Lésions du tronc commun: Reste t il une place pour la chirugie? Pierre Deharo, CHU TIMONE, Marseille
|
|
- Evelyn Basil Jones
- 5 years ago
- Views:
Transcription
1 Lésions du tronc commun: Reste t il une place pour la chirugie? Pierre Deharo, CHU TIMONE, Marseille
2 Disclosure Statement of Financial Interest I currently have, or have had over the last two years, an affiliation or financial interests or interests of any order with a company or I receive compensation or fees or research grants with a commercial company : Speaker's name: Pierre, Deharo, MARSEILLE I do not have any potential conflict of interest
3 Guidelines: indications ESC guidelines, Eur Heart J 2014
4 Methods of revascularisation ESC guidelines, Eur Heart J 2014
5 LMS: evidence 5-y PRECOMBAT + SYNTAX LMS analyse Subgroup of negative study! Cavalcante, JACC 2016
6 SYNTAX calculator = a very complicated tool!
7 New evidence for LMS: What is the source of dilemna? EXCEL STUDY Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease. PCI non inferior to CABG Stone G et al. N Engl J Med Dec NOBLE STUDY Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. PCI NOT non inferior to CABG and CABG superior to PCI Mäkikallio T et al. Lancet Dec. 2016
8 EXCEL Study PCI non inferior to CABG for LM disease LM and SYNTAX<32 Xience stent, 28% BIMA CABG vs PCI, n= 1905 PEP= Death, MI, stroke Stone et al, NEJM 2016
9 NOBLE Study PCI not non-inferior to CABG for LM disease (HR>1.35) Left Main Biomatrix stent (>90%) CABG vs PCI, n= 1201, 8% BIMA PEP= Death, non procedural MI, stroke + Revasc Mäkikallio et al, Lancet 2016
10 Why different results? EXCEL study NOBLE study PEP without repeat revasc. PEP: All MI PEP with repeat revasc. PEP: Only non procedural MI 3 years FU 5 years FU Positive Study Non Inferiority of PCI Negative study No Non inferiority of PCI Superiority of CABG Stone et al, NEJM 2016 Mäkikallio et al, Lancet 2016
11 How study design impacts study results! EXCEL study: PEP NOBLE study: PEP CABG PCI CABG PCI Difference in KM curves Earlier (MI Definition / Early Hazard) Faster (Repeat Revasc. In PEP) Larger (Longer follow-up) Stone et al, NEJM 2016 Mäkikallio et al, Lancet 2016
12 EXCEL NOBLE All cause death Higher Higher CV death Equal Equal Periprocedural MI Lower* Lower Non Periprocedural MI Higher Higher* Revasc Higher* Higher* Stroke Lower Higher ST/SGO Lower* Lower PCI as reference * p<0,05 Stone, NEJM 2016 Makikallio, Lancet 2016
13 EXCEL NOBLE AF Lower* Lower* Transfusion Lower* Lower* Anemia Lower* Lower* PCI as reference * p<0,05 Stone, NEJM 2016 Makikallio, Lancet 2016
14 Revascularization strategy ESC guidelines, Eur Heart J 2014
15 Revascularization strategy STS Age SCA vs. SCAD Diabetes Compliance DAPT SYNTAX Ostial vs. Bifurcation Downstream bed CTO Previous failure All arterial Delays Imaging
16 Revascularization strategy SYNTAX Ostial vs. Bifurcation Downstream bed CTO Previous failure STS Age SCA vs. SCAD Diabetes Compliance DAPT CABG PCI - Hybride Final tailored decision All arterial Delays Imaging
17 One patient is one patient yo Current smoker EF 50% No comorbidity egfr 80 = RIMA to LCX + LIMA to LAD 86 yo COPD PAD Frail EF 30% egfr 40 = PCI to LMS/LAD 1 DES
18 Remaining questions in 2018
19 SYNTAX score 2016 Stone, NEJM 2016 Makikallio, Lancet 2016
20 Score SYNTAXII
21 Constant devices improvement Last generation stents in LMS - diabetes Systematic use of intracoronary imaging in LMS procedures Less invasive PCI (6 Fr radial) Complete revascularisation (CTOs)
22 Conclusions LMS PCI: validated alternative except for complex anatomy Is there still a place for CABG: YES!... But if well done: all arterial
23 Graft patency Tranbaugh et al, Annals of thoracic surgery 2017
24 Conclusions Heart Team Expert centers Patient-based decision instead of SYNTAX based Need for optimization of PCI outcomes (OCT/IVUS, newer DES, bifurcations techniques, CTOs)
Left Main Disease: what is left to surgery? Prof. Jacques Monségu CardioVascular Institute Grenoble, France
Left Main Disease: what is left to surgery? Prof. Jacques Monségu CardioVascular Institute Grenoble, France Background on LM stenosis 5% of patients undergoing angiography Of the myocardium 80% Bifurcation
