Background: Despite advances in hospital management in recent years, it is not clear whether mortality after acute pulmonary embolism (PE) has decreased over time.
Background: Previous studies of the cost-effectiveness of transcatheter aortic valve replacement (TAVR) have been based primarily on a single balloon-expandable system.
Background: There are no data available on specific causes of death from randomized trials that have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI).
Background: Anticoagulation is required during transcatheter aortic valve replacement (TAVR) procedures. Although an optimal regimen has not been determined, heparin is mainly used. Direct thrombin inhibition with bivalirudin may be an effective alternative to heparin as the procedural anticoagulant agent in this setting.
Background: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease.
Background: In EVEREST II (Endovascular Valve Edge-to-Edge Repair Study), treatment of mitral regurgitation (MR) with a novel percutaneous device showed superior safety compared with surgery, but less effective reduction in MR at 1 year.
Background: Complete revascularization may improve outcomes compared with an infarct-related artery (IRA)-only strategy in patients being treated with primary percutaneous coronary intervention (PPCI) who have multivessel disease presenting with ST-segment elevation myocardial infarction (STEMI). However, there is concern that non-IRA PCI may cause additional non-IRA myocardial infarction (MI).
Abstract: An increasing number of devices can provide mechanical circulatory support (MCS) to patients with acute hemodynamic compromise and chronic end-stage heart failure. These devices work by different pumping mechanisms, have various flow capacities, are inserted by different techniques, and have different sites from which blood is withdrawn and returned to the body. These factors result in different primary hemodynamic effects and secondary responses of the body. However, these are not generally taken into account when choosing a device for a particular patient or while managing a patient undergoing MCS. In this review, we discuss fundamental principles of cardiac, vascular, and pump mechanics and illustrate how they provide a broad foundation for understanding the complex interactions between the heart, vasculature, and device, and how they may help guide future research to improve patient outcomes.
Background: Isolated tricuspid valve surgery is associated with high morbidity and mortality, especially in patients with prior cardiac surgery. The transcatheter Forma Repair System (Edwards Lifesciences, Irvine, California) is designed to provide a surface for native leaflet coaptation to reduce tricuspid regurgitation (TR) by occupying the regurgitant orifice area.
Background: Acute ischemic stroke is a leading cause of serious disability and death worldwide. Individual randomized trials have shown possible benefits of mechanical thrombectomy after usual care compared with usual care alone (i.e., intravenous thrombolysis) in the management of acute ischemic stroke patients.
Background: Gastrointestinal (GI) bleeding is a common complication of oral anticoagulation.
Background: The everolimus-eluting bioresorbable vascular scaffold (BVS) is designed to achieve results comparable to metallic drug-eluting stents at 1 year, with improved long-term outcomes. Whether the 1-year clinical and angiographic results of BVS are noninferior to current-generation drug-eluting stents has not been established.
Background: Fractional flow reserve estimated using computed tomography (FFRCT) might improve evaluation of patients with chest pain.
Transcatheter aortic valve replacement (TAVR) indications are rapidly increasing. We report here the case of a 64-year-old man with both severe aortic stenosis and cirrhosis. He was first managed by TAVR and then underwent liver transplantation. Two and one-half years later, he was admitted for heart failure with an echocardiogram showing a moderate intravalvular aortic leak and a high transaortic mean gradient of 38 mm Hg; the left ventricular ejection fraction was normal. Infectious endocarditis was ruled out, and the diagnosis of early valve degeneration was deemed probable. Six months later, he was again admitted for acute heart failure; a severe intravalvular leak was revealed with a mean systolic gradient of 80 mm Hg (Figures 1A and 1B). After a heart team discussion, conventional surgery was performed that allowed confirmation of the typical aspect of aortic valve degeneration (Figures 1C and 1D). To our knowledge, this is the first time that early TAVR valve degeneration was reported. Surgery allowed valve scrutiny and confirmation of the diagnosis.
A 78-year-old man underwent percutaneous coronary intervention with implantation of a 2.5 × 28-mm Absorb bioresorbable scaffold (BRS) (Abbott Vascular, Santa Clara, California) in the mid-left anterior descending coronary artery, and treatment with a drug-coated balloon for recurrent metallic stent restenosis in the proximal segment
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