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Catheterization and Cardiovascular Interventions

Moritz Baquet, David Grundmann, Wolfgang Schmidt, Manuela Thienel, David Jochheim, Christian Tesche, Hans Diogenes Theiss, Stefan Brunner, Steffen Massberg, Julinda Mehilli
AIM AND OBJECTIVE: We sought to investigate and compare outcomes 2 years after Hybrid-stenting with bioresorbable vascular scaffolds (BVS) and contemporary metallic drug-eluting stents (DES) within the same coronary lesion versus BVS alone. METHODS: Between 11/2012 and 7/2015 at our institution, 134 (33.2%) were treated with Hybrid-stenting for complex or long coronary lesions, 270 patients were treated by BVS alone. The primary outcome of interest was target lesion failure (TLF) at 2-years of follow-up...
September 19, 2018: Catheterization and Cardiovascular Interventions
Bimmer E Claessen, José P S Henriques, Jeroen Vendrik, Kirsten Boerlage-van Dijk, René J van der Schaaf, Martijn Meuwissen, Niels van Royen, A T Marcel Gosselink, Marleen H van Wely, Atilla Dirkali, E Karin Arkenbout, Jan J Piek, Jan Baan
OBJECTIVES: To investigate the relative performance of treatment with a paclitaxel-eluting balloon (PEB) compared with an everolimus-eluting stent (EES) for in-stent restenosis (ISR) in patients with diabetes mellitus (DM). BACKGROUND: ISR remains a challenge in contemporary clinical practice, particularly in patients with DM. METHODS: In the multicenter randomized DARE trial, patients with BMS or DES ISR were randomized in a 1:1 fashion to treatment with a PEB or an EES...
September 19, 2018: Catheterization and Cardiovascular Interventions
Razvan T Dadu, Jiaqiong Xu, Hasan Rehman, Moritz Wyler von Ballmoos, Colin M Barker, Manuel Reyes, Mahesh Ramchandani, Ross M Reul, Michael J Reardon, Neal S Kleiman
OBJECTIVES: To evaluate the association between measurements performed during Medtronic CoreValve (MCV) deployment and paravalvular leak (PVL). BACKGROUND: The MCV can be recaptured and repositioned, allowing the TAVR operator to implant at a more favorable position. The association between angiographic measurements of MCV position while the valve is recapturable and PVL post deployment has not been investigated. METHODS: 493 patients undergoing TAVR with MCV (January 2011-July 2017) were included...
September 14, 2018: Catheterization and Cardiovascular Interventions
Hashrul N Rashid, Arthur Nasis, Robert P Gooley, James D Cameron, Adam J Brown
INTRODUCTION: Leaflet thrombosis (LT) defined by computed tomography (CT) following transcatheter aortic valve replacement (TAVR) has been shown to increase cerebrovascular events. The neo-sinus plays an important role in the development of LT. Intra-annular valves (IAV) have a larger neo-sinus when compared to supra-annular valves (SAV), and has been associated with larger thrombus burden. The prevalence of LT with IAV and SAV in a larger, diverse cohort is unknown. METHODS: We performed a systematic review to assess the prevalence of LT in IAV versus SAV TAVR prostheses...
September 14, 2018: Catheterization and Cardiovascular Interventions
Arslan Shaukat, Michael Mooney, M Nicholas Burke, Emmanouil S Brilakis
Acute vessel closure due to dissection is a known complication of percutaneous coronary intervention and can be challenging to treat, especially if guidewire position is lost. Re-entering into the distal true lumen is commonly done during chronic total occlusion interventions, as part of antegrade dissection strategies. We report two cases of acute vessel closure and guidewire position loss in which the Stingray LP system was successfully used to advance a guidewire into the distal true lumen and recanalize the occluded vessel...
September 14, 2018: Catheterization and Cardiovascular Interventions
Martijn S van Mourik, Yvonne C Janmaat, Floortje van Kesteren, Jeroen Vendrik, R Nils Planken, Marieke J Henstra, Juliëtte F Velu, Wieneke Vlastra, Aeilko H Zwinderman, Karel T Koch, Robbert J de Winter, Joanna J Wykrzykowska, Jan J Piek, José P S Henriques, Vincent R Lanting, Jan Baan, Corine Latour, Robert Lindeboom, M Marije Vis
OBJECTIVES: The aim of this study was to assess the predictive value of PMA measurement for mortality. BACKGROUND: Current surgical risk stratification have limited predictive value in the transcatheter aortic valve implantation (TAVI) population. In TAVI workup, a CT scan is routinely performed but body composition is not analyzed. Psoas muscle area (PMA) reflects a patient's global muscle mass and accordingly PMA might serve as a quantifiable frailty measure. METHODS: Multi-slice computed tomography scans (between 2010 and 2016) of 583 consecutive TAVI patients were reviewed...
