https://www.selleckchem.com/products/pf-477736.html woman-centred care.PCI to improve survival is currently recommended as a reasonable alternative to CABG in patients with unprotected left main disease. However, RCTs to support this recommendation has generated mixed results and recently published EXCEL trial has sparked debate about differences in late mortality. To address this point, we performed landmark meta-analysis of 4 RCTs with 5 year follow up data - EXCEL, NOBLE, PRECOMBAT and SYNTAX LEFT MAIN. Overall, there was no significant difference in all-cause mortality between PCI and CABG at 5 years (RR = 1.03 [95% CI = 0.79-1.33]). However, there was apparent change in the direction of association before and after the 1 year landmark that underscores the need for long term follow up in these trials. In addition, we found that PCI was associated with significantly lower rate of intermediate stroke at 1 year (RR = 0.44 [0.24-0.82]) but higher rate of late MI after 1 year (3.31 [2.11-5.18]) compared to CABG. To evaluate the real need for coronary access after transcatheter aortic valve implantation (TAVI). Prospective observational single center registry, including 563 consecutive patients that underwent TAVI between April 2008 and November 2018, with both self and balloon expandable valves in a tertiary European center. Mean age was 82.4 ± 6.9 years, 53.3% were female, 16% had previous history of CABG, 33% of previous PCI and 16.6% of MI. Twenty four percent of the patients were revascularized within one year before TAVI in preparation for the procedure. Median STS Score was 4.82 (IQ 2.84). #link# In a median follow up of 24 months (IQ 21.5), 18 patients (3.2%) were identified as potentially in need for ICA 9 (1.6%) in the setting of stable coronary artery disease and 9 (1.6%) for an acute coronary syndrome. A total of 11 PCI were performed in 9 patients, with a complete success rate of 63.6%. Procedures that were unsuccessful or partially unsuccessful were due