Mitral paravalvular leaks are relatively common after surgical mitral replacement, with an incidence of 7%-17%. Most of these are subclinical leaks, a mere echocardiogram finding, but about 3% of patients can develop heart failure, hemolysis, or a combination of both, thus requiring a new intervention. For symptomatic patients, new surgery has been the traditional treatment...
During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked for almost 20 years the treatment strategy for patients with infarction complicated...
Critical ischemia is the most advanced form of peripheral arterial disease, and it is characterized by ischemic rest pain and ulcers or gangrene. Revascularization is obviously positioned as the first-line treatment, and guidelines recommend both possible strategies (surgery or angioplasty) largely based on the findings of the BASIL trial (British Angioplasty versus Surgery in Ischemic...
A large study conducted in 19 countries has found that a policy of restrictive red-cell transfusion during cardiac surgery is just as safe and effective as more liberal policies. TRICS III enrolled 5243 patients and was presented at the American Heart Association (AHA) Scientific Sessions and published simultaneously in the New England Journal of Medicine (NEJM). Patients were...
Courtesy of the SBHCI. After treating the culprit lesion in patients with acute myocardial infarction complicated by cardiogenic shock, continuing revascularization of all other lesions worsens outcomes. This finding of the CULPRIT-SHOCK trial has changed entirely the way we treated this patient group and will surely modify guidelines. Culprit-lesion treatment with the option to perform...
Courtesy of Dr. Carlos Fava. Coronary perforation (CP) is a very uncommon event (≈0.4%), associated with severe complications that entail risk of death. It has usually been related to patients with a history of myocardial revascularization surgery (MRS). However, this group usually presents lower rates of cardiac tamponade due to pericardial fibrosis caused by surgery. This...
Courtesy of Dr. Carlos Fava. Aortic stenosis can present different hemodynamic patterns, such as low flow and low gradient with reduced or preserved ventricular function. However, evidence on the evolution of different hemodynamic patterns after transcatheter aortic valve replacement (TAVR) is limited. This study consisted in a retrospective analysis of 368 patients who underwent TAVR. The population was divided in...
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...
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and...
Courtesy of Dr. Carlos Fava. Provitional ventricular assist devices are increasingly used in high-risk angioplasties, particularly those involving unprotected left main coronary artery (LMCA) with defective ventricular functioning. However, so far its true role has not been well-studied. This study analyzed 127 consecutive patients in the USpella registry from 2008 to 2015. These subjects underwent high-risk...