One of the limitations of aortic bioprostheses is their durability. When these devices fail, percutaneous valve implantation is a valid strategy. However, it has been shown that there may be high gradients involved. This gradient increase has been associated with worse outcomes and higher mortality rates, as observed in the PARTNER 2 study at 12 months....
Achieving rapid and maximum inhibition of platelet aggregation can reduce complications related to scheduled percutaneous coronary intervention (PCI) in chronic coronary syndromes (CCS). Over the last few decades, the optimal timing for initiating P2Y12 inhibitors and their appropriate dosage have been the subject of numerous studies; however, they have not been clearly established yet. Higher...
Diabetic patients have twice as high a risk of developing coronary artery disease (CAD). Additionally, CAD increases mortality risk. Patients with a history of percutaneous coronary intervention (PCI) tend to need repeat revascularization, even with second generation stents. To date, there are few studies assessing the role of glycemic control in stent failure, stent thrombosis,...
Drug-eluting balloons (DEB) with paclitaxel have shown efficacy and safety in the treatment of femoropopliteal disease. Sirolimus-eluting balloons (DEB S) are currently being introduced. This new drug acts during the cellular resting phase (G0) and is considered potentially more effective than paclitaxel, which is a cytostatic drug. However, there is no conclusive evidence in this...
Delays in the treatment of symptomatic aortic stenosis (AS) reduce prognosis, especially in elderly patients. Accurate assessment of AS severity is crucial to avoid overtreatment and its associated risks. A transthoracic echocardiogram (TTE) is the initial evaluation in the diagnostic algorithm, and severity values are well established. However, some patients may obtain discordant data due...
Coronary Microvascular Dysfunction (CMD) is being increasingly considered a common consequence of STEMI. Its presence partly explains the persistence of angina symptoms in over 50% of patients after PCI, despite successful epicardial artery reperfusion. Also, CMD has been independently associated with worse left ventricular ejection fraction recovery, which leads to worse prognosis, including recurrent events,...
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of patients with severe aortic stenosis (AS). Randomized studies have shown the benefits of TAVR in patients at prohibitive surgical risk, as well as high and intermediate risk. The NOTION trial (Nordic Aortic Valve Intervention Trial) randomized patients with low risk severe AS to TAVR and...
TAVR’s significant advance has driven the development of valve technology, which is currently in its third generation. Even though outcomes have improved, randomized studies are yet to compared balloon-expandable (BEV) vs self-expanding (SEV) valves in randomized studies, and we only have information from different analysis with contradicting conclusions. This was a meta-analysis of 16 studies...
Comparing different transcatheter heart valves (THVs) is necessary to obtain relevant information that facilitates the selection of the appropriate valve for each patient. A previous study compared early outcomes between the self-expanding ACURATE Neo2 valve and the balloon-expandable Sapien 3 Ultra valve. However, there are no comparative data on these two valves in the medium...
Many of the studies comparing TAVR against SAVR in low risk patients included patients between 70-75 years, excluding those with tricuspid valves. This study included low surgical risk patients with severe aortic stenosis and symptoms, 75 years or younger. Participants were randomized 1:1 to receiving TAVR or SAVR, stratified according to sex, need for new...