CTO

TAVI: Balón expandible o autoexpandible ¿Cuál es la respuesta?

Considerations for Optimal Device Selection in TAVR

Many studies have tried to answer the question about whether there is a superior device in transcatheter aortic valve replacement (TAVR). Today, there is no evidence to support such claim, and most patients will likely find operator experience more beneficial than any device per se.   However, there are certain patients with specific characteristics that might...

THEMIS: eventos isquémicos y hemorrágicos en difícil equilibrio para el ticagrelor crónico

Ticagrelor to Improve Venous Graft Patency

Saphenous vein graft patency is one of CABG’s “Achilles heals”, especially after the ARTS trial came out showing bilateral internal mammary artery grafting was not superior to simple internal mammary artery grafting.  Antiaggregation more potent than aspirin might prolong venous graft patency in cases when the available techniques will fail to improve poor outcomes.    Previous...

The Fellow’s Corner | 2nd Clinical Case: An Explosive Mission

Read the case presentation and join the conversation through the comments in this post! Case Introduction: An Explosive Mission! 56-year-old male patient Severe smoker Hypertension Dyslipidemia Sedentary lifestyle and stress A sibling suffered from an acute myocardial infraction Cardiac markers: Standard angina, intensity of 8-9/10, 3-to-4-h long, and dyspnea (on and off for the past...

Una nueva molécula para evitar la nefropatía por contraste

Same Contrast Dose, Different Risk of Kidney Injury, Depending on Procedure

The risk of contrast induced kidney injury is significantly lower in patients receiving transcatheter aortic valve replacement (TAVR) compared against patients getting a coronary angiography or angioplasty.  This is true even for valvular heart disease patients with higher risk profiles.  Differences in contrast-induced acute kidney injury between TAVR or coronary patients had not been previously...

Seguridad de combinar los nuevos anticoagulantes y la doble antiagregación

Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention

Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure.  This highlights the huge variation in indication and the scarce evidence there is on this matter.  Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does...

ESC 2020 | New European Guidelines on Non-ST-Segment Elevation Acute Coronary Syndromes: What’s New?

The new European guidelines on NON-ST-segment elevation acute coronary syndromes (NSTE ACS) were presented virtually during the European Society of Cardiology 2020 Congress (ESC 2020) and published in Eur Heart J. This document includes news regarding a more agile infarction diagnosis, the use of non-invasive imaging, the simplification of anticoagulant therapy, infarction with normal coronary arteries,...

Dietas bajas en carbohidratos y progresión de la calcificación coronaria

Outflow Tract Calcification and the Best Valve in This Context

Moderate or severe left ventricle outflow tract calcification increases the risk of annulus rupture, residual aortic regurgitation and the need for a second valve. This recent study analyzed the performance of different contemporary prosthetic valves in patients with this particular anatomy.  Since the early days of transcatheter aortic valve replacement (TAVR) outflow tract calcification has...

ESC 2020 | Ticagrelor Might Increase Bleeding and Mortality in the Elderly

Ticagrelor compared against clopidogrel produces more bleeding and also more deaths in patients over 80 recently undergoing acute myocardial infarction. Contrary to what has been observed in the general population, these data from the SWEDEHEART registry of post MI patients over 80, show higher bleeding and mortality rates with ticagrelor compared against clopidogrel. These findings...

ESC 2020 | Antihypertensive Therapy Reduces Events Regardless of BP Levels or Risk

Antihypertensive therapy reduces the risk of cardiovascular events even in patients with no history of heart disease or with normal baseline blood pressure (BP). This fuels a long-running debate about thresholds for hypertension diagnosis (which may or may not exist). Beyond that, the higher the baseline BP, the better the benefit. The decision to prescribe...

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