EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
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Left atrial appendage (LAA) closure for stroke prevention in the setting of non-valvular atrial fibrillation is an alternative to oral anticoagulation in patients with increased bleeding risk. It allows similar reduction in thromboembolic events, in particular stroke, compared to warfarin. ⋯ The specific definitions of leak severity, and the longer-term clinical implications are poorly understood. Here we review the mechanisms of incomplete occlusion for the different percutaneous closure devices, the data regarding thromboembolic risk in patients with incomplete appendage closure for both percutaneous and surgical strategies, and provide recommendations for management in these patients.
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Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). ⋯ In this observational study, the guideline-recommended ticagrelor-based primary DAPT regimen was associated with an increased event risk in consecutive ACS patients treated with newer-generation DES.
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Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV-in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aimed to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching. ⋯ Patients with aortic bioprosthesis failure treated with either redo-SAVR or TAV-in-SAV have similar 30-day and one-year clinical outcomes.