More informationPCI for Left Main Coronary Artery Stenosis. Jean Fajadet Clinique Pasteur, Toulouse, France
PCI for Left Main Coronary Artery Stenosis Jean Fajadet Clinique Pasteur, Toulouse, France Athens, October 19, 2018 Left Main Coronary Artery Disease Significant unprotected left main coronary artery disease
More informationEXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017
EXCEL vs. NOBLE: How to Treat Left Main Disease in 2017 AATS International Cardiovascular Symposium December 8-9, 2017 Igor F. Palacios, MD Director of Interventional Cardiology Professor of Medicine Massachusetts
More informationLeft Main PCI vs. CABG: Real World
Management of Patients with Stable CAD Left Main PCI vs. CABG: Real World Marco Roffi, MD, FESC University Hospital Geneva, Switzerland SYNTAX-LMT The SYNTAX trial included a pre-specified subgroup of
More informationSurgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome
Surgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome Chris C. Cook, MD Associate Professor of Surgery Director, CT Residency Program, WVU ACOI 10/17/18 No Disclosures
More informationAssessing Myocardium at Risk: Applying SYNTAX
Assessing Myocardium at Risk: Applying SYNTAX Farouc Jaffer MD PhD FSCAI FACC FAHA Associate Professor of Medicine, Harvard Medical School Director, CAD Program and Chronic Total Occlusion PCI Program
More informationLeft Main Intervention: Where are we in 2015?
Left Main Intervention: Where are we in 2015? David A. Cox, MD FSCAI Director, Cardiology Research Associate Director, Cardiac Cath Lab Lehigh Valley Health Network Allentown, PA Fall Fellows Course Laa
More informationSurgery Grand Rounds
Surgery Grand Rounds Coronary Artery Bypass Grafting versus Coronary Artery Stenting Charles Ted Lord, R1 Coronary Artery Disease Stenosis of epicardial vessels Metabolic & hematologic Statistics 500,000
More informationImportant LM bifurcation studies update
8 th European Bifurcation Club 12-13 October 2012 - Barcelona Important LM bifurcation studies update I Sheiban E-mail: isheiban@yahoo.com Unprotected LM Percutaneous Revascularization What is important
More informationWhen should we indisputably perform CABG? Quand faut-il indiscutablement opérer? Dr Hakim BENAMER
When should we indisputably perform CABG? Quand faut-il indiscutablement opérer? Dr Hakim BENAMER ICPS, Massy ICV-GVM La Roseraie, Aubervilliers Hôpital FOCH, Suresnes Disclosure Statement of Financial
More informationKomplexe Koronarintervention heute: Von Syntax zu bioresorbierbaren Stents
Komplexe Koronarintervention heute: Von Syntax zu bioresorbierbaren Stents Prof. Dr. med. Julinda Mehilli Medizinische Klinik und Poliklinik I Klinikum der Universität München Campus Großhadern Key Factors
More informationPCI for LMCA lesions A Review of latest guidelines and relevant evidence
HCS Working Group Seminars Met Hotel, Thursday 14 th February 2013 PCI for LMCA lesions A Review of latest guidelines and relevant evidence Vassilis Spanos Interventional Cardiologist, As. Director 3 rd
More informationImplications of the New ESC/EACTS Guidelines for Myocardial Revascularization in 2011
Implications of the New ESC/EACTS Guidelines for Myocardial Revascularization in 2011 Prof. Dr. Volkmar Falk Klinik für Herz- und Gefäßchirurgie, Universitätsspital Zürich, Schweiz In 2004 headlines were
More informationLeft Main Intervention: Will it become standard of care?
Left Main Intervention: Will it become standard of care? David Cox, MD FSCAI, FACC Director, Interventional Cardiology Research Associate Director, Cardiac Cath Lab Lehigh Valley Health Network Allentown,
More informationUnprotected left main coronary stenting with a second generation drug-eluting stent. One-year clinical follow-up of the LeMaX pilot study.
Unprotected left main coronary stenting with a second generation drug-eluting stent. One-year clinical follow-up of the LeMaX pilot study. N. Boudou, N. Salvatella, N. Dumonteil, M.C. Morice, O. Darremont,
More informationSURGICAL MYOCARDIAL REVASCULARIZATION: ARTERIAL VS VENOUS GRAFTS, SINGLE VS MULTIPLE GRAFTS?
