Percutaneous cardiological intervention and cardiac surgery: patient-centered care. Position statement of the Spanish Society of Cardiology

Publication date: Available online 28 June 2019Source: Revista Española de Cardiología (English Edition)Author(s): Ángel Cequier, Armando Pérez de Prado, Raúl Moreno, Juan Cosín-Sales, Esteban López de Sá, Artur Evangelista, Héctor Bueno, Manuel AnguitaAbstractThe percutaneous treatment of coronary artery disease and some structural cardiovascular diseases has undergone spectacular changes. More and more patients with different types of heart disease are being treated by percutaneous or transcatheter interventions, with no such increase in patients undergoing cardiac surgery. This situation has led to different types of approach, requiring an objective analysis that includes all the factors possibly influencing these changes. This document assesses the 2 scenarios where this problem is most evident: coronary revascularization and the treatment of aortic stenosis. The document analyzes the situation of coronary revascularization in Spain, and the causes that may explain the differences between the number of patients who currently undergo percutaneous revascularization and those who undergo coronary surgery. In contrast, treatment of aortic stenosis through transcatheter aortic valve implantation will lead to a foreseeable reduction in the number of candidates for surgical replacement. Several international scientific societies have published the requirements on training and experience and the necessary operator and...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research

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AbstractBackgroundUntreated symptomatic high-grade aortic stenosis remains a lethal disease requiring individually adapted valve replacement. High-risk surgical patients benefit from transcatheter aortic valve replacement (TAVR), but there is no uniform standard for patient selection and valve sizing and it is still unclear whether transthoracic (TTE) or transesophageal (TEE) echocardiography is superior in preprocedural aortic annulus sizing. As preprocedural sizing of the native aortic annulus diameter is crucial to outcome and survival, we report the results of a direct comparison between preprocedural sizing with TTE a...
Source: Journal of Echocardiography - Category: Cardiology Source Type: research
Last month, Medtronic announced receipt of U.S. Food and Drug Administration (FDA) approval for and launch of the Evolut Pro+ TAVR (Transcatheter Aortic Valve Replacement) System to treat patients with symptomatic severe aortic stenosis. Aortic steno...
Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiac Surgery Cardiology Exclusive Source Type: blogs
CONCLUSIONS: Although the evaluation of echocardiography cannot guarantee the success of biventricular repair surgery, echocardiography can still provide relatively valuable basis for surgical decision making. PMID: 31348032 [PubMed - as supplied by publisher]
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
This study was conducted to evaluate the prevalence of significant coronary artery disease (CAD) in patients with severe valvular heart disease (VHD) and the association between these two cardiac entities. Our research aims to introduce the theory of a possible causal relationship.MethodsA retrospective study was conducted on 1308 consecutive patients who underwent surgery due to severe VHD in the cardio-vascular department of NDSUH (Notre-Dame de Secours University Hospital) between December 2000 and December 2016. According to transthoracic echocardiography, patients were divided into 4 groups: patients with severe aorti...
Source: Indian Heart Journal - Category: Cardiology Source Type: research
AbstractPurpose of ReviewAging is associated with an increased prevalence of both cancer and heart disease. The progression of aortic valve calcification to aortic stenosis may be accelerated by both cardiovascular risk factors and cancer treatments, such as radiotherapy with mediastinal involvement. Symptomatic aortic stenosis is occasionally diagnosed in cancer patients undergoing cardiovascular evaluation; likewise, cancer is often recognized during assessment preceding aortic valve interventions. In these complex cases, physicians face difficult treatment decisions. Due to a myriad of clinical presentations of cancer a...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Introduction Significant tricuspid regurgitation is a well recognized indicator of right ventricular dysfunction. Recent studies have shown that significant tricuspid regurgitation is potentially associated with increased mortality in patients with severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR). However, data remained sparse and inconclusive. Thus, we performed a systematic review and meta-analysis of the literature to assess the association between significant tricuspid regurgitation and mortality in post TAVR patients. Hypothesis Significant tricuspid regurgitation is predictive f...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Interventional cardiology. Structural heart disease Source Type: research
Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of aortic stenosis. A series of trials in which patients were randomized to receive TAVR or surgical valve replacement have provided arguably the best data collected for this intervention. The 2 most recent randomized clinical trials involving patients who have less than 3% risk of surgical operative mortality suggest that TAVR might be the preferred treatment strategy for this particular patient group. The patient group tested is a critical factor for all randomized clinical trials and determines the potential for generalizability. The data fro...
Source: JAMA - Category: General Medicine Source Type: research
ConclusionsExercise RHC is feasible and safe in this population. Peak pulmonary artery oxygen saturation might identify patients with increased risk of serious adverse events.ResumenIntroducción y objetivosLa estenosis aórtica degenerativa es la valvulopatía más frecuente. Aún no está claro cómo identificar a los pacientes asintomáticos con fracción de eyección del ventrículo izquierdo normal y alta probabilidad de eventos que por ello pudieran beneficiarse de una intervención valvular precoz. En este estudio se describe un protocolo de hem...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
Conclusion: Preprocedural evaluation is one of the most important steps in TAVR. Computed tomography imaging provides extensive information, not only for procedure planning. Our findings emphasize that computed tomography has a crucial role for the preprocedural evaluation of TAVR candidates. PMID: 31061731 [PubMed]
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
This study was conducted to evaluate the prevalence of significant coronary artery disease (CAD) in patients with severe valvular heart disease (VHD) and the association between these two cardiac entities. Our research aims to introduce the theory of a possible causal relationship. METHODS: A retrospective study was conducted on 1308 consecutive patients who underwent surgery for severe VHD in the cardiovascular department of Notre-Dame de Secours University Hospital (NDSUH) between December 2000 and December 2016. According to transthoracic echocardiography, patients were divided into 4 groups: patients with severe a...
Source: Indian Heart J - Category: Cardiology Authors: Tags: Indian Heart J Source Type: research
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