Tag Archives: surgery

Subutilización del tratamiento médico en enfermedad vascular periférica

Thromboendarterectomy vs. Endovascular Therapy in Common Femoropopliteal Territory. Is Surgery Still the Gold Standard?

Thromboendarterectomy vs. Endovascular Therapy in Common Femoropopliteal Territory. Is Surgery Still the Gold Standard?

For lesions in the common femoral artery, guidelines recommend surgical endarterectomy (TEA) as the gold standard. However, endovascular therapy (EVT) is an alternative option for these lesions.  In 2017 the first randomized study comparing TEA vs EVT was carried out, showing that EVT presents clinical benefits, though it does not replace surgical treatment as first

perforación coronaria en angioplastia

Coronary Bifurcation Lesions: MRS or PCI? 10-Year Mortality of the SYNTAX Study

Percutaneous treatment of coronary lesions affecting bifurcations has increased in recent decades. Coronary angioplasty (percutaneous coronary intervention, PCI) in these cases is associated with an increased rate of adverse events in patients with multivessel disease and left main coronary artery lesions. The SYNTAX score, which is a predictor of total mortality, is used to evaluate

La enfermedad vascular periférica se asocia a más eventos en el TAVI

TAVR, More Information Supports Its Use

TAVR has been reported beneficial in the treatment of high and intermediate risk patients but, initially, randomized clinical trials have shown vascular complication and pacemaker implantation rates higher than SAVR in low-risk patients. This will most certainly improve as operator experience and device development advance. This is a randomized 1:1 study including 458 patients receiving

EuroPCR 2022 | Cambios en el daño cardíaco luego del reemplazo valvular aórtico por cirugía

EuroPCR 2022 | TriCLASP, Evolution at 30 Days

Tricuspid regurgitation (TR) is difficult to manage and is a mortality predictor. At present, surgery is recommended, even though its mortality rate is not low.  Endovascular intervention of this entity is currently being developed and according to the European guidelines, it has evidence level IIb C in symptomatic inoperable patients. The TriCLASP included 74 patients

EuroPCR 2022 | Cambios en el daño cardíaco luego del reemplazo valvular aórtico por cirugía

EuroPCR 2022 | Changes in Cardiac Damage after Surgical Aortic Valve Replacement

This study presented at EuroPCR 2022 analyzed the PARTNER study pool and included 1974 patients with a complete echocardiogram. Surgical risk was 17.3% extreme/inoperable, 54.3% intermediate and 28.4% low. 60% received transcatheter aortic valve replacement (TAVR) and the rest surgical aortic valve replacement (SAVR).  6.1% of patients were in stage 0 (no damage), 14.5% were

Estenosis aórtica severa asintomática en añosos: ¿cuándo intervenir?

Transcatheter Edge-To-Edge Repair Is Favorable for Elderly Patients at High Surgical Risk

Mitral valve prolapse is the most frequent cause of mitral valve regurgitation and is associated to hospitalization for cardiac failure and mortality. At present, the preferred treatment for operable patients is mitral valve surgical repair. Transcatheter edge to edge repair (TEER) has shown great benefit patients at high surgical risk; however, it has not been

La revascularización incompleta se asocia a mortalidad en el TAVI

Low Risk Patients: TAVR with Self-Expanding Valves Offers Similar Outcomes to Surgery Based on a Bayesian Analysis?

When compared against surgical valve replacement (SAVR) transcatheter aortic valve replacement (TAVR) has shown benefits across different risk groups, not only in events as death and stroke, but also in quality of life (especially in the first months post procedure) and improved symptoms.  However, a catch-up phenomenon was observed in low-risk patients between the first

Endocarditis infecciosa post TAVI

Infective Endocarditis in TAVR: What’s the Best Treatment?

Infective Endocarditis (IE) rate after TAVR ranges from 0.7% to 3.4%, depending on the different analyses, and is comparable to that after SAVR.  Close to 50% of patients treated with surgery received a prosthetic valve; in TAVR, the figure is lower, possibly due to the characteristics of patients (even though it remains unclear).  Researchers looked

TCT 2021 | FAME 3: Sorpresas en un estudio largamente esperado

TCT 2021 | FAME 3: Surprises in a Long-Awaited Study

Angioplasty could not reach non-inferiority to surgery to treat patients with three-vessel lesions. In this head-to-head study of both revascularization strategies in patients with three-vessel coronary disease, fractional flow reserve (FFR)-guided angioplasty could not reach the performance of myocardial revascularization surgery in relation to a composite of adverse events. The FAME 3 study was presented during

Anillos aórticos pequeños, ¿Qué válvula deberíamos elegir?

High Mortality Rates for Redo Surgery After TAVR

Courtesy of Dr. Carlos Fava. Since the beginnings of transcatheter aortic valve replacement (TAVR) back in 2002, this strategy has gained considerable ground, encompassing not only inoperable or high-risk patients but also those at medium and low risk. Additionally, it came to include patients with failed bioprostheses. The most common reason for surgery was paravalvular leak,