September 12, 2018: Catheterization and Cardiovascular Interventions
Hiroyuki Okumura, Hiroki Hayashi, Masaki Harada, Mikiko Mikuri
A 78-year-old man was admitted to the emergency department because of chest pain following blunt chest trauma. Chest X-ray revealed multiple rib fractures. However, electrocardiogram showed ST elevation in inferior leads suggesting acute myocardial infarction (AMI). Emergency coronary angiography revealed normal left coronary artery and occluded proximal right coronary artery. Thus, percutaneous coronary intervention (PCI) was performed immediately. Antegrade PCI was unsuccessful due to a very large false lumen, which was caused by a blunt trauma...
September 12, 2018: Catheterization and Cardiovascular Interventions
Tuija Javanainen, Jordi Sans-Roselló, Veli-Pekka Harjola, Markku S Nieminen, Johan Lassus, Alessandro Sionis, Marjut Varpula, Raija Jurkko
OBJECTIVES: The aim was to assess the extent of coronary artery disease and revascularization using baseline SYNTAX Score (bSS) and residual SYNTAX Score (rSS) in patients with cardiogenic shock (CS) secondary to ST-segment elevation myocardial infarction (STEMI). The prognostic impact of SYNTAX Score (SS) was evaluated and assessed for additive value over clinical risk scores. BACKGROUND: bSS and rSS have been proven to be useful in risk stratification in stable coronary artery disease as well as in acute coronary syndromes, but they have not been studied in STEMI related CS...
September 12, 2018: Catheterization and Cardiovascular Interventions
Alberto Boi, Francesco Sanna, Angelica Rossi, Bruno Loi
Blunt chest trauma is a common occurrence in vehicle accident. Cardiac injuries following nonpenetrating thoracic trauma have been reported. ST-elevation myocardial infarction (STEMI) due to coronary artery involvement is a rare but extremely serious condition for the high risk of undetected diagnosis. Blunt thoracic trauma may obscure typical chest pain associated with cardiac ischemia especially in patients with high tolerance of pain or secondary administration of analgesic drugs. We report two consecutive cases of young adults admitted to our emergency department after motorcycle accident and concomitant anterior STEMI due to occlusion of left anterior descending artery...
September 12, 2018: Catheterization and Cardiovascular Interventions
Floris E A Udink Ten Cate, Rodina Sobhy, Atul Kalantre, Sakshi Sachdev, Anand Subramanian, Nageswara Rao Koneti, Raman Krishna Kumar, Hala Hamza, Mahimarangaiah Jayranganath, Narayanswami Sreeram
OBJECTIVE: We sought to evaluate the feasibility, technical aspects, and outcome of transcatheter perimembranous ventricular septal defect (pmVSD) closure using duct occluder devices with a single retention disc. BACKGROUND: Use of duct occluder devices to close pmVSD seems a promising alternative therapy. However, limited data exist on this technique. METHODS: From 2010 to 2016, 222 patients (female 47.7%) were identified from databases of five participating institutions in whom pmVSD closure was attempted using an Amplatzer Duct Occluder I or Lifetech duct occluder device...
September 12, 2018: Catheterization and Cardiovascular Interventions
Kevin D Hill, Steve D Mann, Michael P Carboni, Thomas P Doyle, Salim F Idriss, Dana F Janssen, George T Nicholson, Shyam Sathanandam, Greg A Fleming
OBJECTIVES: To evaluate differences in radiation dose and image quality across institutions, fluoroscope vendors and generations of fluoroscopes for pediatric cardiac catheterization. BACKGROUND: Increased recognition of the potentially harmful effects of ionizing radiation has spurred technological advances in fluoroscopes, as well as increased focus on optimizing fluoroscope performance. There is currently little understanding of variability in the dose-image quality relationship across institutions, fluoroscope vendor and/or generation of equipment...
September 12, 2018: Catheterization and Cardiovascular Interventions
Daniel Braun, Michael Näbauer, Steffen Massberg, Jörg Hausleiter
Percutaneous edge-to-edge repair of severe mitral regurgitation has been established as an alternative treatment option for patients at high risk for cardiac surgery. More recently, the introduction of the Cardioband system enabled percutaneous direct annuloplasty. Here, we present a case of simultaneous percutaneous direct annuloplasty with edge-to-edge repair. Moreover, annuloplasty did facilitate clip implantation bei approximating the anterior and posterior mitral leaflet. In conclusion, the combination of direct annuloplasty with edge-to-edge repair is feasible in a single procedure...
September 9, 2018: Catheterization and Cardiovascular Interventions
Frank E Corrigan, Michael J Hall, Jose Miguel Iturbe, Jose F Condado, Norihiko Kamioka, Sharon Howell, Vinod H Thourani, Stephen D Clements, Vasilis C Babaliaros, Stamatios Lerakis
OBJECTIVE: We investigated radioprotective strategies for the interventional echocardiographer (IE) during structural heart interventions in comparison with the interventional cardiologist (IC). BACKGROUND: Structural heart interventions are expanding in complexity with increased reliance on IE. Recent reports have demonstrated concerning exposure and higher radiation to the IE. METHODS: We monitored 32 structural interventions - 19 transcatheter aortic valve replacements (TAVR), 6 transcatheter mitral valve repairs, 5 paravalvular leak closures, and 2 atrial septal defect closures...
