Publications by authors named "Teles R"
Background And Aim: Diabetes has been shown in last decades to be associated with a significantly higher mortality among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI (PPCI). Therefore, the aim of current study was to evaluate the impact of diabetes on times delays, reperfusion and mortality in a contemporary STEMI population undergoing PPCI, including treatment during the COVID pandemic.
Methods And Results: The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry involving PPCI centers from Europe, Latin America, South-East Asia and North-Africa, including patients treated from 1st of March until June 30, 2019 and 2020.
Background: Hypertension is the most prevalent cardiovascular risk factor, with several detrimental effects on the cardiovascular system. Contrasting results have been reported so far on its prognostic role in patients admitted for ST-segment elevation myocardial infarction (STEMI). Therefore, we investigated the impact of hypertension on short-term mortality in a large multicenter contemporary registry of STEMI patients, including patients treated during COVID-19 pandemic.
View Article and Find Full Text PDFThe percutaneous treatment of structural, valvular, and non-valvular heart disease (SHD) is rapidly evolving. The Core Curriculum (CC) proposed by the EAPCI describes the knowledge, skills, and attitudes that define competency levels required by newly trained SHD interventional cardiologists (IC) and provides guidance for training centres. SHD ICs are cardiologists who have received complete interventional cardiology training.
View Article and Find Full Text PDFArticle Synopsis
- The percutaneous treatment of structural heart disease (SHD) is advancing quickly, with the EAPCI's Core Curriculum (CC) defining the necessary competencies for newly trained interventional cardiologists (IC).
- SHD interventional cardiologists manage adult patients throughout the entire treatment process, requiring skills in advanced imaging and planning software, as well as proficiency in procedures related to the aortic, mitral, and tricuspid heart valves.
- Completing specialized SHD training typically takes at least 18 months, though it can be shortened to 1 year for focused training on specific areas, with the goal of promoting standardized, high-quality training across Europe for better patient care and future certifications.
Introduction And Objectives: Transcatheter mitral valve replacement (TMVR) is an emerging treatment alternative for mitral valve (MV) disease in patients who were ineligible for surgical intervention or edge-to-edge repair. This study aimed to assess the short- and mid-term outcomes of this procedure.
Methods: We conducted a prospective registry to include the initial experience with symptomatic, consecutive patients who underwent TMVR using the transapical Tendyne system at 7 centers in the Iberian Peninsula.
Despite progressively uncommon in Western countries, rheumatic heart disease still portrays a significant global burden. In elderly or high-surgical risk patients, plurivalvular disease may require a complex percutaneous approach. Transcatheter aortic valve implantation (TAVI) in patients with previous monoleaflet mitral prosthesis is challenging due to interference between the aortic valve and the rigid mitral mechanical prosthesis "ring.
View Article and Find Full Text PDFExtracellular vesicles (EVs) are small lipid bilayer vesicles released by cells to facilitate cell-to-cell communication. To study their biological roles and functions, they need to be isolated and purified, which can be achieved through a variety of methods. Here, we describe different methods for isolating and purifying EVs, with a focus on calculating the required g-force and centrifugation time with different centrifuges and rotors.
View Article and Find Full Text PDFBackground: Patients with severe aortic stenosis (AS) frequently present with concomitant obstructive coronary artery disease (CAD). In those, current guidelines recommend combined coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR) as the preferred treatment option, although this surgical approach is associated with a high rate of clinical events. Combined transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) with or without FFR have evolved as a valid alternative for cardiac surgery in patients with AS and multivessel or advanced CAD.
View Article and Find Full Text PDFEuropean Society of Cardiology quality indicators for the care and outcomes of adults undergoing transcatheter aortic valve implantation.
Eur Heart J Qual Care Clin Outcomes
December 2024
Aims: To develop a suite of quality indicators (QIs) for the evaluation of the care and outcomes for adults undergoing transcatheter aortic valve implantation (TAVI).
Methods And Results: We followed the European Society of Cardiology (ESC) methodology for the development of QIs. Key domains were identified by constructing a conceptual framework for the delivery of TAVI care.
Impact of the COVID-19 Pandemic on Global TAVR Activity: The COVID-TAVI Study.
JACC Cardiovasc Interv
February 2024
Article Synopsis
- The COVID-19 pandemic led to significant treatment delays for patients needing transcatheter aortic valve replacement (TAVR), with a marked decrease in procedure volumes during the first two waves of the pandemic.
- The study analyzed TAVR case data from 130 centers in 61 countries, finding a 15% drop in cases during the first wave and 7% in the second, particularly affecting regions like Africa, Central-South America, and Asia.
- Factors such as hospital type (private vs public), urban vs rural location, low procedure volumes, a country's socioeconomic status, and stringent public health measures contributed to these reductions, highlighting the need for improved public health policies for future health crises.
Introduction: The COVID-19 pandemic has highlighted the need to identify mechanisms of antiviral host defense against SARS-CoV-2. One such mediator is interferon-g (IFN-γ), which, when administered to infected patients, is reported to result in viral clearance and resolution of pulmonary symptoms. IFN-γ treatment of a human lung epithelial cell line triggered an antiviral activity against SARS-CoV-2, yet the mechanism for this antiviral response was not identified.
View Article and Find Full Text PDFObjective: Aortic stenosis and coronary artery disease (CAD) are frequently associated. The preprocedural evaluation and indications for treatment in patients undergoing transcatheter aortic valve intervention (TAVI) remain controversial. This study sought to 1) determine the prevalence and angiographic characteristics of CAD in TAVI candidates, along with revascularization patterns, and 2) to evaluate the impact of the presence and complexity of CAD, as well as angiography-guided percutaneous coronary intervention, on prognosis after TAVI.
