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Catheterization and Cardiovascular Interventions

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https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#1
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29131513/role-of-vascular-ultrasound-scanning-in-repeated-trans-radial-coronary-artery-intervention-prospective-randomized-study
#2
Mahmoud Farouk Elmahdy, Mohamed Hassan, Ahmed Elguindy
OBJECTIVES: We aimed to detect if pre-procedure vascular ultrasound scanning (VUS) of radial arteries (RAs) can increase the radial access success (RAS) rate and/or reduce the vascular access time (VAT), by guiding the choice of the proper access site for repeated trans-radial interventions (TRIs). BACKGROUND: Currently, repeated-TRIs are encountered more frequently in most of the cath. labs. However, structural changes of the RAs after TRA may hinder it is usage for repeated-TRI...
November 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29131504/balloon-pin-hole-rupture-during-percutaneous-coronary-intervention-for-recurrent-calcified-in-stent-restenosis-a-case-report
#3
Nobuhiro Murata, Tadateru Takayama, Takafumi Hiro, Atsushi Hirayama
Percutaneous coronary intervention (PCI) for patients with in-stent restenosis (ISR) is generally considered safe and effective. However, due to increased tissue hardness, PCI for calcified intra-stent ISR is technically challenging. Here, we report severe angioplasty-related complications in a patient presenting with calcified, recurrent ISR following PCI. After receiving drug-coated balloon (DCB) angioplasty for an initial ISR, the patient developed recurrent ISR during the follow-up period. Intravascular imaging revealed intra-stent calcifications and balloon angioplasty was subsequently performed...
November 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130648/emergent-percutaneous-therapy-for-left-ventricular-assist-device-retrograde-flow
#4
Ryan E Wilson, John C Gurley, Navin Rajagopalan, Thomas A Tribble
With the number of heart transplants being performed each year stagnating due to lack of donors the left ventricular assist device (LVAD) patient population will continue to grow. As more and more patients are living longer with LVADs, either as a bridge to transplant or destination therapy, we will continue to see an increased number of complications related to assist device therapy. One of the common challenges physicians face are patients who suffer from both bleeding and thrombotic complications. When bleeding complications occur anticoagulation is usually reduced or discontinued and then the thrombosis risk increases...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130638/thromboembolism-after-watchman-tm-in-a-clopidogrel-non-responder-a-case-for-concern
#5
Ganesh Venkataraman, Kevin P Bliden, Udaya S Tantry, Paul A Gurbel
Atrial fibrillation (AF) is associated with an increased risk of stroke and thromboembolism (TE). The WATCHMAN(TM) left atrial appendage (LAA) closure device is indicated to reduce the risk of TE from the LAA in patients with non-valvular AF. Here, we present a case of a patient with device-related thrombus who suffered a TE event two months after WATCHMAN(TM) LAA closure and two weeks after switching from aspirin plus warfarin to aspirin plus clopidogrel therapy. Laboratory investigation identified the patient to be hypercoagulable and to be a non-responder to clopidogrel therapy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130619/a-feasibility-study-of-transaxillary-tavi-with-the-lotus-valve
#6
Sagar N Doshi, Sudhakar George, Chun Shing Kwok, Anthony Mechery, Mamas Mamas, Peter F Ludman, Jonathan N Townend, Moninder Bhabra
OBJECTIVES: To assess the feasibility of axillary transcatheter aortic valve implantation (TAVI) using the Lotus valve. BACKGROUND: TAVI is used to treat patients with severe aortic stenosis, with transfemoral (TF) access being the safest and most widely used route. In patients unsuitable for this, there are reports that the axillary artery may be safest alternative access route. The Lotus device is a fully retrievable 2nd generation transcatheter heart valve which is licensed for femoral and transaortic access...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130616/emergency-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-two-center-experience-of-incidence-outcome-and-temporal-trends-from-2010-to-2015
#7
Teresa Trenkwalder, Costanza Pellegrini, Andreas Holzamer, Alois Philipp, Tobias Rheude, Jonathan Michel, Wibke Reinhard, Michael Joner, Albert M Kasel, Adnan Kastrati, Heribert Schunkert, Dierk Endemann, Kurt Debl, N Patrick Mayr, Michael Hilker, Christian Hengstenberg, Oliver Husser