SURGICAL MYOCARDIAL REVASCULARIZATION: ARTERIAL VS VENOUS GRAFTS, SINGLE VS MULTIPLE GRAFTS? Luigi Martinelli Chief, Dept. of Surgery Istituto Clinico Ligure di Alta Specialità RAPALLO During 1987 2006,
More informationBetter CABGs vs Better PCI Devices
CABG vs PCI 2017 Multivessel Coronary Disease Better CABGs vs Better PCI Devices ACC New York, Dec 8, 2017 No Disclosures CABG vs PCI 2017 Stable Multivessel Coronary Disease 1. Are These The two Critical
More informationMise à Jour sur le traitement du Pluritronculaire Philippe Généreux, MD
Mise à Jour sur le traitement du Pluritronculaire Philippe Généreux, MD Columbia University Medical Center and The Cardiovascular Research Foundation, New York, USA Hôpital du Sacré-Coeur de Montréal,
More informationLe# Main Interven-on: When Is It Appropriate. Femi Philip, MD Assistant Professor Of Medicine UC Davis
Le# Main Interven-on: When Is It Appropriate Femi Philip, MD Assistant Professor Of Medicine UC Davis Nil Disclosures Outline What is the LMCA? Should we revascularize severe LMCA disease? What revascularizacon
More informationControversies in Cardiac Surgery
Controversies in Cardiac Surgery 3 years after SYNTAX : Percutaneous Coronary Intervention for Multivessel / Left main stem Coronary artery disease Pro ESC Congress 2010, 28 August 1 September Stockholm
More informationRevascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease
Impact of Angiographic Complete Revascularization after Drug-Eluting Stent Implantation or Coronary Artery Bypass Surgery for Multivessel Coronary Disease Young-Hak Kim, Duk-Woo Park, Jong-Young Lee, Won-Jang
More informationCABG vs PCI: What do the Guidelines Say?
AATS International Cardiovascular Symposium: Sao Paolo 2017 CABG vs PCI: What do the Guidelines Say? David P Taggart MD PhD FRCS FESC Professor of Cardiovascular Surgery, University of Oxford Conflicts
More informationCite this article as:
doi: 10.21037/acs.2018. 05.12 Cite this article as: Ngu JM, Sun LY, Ruel M. Pivotal contemporary trials of percutaneous coronary intervention vs. coronary artery bypass grafting: a surgical perspective..
More informationDeclaration of conflict of interest NONE
Declaration of conflict of interest NONE Claudio Muneretto MD, PhD Director of Division of Cardiac Surgery University of Brescia Medical School Italy Hybrid Chymera Different features and potential advantages
More informationMichael Mack, M.D. Baylor Healthcare System Heart Hospital Baylor Plano Dallas, TX
Michael Mack, M.D. Baylor Healthcare System Heart Hospital Baylor Plano Dallas, TX Boston Scientific, Inc.- Syntax Trial Steering Committee Member- travel expenses paid by trial sponsor Maquet, Inc.- unpaid
More informationCONTEMPORARY USE OF ARTERIAL GRAFTS DURING CORONARY ARTERY BYPASS SURGERY: PARADIGM SHIFT? OR A LITTLE (MORE) TALK THAT NEEDS A LOT MORE ACTION
CONTEMPORARY USE OF ARTERIAL GRAFTS DURING CORONARY ARTERY BYPASS SURGERY: PARADIGM SHIFT? OR A LITTLE (MORE) TALK THAT NEEDS A LOT MORE ACTION JAMES L ZELLNER MD I have no financial disclosures. 1897
More informationPatient. Clinical data Indications: Operation date. Comorbidities: Patient code Birth date: / /
Patient Patient code Birth date: / / Sex: Male Height (cm): Female Weight (kg): Risk Factors: Family history of coronary disease: Hypertension Dyslipidemia Peripheral disease Diabetes Comorbidities: No
More informationCase Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)?
