Original title: Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock (for the IABP-Shock II Trial Investigator) Reference: Holger T, et al. NEJM 367;14:1287 The rate of mortality in cardiogenic shock secondary to acute myocardial infarction (AMI) is high even in patients receiving early revascularization. The use of an intra-aortic balloon counter-pulsation pump (IABP) according to the...
Reference: Fox y colaboradores. Short-term Outcomes of Acute Myocardial Infarction in Patients with Acute Kidney Injury: A Report from the National Cardiovascular Data Registry. Circulation 2012 (in press). The presence of chronic renal failure is common in patients referred for angioplasty. Its presence is associated with increased mortality and bleeding. However, the prevalence is unknown as...
While transcatheter aortic valve replacement (TAVR) has shown benefits, significant coronary artery disease affects 50% or more of patients who undergo such procedure. However, it is still unclear which is the best treatment strategy or how to handle this condition. Quantitative flow ratio (QFR) could be a non-invasive option to assess the severity of coronary...
The retrograde technique has significantly improved the success of percutaneous treatment of chronic total occlusions (CTO). After crossing a collateral channel, creating a connection between the anterograde and retrograde systems is key. The most common technique for this is reverse controlled antegrade and retrograde subintimal tracking (reverse CART). This technique involves inflating a balloon over...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
The edge-to-edge approach with MitraClip has been established as a valid strategy for patients who experience severe symptomatic mitral regurgitation (MI) with high risk for surgery, currently with a IIa indication. MI complicated by cardiogenic shock, which results in a high risk for conventional valve surgery, is a particularly complex scenario. In such a case,...
Transcatheter aortic valve replacement (TAVR) has widely demonstrated its significant benefits, both in high-risk and inoperable patients, as well as in those with intermediate and low risk. While paravalvular regurgitation has been a challenge, its management has improved with operator experience and a deeper understanding of CT angiographies. However, in cases of regurgitation, elevated gradient,...
The retrograde approach for recanalizing chronic total occlusions (CTO) has undergone significant evolution since its introduction in 1990, improving both in terms of techniques and specialized materials. The increased skill applied to this strategy has resulted in increased success rates for the treatment of CTO in sites with an adequate volume of procedures. Given the...
Aortic stenosis (AS) is a progressive disease associated with morbidity and mortality, especially in severe cases. However, recent studies have revealed that moderate stenosis can also have unfavorable consequences in the course of the disease. One of the challenges lies in that determining its severity is sometimes difficult due to discrepancies between valve area, gradient,...