BACKGROUND: Although the incidence of periprocedural complications has decreased in transcatheter aortic valve implantation (TAVI), life-threatening complications occur and emergency veno-arterial extracorporeal membrane oxygenation (vaECMO) can provide immediate circulatory stabilization. We report our two-center experience of vaECMO during life-threatening complications in TAVI. METHODS: From January 2010 to December 2015, 1,810 consecutive patients underwent TAVI at two centers...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130613/impact-of-anemia-on-long-term-outcomes-after-percutaneous-coronary-intervention-for-chronic-total-occlusion
#8
Barbara E Stähli, Cathérine Gebhard, Michael Gick, Miroslaw Ferenc, Kambis Mashayekhi, Heinz Joachim Buettner, Franz-Josef Neumann, Aurel Toma
OBJECTIVES: A single-centre, observational study was performed in order to investigate the relationship between anemia and outcomes after percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). BACKGROUND: Anemia has been identified as adverse predictor in patients with coronary artery disease undergoing coronary revascularization. Data on the impact of anemia on outcomes in patients undergoing PCI for CTO lesions are lacking. METHODS: A total of 1,964 patients undergoing CTO PCI were stratified according to the presence/absence of anemia (hemoglobin of <13 g/dl for men and <12 g/dl for women)...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#9
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130587/pushing-boundaries-implantation-of-the-34-mm-medtronic-corevalve-in-patients-with-a-large-aortic-annulus
#10
Adham Elmously, Berhane Worku, S Chiu Wong, Arash Salemi
The relationship between adherence to the recommended CoreValve sizing parameters and clinical outcomes is not well known for the recently released 34 mm valve, which is currently the largest available transcatheter valve. There is a presumed temporal reduction in paravalvular regurgitation in patients who receive an in-range valve, however, certain patients possess annular dimensions that are too large. We therefore describe two patients with annular dimensions larger than the manufacturer recommended range for the 34 mm CoreValve, who despite this underwent transcatheter aortic valve replacement with excellent clinical outcomes...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130582/periprocedural-transfusion-in-patients-undergoing-transfemoral-transcatheter-aortic-valve-implantation
#11
N Patrick Mayr, Gunther Wiesner, Alexander Hapfelmeier, Pieter van der Starre, Oliver Husser, Sabine Bleiziffer, Heribert Schunkert, Rüdiger Lange, Peter Tassani-Prell, Klaus Martin
OBJECTIVES: The aim of this investigation was to identify patient's characteristics and periprocedural variables related to periprocedural transfusion in transfemoral Transcatheter Aortic Valve Implantation (tf-TAVI). BACKGROUND: Transfusion of allogenic red-blood cells (RBC) in tf-TAVI and the number of transfused units has been linked to an increased 30-day mortality. In line with the trend of minimization and cost-effectiveness, transfusion should be avoided, wherever possible...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130573/planned-angiographic-control-versus-clinical-follow-up-for-patients-with-unprotected-left-main-stem-stenosis-treated-with-second-generation-drug-eluting-stents-a-propensity-score-with-matching-analysis-from-the-fails-failure-in-left-main-with-second-generation
#12
Fabrizio D'Ascenzo, Mario Iannaccone, Marco Pavani, Hyroishi Kawamoto, Javier Escaned, Ferdinando Varbella, Giacomo Boccuzzi, David Hiddick-Smith, Antonio Colombo, Fiorenzo Gaita
BACKGROUND: The value of angiographic follow-up in unprotected left main (ULM) stenting remains undefined. METHODS: The FAILS-2 registry included consecutive patients presenting with a critical lesion of an ULM treated with second generation drug eluting stents in 6 centers from June 2007 to January 2015. Patients were stratified into two groups: those discharged with planned angiographic follow-up and those with clinical follow-up. MACE (Major Adverse Clinical Events, a composite end point of death, myocardial infarction, TLR, and ST) was the primary end point, while each component was a secondary endpoint Sensitivity analysis was performed for patients treated with a provisional or a two-stent strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29106070/transverse-partial-stent-ablation-with-rotational-atherectomy-for-suboptimal-culotte-technique-in-left-main-stem-bifurcation
#13
Giovanni Luigi De Maria, Rajesh Kharbanda, Adrian P Banning
