Interventional cardiology news to note
Diabetes patients had similar outcomes from coronary artery bypass grafting (CABG) as from percutaneous coronary intervention (PCI) for left main coronary artery disease, like the rest of the EXCEL cohort. (Journal of the American College of Cardiology)
Among alternate approaches to transcatheter aortic valve replacement with the Sapien 3 valve, trans-subclavian and transaxillary access are growing in popularity, according to data from the TVT Registry. These approaches were associated with lower 30-day mortality and shorter hospital stays -- but more stroke compared with going the transapical or transaortic route. (JACC: Cardiovascular Interventions)
Women getting catheter ablation for atrial fibrillation experienced more complications and 30-day readmissions than men -- but they still paid less due to lower resource use, according to an analysis of the U.S. Nationwide Readmissions Database. (European Heart Journal)
Catheter ablation may be a promising treatment for post-MI refractory ventricular fibrillation storm, based on a small observational study in Circulation.
The newer Cera and Figulla septal occludersperformed on par with Amplatzer in a small prospective study conducted at one Indian center. "Modified structural new designs do not show any advantages on the procedural complications on early and mid-term follow-up, but long-term studies are warranted," the authors reported in EuroIntervention.
In the PARADIGM study, patients with highly-calcific carotid stenoses were left with more residual stenosis than other patients after carotid artery stenting with the CGuard dual-layer stent (9% vs 3% without such calcification, P=0.002). By 12 months, however, in-stent velocities were normal and no adverse events occurred. (Catheterization and Cardiovascular Interventions)
Analysis of decisions by heart team members at one London hospital showed "a careful selection process resulting in appropriate patient‐specific decision making." Patients with complex coronary artery disease (CAD) were more often picked for PCI if they were older and had chronic kidney disease and/or peripheral artery disease. Those with cardiogenic shock and left ventricular dysfunction were especially unlikely to get CABG, whereas younger patients with three-vessel CAD were more often recommended for surgery. (Journal of the American Heart Association)
Read the original article on Medpage Today: TAVR Alternate Access Options; VF Storm Ablation; Heart Team Decision-Making