key: cord-026846-3u3x52f8
authors: nan
title: Inside This Issue
date: 2020-06-22
journal: JACC Cardiovasc Interv
DOI: 10.1016/s1936-8798(20)31180-8
sha: 
doc_id: 26846
cord_uid: 3u3x52f8

nan

The authors pooled data on 19,833 patients from 18 randomized trials evaluating outcomes after percutaneous coronary intervention, categorized according to the presence of angiography core laboratory-confirmed moderate or severe coronary artery calcification in any target lesion.

Coronary artery calcification was significantly associated with an increase in 5-year adverse events.

Second-generation drug-eluting stents compared with first-generation drug-eluting stents were associated with significant reductions in the 5-year risks for target lesion failure and stent thrombosis in patients with target lesion moderate or severe coronary artery calcification. and their composite were similar among the groups (6.7% vs. 6.8%, p = 0.63; 6.1% vs. 6.4%, p = 0.70; and 9.8% vs. 9.8%, p = 0.76, respectively). The results show that excellent outcomes can be achieved using either 2D-US or FCA in high-volume, experienced centers. The coronavirus disease-2019 (COVID-19) pandemic has strained health care resources around the world, causing many institutions to curtail or stop elective procedures. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. The effective triage of these patients has become challenging in the current environment as clinicians have had to weigh the risk of bringing susceptible patients into the hospital environment during the COVID-19 pandemic against the risk of delaying a needed procedure. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic. 

Angiographic Findings of the Development of a Reverse Blood Supply After Percutaneous Deep Venous Arterialization