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Journal of Invasive Cardiology

Iosif Xenogiannis, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, James W Choi, M Nicholas Burke, Anthony H Doing, Phil Dattilo, Catalin Toma, A J Conrad Smith, Barry Uretsky, Oleg Krestyaninov, Dmitrii Khelimskii, Elizabeth Holper, Srinivasa Potluri, R Michael Wyman, David E Kandzari, Santiago Garcia, Michalis Koutouzis, Ioannis Tsiafoutis, Wissam Jaber, Habib Samady, Jeffrey W Moses, Nicholas J Lembo, Manish Parikh, Ajay J Kirtane, Ziad A Ali, Darshan Doshi, Peter Tajti, Bavana V Rangan, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: The most common re-entry technique during retrograde chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is reverse controlled antegrade and retrograde tracking (rCART). The use of guide-catheter extensions can facilitate rCART, but has received limited study. METHODS: We compared the clinical and procedural characteristics and outcomes of traditional rCART vs guide-catheter extension rCART vs cases in which both techniques were used (combined rCART) in patients with successful retrograde CTO crossing in a contemporary multicenter CTO-PCI registry...
November 11, 2018: Journal of Invasive Cardiology
Derek Phan, Armen Chalian, Raj Makkar, Robert J Siegel, Florian Rader
BACKGROUND: More than 50% of embolic strokes occur >24 hours after transcatheter aortic valve replacement (TAVR) and are therefore not directly procedure related. We aimed to determine immediate changes in left atrial (LA) function after TAVR, that may alter short-term and long-term stroke risk after TAVR. METHODS: Transesophageal and transthoracic echocardiography were performed before and immediately after TAVR to evaluate left atrial appendage (LAA) velocities and Doppler echocardiographic markers of LA function...
November 11, 2018: Journal of Invasive Cardiology
Marc Laine, Thibaut Dabry, Nicolas Combaret, Pascal Motreff, Etienne Puymirat, Franck Paganelli, Franck Thuny, Jennifer Cautela, Michael Peyrol, Julien Mancini, Gilles Lemesle, Laurent Bonello
OBJECTIVES: Early endothelialization of drug-eluting stent (DES) is a major challenge to reduce the risk of stent thrombosis and the duration of dual-antiplatelet therapy (DAPT) in high bleeding-risk patients. The aim of the present study is to evaluate very early strut coverage with optical coherence tomography (OCT) of the Synergy stent (Boston Scientific) at 1 month in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients. METHODS: This substudy of the EARLY trial prospectively included NSTE-ACS patients treated with the Synergy DES...
November 11, 2018: Journal of Invasive Cardiology
Nicola S Vos, Giovanni Amoroso, Maarten A Vink, Moniek Maarse, Rob Adams, Jean-Pau R Herrman, Mark S Patterson, Renè J van der Schaaf, Ton Slagboom, Robbert J de Winter
OBJECTIVES: Pretreatment with P2Y12 inhibitors before primary percutaneous coronary intervention (PPCI) can reduce the incidence of major adverse cardiovascular event (MACE) rate in ST-segment elevation myocardial infarction (STEMI) patients. We investigated differences in coronary reperfusion and clinical outcomes between prehospital administration of prasugrel vs ticagrelor in a historical cohort analysis. METHODS AND RESULTS: We conducted a retrospective analysis of prospectively collected data of 533 STEMI patients, directly referred by the ambulance for PPCI, and pretreated with either prasugrel (2013-2014) or ticagrelor (2015-2016)...
October 15, 2018: Journal of Invasive Cardiology
Rajkumar Doshi, Evan Shlofmitz, Krunalkumar Patel, Perwaiz Meraj
OBJECTIVES: The aim of this study was to investigate the safety and efficacy of atherectomy devices in obese patients with coronary artery calcification (CAC). BACKGROUND: Atherectomy is an important tool for lesion preparation in patients with CAC undergoing percutaneous coronary intervention (PCI). There have been no studies that compared the outcomes of orbital atherectomy (OA) and rotational atherectomy (RA) in obese patients. METHODS: A total of 35,590 patients from five tertiary-care hospitals who underwent PCI between January 2011 to April 2016 were identified...