September 9, 2018: Catheterization and Cardiovascular Interventions
Riccardo Gorla, Gaspare Sergio Cannone, Francesco Bedogni, Federico De Marco
Transfemoral approach is considered the preferred route to perform transcatheter aortic valve implantation (TAVI) by most operators due to the low invasiveness and good outcome, as compared to non-transfemoral approach. However, transfemoral access is not always feasible particularly in patients with small and calcific vessels. Recently, catheter-based lithoplasty has emerged as a new technique based on the use of circumferential pulse pressure waves to disrupt calcific plaques. This technology may help to expand eligibility for transfemoral TAVI to patients with calcific ileo-femoral vessels and at high risk for non-transfemoral approach...
September 9, 2018: Catheterization and Cardiovascular Interventions
Florian Blachutzik, Stephan Achenbach, Monique Tröbs, Mohamed Marwan, Melissa Weissner, Holger Nef, Christian Schlundt
BACKGROUND: Optimal implantation results of bioresorbable scaffolds (BRS) are typically assumed to require postdilatation with non-compliant (NC) balloons to achieve full scaffold apposition and minimize event rates. We systematically evaluated the mechanical effect of NC balloon postdilatation on magnesium-based BRS (Magmaris®, Biotronik AG, Bülach, Switzerland) in vivo. METHODS: In 35 patients, 40 Magmaris® BRS were implanted to treat 37 de novo coronary artery stenoses...
September 9, 2018: Catheterization and Cardiovascular Interventions
Salvatore Brugaletta, Angel Cequier, Fernando Alfonso, Andrés Iñiguez, Sebastian Romaní, Antonio Serra, Pablo Salinas, Javier Goicolea, Pascual Bordes, Bruno García Del Blanco, Rosana Hernández-Antolín, Alberto Pernigotti, Josep Gómez-Lara, Manel Sabaté
AIM: Use of a BRS either in clinical practice or in the setting of an acute myocardial infarction (MI) is controversial. Despite an overall high rate of thrombosis, vascular healing response following BRS implantation tend to superiority as compared to metallic drug-eluting stent in ST-segment elevation myocardial infarction (STEMI) patients. We sought to compare the in-stent/scaffold vasomotion between metallic bioresorbable scaffold (BRS) and sirolimus eluting stent (SES) at 12-month angiographic follow-up in the setting of patients with STEMI treated by primary PCI...
September 9, 2018: Catheterization and Cardiovascular Interventions
Abdelhakim Allali, Mohammad Abdelghani, Nader Mankerious, Mohamed Abdel-Wahab, Gert Richardt, Ralph Toelg
OBJECTIVES: We aimed to investigate the feasibility, safety, and outcome of rotational atherectomy (RA) in the setting of acute coronary syndrome (ACS). BACKGROUND: Limited data are available on the use of RA in patients presenting with ACS. METHODS: This analysis is from an observational registry, which enrolled all consecutive patients undergoing RA in a tertiary center. Between 2002 and 2015, 433 patients with stable coronary artery disease (SCAD) were treated with RA...
September 9, 2018: Catheterization and Cardiovascular Interventions
Kevin D Hill, Wei Du, Gregory A Fleming, Thomas J Forbes, David G Nykanen, Jaxk Reeves, Yan Du, Daisuke Kobayashi
OBJECTIVES: To externally validate the CRISP score, and determine if refinements might improve clinical utility. BACKGROUND: The CRISP score estimates risk of serious adverse events (SAEs) for pediatric catheterization. METHODS: Pediatric (age < 18) procedures reported to the Congenital Cardiovascular Interventional Study Consortium registry from 05/08 to 09/17 (n = 29,830, 27 centers) were divided into a development dataset of 14,784 earlier procedures, and a validation dataset of 15,046 more recent procedures...
September 9, 2018: Catheterization and Cardiovascular Interventions
Andreas Schaefer, Florian Deuschl, Lenard Conradi, Ulrich Schäfer
Valve-in-valve (ViV) procedures for failing bioprostheses carry a certain risk for device malfunction. We herein report a case of a failing Evolut R in a deteriorated Mitroflow, treated with a Sapien 3. An 81 year old female patient received surgical aortic valve replacement and was treated by ViV due to deterioration. Three years later, echocardiography revealed a pressure gradient of peak/mean 105/63 mmHg. Subsequently, a second ViV procedure with initial intentional rupture of the bioprosthetic stent was performed...
September 9, 2018: Catheterization and Cardiovascular Interventions
Laura Gellis, Kimberlee Gauvreau, Michael Ferguson, Lisa Bergersen, Keri Shafer, Diego Porras
BACKGROUND: Adults with congenital heart disease (ACHD) are vulnerable to contrast-induced acute kidney injury (CI-AKI) after cardiac catheterization. The aim of this study was to identify risk factors for clinically significant CI-AKI and evaluate the predictive value of contrast volume to estimated glomerular filtration rate ratio (V/eGFR) for the risk of CI-AKI following catheterization in the ACHD population. METHODS: ACHD patients who underwent catheterization at Boston Children's hospital between 1/2011 and 1/2017 were retrospectively analyzed...
September 9, 2018: Catheterization and Cardiovascular Interventions
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