Publications by authors named "Juan H Alonso Briales"
Background: Severe aortic stenosis (AS) coexists with coronary artery disease (CAD) in approximately 50% of patients. The preferred treatment is combined surgical aortic valve replacement (SAVR) and coronary artery bypass grafting (CABG). However, transcatheter aortic valve replacement (TAVR) along with percutaneous coronary intervention (PCI) has emerged as a viable alternative.
View Article and Find Full Text PDFSpanish cardiac catheterization and coronary intervention registry. 33rd official report of the Interventional Cardiology Association of the Spanish Society of Cardiology (1990-2023).
Rev Esp Cardiol (Engl Ed)
November 2024
Article Synopsis
- The article reviews the 2023 activity report from the Interventional Cardiology Association of the Spanish Society of Cardiology, highlighting key trends in interventional cardiology practices in Spain.
- A survey involving 119 hospitals revealed a slight decrease in diagnostic studies but an increase in percutaneous coronary interventions (PCI), with a notable rise in the use of drug-coated balloons and techniques for plaque modification.
- The findings indicate a stabilization in coronary interventions while showcasing a growth in complex procedures, particularly for valvular and nonvalvular structural heart diseases, with primary PCI becoming the leading treatment for myocardial infarction.
Transcatheter aortic valve implantation (TAVI) now represents the mainstay of treatment for severe aortic stenosis. Owing to its exceptional procedural efficacy and safety, TAVI has been extended to include patients at lower surgical risk, thus now encompassing a diverse patient population receiving this treatment. Yet, long-term outcomes also depend on optimal medical therapy for secondary vascular prevention, with antithrombotic therapy serving as the cornerstone.
View Article and Find Full Text PDFArticle Synopsis
- This article reports on the annual activities of the Interventional Cardiology Association of the Spanish Society of Cardiology for 2022.
- A total of 111 centers participated, revealing a 4.8% increase in diagnostic studies and a significant 22% rise in PCIs on the left main coronary artery, while the overall PCI numbers remained stable.
- Key trends included a preference for the radial approach in 94.9% of cases, increased use of drug-eluting balloons and intracoronary imaging, and a continuous rise in noncoronary procedures, especially those related to heart valve and structural heart issues.
Introduction And Objectives: Transcatheter edge-to-edge repair (TEER) should be considered in patients with heart failure and secondary mitral regurgitation (MR). Angiotensin receptor-neprilysin inhibitors (ARNIs) have been demonstrated to improve prognosis in heart failure. We aimed to evaluate the impact ARNIs on patient selection and outcomes.
View Article and Find Full Text PDFBackground And Objectives: Evidence regarding redo percutaneous interventions for recurrent mitral regurgitation is scarce. We ought to evaluate procedural and clinical outcomes of repeated edge-to-edge transcatheter mitral valve repair (TMVR) interventions.
Methods: This multicenter study collected individual data from eight high-volume TMVR Centers in Spain.
Background: Isolated atrial fibrillation can cause mitral regurgitation (MR) in patients with normal left ventricular systolic function and no organic disease of the mitral valve. Little information is available regarding outcomes of Mitraclip in patients with atrial functional mitral regurgitation (AFMR). We aimed to evaluate 12-month clinical and echocardiographic outcomes of transcatheter mitral valve repair (TMVR) with MitraClip in patients with AFMR compared to those with ventricular functional or degenerative/mixed MR.
View Article and Find Full Text PDFBackground And Aim: Recent randomized data comparing percutaneous mitral valve repair (PMVR) versus optimal medical treatment in patients with functional MR (FMR) seemed to highlight the importance of the learning curve not only for procedural outcomes but also for patient selection. The aim of the study was to compare a contemporary series of patients undergoing PMVR using a second-generation Mitraclip device (Mitraclip NT) with previous cohorts treated with a first-generation system.
Methods: This multicenter study collected individual data from 18 centers between 2012 and 2017.
The majority of familial hypercholesterolemia index cases (FH-IC) remain underdiagnosed and undertreated because there are no well-defined strategies for the universal detection of FH. The aim of this study was to evaluate the diagnostic yield of an active screening for FH-IC based on centralized analytical data. From 2016 to 2019, a clinical screening of FH was performed on 469 subjects with severe hypercholesterolemia (low-density lipoprotein cholesterol ≥220 mg/dL), applying the Dutch Lipid Clinic Network (DLCN) criteria.
View Article and Find Full Text PDFBackground: In catheter-based procedures, acute kidney injury (AKI) is a frequent, serious complication ranging from 10% to 30%. In MitraClip (Abbott Vascular, Santa Clara, California), a usually contrast-free procedure, there is scarce data about its real incidence and impact.
Objectives: This study aimed to evaluate incidence, predictive factors, and midterm outcomes of AKI in patients with significant mitral regurgitation (MR) undergoing transcatheter valve repair with MitraClip.
Background: Transcatheter mitral valve repair (TMVR) could improve survival in functional mitral regurgitation (FMR), but it is necessary to consider the influence of left ventricular ejection fraction (LVEF). Therefore, we compare the outcomes after TMVR with Mitraclip between two groups according to LVEF.
