Short- and intermediate-term outcomes of transcatheter aortic valve replacement in low-risk patients: A meta-analysis and systematic review.

Background: Transcatheter aortic valve replacement (TAVR) being currently employed in low surgical risk patients with severe symptomatic aortic stenosis (AS). The durability and extended outcomes of TAVR as compared to surgical aortic valve replacement (SAVR) in low-risk patients remains uncertain.

Methods: We selected randomized controlled trials (RCT) comparing outcomes of TAVR vs.

Sodium-Glucose Cotransporter-2 Inhibitors and Primary Prevention of Atherosclerotic Cardiovascular Disease: A Meta-Analysis of Randomized Trials and Systematic Review.

Background Sodium-glucose cotransporter-2 (SGLT2) inhibitors reduce atherosclerotic cardiovascular disease (ASCVD) events in patients with prior ASCVD and type 2 diabetes; however, this benefit is uncertain in patients without established ASCVD. Methods and Results Large-scale cardiovascular outcome randomized controlled trials or their prespecified subgroup analyses were selected, evaluating SGLT2 inhibitors versus placebo for primary prevention of ASCVD (inception, March 2023). The primary outcome was atherosclerotic major adverse cardiovascular events (MACEs), which was a composite of cardiovascular mortality, myocardial infarction, and stroke.

Assessment of Repeat Revascularization in Percutaneous Coronary Intervention Randomized Controlled Trials as a Surrogate for Mortality: A Meta-Regression Analysis.

The association of repeat revascularization after percutaneous coronary intervention (PCI) with mortality is uncertain. To assess the association of repeat revascularization after PCI with mortality in patients with coronary artery disease (CAD). We identified randomized controlled trials comparing PCI with coronary artery bypass graft (CABG) or optimal medical therapy (OMT) using electronic databases through January 1, 2022.

Tips and Tricks for Successful Trans-EVAR TAVR: Buddy up!

Described is challenging trans-catheter aortic valve replacement (TAVR) procedure done via tortuous iliofemoral access with prior endovascular aneurysm repair. Detailed pre-procedural planning enabled the operators to overcome the challenges while employing the following 4 strategies: Although trans-EVAR TAVR remains somewhat unpredictable, especially these 4 strategies may simplify and reduce the inherent failure rate of such procedures.

Two-Step V-Stenting and Simultaneous Kissing Stent via 6F Guides: Simple Just Got Simpler.

V-stenting (VS) and simultaneously kissing stents (SKS) upfront 2-stent strategies for treating large diameter bifurcations and especially distal left main coronary artery (LMCA) disease. Former teaching suggests that the minimal requirements for VS and SKS requires 8F guiding catheters or 7.5F sheathless guide.

Trends in Premature Mortality From Acute Myocardial Infarction in the United States, 1999 to 2019.

Background Evaluating premature (<65 years of age) mortality because of acute myocardial infarction (AMI) by demographic and regional characteristics may inform public health interventions. Methods and Results We used the Centers for Disease Control and Prevention's WONDER (Wide-Ranging Online Data for Epidemiologic Research) death certificate database to examine premature (<65 years of age) age-adjusted AMI mortality rates per 100 000 and average annual percentage change from 1999 to 2019. Overall, the age-adjusted AMI mortality rate was 13.

Ipsilateral Protection and Bailout for Large-Bore Access.

This manuscript describes the refinements of ipsilateral wire protection and bailout strategy for large-bore femoral access and especially transcatheter aortic valve replacement. This ipsilateral wire protection requires no additional expenses and can provide effective arteriotomy site protection without the need for contralateral femoral access, especially in cases when contralateral wiring and crossover are not feasible. Ipsilateral wiring can be done both as prophylactic protection and as bailout strategy.

Transcatheter versus surgical aortic valve replacement in patients with end stage renal disease.

Objective: To assess contemporary national trends of comorbidities, outcomes, and health care resource utilization in patients with aortic stenosis (AS) and end-stage renal disease (ESRD) undergoing transcatheter and surgical aortic valve replacement (TAVR and SAVR).

Methods And Results: The National-Inpatient-Sample was used to study trends in patients with AS and ESRD undergoing TAVR and SAVR between January 2012 and December 2017. Of 12,550 patients, 5,735 underwent TAVR and 6,815 underwent SAVR.

Meta-Analysis of Catheter Ablation versus Medical Therapy in Patients with Atrial Fibrillation Without Heart Failure.

Introduction: Catheter ablation has shown to reduce mortality in patient with atrial fibrillation (AF) and heart failure (HF) with reduced ejection fraction. Its effect on mortality in patients without HF has not been well elucidated.

Methods: Thirteen randomized controlled trials encompassing 3856 patients were selected using PubMed, Embase and the CENTRAL till April 2019.

Transcatheter mitral valve repair in patients with chronic liver disease: Insights from the national inpatient sample.

Objective: To evaluate contemporary national trends of morbidity, mortality, and healthcare utilization in patients with mitral regurgitation (MR) and co-existing chronic liver disease (CLD) undergoing transcatheter mitral valve repair (TMVR).

Methods: The National Inpatient Sample (NIS) was used to assess trends in patients undergoing TMVR between January 2012 and December 2017. Propensity match analysis was done to compare it to subjects without underlying CLD.

Transcatheter valve-in-valve aortic valve replacement with bioprosthetic valve Fracture/Stretching technique in a degenerated mitroflow valve.

We describe a successful bioprosthetic annular stretching in a patient with severe prosthetic aortic valve stenosis from a degenerated 19-mm Mitroflow valve (Sorin Group USA Inc, Arvada, CO, USA). This technique allowed for implantation of a 23-mm Evolut-R Pro valve (Medtronic, Minneapolis, MN, USA) with significant improvement in hemodynamics after prosthetic annular stretching. We have also summarized other case series and case reports which have previously described similar techniques.

Efficacy and safety of low dose rivaroxaban in patients with coronary heart disease: a systematic review and meta-analysis.

The mortality effects and risk-benefit profile of low dose rivaroxaban (2.5 mg twice daily) in patients with coronary heart disease are not completely understood. Five randomized controlled trials (26,110 patients) were selected using PubMed and Cochrane library till April 2019.

De-escalation of antiplatelets after percutaneous coronary intervention: a Bayesian network meta-analysis of various de-escalation strategies.

Aims: To compare early de-escalation of dual antiplatelet therapy (DAPT) (1-3 months) to monotherapy with either P2Y12 inhibitor or aspirin vs. 12 months DAPT after percutaneous coronary intervention (PCI) with drug-eluting stent (DES).

Methods And Results: Electronic databases of Medline, Embase, and Cochrane library were searched through February 2020 to identify randomized controlled trials.