The Influence of the Learning Curve on Clinical Outcomes in Balloon-Expandable versus Self-Expandable Transfemoral Transcatheter Aortic Valve Implantation.

Introduction: Balloon-expandable (BE) and self-expandable (SE) prostheses are the main types of devices currently used in transcatheter aortic valve implantation (TAVI). Despite the different designs, clinical practice guidelines do not make any specific recommendation on the selection of one device over the other. Most operators are trained in using both BE and SE prostheses, but operator experience with each of the two designs might influence patient outcomes.

The effect of the learning curve on paravalvular aortic regurgitation and mid-term mortality in transfemoral transcatheter aortic valve implantation.

Objective: Paravalvular aortic regurgitation is an important independent mortality predictor in transcatheter aortic valve implantation (TAVI). Our study evaluated the association between paravalvular aortic regurgitation and mid-term mortality in relation with the learning curve, in patients with severe aortic stenosis who underwent transfemoral TAVI in the first 3 years since the establishment of the program.

Methods: Patients with severe aortic stenosis who underwent transfemoral TAVI between 2017 and 2020 were included in the analysis.

Transcatheter aortic valve implantation in a patient with interventricular membranous septal aneurysm resulted in cardiac tamponade of unclear etiology.

An 86-year-old lady with severe aortic stenosis and interventricular membranous septal aneurysm underwent transfemoral transcatheter aortic valve implantation (TAVI). A balloon-expandable valve was deployed after a difficult native valve crossing. Transesophageal echocardiography showed a rapidly accumulating pericardial effusion, with pericardial thrombus and subsequent cardiac tamponade.

New Predictors of Early and Late Outcomes after Primary Percutaneous Coronary Intervention in Patients with ST-Segment Elevation Myocardial Infarction and Unprotected Left Main Coronary Artery Culprit Lesion.

Objectives: The study evaluated the correlation between baseline SYNTAX Score, Residual SYNTAX Score, and SYNTAX Revascularization Index and long-term outcomes in ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) on an unprotected left main coronary artery lesion (UPLMCA).

Background: Previous studies on primary PCI in UPLMCA have identified cardiogenic shock, TIMI 0/1 flow, and cardiac arrest, as prognostic factors of an unfavourable outcome, but the complexity of coronary artery disease and the extent of revascularization have not been thoroughly investigated in these high-risk patients.

Methods: 30-day, 1-year, and long-term outcomes were analyzed in a cohort of retrospectively selected, 81 consecutive patients with STEMI, and primary PCI on UPLMCA.

Neutrophil-to-Lymphocyte Ratio: A Comparative Study of Rupture to Nonruptured Infrarenal Abdominal Aortic Aneurysm.

Background: Neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a useful predictor of cardiovascular risk and adverse outcomes. According to previous studies, an NLR >5 has the highest sensitivity and specificity for postoperative morbidity and mortality in cardiovascular disease. This study aims to evaluate the NLR in cases of infrarenal unruptured abdominal aortic aneurysm (uAAA) and ruptured abdominal aortic aneurysm (rAAA) and to assess the role of NLR as a prognostic marker of 30-day mortality in patients with uAAA and rAAA who underwent surgical repair.

Giant Infrarenal Aortic Aneurysm Rupture Preceded by Left Lower Limb Motor Deficit.

This report presents the surgical repair and postsurgical outcomes following a ruptured infrarenal aortic aneurysm with a maximum transverse diameter of 20 cm. Its association with acute lower limb motor deficit is rare. Open surgery of giant abdominal aortic aneurysms is often the only available treatment, favored over an endovascular approach in the presence of increased aneurysm size with dislodged abdominal organs, adhesions, and short and angled proximal infrarenal aortic neck, presenting significant additional surgical and anesthesiological challenges.

Coronary-Subclavian Steal: Case Series and Review of the Literature.

Coronary subclavian steal syndrome (CSSS) is a relatively uncommon entity, and its clinical spectrum is characterized by stable exertional angina and rarely as acute coronary syndrome. The diagnosis can be established easily by angiography. We report a case series of three patients with CSSS and acute coronary syndrome and we review the literature in the attempt to understand the nature of symptomatology and the mechanisms of ischemia in this condition.

Transthoracic Doppler echocardiography of the left internal mammary artery graft.

Assessment of the left internal mammary artery (LIMA) graft patency currently requires invasive investigation through coronary angiography. In the last years the successful application of noninvasive Doppler spectrum analysis has been reported for patency assessment of the LIMA graft after myocardial revascularization. Echocardiography is considered to be a sensitive noninvasive screening modality to diagnose critical narrowing of LIMA grafts and angiography should be reserved for cases in which Doppler echocardiography fails to visualize the LIMA or reveals an abnormal flow pattern.

Left internal mammary artery graft dysfunction diagnosed by transthoracic Doppler echocardiography. A report of two cases.

Transthoracic Doppler echocardiography (TDE) is a non-invasive and easy reproducible method to assess the left internal mammary artery (LIMA) graft patency after coronary artery bypass graft surgery (CABG). LIMA graft dysfunction is rare, its rate being 10% at 10 to 15 years after revascularization. The most common cause of graft dysfunction is the competitive flow with the native coronary artery, when the stenosis of the bypassed vessels is not severe.