Conventional mitral valve surgery for degenerative mitral valve disease is associated with morbidity and mortality. The first-in-man experience with a novel poltetrafluoroethylene knot implantation device (Harpoon TSD-5) implanted through a small left thoracotomy has demonstrated 100% procedural success with minimal residual MR and significant reductions in end-diastolic volume and left atrial volume.
The natural history of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are uncertain. An Australian study has indicated ARF recurrence and progression to RHD are highest in the first year after the initial episode. The development of complications such as heart failure, AF, endocarditis, and stroke were highest in the first year after the diagnosis of RHD.
The PARADIGM-HF trial has confirmed the safety and efficacy of LCZ696 in the treatment of heart failure (HF). Assessment of the risk of 30-day readmission for any cause following investigator-reported HF hospitalization has indicated that the combination of enalapril and LCZ696 reduces 30-day readmissions and this was maintained when the time window was extended to 60 days.
Despite a number of models predicting the risk of bleeding in patients with AF who require anticoagulation, bleeding remains a major issue in such patients. Combining data from both the ARISTOTLE and RE-LY study, investigators have recommended a novel prediction model incorporating age, history of bleeding, and biomarkers GDF-15, cTNT-hs, and hemoglobin which has been shown to outperform the HAS-BLED and ORBIT scores.
TAVR is increasingly being recognized as the treatment of choice in patients with symptomatic severe aortic stenosis who are considered high-risk for surgery. 3-year follow-up data from 750 patients has indicated that as compared with SAVR, TAVR is associated with lower all-cause mortality, stroke, and MACCE. TAVR was associated with greater moderate or severe residual aortic regurgitation.
Nicole Lou Reporter, MedPage Today/CRTonline.org
Peter K. Smith, M.D., et al.
Darren Mylotte, et al.
H Kamel, et al.; Circ 2016; 134:527-533
V Auffret, et al.; JACC 2016; 68:673-684
S Haussig, et al. ; JAMA 2016; 316:592-601
What is your first line of therapy for restenosis of DES?
Drug Coated Balloon
Another Drug Eluting Stent
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