View Article and Find Full Text PDFArticle Synopsis
- - The study investigates how prosthesis-patient mismatch (PPM) after transcatheter aortic valve implantation (TAVI) affects patient outcomes, particularly focusing on balloon-expandable and self-expandable valves in patients with small aortic annuli.
- - Data was analyzed from a retrospective registry of 628 patients with severe aortic stenosis, revealing that those with severe PPM had a higher risk of all-cause mortality compared to those with less than moderate PPM, particularly after implantation of certain valve types.
- - The findings conclude that patients with small aortic annuli and severe PPM face increased early mortality risk, while the use of supra-annular valves (SAV) appears to protect against severe PPM
Article Synopsis
- There has been a significant increase in the use of transcatheter aortic valve implantation (TAVI) to treat symptomatic severe aortic stenosis, prompting the need for streamlined procedures in specialized Heart Valve Centres.
- The 2022 European TAVI Pathway Survey collected input from 147 TAVI centres in 26 countries, revealing details about their procedural practices and patient management.
- Findings indicate that while minimalist TAVI methods are widely adopted, many patients still experience longer hospital stays, suggesting room for improvement in discharge processes.
Article Synopsis
- Valvular heart disease (VHD) is a leading cause of heart failure and is often challenging to manage, especially in patients receiving conservative treatment.
- Recent advancements in catheter-based interventions have expanded treatment options for both high-risk and lower-risk patients, potentially benefiting a broader range of individuals with VHD.
- This clinical consensus statement aims to evaluate the evidence for managing cardiogenic shock related to left-sided VHD and propose a practical approach for using less invasive transcatheter interventions in challenging situations where traditional surgery poses high risks.
Article Synopsis
- - The study aimed to evaluate the long-term effectiveness of the Portico valve in transcatheter aortic valve implantation (TAVI) for elderly patients with severe aortic valve stenosis, focusing on outcomes like death and complications.
- - Data from 803 patients, mainly older adults with a median age of 82, showed that over three years, 37.5% experienced major adverse events, with all-cause death at 35.1% and low rates for stroke (3.4%) and myocardial infarction (1.0%).
- - Results indicate that the Portico valve provides favorable long-term outcomes, though risk factors such as peripheral artery disease and chronic obstructive pulmonary disease significantly influenced patient prognosis. *
Background And Aim: Parenteral anticoagulation is recommended for all patients presenting with ST-segment elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (PPCI). Whether upstream anticoagulation improves clinical outcomes is not well established. We conducted a systematic review and meta-analysis of contemporary evidence on parenteral anticoagulation timing for STEMI patients.
View Article and Find Full Text PDFBackground: Prospective data about transcatheter aortic valve implantation (TAVI) in bicuspid aortic valve (BAV) patients are limited.
Aims: We aimed to evaluate the clinical impact of the Evolut PRO and R (34 mm) self-expanding prostheses in BAV patients and explore the impact of different computed tomography (CT) sizing algorithms in a prospective registry.
Methods: A total of 149 bicuspid patients were treated in 14 countries.
Objective: The aim of this study was to optimize the sensitivity, specificity and cost-effectiveness of the RNA-Oligonucleotide Quantification Technique (ROQT) in order to identify periodontal pathogens that remain unrecognized or uncultured in the oral microbiome.
Design: Total nucleic acids (TNA) were extracted from subgingival biofilm samples using an automated process. RNA, DNA and Locked Nucleic Acid (LNA) digoxigenin-labeled oligonucleotide probes targeting 5 cultivated/named species and 16 uncultivated or unnamed bacterial taxa were synthesized.
Background: Transaxillary (TAx) transcatheter aortic valve implantation (TAVI) is a preferred alternative access in patients ineligible for transfemoral TAVI.
Aims: This study used the Trans-AXillary Intervention (TAXI) registry to compare procedural success according to different types of transcatheter heart valves (THV).
Methods: For the TAXI registry anonymized data of patients treated with TAx-TAVI were collected from 18 centers.
Article Synopsis
- * A study involving over 16,600 STEMI patients found a 16% reduction in PPCI procedures in 2020 compared to 2019, with the elderly experiencing the most significant delays.
- * Consequently, there was a notable increase in 30-day mortality rates during the pandemic, particularly among older patients, attributed to longer ischemia times and treatment delays.
Background: Treatment of aortic stenosis in patients with small annuli is challenging and can result in prosthesis-patient mismatch (PPM).
Aims: We aimed to compare the forward flow haemodynamics and clinical outcomes of contemporary transcatheter valves in patients with small annuli.
Methods: The TAVI-SMALL 2 international retrospective registry included 1,378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm) treated with transfemoral self-expanding (SEV; n=1,092) and balloon-expandable valves (BEV; n=286) in 16 high-volume centres between 2011 and 2020.
Background: Initial data about the performance of the new-generation SAPIEN 3 Ultra (S3U) valve are highly promising. However, evidence about the longer-term performance and safety of the S3U is scarce.
Aims: We aimed to investigate the 1-year clinical and echocardiographic outcomes of transcatheter aortic valve implantation (TAVI) using the S3U compared with its predecessor, the SAPIEN 3 valve (S3).
Background: Sex-specific characteristics in patients with aortic stenosis and small annuli undergoing transcatheter aortic valve implantation (TAVI) might affect clinical outcomes and hemodynamics.
Methods: TAVI-SMALL 2 international retrospective registry included 1378 patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area < 400 mm2) treated with transfemoral TAVI at 16 high-volume centers between 2011 and 2020. Women (n = 1233) were compared with men (n = 145).