Symptomatic patients with <1 cm² aortic valve area will benefit from an intervention regardless parameters such as flow and gradient, even if these are normal (or at least not severe). A valve replacement will be indicated without question (either surgical or percutaneous) in patients with >40 mHg mean gradient or low gradient justified by low<a href="https://solaci.org/en/2018/09/27/aortic-stenosis-with-normal-flow-low-gradient-should-we-intervene-or-wait/" title="Read more" >...</a>
Elective, uncomplicated repeat revascularization after stent restenosis is associated with higher mortality rates according to a new meta-analysis that will be published soon in J Am Coll Cardiol Intrv. Historically, interventional cardiologists have seen target lesion revascularization (TLR) as a procedure that “unjustly” increased combined events in clinical studies and our own databases, thus representing<a href="https://solaci.org/en/2018/05/16/restenosis-does-not-seem-as-benign-as-we-thought/" title="Read more" >...</a>
The association between aortic stenosis and some degree of mitral stenosis (MS) is around 10% (depending on the series), and it is related with negative outcomes. In high-risk and inoperable patients who underwent TAVR, that association and its significance have not been studied yet. The study analyzed data from the Society of Thoracic Surgeons/American<a href="https://solaci.org/en/2018/04/21/we-should-consider-mitral-stenosis-before-tavr/" title="Read more" >...</a>
The presence of coronary artery disease (CAD) in patients with aortic stenosis is high, reaching 50% to70% of cases. This poses a great challenge as to what strategy to use and the things we can do. Even though it has been shown complete revascularization is beneficial, it is often difficult to achieve. Instead, reasonable incomplete<a href="https://solaci.org/en/2018/04/18/do-the-best-coronary-revascularization-prior-tavr/" title="Read more" >...</a>
The association between aortic stenosis and coronary disease is common, since both conditions share pathogenesis, risk factors, and symptoms. Transcatheter aortic valve replacement (TAVR) is currently indicated for high-risk and inoperable patients. It also appears as a valid alternative for the treatment of intermediate-risk patients, and it could soon be indicated for low-risk patients. Coronary<a href="https://solaci.org/en/2018/02/20/coronary-disease-works-as-a-30-day-predictor-in-tavr/" title="Read more" >...</a>
Measuring fractional flow reserve (FFR) with a 0.014 pressure wire is the standard to assess the functional significance of epicardial coronary artery stenosis. The use of FFR in the clinical practice lags despite strong supporting evidence. Some of the reasons behind this are technical aspects, like pressure wire handling limitations when assessing certain lesions, or how<a href="https://solaci.org/en/2018/02/09/new-ffr-measuring-device-to-guide-coronary-revascularization-with-our-preferred-wire/" title="Read more" >...</a>
Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are commonly used to assess physiological severity of angiographically intermediate stenosis. Both indexes quantify a pressure ratio as subrogate to measuring flow, which is much harder to do. Discordance between FFR and iFR occurs in up to 20% of cases, which should not be a matter<a href="https://solaci.org/en/2018/01/14/physiologically-assessing-intermediate-stenosis-could-ffr-be-replaced/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Severe left main coronary artery (LMCA) lesions have a bad prognosis in coronary disease. In that scenario, current guidelines recommend surgery as the treatment of choice. However, due to the current development of second-generation drug-eluting stents (DES) and greater operator expertise, left main coronary artery angioplasty appears as a valid alternative<a href="https://solaci.org/en/2018/01/05/coronary-angioplasty-is-a-valid-alternative-for-left-main-coronary-artery-disease/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has been proven to reduce mortality and improve the quality of life of patients with pure severe aortic stenosis (PAS). However, there is a significant number of patients who experience mixed aortic stenosis associated with moderate/severe aortic regurgitation (MAS). These subjects were excluded from the PARTNER<a href="https://solaci.org/en/2017/12/12/tavr-in-patients-with-pure-vs-mixed-aortic-stenosis-benefits-and-evolution/" title="Read more" >...</a>
Courtesy of the Brazilian Society of Hemodynamics and Interventional Cardiology (SBHCI). The SeQuent Please paclitaxel-coated balloon provides non-inferior angiographic results when compared with the Xience everolimus-eluting stent for the treatment of in-stent restenosis. At 6 months, the minimal lumen diameter was 1.71 mm in the drug-coated balloon arm and 1.74 mm in the Xience arm, a difference that<a href="https://solaci.org/en/2017/11/01/dare-drug-coated-balloons-compete-with-des-for-the-treatment-of-in-stent-restenosis/" title="Read more" >...</a>