Key result
Novel percutaneous interventions such as transcatheter aortic valve implantation, MitraClip, left atrial appendage closure, and renal denervation provide promising alternatives for patients with non-coronary cardiac conditions who are at high surgical risk.
Recent innovations in interventional cardiology have dramatically expanded therapeutic options beyond coronary artery disease to include structural heart disease, stroke prevention, and hypertension management.
May expand options for high-risk non-coronary patients; leaves open need for randomized trials before practice change.
Summary Recent innovations in interventional cardiology have dramatically expanded the therapeutic options for patients with cardiac conditions. Interventional cardiology is no longer limited to the treatment of coronary artery disease but allows also treatment of valvular disease, stroke prevention, hypertension, etc. One of the most important new treatment options is the percutaneous treatment for aortic valve stenosis (transcatheter aortic valve implantation), since aortic valve disease is a rather common problem in elderly patients, with many of them at high risk for surgery. Similarly, mitral regurgitation is often associated with comorbidities which make surgery high risk. The MitraClip is a promising percutaneous alternative to surgical valve repair or replacement. Other procedures discussed in this review are the percutaneous left atrial appendage closure as a non-pharmacologic therapy to prevent strokes, and renal denervation for resistant hypertension. This review explains the basic principles of these procedures, the most important clinical evidence, and also provides additional recent clinical data on each of these them.
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Meier et al. (2013) conducted a review in Non-coronary cardiac conditions (atrial fibrillation, mitral regurgitation, aortic stenosis, resistant hypertension). Novel non-coronary cardiac interventions (LAA closure, MitraClip, TAVI, renal denervation) was evaluated. Novel percutaneous interventions such as transcatheter aortic valve implantation, MitraClip, left atrial appendage closure, and renal denervation provide promising alternatives for patients with non-coronary cardiac conditions who are at high surgical risk.
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