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Interventional/Surgery

No time like the present: Study supports early mitral-valve repair in asymptomatic patients

7 COMMENTS - Feb 1, 2010 13:45 EST

In a study of 4586 patients with severe degenerative mitral regurgitation, even mild heart-failure symptoms are associated with decline in cardiac function, suggesting that early valve surgery will yield better long-term outcomes than surgery after symptoms become manifest.

Fort Lauderdale, FL - The authors of a large study of mitral-valve repair in asymptomatic patients argue in favor of early surgery, when the chances of procedural success are highest, instead of waiting for heart-failure symptoms to appear [1].

Current American College of Cardiology/American Heart Association (ACC/AHA) guidelines suggest that surgery is acceptable in mitral-regurgitation patients with no symptoms or changes in the left ventricle, if the chances of surgery success are at least 90%. However, the majority of patients in the US meeting these criteria do not have early surgery, lead author Dr A Marc Gillinov (Cleveland Clinic, OH) explained to heartwire. "The problem with this strategy is that delay, in some patients, results in damage to the left ventricle." Read full article »

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Interventional/Surgery

DES Comparisons: Insights From Late-term Follow-up

1 COMMENT - Dec 21, 2009 11:25 EST

COMPARE, ENDEAVOR IV, SIRTAX-LATE, SPRIT IV -- given the abundance of data comparing the various DES are there any patterns emerging? Dr. King leads a panel discussion with Drs. Cohen and Williams.

Interventional/Surgery

PCI in Left Main Disease: Are We There Yet?

4 COMMENTS - Nov 11, 2009 11:41 EST

SYNTAX and MAIN-COMPARE suggest a role for PCI in subsets of patients with left main disease; however, in current ACC/AHA guidelines this remains a class III indication. Dr. Turco chairs a roundtable with interventionalists Drs Kandzari and Park and surgeon Dr Sabik.

Interventional/Surgery

Emerging Stent Technologies: Adding Innovation and New Science to Clinical Practice

5 COMMENTS - Oct 20, 2009 13:38 EDT

Dr. Dean Kereiakes leads an international panel of experts, Drs. Meredith, Banning, and Hermiller, as they discuss fascinating developments in stent and polymer technology and design their "dream stent."

Interventional/Surgery

There's Triple Vessel Disease and Triple Vessel Disease: Risk Assessment

3 COMMENTS - Jun 22, 2009 08:08 EDT

How do the results of the SYNTAX trial impact clinical practice now? Join Drs. Banning and Hill as they present a complex case taken directly from the SYNTAX trial and discuss how new data will impact their choice of treatment, and listen to an overview of the trial presented by Dr. William Wijns.

Interventional/Surgery

Percutaneous Pulmonary Valve Implantation

1 COMMENT - Dec 3, 2009 12:21 EST

The percutaneous pulmonary valve (PPV) was the first transcatheter valve developed. Dr. Ziyad Hijazi discusses this work with PPV inventor, Dr. Philipp Bonhoeffer, including the European and US experience so far in patients with prior right ventricular outflow tract surgery.

Interventional/Surgery

TAVI vs AVR Patient Selection

Oct 27, 2009 14:49 EDT

The PARTNER and PAVIS trials of transcatheter aortic valve implementation will include inoperable or very high-surgical-risk patients. In Europe, where the devices have been approved for a few years, the technology is being expanded to lesser-risk patients. Interventionalist Dr Jeffrey Popma discusses the selection of patients with surgeon Dr Mathew Williams.

Imaging

Trials and Tribulations: Debating Controversial Topics in Cardiovascular Disease

Dec 21, 2009 09:48 EST

Fellows from The Mayo Clinic, Duke University, and The Cleveland Clinic discuss challenging cases with their mentors.

Interventional/Surgery

Drug-Eluting Stents: Head-to-Head Clinical Trial Results

2 COMMENTS - Oct 16, 2009 11:06 EDT

How do drug-eluting stents compare? Our panel of experts, Drs. Stone, Kereiakes, Serruys, and Windecker discuss the late-breaking trials at TCT 2009 of DES vs DES.

Clinical cardiology

New Data on Polyvascular Disease and ACS

1 COMMENT - Jun 23, 2009 09:40 EDT

Recently published data suggest that prior polyvascular disease increases the risk for inhospital adverse events in patients with ACS. Join Drs. Deepak Bhatt, Jean-Pierre Bassand, and José R. Gonzalez-Juanatey for a discussion of the current data on identification and management of patients with polyvascular disease.

Clinical cardiology

Combination Therapy and Cardiovascular Events: A Neurologist's Perspective

1 COMMENT - Jun 17, 2009 11:48 EDT

AF can lead to stroke, congestive heart failure, and other serious complications. Successful management should include reducing these risks. Join our expert panel, Drs. Peter Rothwell, Donald Easton, and Mark Alberts, as they discuss new data and strategies for improving outcomes in patients with AF.

