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An increasing number of surgical aortic bioprostheses (SAVR) have been implanted in recent years, and increasingly more patients will be candidates for reintervention due to structural deterioration of the valve. Valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) has become a safe and effective alternative to surgery in highrisk patients with lower early mortality; however, as a complex procedure with many pitfalls, ViV-TAVI should be performed in high-volume centers with experienced staff. A higher risk of peri- and postprocedural complications involves prosthesis-patient mismatch with a risk of high residual gradient, a risk of coronary obstruction, or an increased risk of thrombosis of the leaflets of the bioprosthesis. An exact preproce‑ dural planning as well as detailed information and knowledge of specific features of the original bioprosthesis are all of crucial importance. The operator must be familiar with the proper implantation technique and selection of a suitable type of TAVI prosthesis for specific anatomy. Because TAVI is now available to younger patients with a longer life expectancy, a lifetime strategy of aortic stenosis treatment must be considered since the initial intervention will influence all future therapeutic choices. [ABSTRACT FROM AUTHOR]

Mitral regurgitation is the second most frequent valve disease in the adult population. Until recently, surgical repair or replace‑ ment were the only therapeutic options, leaving many patients untreated and even underdiagnosed, most frequently due to a presumably high surgical risk, particularly in those with secondary mitral regurgitation. Over the last few years, there has been exponential growth in the number of catheter-based procedures, with most of them using the transcatheter edge-to-edge repair (TEER) technique. Furthermore, the evolution of other systems is under way that preferentially use the transseptal approach, are more comprehensive, and are aimed at transcatheter mitral valve replacement. The purpose of this article is to review the current transcatheter repair systems and the evidence base for their use. [ABSTRACT FROM AUTHOR]

The National Registry of Cardiovascular Interventions (NRKI) is a prospective multicentre registry that collects data on all percutaneous coronary interventions (PCIs) performed from all PCI centers in the Czech Republic, prospectively since 2005. In the period 2005-2017, it is noticeable (approx. 14 %) an increase in the number of patients treated and PCIs performed. The proportion of men and women does not change substantially (70 : 30), the average age of patients is increasing, more for men than for women. PCI for ACS has been around 50 % in the long term, with primary PCI in the acute phase of STEMI around 6,000 patients annually - even the number of these procedures has not decreased by 2018. The most frequently intervened artery is LAD and then RCA, increasing is the number of interventions of the left main coronary artery. A gratifying fact is dominant transradial access to PCI (75 %) and usage of drug - eluting stents (over 95 % in 2018). The data on the overall mortality of patients (30 day and 1-year) are objectivized, with clinical manifestation of the disease (STEMI vs NSTE-AKS vs chronic CHD) and age of the patients playing the dominant role. [ABSTRACT FROM AUTHOR]

The treatment of symptomatic primary mitral regurgitation is guided by symptoms and assessment of ventricular function and size, atrial fibrillation, pulmonary hypertension, and left atrial size, with mitral valve repair being the preferred method and mitral valve replacement being used in the case of unfavorable morphology. In secondary mitral regurgitation, there is no conclusive evidence for survival benefit after mitral valve intervention. Over the last few years, less invasive catetheter-based systems have been subjected to clinical trial (whose brief oveview is given), but only MitraClip implantation (as a method of creating edge-toedge mitral valve repair) has sufficient clinical evidence. Two randomized clinical trials compared transcatetheter mitral valve repair with optimal medical therapy in heart failure patients with secondary mitral regurgitation. In the MITRA-FR trial, the primary outcome of combined all-cause mortality or heart failure associated hospitalization at one year was not different (54.6 % vs. 51.3 %, p =, 53). But in contrast, in the COAPT trial significant reduction of mortality (29.1 % vs. 46.1 %, p < 0.001) and heart failure hospitalizations (35.8 % vs 67.9 % per patient-year, p < 0.001) in the MitraClip group was achieved. The degree of mitral regurgitation in the context of left ventricular dilatation and classification of mitral regurgitation into „proportionate” and „disproportionate” can both aid in choosing an optimal treatment. [ABSTRACT FROM AUTHOR]

The 2018 ESC/EACTS Guidelines on myocardial revascularization are the guidelines' third version, having 70 pages of text and a total of 786 citations. Along with the main document, Supplementary data are available with another 19 pages of text and 122 citations. The article deals with the guidelines published, briefly summarizing the main principles in the indications of myocardial revascularization in patients with both acute and chronic forms of CAD and in specific patient subgroups. [ABSTRACT FROM AUTHOR]