The Journal of invasive cardiology
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Multicenter Study Comparative Study
Transradial versus transfemoral intervention for the treatment of left main coronary bifurcations: results from the COBIS (COronary BIfurcation Stenting) II Registry.
We compared clinical outcomes of transradial (TR) and transfemoral (TF) percutaneous coronary interventions (PCI) in patients with left main coronary artery (LMCA) bifurcation lesions. ⋯ TR-PCI is a safe and effective vascular approach, even in patients with LMCA bifurcation lesions undergoing PCI with DES implantation.
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Acquired von Willebrand syndrome (aVWS) is a common complication of severe aortic valve stenosis and can be corrected by surgical valve replacement. Transcatheter aortic valve implantation (TAVI) is gaining importance, but the influence of this new technique on aVWS has never been examined. The objective of this study was to assess the impact of TAVI on aVWS. ⋯ Acquired von Willebrand syndrome due to aortic valve stenosis can successfully be corrected by TAVI.
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Mitral regurgitation (MR) is a complication that may occur during transcatheter aortic valve implantation (TAVI) in a certain percentage of cases and may require different treatments depending on the mechanism. Our purpose was to describe the occurrence rate of this complication during TAVI with the CoreValve prosthesis, as well as to assess the usefulness of transesophageal echocardiogram (TEE) in the detection of the mechanism of MR. ⋯ There is a certain percentage of patients treated with CoreValve prosthesis who develop significant MR during the procedure. TEE, unlike angiography, can define the very diverse mechanisms of MR in 100% of cases, and elucidates the best approach to this complication. Surgery was not required in any case.
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This is the first reported case of partial aortic valve and annulus rupture during transcatheter aortic valve replacement, and its successful management through percutaneous means. It stresses the fact that even severe procedural complications can often be treated by a heart team endovascularly, without requiring sternotomy.
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To provide a simplified, standardized methodology for a successful transfemoral transcatheter aortic valve replacement (TAVR) procedure with the Sapien XT valve in patients with severe aortic stenosis (AS). ⋯ Fluoroscopy-guided TAVR with the use of just analgesics with or without conscious sedation is safe and effective, and this potentially enables a more time-effective and cost-effective procedure. This paper provides simplified, stepwise guidance on how to perform transfemoral TAVR with the Sapien XT valve.