Cronicon OPEN ACCESS CARDIOLOGY Case Report Left Main Stenosis. Percutaneous Coronary Intervention (PCI) or Coronary Artery Bypass Graft Surgery (CABG)? Valentin Hristov* Department of Cardiology, Specialized
More informationCOMMENT DEFINIR UN PLURITRONCULAIRE. Didier Carrié CHU Toulouse Rangueil
COMMENT DEFINIR UN PLURITRONCULAIRE VISION ANGIOGRAHIQUE DU PLURITRONCULAIRE Didier Carrié CHU Toulouse Rangueil Congrès GRCI 03 Décembre 2010 Pôle Cardiovasculaire et Métabolique Avec quel œil je regarde
More informationLeft Main PCI. Integrated Use of IVUS and FFR. Seung-Jung Park, MD, PhD
Left Main PCI Integrated Use of IVUS and FFR Seung-Jung Park, MD, PhD Professor of Medicine, University of Ulsan College of Medicine, Heart Institute, Asan Medical Center, Seoul, Korea Efficacy of Left
More informationManagement of cardiovascular disease - coronary interventions -
Master Classes in Preventive Cardiology I Management of diabetes in patients with CVD European Heart House Management of cardiovascular disease - coronary interventions - Francesco Cosentino MD, PhD, FESC
More informationCoronary interventions
Controversial issues in the management of ischemic heart failure Coronary interventions Maciej Lesiak Department of Cardiology, University Hospital in Poznan none DECLARATION OF CONFLICT OF INTEREST CHF
More informationPCI vs. CABG From BARI to Syntax, Is The Game Over?
PCI vs. CABG From BARI to Syntax, Is The Game Over? Seung-Jung Park, MD, PhD Professor of Medicine, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea PCI vs CABG Multi-Vessel Disease
More informationCan Angiographic Complete Revascularization Improve Outcomes for Patients with Decreased LV Function? NO!
Can Angiographic Complete Revascularization Improve Outcomes for Patients with Decreased LV Function? NO! Young-Hak Kim, MD, PhD Heart Institute, University of Ulsan College of Medicine Asan Medical Center,
More informationChronic Total Occlusion: a case for coronary artery bypass grafting
Chronic Total Occlusion: a case for coronary artery bypass grafting Rune Haaverstad Professor & Chief Dept. of Cardiothoracic Surgery Haukeland University Hospital Bergen, Norway Disclosure Research cooperation
More informationJ. Schwitter, MD, FESC Section of Cardiology
J. Schwitter, MD, FESC Section of Cardiology CMR Center of the CHUV University Hospital Lausanne - CHUV Switzerland Centre de RM Cardiaque J. Schwitter, MD, FESC Section of Cardiology CMR Center of the
More informationQuality of Life After Everolimus- Eluting Stents or Bypass Surgery for Treatment of Left Main Coronary Artery Disease:
Quality of Life After Everolimus- Eluting Stents or Bypass Surgery for Treatment of Left Main Coronary Artery Disease: Results from the EXCEL Trial Suzanne J. Baron MD MSC on behalf of the EXCEL Investigators
More informationSTEMI AND MULTIVESSEL CORONARY DISEASE
STEMI AND MULTIVESSEL CORONARY DISEASE ΤΣΙΑΦΟΥΤΗΣ Ν. ΙΩΑΝΝΗΣ ΕΠΕΜΒΑΤΙΚΟΣ ΚΑΡΔΙΟΛΟΓΟΣ Α ΚΑΡΔΙΟΛΟΓΙΚΗ ΝΟΣ ΕΡΥΘΡΟΥ ΣΤΑΥΡΟΥ IRA 30-50% of STEMI patients have additional stenoses other than the infarct related
More informationWhat do the guidelines say?
Percutaneous coronary intervention in 3-vessel disease and main stem What do the guidelines say? Nothing to disclose Dariusz Dudek Institute of Cardiology, Jagiellonian University Krakow, Poland The European
More informationhigh SYNTAX Score? I Sheiban Division of Cardiology Interventional Card. University of Turin Turin / Italy
What to do with patients with high SYNTAX Score? I Sheiban Division of Cardiology Interventional Card. University of Turin San Giovanni Battista Hospital Turin / Italy Who are the patients with high SYNTAX
More informationEvidence-Based Management of CAD: Last Decade Trials and Updated Guidelines
Evidence-Based Management of CAD: Last Decade Trials and Updated Guidelines Enrico Ferrari, MD Cardiac Surgery Unit Cardiocentro Ticino Foundation Lugano, Switzerland Conflict of Interests No conflict
More informationNCVD-PCI Registry. Percutaneous Coronary Intervention (PCI) Registry, MALAYSIA c/o National Heart Association of Malaysia
NCVD-PCI Registry National Cardiovascular Disease Database (NCVD) National Cardiovascular Disease Database (NCVD) Percutaneous Coronary Intervention (PCI) Registry, MALAYSIA c/o National Heart Association
More informationLEFT MAIN PERCUTANEOUS CORONARY INTERVENTION. A/Prof Koh Tian Hai Medical Director National Heart Centre, Singapore
LEFT MAIN PERCUTANEOUS CORONARY INTERVENTION A/Prof Koh Tian Hai Medical Director National Heart Centre, Singapore Disclosures Advisory Panel, Asian Medical Board Medtronics, Abbott Vascular. Speaker-honoraria,
More informationISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions
Julinda Mehilli, MD Deutsches Herzzentrum Technische Universität Munich Germany ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions Background Left main
More informationΑγγειοπλαστική σε Nόσο Στελέχους: Που βρισκόμαστε. Βάιος Τζίφος Δ/ντής Τμήματος Επεμβατικής Καρδιολογίας Τομέας Καρδιάς Ερρίκος Ντυνάν Hospital Center
Αγγειοπλαστική σε Nόσο Στελέχους: Που βρισκόμαστε. Βάιος Τζίφος Δ/ντής Τμήματος Επεμβατικής Καρδιολογίας Τομέας Καρδιάς Ερρίκος Ντυνάν Hospital Center Δεν έχω οικονομική σχέση με φαρμακευτική εταιρία.
