In the aging society, the issue of coronary chronic total occlusion (CTO) has become a challenge for invasive cardiologists. Despite the lack of clear indications in European and American guidelines, the rates of percutaneous coronary interventions (PCI) for CTO increased over the last years. Well-conducted randomized clinical trials (RCT) and large observational studies brought significant and substantial progress in many CTO blind spots. However, the results regarding the rationale behind revascularization and the long-term benefit of CTO are inconclusive. Knowing the uncertainties regarding PCI CTO, our work sought to sum up and provide a comprehensive review of the latest evidence on percutaneous recanalization of coronary artery chronic total occlusion.

Background/Objectives: Congenital heart disease (CHD) is the most common birth defect worldwide, with a prevalence rate of 2.78 per 1000 births. CHD, as with any chronic illness, poses a certain risk of comorbidities. The prevalence rate of psychiatric disorders in adults suffering from CHD is as high as 12.4%, and in the pediatric CHD patient group, this figure is over 35%. Methods: An extensive literature search was conducted in reputable databases, such as PubMed, Scopus, and Web of Science, in the timeframe of November 2024 to March 2025. Ultimately, we selected 146 articles to be included in this review. Results: Depression, anxiety disorders, bipolar disorder, autism spectrum disorders, and PTSD are amongst the most frequently occurring. CHD concomitant with a mental disorder poses an increased risk of complications, worsening both cardiological and psychiatric outcomes. Conclusions: CHD is a multidisciplinary illness that needs to be treated with caution and screening for it should be integrated with investigations of psychiatric comorbidities, using scales such as HADS and BDI-2, while considering their moderate accuracy. Prevention, early detection, and intervention in CHDs are necessary steps in patient healthcare, not omitting patient education. The quality of life is also influenced by CHDs, as chronic heart failure has been confirmed as an independent factor in diminishing QoL levels. In addition to this, it extrapolates the need for the establishment of standardized guidelines regarding this topic.

Introduction: Cardiovascular diseases (CVDs) are a vast and widespread problem around the world, responsible for around one third of global deaths, of which 85% were due to heart attack and stroke in 2022. There are a lot of well-established risk factors for CVDs, including smoking, diabetes mellitus, obesity, poor diet, alcohol use, and sedentary lifestyle. Psychiatric disorders, however, are not among those frequently cited. Over a billion people worldwide suffer from some kind of mental disorder, with anxiety and depression being among the leading causes of long-term disability. All-cause death is significantly elevated in individuals with all mental health disorders. Methods: This narrative review aims to provide details on the selected psychiatric disorders and their pharmacotherapy with regard to the risk of developing cardiac illness by reviewing the available literature and the 2025 ESC Clinical Consensus Statement on mental health and cardiovascular disease. Results: Primary and secondary prevention of cardiovascular complications in the psychiatric disease population is an essential component in clinical healthcare. Conclusions: Taking all into account, it is essential to underline the role of the activation of the sympathetic nervous system and chronic inflammation, ultimately leading to metabolic syndrome in individuals with mental disorders, as well as an increase in residual cardiovascular risk and the development of CVDs, thereby worsening their long-term prognosis. In view of risky lifestyle behaviors in this population, it is essential to screen proactively, mitigate risk factors, consider the role of pharmacotherapy, and, if needed, initiate appropriate treatment.

Background: Valve-in-Valve (ViV) transcatheter aortic valve implantation (TAVI) has emerged as a viable therapeutic option for structural valve degeneration following surgical aortic valve replacement (SAVR) or prior TAVI. However, the understanding of long-term complications and their management remains limited. Case presentation: We present the case of a 69-year-old male with a history of ViV-TAVI, who presented with symptoms of non-ST elevation myocardial infarction (NSTEMI) and transient ischemic attack (TIA). Computed tomography (CT) revealed thrombosis of the ascending aortic graft and aortic valve prosthesis. Transthoracic echocardiography (TTE) further confirmed new valve dysfunction, indicated by an increase in the aortic valve mean gradient. Treatment with low-molecular-weight heparin (LMWH) resulted in partial thrombus resolution. The multidisciplinary Heart Team opted against coronary angiography and recommended the long-term administration of vitamin K antagonists (VKAs). Follow-up CT showed the complete resolution of the thrombus. Conclusions: Thrombosis of the aortic graft and aortic valve following ViV-TAVI may be attributed to alterations in blood flow or mechanical manipulations during the TAVI procedure, yet it can be effectively managed with VKA therapy. CT is a valuable tool in coronary assessment in patients with NSTEMI and aortic valve and/or aortic graft thrombosis.