1,721,069 research outputs found
Angioplasty in chronic coronary syndromes after the ISCHEMIA trial: What's new? - The interventional cardiologist's point of view
No full textFocus on relevant aspects of 2020 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
No full textReduction of hospitalisations and increased mortality for acute coronary syndromes during covid-19 era: Not all countries are equal
No full textAlgorithm for diagnosis of infective endocarditis after transcatheter aortic valve replacement
No full text
Pathophysiology of aortic stenosis and approach to treatment with percutaneous valve implantation
No full textAortic stenosis (AS) is the most commonly acquired valvular heart disease in the Western world (2-7% of the population aged >65 years) and the mortality for untreated symptomatic severe AS is up to 50-60% at 2 years in high-risk patients. This review summarizes laboratory and recent clinical investigations concerning AS and current best treatment. Particular emphasis will be placed on pathophysiology and on the concept of afterload mismatch and preload reserve in which left ventricular function is proportionately matched to level of left ventricular pressure, mainly because such studies carry important implications for both treatment with transcatheter aortic valve implantation (TAVI) and prognosis. Surgical aortic valve replacement is currently the gold-standard treatment for patients with severe symptomatic AS. Without surgery, the prognosis is extremely poor, with a 3-year survival rate 75 years with severe AS are declined for surgery. TAVI was recently introduced as a new therapeutic option for patients with AS, so the current indications, the technical differences between 2 different transcatheter aortic valves and the clinical available data will be also examined in detail
Transcatheter aortic valve implantation in patients at intermediate surgical risk
No full textTranscatheter Aortic Valve Implantation (TAVI) has revolutionized the treatment of elderly patients with symptomatic severe aortic stenosis (AS). Initially tested in unoperable or high surgical risk patients, the safety and efficacy of TAVI has progressively improved, with increasing operators' experience and continuous technical refinements of the devices and of the delivery systems. Hence, the extension of clinical indications for TAVI to the intermediate-risk population has been attracting cardiologists in recent years. This idea was supported by the results of recent studies suggesting that transfemoral TAVI might be associated with a survival benefit in both high- and intermediate-risk patients with severe AS. Therefore, the aim of this review is to summarize the currently available evidence from multiple observational studies, substudies from large country registries, mached group comparisons, a substudy of randomized studies, and randomized trials, as well as in recent meta-analyses on the use of TAVI in patient at intermediate-risk for surgery
Cardiovascular Prognosis in Patients with Peripheral Artery Disease and Approach to Therapy
No full textPeripheral artery disease (PAD), the pathophysiologic narrowing of the arterial blood vessels of the lower limbs due to atherosclerosis, is estimated to affect more than 200 million people worldwide and its prevalence ranges from 0.9 to 31.3% in people aged ≥50 years. It is an established marker of systemic obstructive atherosclerosis, which depicts patients at higher risk of myocardial infarction and stroke, due to the involvement of coronary and cerebral arteries in the atherosclerotic process. Therefore, identifying PAD, particularly in patients with coronary artery disease, is important to assess the cardiovascular risk score and implement specific therapies and prevention strategies. Since PAD emerged as an important clinical cardiovascular predictor, even more than other typical cardiovascular risk factors, an aggressive strategy to identify and treat PAD patients should be pursued by general practitioners, cardiologists, and vascular surgeons; similarly, preventive strategies should be implemented to improve prognosis and outcomes, particularly in patients suffering from both coronary artery disease and PAD. In this review, we describe the pathophysiology, including limb vasoconstriction after coronary angioplasty, the diagnosis of PAD, prognosis according to cardiovascular events, coronary artery disease, and heart failure. Furthermore, a large section of this review is on management, which spans from risk factors’ modification to antithrombotic therapy, and revascularization is provided. Finally, considerations about newer therapeutic options for the “desert foot” are discussed, including gene therapy
The five-year outcome of the transcatheter aortic valve replacement in the partner 2A study in patients with intermediate surgical risk-what is clear and what it is unclear
Full text link
- …
