (fractures, lack of expansion, overlapping, deformation), extreme tortuosity, severe calcification, tandem lesions after CTO, and aorto-ostial lesions, with little...
The aim of this study was to evaluate the long-term performance of transcatheter aortic valve replacement (TAVR) and surgically-implanted valves through longitudinal echocardiographic follow-up of the PARTNER I trial patients. The study included all patients receiving TAVR or undergoing surgery who had a post-implant echocardiogram at five years analyzed for peak systolic velocity, mean gradient,...
The use of both internal thoracic (mammary) arteries for myocardial revascularization surgery might improve long-term outcomes, compared with the use of a single internal thoracic artery. Patients scheduled for myocardial revascularization surgery (only multivessel procedures; combined valve procedures were excluded) were randomized to receive a single internal-thoracic-artery graft (internal thoracic artery for the anterior...
Courtesy of Dr. Carlos Fava. Left main coronary artery (LMCA) lesions have always been defined as high-risk, with surgery as treatment of choice. Drug-eluting stents (DES) have slowly changed that, but their use still lacks strong supporting evidence. The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) study...
Paravalvular Leak (PVL) occurs in 5 to 17% of patients undergoing surgical valve replacement. Percutaneous device closure of PVL represents an alternative to repeat surgery. All centers in UK and Ireland performing percutaneous PVL closure delivered their data to the UK PVL registry. Data were analyzed for factors associated with mortality and major cardiovascular...
Fundamentos: A gestão otimizada da terapia antiplaquetária perioperatória para pacientes com stents coronários não foi completamente esclarecida. Os dados atualmente disponíveis sobre a segurança e eficácia de diferentes regimes antiplaquetários entre os pacientes submetidos à cirurgia com stent têm resultados inconsistentes. Com isso, um consenso foi elaborado por várias sociedades nacionais na Itália, incluindo a...
This is the first trial that used autologous cardiac stem cells for the treatment of ischemic cardiomyopathy. It consecutively enrolled 37 patients with reduced ejection fraction (lower than 40%) before myocardial revascularization surgery. It was administered by intra coronary infusion and 17 were control subjects. In the group injected with stem cells, EF significantly improved...
A total of 18,273 patients receiving angioplasty in hospitals with or without central vascular surgery were followed for 9 months and the costs were evaluated. Mortality and the occurrence of events were not different between the two groups. The cost of treatment was lower in the central vascular surgery centers (23,961 USD versus 25,540 USD,...
Minimally invasive interventions allow us to respond to any complications related to the heart, so it is expected to decrease open-heart surgery dramatically; in a decade, minimally invasive procedures definitely replace conventional surgery. This was highlighted on Wednesday during the XXV Meeting of the Cardiac Catheterization and Interventional Cardiology of the Spanish Society of Cardiology...
Original title: Drug-Eluting Stents versus Bare Metal Stents Prior to Noncardiac Surgery. Reference: Sripal Bangalore, et al. Catheterization and Cardiovascular Intervention 2015;85:533-41 Drug eluting stents (DES) have proved beneficial compared to bare metal stents (BMS), but the need to program a surgical procedure after a percutaneous coronary intervention (PCI) has limited its use. This study analyzed patients receiving...