International practice guidelines for the care of patients with valvular heart disease were most recently updated in 2017, before the publication of the results of the COAPT and MITRA-FR trials in 2018, and these guidelines were conservative in their recommendations regarding surgery for secondary mitral regurgitation.
Intervention
Criteria for Neurosurgical or Neuroradiologic Intervention for Mold Infections of the Central Nervous System (CNS)
The clinical characteristics of mold infections of the CNS warrant assessment for possible biopsy and neurosurgical intervention. A definitive diagnosis almost invariably requires a biopsy, with prompt inspection of the specimen by means of wet-mount preparation with calcofluor white stain, culture, and histologic analysis (with Gomori methenamine silver stain and periodic acid–Schiff stain). In situ hybridization and immunohistochemical analysis may be helpful if cultures of biopsy specimens are negative.
Clinical Indications and Contraindications to Percutaneous Coronary Intervention (PCI)
Percutaneous coronary interventions (PCI) include percutaneous transluminal coronary angioplasty (PTCA) with or without stenting. Primary indications are treatment of angina pectoris (stable or unstable), myocardial ischemia, and acute MI (particularly in patients with developing or established cardiogenic shock).