Outcomes of 10,312 patients treated with everolimus-eluting bioresorbable scaffolds during daily clinical practice - results from the European Absorb Consortium.

OBJECTIVES: To asses mid-term clinical outcomes of bioresorbable vascular scaffolds (BVS) for the treatment of coronary artery disease in a large-scale all-comers population. BACKGROUND: Several clinical settings are underrepresented in randomized studies investigating BVS against drug-eluting stents. Whether their results can be translated into the heterogeny patient population seen during daily routine requires further investigation. METHODS: The European ABSORB Consortium comprises the following European registries: GABI-R, ABSORB UK Registry, ABSORB France, BVS RAI Registry, and REPARA BVS Registry, which all prospectively collected patient-level data regarding outcomes following unrestricted BVS implantation. The primary endpoint of target lesion failure (TLF) includes cardiac death, target-vessel myocardial infarction (TVMI) and target-lesion revascularisation (TLR) at 12 months. The incidence of scaffold thrombosis (ST) according to ARC criteria was also assessed. Multivariable analysis was used to adjust for differences in patient and lesion characteristics. RESULTS: A total of 10,312 patients (mean age 58.4 ± 11.4 y) underwent BVS implantation during routine practice. The 12-month follow-up was complete in 95.5% of patients. At 12 months, the primary endpoint of TLF occurred in 3.6%; its components cardiac death, TVMI and TLR were documented in 1.2%, 1.8%, and 2.6%, respectively. The definite/probable ST rate was 1.7%. Absence of predilatation, discontinuation of DAPT and scaffold diameter below 3 mm were independent predictors of ST. CONCLUSIONS: The EAC demonstrates reasonable real-world clinical outcome data after BVS implantation. However, the rate of scaffold thrombosis remains high.

Rheumatic mitral stenosis in a 28-week pregnant woman treated by mitral valvuoplasty guided by low dose of radiation: a case report and brief overview.

Rheumatic mitral stenosis is still a pathological condition that affects young patients and is an important cause of mortality. 2017-European Guidelines for the management of valvular heart disease suggest a percutaneous approach with a mitral commissurotomy for the treatment of symptomatic pregnant women. Mitral commissurotomy procedure involves radiation exposure that is incompatible with the pregnancy condition. In our case, we present percutaneous mitral commissurotomy (PMC) to a 28-week pregnant woman with a low-radiation dose and the use of transesophageal echocardiography. The woman presented with a mitral transvalvular mean gradient of 21.6 mmHg and with symptoms non-responsive to medical treatment. PMC was driven by a transesophageal echocardiographic probe. This case demonstrates the feasibility and safety of PMC in a pregnant woman with severe rheumatic mitral stenosis.