Methods: In an observational registry study, we compared the outcomes in patients with FMR who underwent TMVR with and without LVEF <30%.
Introduction And Objectives: Transcatheter mitral valve repair (TMVR) with MitraClip is a therapeutic option for high surgical risk patients with severe mitral regurgitation (MR). The main objective of this study was to analyze differences in outcomes in patients with severe MR according to the cause of MR.
Methods: Observational, multicenter, and prospective study with consecutive patient inclusion.
Article Synopsis
- * Several studies show that transcatheter aortic valve replacement (TAVR) benefits patients with aortic stenosis, but persistent fibrosis and myocardial hypertrophy can lead to worse outcomes.
- * This study aimed to investigate the effects of renin-angiotensin system (RAS) inhibitors on heart remodeling and clinical outcomes after TAVR in patients with severe aortic stenosis.
- * The results demonstrated that RAS inhibitor treatment was linked to reduced left ventricular hypertrophy, lower cardiovascular mortality at three years, and fewer incidents of new atrial fibrillation and cerebrovascular events.
Background: The impact of preexisting left bundle branch block (LBBB) in transcatheter aortic valve replacement (TAVR) recipients is unknown. The aim of this study was to determine the impact of preexisting LBBB on clinical outcomes after TAVR.
Methods And Results: This multicenter study evaluated 3404 TAVR candidates according to the presence or absence of LBBB on baseline ECG.
Article Synopsis
- Malnutrition significantly affects the prognosis of patients undergoing transcatheter aortic valve replacement (TAVR), and this study aimed to assess the prevalence and mortality risk linked to the nutritional risk index (NRI) in this population.
- The study analyzed data from 941 TAVR patients and categorized them into four groups based on their NRI scores, revealing that 48% were at moderate or severe nutritional risk.
- Findings indicated that patients at moderate or severe nutritional risk had a 45% higher risk of mortality during follow-up compared to those with no or mild risk, suggesting that the NRI could be a valuable tool for predicting outcomes in TAVR patients.
Article Synopsis
- The authors studied the learning curve and annual case volume needed for successful outcomes in transcatheter aortic valve replacement (TAVR), a complex heart procedure.
- They analyzed data from 3,403 patients across 16 centers and categorized their experience levels and annual case volumes to assess procedural and 30-day outcomes.
- Results indicated that lower operator experience and annual case volume correlated with higher mortality rates and poorer safety outcomes, highlighting the importance of training and experience in TAVR procedures.
Article Synopsis
- The study compared percutaneous revascularization and conservative treatment for severe lesions in secondary branches of epicardial arteries to evaluate their effectiveness in preventing cardiovascular events.
- After analyzing data from 679 lesions over an average follow-up of 22.2 months, there were no significant differences in outcomes between the two treatment methods, including rates of cardiovascular death and nonfatal myocardial infarction.
- Key factors linked to increased event occurrence included diabetes, history of acute myocardial infarction, and longer lesion length.
Introduction: Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement.
View Article and Find Full Text PDFObjectives: The aim of this study was to determine the prognosis and specific complications of patients with prosthetic mitral valves (PMVs) undergoing transcatheter aortic valve replacement (TAVR).
Background: TAVR is performed relatively often in patients with PMVs, but specific risks are not well described.
Methods: A multicenter analysis was conducted, including patients with severe symptomatic aortic stenosis who underwent TAVR at 10 centers.
Background: Despite rapidly increasing use of TAVR across institutions, limited data is available for the effect of procedural experience on TAVR outcomes. We investigate the relationship between institutional experience and TAVR outcomes.
Methods: 1953 patients undergoing TAVR at 8 international sites were grouped into chronological quantiles (Q) to assess temporal changes on procedural and clinical outcomes and multivariate logistic regression performed to determine predictors of device success, early safety and all-cause mortality.
Objectives: This study sought to assess the influence of baseline right bundle branch block (RBBB) on all-cause and cardiovascular mortality as well as sudden cardiac death (SCD) among patients undergoing transcatheter aortic valve replacement (TAVR).
Background: Few data exist regarding the late clinical impact of pre-existing RBBB in TAVR recipients.
Methods: A total of 3,527 patients (mean age 82 ± 8 years, 50.
Introduction And Objectives: Transcatheter aortic valve implantation (TAVI) is a safe and effective alternative to surgical treatment in patients with severe aortic stenosis (AS) and those who are inoperable or at high surgical risk. The primary objective of this study was to evaluate the long-term survival of consecutive patients with severe AS treated with TAVI.
Methods: Observational, multicenter, prospective, follow-up study of consecutive patients with severe symptomatic AS treated by TAVI in 3 high-volume hospitals in Spain.
Objectives: We aimed to determine whether body mass index (BMI) is a prognostic indicator for long-term, all-cause mortality in patients undergoing transcatheter aortic valve implantation (TAVI).
Background: Obesity in patients with established cardiovascular disease has previously been identified as an indicator of good prognosis, a phenomenon known as the "obesity paradox". The prognostic significance of BMI in patients with severe aortic stenosis (AoS) undergoing TAVI is a matter of current debate, as published studies are scarce and their results conflicting.