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...
Original Title: Effects of Age and Sex on Clinical Outcomes after Percutaneous Coronary Intervention Relative to Coronary Artery Bypass Grafting in Patients with Triple Vessel Coronary Artery Disease. Reference: KyoheiYamaji et al. Circulation. 2016 Mar 23. [Epub ahead of print]. Sex and age are factors that are often considered in the daily practice to decide...
Transcatheter aortic valve replacement (TAVI) with the new generation balloon expandable valve is at least as good as surgery in intermediate risk patients with severe symptomatic aortic stenosis. For those that can be accessedfemorally, TAVI seems even better than surgery. In all, 2032 intermediate risk patients were randomized in 57 centers to TAVI with Sapien...
The last generation of the balloon expandable valve resulted superior to surgery in intermediate riskpatients, in a registry analyzis. Patients treated with the SAPIEN 3 valve showed lower rates of death, stroke and paravalvular leak at one year than patients undergoing surgery. This third generation improves the SAPIEN XT with a skirt designed to prevent...
At 3 year follow up, the CoreValve US Pivotal study on high risk elderly patients, the self-expanding valve showed a lasting benefit vs. surgery. These findings could suggest that the self-expanding valve should be considered the preferred treatment in patients with symptomatic severe aortic stenosis at increased risk for surgery. The study included 797 patients...
Original Title: Left main stenting in Comparison with Surgical Revascularization 10-year outcomes of the (Left Main Coronary Stenting) LE MANS trial. Reference: Buszman P et al. J Am CollCardiolIntv. 2016;9(4):318-327. doi:10.1016/j.jcin.2015.10.044. Courtesy of Dr. Guillermo Migliaro. Long term outcomes of left main stenting are unknown. This study reports 10 year follow up outcomes of the LEMANS trial patients. The...
Original Title: Randomized Trial of stent versus Surgery for Asymptomatic Carotid Stenosis. Kenneth Rosenfield. N Engl J Med. 2016 Feb 17. [Epub ahead of print] Courtesy of Dr. Carlos Fava. Stokes are one of the main causes of death and disability in the world and up to 20% of strokes can be explained by carotid stenosis....
Original Title: Randomized Comparison of Percutaneous Repair and Surgery for Mitral Regurgitation. 5 – Years Results of EVEREST II. Reference: Ted Feldman et al. J Am Coll Cardiol 2015;66:2844-54 Courtesy of Dr. Carlos Fava The MitraClip at 12 months in the EVEREST II trial showed similar outcomes to that of surgery, with improved ventricular remodeling and...
Original Title: Revascularization in diabetics with multivessel disease: a population-based evaluation of outcomes. Presenter: Ramanathan K. Real-world data support the role of CABG over PCI in diabetic patients with multivessel disease. However, PCI continues to be a common option for this patient population, according to an analysis of 2 Canadian registries. Sourcing data from 2...