More informationReconciling the Results of the Randomized Trials
Management of Stable Angina in Multivessel Disease: Reconciling the Results of the Randomized Trials Eric A. Cohen MD, FRCPC Schulich Heart Centre Sunnybrook Health Sciences Centre Toronto ON ACC Rockies
More informationFFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium
FFR and CABG Emanuele Barbato, MD, PhD, FESC Cardiovascular Center Aalst, Belgium Conflict of Interest Institutional research grants and speaker s fee from St. Jude Medical and Boston Scientic to Cardiovascular
More informationThe SYNTAX-LE MANS Study
The SYNTAX-LE MANS Study Synergy Between PCI with TAXUS Express and Cardiac Surgery: Late (15-month) Left Main Angiographic Substudy A. Pieter Kappetein, MD, PhD Erasmus MC, Rotterdam, NL SYNTAX-LE MANS
More informationCOMPARE Trial Elvin Kedhi Maasstad Ziekenhuis Rotterdam The Netherlands
COMPARE Trial Elvin Kedhi Maasstad Ziekenhuis Rotterdam The Netherlands TCTAP 2010 Seoul, Korea Disclosures Research Foundation of the Cardiology Department has received unrestricted research grants from:
More informationMaster Class in Preventive Cardiology Focus on Diabetes and Cardiovascular Disease Geneva April
Master Class in Preventive Cardiology Focus on Diabetes and Cardiovascular Disease Geneva April 14 2011 Coronary interventions in patients with diabetes Lars Rydén Karolinska Institutet Stockholm, Sweden
More informationLa FFR quoi d autre: En pratique? Pierre Deharo, CHU TIMONE, Marseille
La FFR quoi d autre: En pratique? Pierre Deharo, CHU TIMONE, Marseille La FFR quoi d autre: En pratique? How to avoid non reliable results Management of MVD Non Culprit in STEMI Left main Severe AS Post
More informationMoins de 6 mois d antiagrégants après DES?
Moins de 6 mois d antiagrégants après DES? High Tech - Marseille 25 au 27 janvier 2011 Marie-Claude MORICE, MD, FESC, FACC Massy, France Pas de conflit d interet Was optimal duration of DAPT already established
More informationDisclosures. Theodore A. Bass MD, FSCAI. The following relationships exist related to this presentation. None
SCAI Fellows Course December 10, 2013 Disclosures Theodore A. Bass MD, FSCAI The following relationships exist related to this presentation None Current Controversies on DAPT in PCI Which drug? When to
More informationΑΝΤΙΓΝΩΜΙΕΣ ΣΤΗΝ ΕΠΕΜΒΑΤΙΚΗ ΚΑΡΔΙΟΛΟΓΙΑ:Νόσος στελέχους Αγγειοπλαστική
ΑΝΤΙΓΝΩΜΙΕΣ ΣΤΗΝ ΕΠΕΜΒΑΤΙΚΗ ΚΑΡΔΙΟΛΟΓΙΑ:Νόσος στελέχους Αγγειοπλαστική X. ΓΡΑΪΔΗΣ Επεμβατικός καρδιολόγος, FSCAI Kλινική Euromedica-Κυανούς Σταυρός, Θεσσαλονίκη The Fear factor The two words LEFT MAIN
More informationPTCA 1979: : I
The SYNTAX Message is Clear: CABG is Preferred in Complex MVD Angioplasty Summit TCTAP 2012 Seoul, Korea April 2012 David R. Holmes, MD Mayo Clinic Rochester, MN Presenter Disclosure Information David
More informationThe MAIN-COMPARE Study
Long-Term Outcomes of Coronary Stent Implantation versus Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Disease Revascularization for Unprotected Left MAIN Coronary Artery Stenosis:
More informationStable Angina: Indication for revascularization and best medical therapy
Stable Angina: Indication for revascularization and best medical therapy Cardiology Basics and Updated Guideline 2018 Chang-Hwan Yoon, MD/PhD Cardiovascular Center, Department of Internal Medicine Bundang
More informationLong-term outcomes of PCI vs. CABG for ostial/midshaft lesions in unprotected left main coronary artery
Journal of Geriatric Cardiology (2017) 14: 254 260 2017 JGC All rights reserved; www.jgc301.com Research Article Open Access Long-term outcomes of PCI vs. CABG for ostial/midshaft lesions in unprotected
More informationMichael Mack, M.D. Baylor Healthcare System Heart Hospital Baylor Plano Dallas, TX
Michael Mack, M.D. Baylor Healthcare System Heart Hospital Baylor Plano Dallas, TX Maquet, Inc.,- unpaid consultant Cordis, Inc.,- unpaid consultant Boston Scientific, Inc.,- travel expenses paid for Syntax
