CardioExchange Archive

February 28th, 2012

Slow Uptake of Transcatheter Aortic Valves: Learning from History?

Larry Husten, PHD

Transcatheter aortic valve replacement (TAVR) has been one of the most exciting new developments in cardiovascular medicine in recent years. The growing enthusiasm over TAVR led to concern and even alarm in some quarters that its introduction would ignite a stampede of uptake, mirroring the early over-enthusiasm for similarly disruptive devices like stents and ICDs […]

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February 8th, 2012

Two Different Perspectives on the CABG Versus PCI Message in ASCERT

Fred H Edwards, MD, MS, Richard A. Lange, MD, MBA and L. David Hillis, MD

At the recent meeting of the Society of Thoracic Surgeons (STS), Fred Edwards presented the high-risk subset of ASCERT (ACCF-STS Database Collaboration on the Comparative Effectiveness of Revascularization Strategies). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to Edwards and Christopher White, the president of the Society for Cardiovascular Angiography and Interventions (SCAI). Rick Lange and David […]

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February 3rd, 2012

CMS Releases Details of Proposed National Coverage for TAVR

Larry Husten, PHD

On Thursday the Centers for Medicare & Medicaid Services (CMS) released a memo containing details of its proposed Medicare coverage for transcatheter aortic valve replacement (TAVR). The memo is a response to a formal request for national coverage determination (NCD) from the Society of Thoracic Surgeons (STS) and the American College of Cardiology (ACC). The memo will be open […]

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January 31st, 2012

Guiding TAVR into Clinical Practice

Steven Bailey, MD, Richard A. Lange, MD, MBA and L. David Hillis, MD

The ACC, AATS, SCAI, and STS have issued a critical consensus document to guide the use of transcatheter aortic valve replacement (TAVR) as it enters clinical practice in the U.S. (see also our CardioExchange news coverage here). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to writing committee member Steven R Bailey, the Janey Briscoe Distinguished Professor of […]

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January 31st, 2012

Consensus Document Provides Roadmap to Uptake of TAVR in U.S.

Larry Husten, PHD

Following the recent FDA approval of transcatheter aortic valve replacement (TAVR), the ACC, AATS, SCAI, and STS — in conjunction with several other medical organizations — have released a critical consensus document to guide use of the new landmark procedure. “We have tried to collate the evidence into a coherent road map for judicious use, rational dispersion, […]

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January 31st, 2012

Appropriate Use Criteria for Revascularization Updated

Larry Husten, PHD

The ACC, AHA, and other organizations have released updated appropriate use criteria for coronary revascularization. The 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update incorporates data from the SYNTAX trial on the indications for PCI and CABG in patients with symptomatic, multivessel disease, as well as data from the CathPCI registry. Here are some of the key ratings: […]

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January 30th, 2012

Very Large Observational Study Finds Significant Mortality Advantage for CABG Over PCI in High-Risk Patients

Larry Husten, PHD

Although PCI has a small, early mortality benefit compared to CABG in high-risk patients, after the first year a striking survival advantage for CABG develops, according to results of the ASCERT study, presented on Monday at the annual meeting of the Society of Thoracic Surgeons (STS). Fred Edwards presented the high-risk subset of ASCERT (ACCF-STS Database Collaboration […]

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January 24th, 2012

Whistleblower Lawsuit Filed Against 5 Cardiologists in Pennsylvania

Larry Husten, PHD

The U.S. government has joined a cardiologist in a whistleblower lawsuit against Hamot Medical Center  in western Pennsylvania  and a group of cardiologists with whom he once practiced, Ed Palattella reports in the Erie Times-News. Cardiologist Tullio Emanuele, who now practices in Kentucky, has accused five former colleagues — members of Medicor Associates Inc. and its affiliate, Flagship Cardiac, […]

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January 18th, 2012

Cangrelor and Alaska’s “Bridge to Nowhere”

Richard A. Lange, MD, MBA and L. David Hillis, MD

The Gravina Island Bridge (also known as The Bridge to Nowhere) was a proposed bridge to replace the ferry that currently connects Ketchikan, Alaska (population, 14,000) to the Ketchikan International Airport on Gravina Island (population, 50) at a projected cost of $398 million. The bridge was to have been nearly as long as the Golden Gate […]

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January 17th, 2012

Cangrelor Proposed as Bridge to Surgery

Larry Husten, PHD

As a potent and reversible platelet inhibitor, cangrelor has been proposed for use in a bridging strategy for patients scheduled for surgery who are currently taking clopidogrel or another thienopyridine. To test this strategy, the BRIDGE investigators randomized 210 ACS or stent patients awaiting CABG and taking a thienopyridine to receive either cangrelor or placebo for at […]

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