October 15, 2018: Journal of Invasive Cardiology
Christopher Reiff, Sergey Gurevich, Stefan Bertog, Paul Sorajja, Rosemary Kelly, Santiago Garcia
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) transcatheter valve therapy (TVT) transcatheter aortic valve replacement (TAVR) score was developed to predict in-hospital mortality in patients undergoing commercial TAVR in the United States. Veterans Affairs (VA) hospitals are not included in the TVT registry. METHODS: The STS/ACC TVT-TAVR score was estimated in 195 veterans undergoing TAVR from 2015-2017. Discrimination was estimated by calculating the area under the receiver operating characteristics curve (AUC) for two outcomes of interest: in-hospital and 30-day mortality...
September 15, 2018: Journal of Invasive Cardiology
Pascal Frederiks, Hans Vandekerckhove, Kurt Hermans
A 73-year-old woman presented with exertional chest pain and mild dyspnea for several months. In this case, preoperative coronary angiography showed neovascularization originating from the right coronary artery (RCA) and left circumflex (LCX). Vascular supply in left atrial myxomas usually originates from the LCX and sometimes from the RCA, but vascular supply from both the right and left coronary arteries is rarely seen.
November 2018: Journal of Invasive Cardiology
Brett Hiendlmayr, Kerry E McGuire, Lauren E Curtis, William H Perucki, Saqib Ali Gowani, Amged Abdelaziz, Nicole E Hoover, Mohiuddin Cheema, Talhat Azemi
Periprocedural stroke related to transcatheter aortic valve replacement (TAVR) is associated with increased morbidity and mortality. Cerebral embolic protection using the Sentinel device (Claret Medical) has demonstrated reduced rates of stroke during TAVR. However, alternative access such as a transcarotid approach precludes the use of the Sentinel device. We report a case using cerebral embolic protection during a right transcarotid TAVR.
November 2018: Journal of Invasive Cardiology
Amged Abdelaziz, Saqib Ali Gowani, Brett Hiendlmayr, Jennifer Jantz, Francis Kiernan, Raymond G McKay
Left atrial dissection is an exceedingly rare complication of cardiac surgery, with an incidence of 0.16%-0.84%. We report the first case of interatrial dissection and hematoma in association with the MitraClip procedure. Hemodynamically stable patients can be managed conservatively, with echocardiographic imaging, often with resolution of the dissection over the course of weeks. Our patient remained hemodynamically stable and asymptomatic post operation; at 1-month follow-up, echocardiogram showed resolution of the interatrial septal dissection...
November 2018: Journal of Invasive Cardiology
Giovanni Lorenzoni, Pierluigi Merella, Paolo Pischedda, Gavino Casu
Left atrial appendage (LAA) perforation is a possible complication not only after release of the closure device, but also during the diagnostic phase due to sheath positioning in the LAA. We present an 83-year-old woman with permanent atrial fibrillation and high thromboembolic and bleeding risk who was admitted for elective percutaneous LAA closure. During angiographic study, she suddenly became hypotensive. Heart perforation with leakage of contrast in the pericardial space was evident and imaging confirmed cardiac tamponade...
November 2018: Journal of Invasive Cardiology
Adrian Mercado-Alamo, Anwar Zaitoun, Saroj Neupane, Thomas Davis
Deep vein thrombosis due to superficial femoral artery aneurysm is an extremely rare condition that develops due to aneurysm direct compression of a segment of the venous system. We present a 57-year-old female patient who had recently undergone a left superficial femoral artery (SFA) intervention at an outside institution due to significant peripheral artery disease. Imaging revealed a 3.2 cm SFA aneurysm with secondary mass effect on the left mid superficial femoral vein. She underwent successful exclusion of the aneurysm with a 6...
November 2018: Journal of Invasive Cardiology
Aleksander Araszkiewicz, Stanislaw Jankiewicz, Bartosz Zabicki, Marek Grygier, Maciej Lesiak
The ring-like lesions in chronic thromboembolic pulmonary hypertension (CTEPH) patients are sometimes difficult to dilate because they are hard and fibrotic. For this reason, slightly oversized balloons are used; however, this may result in an increased risk of vessel rupture. We present a 62-year-old female with residual pulmonary hypertension after pulmonary endarterectomy for CTEPH who underwent balloon pulmonary angioplasty (BPA). Implantation of a covered stent not only protects the ruptured vessel, but also keeps perfusion in the future...
November 2018: Journal of Invasive Cardiology
Ian C Gilchrist
An editorial addressing the concerns related to the unique technical and anatomical components of the hand.