Clinical cardiology

2009 Antiplatelet Debate: What's New in ACS

7 COMMENTS - Jun 12, 2009 15:03 EDT

Despite modern therapy, the rates of death, MI, bleeding, and readmission remain high in patients with ACS. Join Drs. Jeffery Popma, Héctor Bueno, Freek Verheugt, and Sunil. Rao for a review of the latest data on antiplatelet therapy for patients with ACS.

Interventional/Surgery

Sirolimus-eluting stent beneficial for in-stent restenosis

Feb 9, 2010 10:30 EST

The overall rate of target lesion revascularization after sirolimus-eluting-stent implantation was 11% at four years, with an overall incidence of stent thrombosis of less than 1% annually, report investigators.

Prevention

Repeatedly telling patients of their coronary disease risk improves outcomes

Feb 8, 2010 17:00 EST

Providing patients with their global coronary heart disease risk appears to improve the accuracy of their risk perception, and repeating risk information improves outcomes slightly, according to a review of 20 studies.

Imaging

Zero means nothing: "Gatekeeper" role of calcium scoring questioned

2 COMMENTS - Feb 8, 2010 17:00 EST

Zero coronary calcification does not exclude obstructive stenosis or the need for revascularization in patients referred for coronary angiography, according to a new substudy of the CORE 64 study.

Arrhythmia/EP

A good report card for laser-assisted pacemaker/ICD lead extraction

Feb 5, 2010 09:30 EST

Non-procedure-related clinical issues, such as diabetes or device-related infection, are a major cause of poor procedural and clinical outcomes; still, the overall success rate is high, and complication rate is very low, suggests a multicenter experience of >1400 cases.

heartbriefs

Statins fail to slow progression of small AAAs

2 COMMENTS - Feb 4, 2010 15:45 EST

The negative results, according to researchers, highlight the need for more research to develop medications targeted specifically at reducing abdominal aortic aneurysm growth.

News

Procedure volume is a close proxy for popular hospital quality rankings

1 COMMENT - Feb 3, 2010 14:30 EST

A study comparing cardiovascular outcomes at the "best hospitals," according to two popular hospital ranking systems, shows that the systems do identify high-quality hospitals, but not all of them.

Clinical cardiology

Herbal heartache: New review reminds cardiologists to query supplement use

Feb 1, 2010 17:00 EST

More than 15 million people in the US alone take herbal remedies and/or vitamins at doses that may be interacting with their cardiovascular medications, potentially putting them at risk.

Thrombosis

No rebound effect with platelets after stopping clopidogrel

Feb 1, 2010 17:00 EST

Tapering off clopidogrel treatment after the implantation of a drug-eluting stent does not result in lower platelet-aggregation values than those seen after the antiplatelet medication is abruptly stopped.

Interventional/Surgery

POPE published: Avoid NSAIDs for asymptomatic pericardial effusions

1 COMMENT - Feb 1, 2010 17:00 EST

Diclofenac does not reduce pericardial effusions, according to the POPE study. This should signal the end of routine use of NSAIDs in this indication, comments an expert.

Interventional/Surgery

Best timing of surgery for active mitral endocarditis remains controversial

2 COMMENTS - Feb 1, 2010 11:30 EST

A small study suggests supports the safety of early surgery for mitral regurgitation in the setting of endocarditis, instead of waiting for the usual six weeks for antibiotics to work.

Imaging

OCT finds additional at-risk lesions in AMI patients

4 COMMENTS - Jan 29, 2010 13:45 EST

The study is one of the first to compare rates of thin-cap, or vulnerable, plaques in AMI survivors and stable-angina patients, identifying important differences.

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Editorial Programs

Editorial series

Technology and the future of cardiovascular care

Feb 4, 2010 15:00 EST

Dr Eric Topol talks to heartwire's Shelley Wood about remote monitoring, individualized medicine, and the changing face of cardiovascular care.

Editorial series

The PLATO STEMI subanalysis: Will ticagrelor become the new go-to drug for antiplatelet therapy?

Jan 29, 2010 10:30 EST

Watch Drs Bob Harrington, Sanjay Kaul, and Gregg Stone as they debate the future of ticagrelor in a discussion moderated by heartwire's Lisa Nainggolan.

Editorial series

Perspectives from AHA 2009: Wrapping up the Scientific Sessions with Clyde Yancy and Nancy Brown

Dec 2, 2009 11:15 EST

AHA president Dr Clyde Yancy and CEO Nancy Brown share insights from the recent sessions and discuss ongoing initiatives with heartwire's Shelley Wood.