1,722,602 research outputs found
Myocardial Revascularization for Left Main Coronary Artery Disease: A Step Toward Individualized Treatment Selection.
No full textDual Antiplatelet Therapy in Percutaneous Coronary Intervention: A Tale of 2 Decades With New Perspectives in the Era of New-Generation Drug-Eluting Stents.
No full textThe Conundrum of Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation
No full textLow-dose aspirin to reduce the risk for myocardial infarction among patients with coronary stents undergoing noncardiac surgery
No full textCurrent state of alternative access for transcatheter aortic valve implantation
No full textThe transfemoral (TF) route constitutes the undisputed default access for transcatheter aortic valve implantation (TAVI). In patients in whom anatomical constraints preclude a TF approach, several alternative access routes have been used. Transthoracic (transapical and transaortic) access routes show higher mortality and bleeding complication rates than the TF approach, which is attributable to the higher baseline risk of the selected patients and the more invasive nature of these procedures. Alternative transarterial approaches (transaxillary, transcarotid, transinnominate) have demonstrated high technical success rates and a favourable safety profile in selected patients and are particularly valuable in the presence of poor respiratory function or previous cardiothoracic surgery. The transcaval approach is an innovative fully percutaneous approach that allows the introduction of large-bore sheaths and shows promising results in high-risk patients. Diligent procedural planning, appropriate patient selection and the expertise of the Heart Team allow the achievement of an adequate safety and efficacy profile of TAVI performed via alternative access. Future studies incorporating standardised and independent outcome assessment are required to gain further knowledge on the risk/benefit relation pertaining to the specific approaches and improve selection of the appropriate access route for the individual patient
Stable coronary artery disease: revascularisation and invasive strategies
No full textStable coronary artery disease is the most common clinical manifestation of ischaemic heart disease and a leading cause of mortality worldwide. Myocardial revascularisation is a mainstay in the treatment of symptomatic patients or those with ischaemia-producing coronary lesions, and reduces ischaemia to a greater extent than medical treatment. Documentation of ischaemia and plaque burden is fundamental in the risk stratification of patients with stable coronary artery disease, and several invasive and non-invasive techniques are available (eg, fractional flow reserve or intravascular ultrasound) or being validated (eg, instantaneous wave-free ratio and optical coherence tomography). The use of new-generation drug-eluting stents and arterial conduits greatly improve clinical outcome in patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). PCI is feasible, safe, and effective in many patients with stable coronary artery disease who remain symptomatic despite medical treatment. In patients with multivessel and left main coronary artery disease, the decision between PCI or CABG is guided by the local Heart Team (team of different cardiovascular specialists, including non-invasive and invasive cardiologists, and cardiac surgeons), who carefully judge the possible benefits and risks inherent to PCI and CABG. In specific subsets, such as patients with diabetes and advanced, multivessel coronary artery disease, CABG remains the standard of care in view of improved protection against recurrent ischaemic adverse events
Long-Term Assessment of Bioresorbable Coronary Scaffolds: Disappearing Stents, Reappearing Atherosclerosis ∗
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