Is sex associated with adverse outcomes after percutaneous coronary intervention for CTO?

BACKGROUND: Conflicting results have been reported regarding sex differences in percutaneous coronary intervention (PCI), but their potential influence on clinical outcomes after chronic total coronary occlusion (CTO) PCI remains unknown. We aimed to identify sex-related differences in long-term clinical outcomes after CTO PCI. METHODS AND RESULTS: All consecutive patients undergoing CTO PCI between 2004 and 2012 were included in a prospective registry. Baseline, procedural characteristics and clinical outcomes were compared according to sex. Out of 1343 patients, 194 were female (14.4%). Women were older (68.5 ±â€¯9.9 vs 62.3 ±â€¯10.8 years, p < 0.001), more frequently diabetic (33.5% vs 26.4%, p = 0.026) and hypertensive (70.1% vs 57.4%, p < 0,001), whereas males were more frequently smokers (28.5% vs 15.5%, p < 0.001). J-CTO score was similar between both sexes (1.59 ±â€¯0.91 vs 1.51 ±â€¯0.88). The procedural success rate was also similar in men and women (74.0% vs 77.3%, respectively). At 8 years' follow-up, successful CTO PCI was associated with reduced mortality in women (14.8% vs 36.2%, p = 0.003) and men (18.5% vs 29.1%, p < 0.001). In successful CTO PCI cases, no sex-related differences were observed in terms of major adverse cardiac events. CONCLUSIONS: Our study suggests an equal benefit of CTO interventions with a marked reduction in mortality after successful CTO PCI in women and men alike.

[Mitral valve repair in the course of active infectious endocarditis. Study of four patients]. / Reparación valvular mitral en el curso de una endocarditis infecciosa activa. Estudio de cuatro pacientes.

BACKGROUND AND OBJECTIVE: Mitral valve (MV) repair is the preferred surgical treatment for degenerative mitral regurgitation (MR). However, questions remain about the efficacy of MV repair when performed for MR caused by infective endocarditis (IE), particularly during its active phase. Although several observational studies have suggested the superiority of MV repair over replacement in patients undergoing surgery for IE, many centres are still opting for valve replacement because of its technical feasibility and reproducibility. In the following document we expose the experience of our hospital. PATIENTS AND METHOD: We present a series of 4 patients who recently underwent surgery for IE during its active phase. Epidemiological and clinical characteristics are discussed. RESULTS: All patients underwent different MV repair techniques. No relapse or reinfection has been reported. All patients present MR grades 0 or iI/ivIV at follow up. CONCLUSIONS: Even during the active phase of IE, MV repair is a feasible technique with good postoperatory results.