Courtesy of Dr. Carlos Fava Surgical aortic valve replacement in a small annulus (<400 mm2) is associated with shorter duration, higher valve deterioration and patient prosthesis mismatch (PPM). They present a negative impact as regards duration and evolution. TAVR might be an option, with superior hemodynamic outcome and lower PPM. Read also: “Patients and Healthcare...
Previous studies in which revascularization was guided by angiography alone found that coronary angioplasty does not improve outcomes compared with optimal medical treatment in patients with chronic stable angina. The FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared angioplasty guided by fractional flow reserve (FFR) with optimal medical treatment, arriving to...
In the US, more than 4 million patients with chronic stable angina are looking to rule out heart disease. Most undergo functional diagnostic studies that might lead to invasive coronary angiography followed by revascularization. CT has become an alternative diagnostic tool thanks to its precision to rule out heart disease (negative predictive value between 97...
Even in the hands of experienced operators, rechanneling and angioplasty of a chronic total occlusion (CTO) results in patients and the whole cath lab team receiving high doses of radiation, according to this registry presented at the American Heart Association 2017 Scientific Sessions. Up to 23% of patients who undergo rechanneling of a CTO receive...
1) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Read more 2) Multivessel Disease and Severe Carotid Stenosis: How to Proceed Myocardial revascularization surgery (CABG) is...
Cardiac Artery Bypass Graft Surgery has been shown more effective than percutaneous coronary intervention (basically because it renders lower revascularization rate) in patients with severe left main bifurcation lesions receiving 1st generation drug eluting stents. This is why the 2014 American guidelines recommend CABG for most patients. But the EXCEL and the NOBLE trials brought back hope to...
Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may...
According to this Chinese study, dual antiplatelet therapy with ticagrelor and aspirin improves vein graft patency a year after surgery without increasing the risk for major bleeding. Treatment with the P2Y12 inhibitor ticagrelor in combination with aspirin has been widely accepted for patients with acute coronary syndrome undergoing angioplasty. However, there were no related data regarding surgical revascularization. Read also: “Ticagrelor...
Patients with peripheral vascular disease or prior acute myocardial infarction (especially within the first two years after the event) could find a particular benefit the PCSK9 receptor inhibitor evolocumab. Given its high cost, the drug is not yet cost/effective and when prescribed, most patients were no table to complete the treatment. Read also: “Missed Opportunities with...
The discussion about the best anti-thrombotic strategy for patients with atrial fibrillation undergoing PCI seemed never-ending until the RE-DUAL PCI trial was published in the New England Journal of Medicine (NEJM). This study has arrived to simplify the tough choice between the risk of a thrombotic event vs. the risk of bleeding with a simpler scheme, without...