1,721,067 research outputs found
Percutaneous Repair for Secondary Mitral Regurgitation
No full textTo the Editor: Obadia et al. (Dec. 13 issue)(1) describe the results of the MITRA-FR trial (Percutaneous Repair with the MitraClip Device for Severe Functional/Secondary Mitral Regurgitation), a randomized, controlled trial of this device for percutaneous mitral-valve repair in patients with chronic heart failure and severe secondary mitral-valve regurgitation. The trial showed no clinical benefit for percutaneous correction of functional mitral regurgitation over medical therapy alone. The cardiovascular death rate at 1 year (21.7% in the intervention group and 20.4% in the control group) was unusually high and much higher than the rates reported in the largest real-world MitraClip registries . .
Aortic Valvuloplasty as Bridging for TAVI in High-Risk Patients with Heyde's Syndrome: A Case Report.
No full textEstimating Incidence of Organ Cancer Related to PCI Radiation Exposure in Patients Treated For Acute and Chronic Total Occlusions
No full textHow should I treat a long and huge coronary pseudoaneurysm after spontaneous coronary artery dissection?
No full textPercutaneous coronary intervention in patients with a single remaining vessel
No full textPercutaneous coronary intervention in a patient's last remaining coronary conduit is perceived to be high risk, although there are no published data on outcomes in this lesion cohort. We report our experience with 16 patients who underwent intervention in their sole remaining vessel between 1998 and 2005. All patients had previously undergone coronary artery bypass grafting, had a history of myocardial infarction, had impaired left ventricular systolic function, and were symptomatic with unstable angina or minimal effort angina. There was 1 periprocedural death 10 hours after the procedure, and another patient died 4 months after the procedure. At 6-month follow-up, 2 patients had undergone target lesion revascularization. There was a significant and sustained improvement in symptom status, with 75% of patients being asymptomatic or in Canadian Cardiovascular Society class I after 6 months. Given the complexity of the patients and lesions treated in this cohort, periprocedural and long-term outcomes are acceptable with a notable improvement in symptomatic status. In conclusion, these data support percutaneous intervention as a realistic treatment option for this often highly symptomatic and difficult-to-treat patient cohort
Meta-Analysis of Relation Between Left Ventricular Dysfunction and Outcomes After Transcatheter Mitral Edge-to-Edge Repair
No full textRandomized controlled trials (RCTs) and observational studies provided conflicting results regarding the role of left ventricular (LV) function on outcomes after transcatheter edge-to-edge repair (TEER). The study aimed to provide a comprehensive assessment of searched to identify studies on TEER for secondary mitral regurgitation reporting outcomes stratified for LV ejection fraction < 30% and > 30%. The prespecified primary end points were the composite of all-cause death or heart failure (HF) hospitalization and New intervals (CIs) were estimated by random-effects models. Multiple sensitivity analyses accounting for baseline characteristics and study design were applied. A total of 6 studies (1,957 patients) with 1 year or 2 years of follow-up were available. Severe LV dysfunction was associated with an increased risk of death or HF hospitalization (OR 1.71, 95% CI 1.14 to 2.57). Conversely, comparable rates of NYHA class III/IV (OR 1.06, 95% CI 0.82 to 1.38) or secondary end points (reinterventions, recurrence of significant secondary mitral regurgitation) were found regardless of the baseline LV function. Subgroup meta-analysis found no difference in the composite primary end point between patients with LV ejection fraction < 30% and >= 30% enrolled in RCTs. In conclusion, TEER seems to be associated with higher mortality or HF hospitalization rates in patients with severe LV dysfunction. However, RCTs found no differences between groups. No impact of LV function was found on the risk of NYHA class III/IV or other clinical outcomes. (C) 2022 Elsevier Inc. All rights reserved
Effects of drug-eluting stents after rotational atherectomy: Evidence from a multicenter experience
No full textAims Rotational atherectomy is used as an adjuvant tool for percutaneous coronary interventions, especially in case of highly calcific atherosclerotic plaques. Subsequent drugeluting stent (DES) implantation is common; however, there is a paucity of clinical evidence to support this practice. Methods From the databases of four high-volume Italian centers, we analyzed the angiographic outcome of patients who underwent rotational atherectomy in native coronary vessels followed by DES or bare metal stent (BMS) implantation. Primary study endpoint was late lumen loss at the longest available follow-up. Other analyses consisted of the evaluation of in-stent percentage diameter stenosis, binary restenosis, major adverse cardiovascular events, and stent thrombosis at angiographic control. Results Between 2006 and 2011, 672 patients with 734 lesions treated had complete angiographic follow-up and were enrolled into this study; 385 lesions were treated with DES and 349 with BMS. The average follow-up length was 9 ± 5 months. Only a few significant differences regarding baseline clinical and angiographic characteristics were observed. Late lumen loss result significantly improved after DES implantation in comparison with BMS (0.54 ± 0.79 vs. 1.01 ± 1.13; P = 0.001), as well as in-stent percentage diameter stenosis (P = 0.01) and binary restenosis (P =0.007). Major adverse cardiovascular events did not differ significantly, but showed an improved trend in the DES group, driven by a significantly lower target lesion revascularization (6.9 vs. 11.6%; P =0.04). Conclusion In a cohort of patients treated with rotational atherectomy and with complete angiographic follow-up, DES implantation is associated with improved late lumen loss over BMS. However, the DES effect in terms of angiographic endpoints seems mitigated if compared to previous studies
Therapeutical approach of tricuspid regurgitation and right heart failure
No full text: Significant tricuspid regurgitation (TR) is a relatively common condition, affecting approximately 4 % of the elderly population. However, there are currently no clear guidelines for its medical management due to a lack of sufficient data in the literature. This review examines the pathophysiology of TR, categorizes its etiologies, and evaluates therapeutic options, both pharmacological and non-pharmacological, to optimize intervention timing and hemodynamic management. Based on the etiology and severity of TR, we suggest a gradual, stage-based algorithm for diuretic therapy titration and a management approach derived from common clinical practices
- …