More informationUnprotected LM intervention
Unprotected LM intervention Guideline for COMBAT Seung-Jung Park, MD, PhD Professor of Internal Medicine, Seoul, Korea Current Recommendation for unprotected LMCA Stenosis Class IIb C in ESC guideline
More informationDiabetic Patients: Current Evidence of Revascularization
Diabetic Patients: Current Evidence of Revascularization Alexandra J. Lansky, MD Yale University School of Medicine University College of London The Problem with Diabetic Patients Endothelial dysfunction
More informationSouthern Thoracic Surgical Association CABG in 2012: Implications of the New ESC/EACTS Guidelines
Southern Thoracic Surgical Association 2011 CABG in 2012: Implications of the New ESC/EACTS Guidelines David P Taggart MD PhD FRCS Professor of Cardiovascular Surgery, University of Oxford Conflicts of
More informationThree-Year Clinical Outcomes with Everolimus-Eluting Bioresorbable Scaffolds: Results from the Randomized ABSORB III Trial Stephen G.
Three-Year Clinical Outcomes with Everolimus-Eluting Bioresorbable Scaffolds: Results from the Randomized ABSORB III Trial Stephen G. Ellis MD Dean J. Kereiakes MD and Gregg W. Stone MD for the ABSORB
More informationFRACTIONAL FLOW RESERVE: STANDARD OF CARE
FRACTIONAL FLOW RESERVE: FROM INVESTIGATIONAL TOOL TO STANDARD OF CARE TCT ASIA Seoul, Korea, april 26 th, 2012 Nico H. J. Pijls, MD, PhD Catharina Hospital, Eindhoven, The Netherlands FRACTIONAL FLOW
More informationPCI or CABG for severe unprotected left main coronary artery disease: making sense of the NOBLE and EXCEL trials
Editorial PCI or CABG for severe unprotected left main coronary artery disease: making sense of the NOBLE and EXCEL trials Anthony A. Holmes, Sripal Bangalore Leon H. Charney Division of Cardiology, New
More informationLessons learned From The National PCI Registry
Lessons learned From The National PCI Registry w a v e On Behalf of The Publication Committee of the National PCI Registry Objectives & Anticipated Achievements To determine the epidemiology of patients
More informationWhat oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor
76 year old female Prior Hypertension, Hyperlipidemia, Smoking On Hydrochlorothiazide, Atorvastatin New onset chest discomfort; 2 episodes in past 24 hours Heart rate 122/min; BP 170/92 mm Hg, Killip Class
More informationTRIAL UPDATE 1. ISAR TRIPLE SECURITY Trial. Dr Deven Patel Royal Free Hospital
TRIAL UPDATE 1 ISAR TRIPLE SECURITY Trial Dr Deven Patel Royal Free Hospital NO CONFLICT OF INTEREST TO DECLARE ISAR TRIPLE Comparison of 6 weeks vs 6 months Triple Therapy in patients on oral anticoagulation
More informationLM stenting - Cypher
LM stenting - Cypher Left main stenting with BMS Since 1995 Issues in BMS era AMC Restenosis and TLR (%) 3 27 TLR P=.282 Restenosis P=.71 28 2 1 15 12 Ostium 5 4 Shaft Bifurcation Left main stenting with
More informationRelations of Interest
Relations of Interest Consulting Fees on my behalf go to the Cardiovascular Research Center Aalst Contracted Research between the Cardiovascular Research Center Aalst and several pharmaceutical and device
More informationDESCRIPTION: Percentage of patients aged 18 years and older undergoing isolated CABG surgery who received an IMA graft
Measure #43 (NQF 0134): Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery National Quality Strategy Domain: Effective Clinical Care 2017 OPTIONS
More informationWhat s New in Antiplatelet Therapy and DES in 2016
What s New in Antiplatelet Therapy and DES in 2016 Peter Pollak MD Director of Structural Heart Disease & Intervention Mayo Clinic Florida 2016 slide-1 Disclosures Financial None Off-label - None 2016
More informationChapter 29 Left Main Intervention in the Light of EXCEL and NOBLE Trials
Chapter 29 Left Main Intervention in the Light of EXCEL and NOBLE Trials DEBDATTA BHATTACHARYYA AYAN KAR The incidence of angiographically significant left main stenosis described in various studies has
