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Archive for 2017

Dr Malik talks ‘TAVI’ at the BGS Cardiovascular Section Conference

Dr Malik gave a Talk on Transcatheter Aortic Valve intervention (TAVI) to Care of the Elderly Physicians in London.

  1. What is it
  2. How do you do it?
  3. Who is suitable?
  4. Who is not suitable

Dr Malik says: “The role of TAVI is increasing as the risk of the procedure goes down. It is now possible to quote a 1% mortality in many centres. However, if you are very sick, TAVI can be life saving. I gave this talk to Care of the Elderly Physicians in London. It was an honour to be invited to speak. It gives a summary of ‘How, Why and Why Not’ for TAVI procedures. Have a look!”

Watch it here!

Dr Malik and the team publish new TAVI research

Dr Malik and his team have published another paper on the topic of TransCatheter Aortic Valve Intervention (TAVI or TAVR).

He said: “We know TAVI can be done for your own aortic valve that is diseased, or inside a surgical Tissue aortic (or even mitral) valve. This article covers the concept of the failing TAVI valve and how to treat it. As patients survive longer after TAVI, some will experience degeneration of this valve too. We need to predict why, and try to prevent it. We also need to work out how to treat this problem. This could be with a further TAVI inside the TAVI.”

Read the paper here.

Entresto – a combination of Valsartan and Sacubitril

Please see the attached prescribing sheet for Entresto (a combination of Valsartan and Sacubitril):

It is a novel agent for use in heart failure. You cannot take it with an ACE Inhibitor and not if you have had a bad reaction to an ACI inhibitor.

It appears to be better than just an ACE inhibitor alone- previously the best drug you could have in heart failure. If you treat 80 patients, you actually save 1 life.

  1. Fonarow GC, Hernandez AF, Solomon SD, et al. Potential mortality reduction with optimal implementation of angiotensin receptor neprilysin inhibitor therapy in heart failure. JAMA Cardiol. Published online June 22, 2016.
  2. Gaziano TA, Fonarow GC, Claggett B, et al. Cost-effectiveness analysis of sacubitril/valsartan vs enalapril in patients with heart failure and reduced ejection fraction. JAMA Cardiol. Published online June 22, 2016

The other drug in Heart Failure is Ivabradine. If the heart rate is still >70 beats a minute after betablocker use, then we can add ivabradine- that too seems to save lives.

Dr Malik at CSI-Frankfurt in November 2017

Dr Malik was part of the Faculty at CSI LAA 2017 in Frankfurt.

He moderated a session on new devices and commented on some of the fantastic cases shown.

He said, “It was a pleasure to attend with colleagues from around the world who also perform closure of the left atrial appendage (LAA) to reduce stroke risk in patients with atrial fibrillation (AF).  “

He was tweeting live from the meeting to share knowledge with those that could not attend – check out Dr Malik’s twitter here!

TCT 2017: Wrap-Up with Dr. C. Michael Gibson and Dr. Ajay Kirtane

Dr Malik was one of the investigators for the ORBITA trial published in the Lancet, presented at TCT 2017 in Denver earlier this month, and discussed in this video.
Angioplasty and stenting in heart attacks saves lives. In patients with stable symptoms and one blockage only, medical therapy is also very good. The ORBITA trial really breaks new ground in challenging the “see it, stent it” occluostenotic reflex that come in cardiology have had.

Dr Malik in the ORBITA study

Twitter was very active with this 200 patient study that Dr Malik was involved with.
He said:
It should make you think: why is a stent being put in?
  • In stable angina, it is for symptom control. Tablets might work just as well.
  • In unstable angina or a heart attack it is to save a life.
The ORBITA study was in stable angina with only one diseased blood vessel.
If in doubt, you need to discuss with your cardiologist.