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Showing posts from October, 2023

Preventing early mortality after Coronary angioplasty

Coronary angioplasty aka PCI is a common procedure with excellent success rates. The in-hospital mortality following PCI is 1-2% and in the setting of acute coronary syndrome is 3%. Additionally,1-2% of patients die after discharge within 30 days.  Two recent retrospective database analyses from the states of New York and Michigan Blue shield studied mortality after PCI1,2. The New York database included 135,000 patients studying in-hospital and 30-day mortality while the Michigan database had 92,000 patients analysing in-hospital mortality.  I present these papers with the learning points so that we can improve patient outcomes.  The findings Both databases showed a 1.5% - 30-day mortality after PCI. 30% of these deaths are preventable. Most in-hospital deaths were non preventable (70%). They were attributed to pre-existing cardiac conditions such as cardiogenic shock, left ventricular failure, co-morbidities etc. Most of them are emergency and high-risk patients. 30% of in-hospital

Transcatheter Aortic Valve Replacement (TAVR) Surgery

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure to replace a diseased aortic valve. It is a newer procedure than traditional open-heart surgery to replace the aortic valve, and it has become increasingly popular in recent years. The aortic valve is one of four valves in the heart that control the flow of blood. It is located between the left ventricle and the aorta, the main artery that carries blood from the heart to the rest of the body. If the aortic valve becomes narrowed or stiff, it can make it difficult for the heart to pump blood efficiently. This can lead to a condition called aortic stenosis. TAVR is a good option for patients with aortic stenosis who are at high risk for complications from open-heart surgery. This may include patients with other medical conditions, such as chronic kidney disease or lung disease, or older patients. During TAVR, a doctor inserts a thin, flexible tube called a catheter through a small incision in the groin, chest