More informationPercutaneous coronary intervention in left main disease: SYNTAX, PRECOMBAT, EXCEL and NOBLE combined cardiology and cardiac surgery perspective
Perspective Percutaneous coronary intervention in left main disease: SYNTAX, PRECOMBAT, EXCEL and NOBLE combined cardiology and cardiac surgery perspective Duk-Woo Park 1, Jung-Min Ahn 1, Seung-Jung Park
More informationControversies in Coronary Revascularization. Atlanta CCU April 15, 2016
Controversies in Coronary Revascularization Atlanta CCU April 15, 2016 Habib Samady MD FACC FSCAI Professor of Medicine Director, Interventional Cardiology, Emory University Director, Cardiac Catheterization
More informationDrug Eluting Stents Sometimes Fail ESC Stockholm 29 Set 2010 Stent Thrombosis Alaide Chieffo
Drug Eluting Stents Sometimes Fail ESC Stockholm 29 Set 2010 Stent Thrombosis 11.45-12.07 Alaide Chieffo San Raffaele Scientific Institute, Milan, Italy Historical Perspective 25 20 15 10 5 0 Serruys 1991
More informationR&M Solutions
PCI with DES versus CABG & syntax score Dr. Mohamed Sobhy, MD, FACC, FESC Professor of Cardiology, Alexandria University, Egypt Head of Cardiology Department President of Egyptian Society of Cardiology
More informationCount Down to COMBAT
Count Down to COMBAT Randomized COMparison of Bypass Surgery versus AngioplasTy using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease Roxana Mehran, MD Associate Professor of
More informationPerspective of LM stenting with Current registry and Randomized Clinical Data
Asian Pacific TCT Perspective of LM stenting with Current registry and Randomized Clinical Data Patrick W. Serruys MD PhD Yoshinobu Onuma MD Seung-Jung Park MD, PhD 14:48-15:00, 2009 Symposium Arena, Level
More informationΑΓΓΕΙΟΠΛΑΣΤΙΚΗ ΣΤΟ ΔΙΑΒΗΤΙΚΟ ΑΣΘΕΝΗ
ΑΓΓΕΙΟΠΛΑΣΤΙΚΗ ΣΤΟ ΔΙΑΒΗΤΙΚΟ ΑΣΘΕΝΗ Νίκος Μεζίλης MD, FESC Κλινική Άγιος Λουκάς Why diabetes is associated with restenosis endothelial dysfunction metabolic alterations accelerated platelet deposition
More informationRevascularization In HFrEF: Are We Close To The Truth. Ali Almasood
Revascularization In HFrEF: Are We Close To The Truth Ali Almasood HF epidemic 1-2% of the population have HF At least one-half have heart failure with reduced ejection fraction (HF- REF) The most common
More informationNOBLE and EXCEL: The debate for excellence in dealing with left main stenosis
O P E N A C C E S S 1 Aswan Heart Centre, Aswan, Egypt 2 Sultan Qaboos University Hospital, Muscat, Sultanate of Oman 3 Cairo University, Cairo, Egypt *Email: hatem.hosny@aswanheartcentre.com Lessons from
More informationUpgrade of Recommendation
Challenges in LM PCI Decision-making process for stenting Young-Hak Kim, MD, PhD, Heart Institute, University of Ulsan College of Medicine Asan Medical Center, Seoul, Korea Upgrade of Recommendation for
More informationCoronary Interventions Indications, Treatment Options and Outcomes
Coronary Interventions Indications, Treatment Options and Outcomes A talk should be like a woman s skirt long enough to cover the subject, but short enough to keep it interesting. Coronary anatomy Physiology
More informationGRAND ROUNDS - DILEMMAS IN ANTICOAGULATION AND ANTIPLATELET THERAPY. Nick Collins February 2017
GRAND ROUNDS - DILEMMAS IN ANTICOAGULATION AND ANTIPLATELET THERAPY Nick Collins February 2017 DISCLOSURES Before I commence Acknowledge.. Interventional Cardiologist Perception evolved. Interventional
More informationClinical Seminar. Which Diabetic Patient is a Candidate for Percutaneous Coronary Intervention - European Perspective
Clinical Seminar Which Diabetic Patient is a Candidate for Percutaneous Coronary Intervention - European Perspective Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical
More informationWhich drug do you prefer for stable CAD? - P2Y12 inhibitor
Which drug do you prefer for stable CAD? - P2Y12 inhibitor Jung Rae Cho, MD, PhD Cardiovascular Division, Department of Internal Medicine Kangnam Sacred Heart Hospital, Hallym University Medical Center,