November 2018: Journal of Invasive Cardiology
Takahiro Nomura, Yoshio Maeno, Sung-Han Yoon, Yigal Abramowitz, Sharjeel Israr, Masaki Miyasaka, Yoshio Kazuno, Nobuyuki Takahashi, Hiroyuki Kawamori, Mamoo Nakamura, Hasan Jilaihawi, Raj R Makkar
BACKGROUND: Transcatheter aortic valve replacement (TAVR) in cases with left ventricular outflow tract calcification (LVOT-CA) remains a challenging procedure. The aim of this study was to compare the early outcomes of patients undergoing TAVR in LVOT-CA with new-generation devices vs early-generation devices. METHODS: Between January 2014 and December 2016, a total of 433 patients with severe aortic stenosis who had a preprocedural multidetector computed tomography underwent TAVR in a LVOT-CA...
November 2018: Journal of Invasive Cardiology
Lawrence Ang, Abdullah Almasoud, Samhita Palakodeti, Ehtisham Mahmud
OBJECTIVES: Quantify and characterize bacterial contamination of lead aprons in a high-volume catheterization laboratory and evaluate the efficacy of decontamination using an ultraviolet-C (UV-C) radiation system. BACKGROUND: Bacterial contamination and ineffective disinfection of personal protective equipment in medical centers pose potential health risks to patients and medical staff. The contamination burden of lead aprons and a reliable disinfection strategy are unknown...
November 2018: Journal of Invasive Cardiology
Abdallah El Sabbagh, Megha Prasad, Chad J Zack, Robert J Widmer, Brad S Karon, Amir Lerman, Allan S Jaffe
BACKGROUND: Coronary endothelial dysfunction (CED) is associated with recurrent ischemia. The role of high-sensitivity cardiac troponin I (hscTnI) levels in patients with CED has not been established. METHODS: Patients with suspected ischemia, who underwent clinically indicated coronary angiography and were found to have non-obstructive coronary artery disease, were included in the study. CED was defined as ≤50% increase in coronary blood flow from baseline and/or a decrease in epicardial coronary artery diameter >20% in response to maximal dosages of acetylcholine...
November 2018: Journal of Invasive Cardiology
Nicolas W Shammas, Gail A Shammas, Susan Jones-Miller, Qais Radaideh
BACKGROUND: We report on intraprocedural and up to 1-year outcomes on the safety of the Atlas Gold balloon (Bard) in iliofemoral venous interventions. METHODS: All patients who underwent iliofemoral vein compression treatment in our laboratory from September 1, 2013 to May 30, 2017 were identified and medical records were reviewed. The primary safety endpoint was the intraprocedural freedom from major device-related serious adverse events (≥95%) for the Atlas Gold balloon in iliofemoral venous treatment...
November 2018: Journal of Invasive Cardiology
Peter Tajti, Aris Karatasakis, Barbara A Danek, Khaldoon Alaswad, Dimitri Karmpaliotis, Farouc A Jaffer, James W Choi, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, M Nicholas Burke, Oleg Krestyaninov, Dmitrii Khelimskii, Catalin Toma, Anthony H Doing, Barry Uretsky, Michalis Koutouzis, Ioannis Tsiafoutis, R Michael Wyman, Santiago Garcia, Elizabeth Holper, Iosif Xenogiannis, Bavana V Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis
OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². RESULTS: Compared with patients without CKD (n = 1444; 73%), patients with CKD (n = 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity...
November 2018: Journal of Invasive Cardiology
Michael Megaly, Michael Rofael, Marwan Saad, Mehdi Shishehbor, Emmanouil S Brilakis
BACKGROUND: Treating coronary bifurcations remains limited by technical difficulties and suboptimal long-term outcomes, often affecting the side branch (SB). Drug-coated balloon (DCB) in SB treatment could reduce neointimal hyperplasia and the risk for restenosis. METHODS: We performed a systematic review of all studies published between January 2000 and February 2018 reporting the outcomes of DCB vs non-coated balloon angioplasty (BA) in the treatment of the SB in coronary bifurcation lesions...
November 2018: Journal of Invasive Cardiology
Wallace W K Chow, Rong Bing, Juliana Kanawati, Jerrett Lau, Javed Sheriff, Mario D'Souza, David Brieger
INTRODUCTION: Radial access for diagnostic coronary angiography (CAG) has gained traction in recent years over the femoral artery approach, but difference in image quality has not been extensively studied. This study aims to compare image quality and diagnostic value in radial vs femoral access in patients undergoing invasive CAG. METHODS: This is a retrospective study of 200 patients (100 radial and 100 femoral) undergoing CAG at an experienced center from 2014 to 2015...
November 2018: Journal of Invasive Cardiology
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