Coronary microvascular dysfunction (CMD) is emerging as an important cause of myocardial ischemia, and its role in the pathogenesis of cardiovascular disease—including angina patients with nonobstructive coronary lesions—is well known. Currently, there are several definitions of CMD and several invasive and noninvasive diagnostic tests. Using invasive tests, heterogeneous patterns of microvascular dysfunction, such as coronary...
The current indication for severe left main lesion continues to be coronary artery bypass graft surgery (CABG) but percutaneous coronary intervention (PCI) has come far in this territory thanks to increasing operator experienced and the use of IVUS during procedures. At present, left main disease have a Class IIa indication in the American guidelines when...
The safety and efficacy of drug-coated balloons (DCB) has been established for the treatment of in-stent restenosis of conventional bare-metal stents (BMS) and drug-eluting stents (DES). Furthermore, these devices are also used to treat de novo coronary lesions, as demonstrated in the BASKET-SMALL 2—where DCBs were non-inferior to stents—and the DEBUT RCT trials—, where DCBs...
One of the challenges of percutaneous coronary interventions (PCI) are <2.5 mm vessels, since complications and restenosis complications rate are higher than with >3.0 mm vessels. Drug Coated Balloons (DCB) can be a useful tool, but their efficacy and safety [vs. plain old balloon angioplasty] remains unclear. PEPCAD China SVD is a prospective and multicenter...
Left main coronary artery percutaneous coronary intervention (LMCA PCI) is a treatment option that is increasingly used in our setting. One of the reasons for choosing this therapeutic strategy is the improvements in devices and techniques. However, the long-term results of LMCA PCI are not well established. The aim of this retrospective study was to...
Patients with severe symptomatic aortic stenosis treated with aortic valve replacement might still present cardiac failure, even after successful procedures. According to some reports, the incidence of cardiac failure after TAVR varies between 9% and 24%. The prognostic relevance of rehospitalization in these patients has not been studied yet; in fact, it remains unclear whether...
Percutaneous coronary intervention (PCI) to the left main coronary artery (LMCA) with drug-eluting stent implantation is currently a major challenge due to the size of the vessel, the compromise of a bifurcation lesion in important branches, and the potential risk of complications. Available information on LMCA PCI comes from studies where DES stents were implanted...
Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk. The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis. Prolonged DAPT has been associated with...
There are many current randomized trials comparing percutaneous coronary intervention (PCI) with myocardial revascularization surgery (MRS) for the treatment of left main coronary artery disease (LMCAD). In the European Society of Cardiology guidelines, PCI is classified as Ia (LMCAD with low-complexity coronary disease) or IIa indication (intermediate complexity), whereas, according to the American Heart Association...
Aortic stenosis is associated to significant coronary artery disease (CAD) in nearly 50% of cases. When we decide to treat aortic disease using surgery, it has been established we should also treat heart disease. However, when using transcatheter aortic valve replacement (TAVR), this is still unclear, given that in many occasions we see stable lesions...