More informationPCI for Left Anterior Descending Artery Ostial Stenosis
PCI for Left Anterior Descending Artery Ostial Stenosis Why do you hesitate PCI for LAD ostial stenosis? LAD Ostial Lesion Limitations of PCI High elastic recoil Involvement of the distal left main coronary
More informationOverview of Trasradial Approach for Coronary Angiography and Intervention. A/Prof. Phạm Mạnh Hùng, MD.FACC., FESC
Overview of Trasradial Approach for Coronary Angiography and Intervention A/Prof. Phạm Mạnh Hùng, MD.FACC., FESC Outline Historical perspective and current trends Rationale for the radial approach Bleeding
More informationFaculty/Presenter Disclosure
Faculty/Presenter Disclosure Faculty: Andre Lamy Relationships with commercial interests: Grants/Research Support: None Speakers Bureau/Honoraria: None Consulting Fees: None Other: None CORONARY: The Coronary
More informationChronic Total Occlusion: A case for coronary artery bypass grafting
Chronic Total Occlusion: A case for coronary artery bypass grafting Prof. Alfredo R Galassi MD, FESC, FACC, FSCAI Director of Cardiac Catheterization and Interventional Cardiology Unit Department of Medical
More informationFractional Flow Reserve: Review of the latest data
Fractional Flow Reserve: Review of the latest data Michalis Hamilos, MD, PhD, FESC University Hospital of Heraklion Fractional Flow Reserve (FFR) Coronary angiography does not always tell the truth Most
More informationRationale for Percutaneous Revascularization ESC 2011
Rationale for Percutaneous Revascularization Marie Claude Morice, Massy FR MD, FESC, FACC ESC 2011 Paris Villepinte - 27-31 August, 2011 Massy, France Potential conflicts of interest I have the following
More informationCoronary stenting: the appropriate use of FFR
Coronary stenting: the appropriate use of FFR Morton J. Kern, MD Professor of Medicine Chief of Cardiology LBVA Associate Chief Cardiology University California Irvine Orange, California To treat or not
More informationInstantaneous Wave-Free Ratio
Instantaneous Wave-Free Ratio Alejandro Aquino MD Interventional Cardiology Fellow Washington University in St. Louis Barnes-Jewish Hospital Instantaneous Wave-Free Ratio Alejandro Aquino MD Disclosure
More informationHREVS: A Randomized Trial of PCI vs CABG vs Hybrid Revascularization in Patients With Coronary Artery Disease. Vladimir Ganyukov, MD, PhD
HREVS: A Randomized Trial of PCI vs CABG vs Hybrid Revascularization in Patients With Coronary Artery Disease Vladimir Ganyukov, MD, PhD Nikita Kochergin MD, Aleksandr Shilov MD, PhD, Roman Tarasov, MD,
More informationCoronary Stent Choice in Patients With Diabetes Mellitus
Rome Cardiology Forum 2014 Coronary Stent Choice in Patients With Diabetes Mellitus Stephan Windecker Department of Cardiology Swiss Cardiovascular Center and Clinical Trials Unit Bern Bern University
More informationSAHA PCI or CABG for Left Main and Multi-Vessel Disease: when I would definitely/ maybe/never refer my patient for PCI or CABG
SAHA 2017 PCI or CABG for Left Main and Multi-Vessel Disease: when I would definitely/ maybe/never refer my patient for PCI or CABG David P Taggart MD PhD FRCS FESC Professor of Cardiovascular Surgery,
More informationRevascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing
Revascularization in Severe LV Dysfunction: The Role of Inducible Ischemia and Viability Testing Evidence and Uncertainties Robert O. Bonow, MD, MS, MACC Northwestern University Feinberg School of Medicine
More informationApplication of Appropriate Use Criteria in Clinical Care of CAD. Peter K. Smith, MD Professor and Chief Thoracic Surgery Duke University 4/29/2012
Application of Appropriate Use Criteria in Clinical Care of CAD Peter K. Smith, MD Professor and Chief Thoracic Surgery Duke University 4/29/2012 Influence of Severity and Location of Stenosis on Cardiac
More information