Longitudinal rotational atherectomy of metal struts is well described as bail-out strategy to treat undilatable instent restenosis. Ablation of metal stent struts jailing the ostium of a major side branch in a coronary bifurcation is not described. In the current report, we describe a case of "transverse" rotational atherectomy to treat a failure of culotte stenting in a left main stem bifurcation. We document for the first time in vivo and in man the effect of this strategy using optical coherence tomography...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105984/hemodynamic-classification-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-compared-with-angiographic-or-echocardiographic-classification-for-prediction-of-1-year-mortality
#14
Simon Schoechlin, Tim Brennemann, Abdelhakim Allali, Philip Ruile, Nikolaus Jander, Martin Allgeier, Michael Gick, Gert Richardt, Franz-Josef Neumann, Mohamed Abdel-Wahab
OBJECTIVES: We sought to assess angiographic, echocardiographic and hemodynamic grading of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) with respect to prediction of 1-year mortality. BACKGROUND: Meaningful criteria for the severity of PVL are needed to allow intraprocedural guidance and patient management after TAVI. METHODS: We pooled the prospective TAVI databases of 2 German centers. During TAVI, PVL was assessed angiographically and by the aortic regurgitation index (ARI)...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105964/simultaneous-transcatheter-transfemoral-aortic-and-transeptal-mitral-valve-replacement-using-edward-sapien-s3
#15
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105953/comparison-of-self-expanding-and-balloon-expandable-transcatheter-aortic-valves-morphology-and-association-with-paravalvular-regurgitation-evaluation-using-multidetector-computed-tomography
#16
João G Almeida, Sara M Ferreira, Paulo Fonseca, Tiago Dias, Cláudio Guerreiro, Ana Barbosa, Pedro Teixeira, Mónica Carvalho, Wilson Ferreira, Nuno D Ferreira, Pedro Braga, José Ribeiro, Vasco G Ribeiro
OBJECTIVES: Compare final morphology of self-expanding and balloon-expandable prosthesis and association with paravalvular regurgitation (PVR). BACKGROUND: PVR after transcatheter aortic valve replacement (TAVR) remains a frequent complication. A better understanding of the prosthesis geometry may be important to improve selection of the best device for each case and possibly reduce the rates of PVR. METHODS: Retrospective study including patients consecutively submitted to transcatheter aortic valve replacement: August/2007-October/2016...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29086475/differential-responses-to-larger-volume-intra-aortic-balloon-counterpulsation-hemodynamic-and-clinical-outcomes
#17
David A Baran, Gautam K Visveswaran, Ahmed Seliem, Michael DiVita, Najam Wasty, Marc Cohen
OBJECTIVES: Examine hemodynamic and clinical correlates of use of an intra-aortic balloon pump catheter in a single center. BACKGROUND: The intra-aortic balloon pump catheter (IABC) has been used for 50 years but the clinical benefit is still debated. We reviewed 76 patients with right heart catheter measurements prior to IABC to assess response and outcomes. METHODS: All patients who received IABC with a 50cc balloon for at least 1 hour were included in this retrospective chart review study...
October 31, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29086474/when-high-volume-pci-operators-in-high-volume-hospitals-move-to-lower-volume-hospitals-do-they-still-maintain-high-volume-and-quality-of-outcomes
#18
Tsung-Hsueh Lu, Sheng-Tun Li, Fu-Wen Liang, Jo-Chi Lee, Wei-Hsian Yin
OBJECTIVES: The aim of this quasi-experimental study was to examine whether high-volume percutaneous coronary intervention (PCI) operators still maintain high volume and quality of outcomes when they moved to lower volume hospitals. BACKGROUND: Systematic reviews have indicated that high-volume PCI operators and hospitals have higher quality outcomes. However, little is known on whether high PCI volume and high quality outcomes are mainly due to operator characteristics (i...
October 31, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29086469/omission-of-heart-transplant-recipients-from-the-2017-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-stable-ischemic-heart-disease
#19
LETTER
Abhinav Goyal, Steven W Tabak, Timothy D Henry, Jon A Kobashigawa
No abstract text is available yet for this article.
October 31, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29086466/public-unawareness-of-physician-reimbursement
#20
Nicole Lilly Herrick, John Fontanesi, Toni Rush, Richard A Schatz
OBJECTIVES: To assess subjects' perception of healthcare costs and physician reimbursement. BACKGROUND: The lack of transparency in healthcare reimbursement leaves patients and physicians unaware of the distribution of health care dollars. METHODS: Anonymous survey-based study by means of convenience sampling. Participants were asked to estimate the total hospital cost and physician fee for one of the six medical procedures (n = 250). RESULTS: On the average for all 6 procedures, patients estimated the total cost was $36,177, ∼1,540% more than the actual Medicare rate of $7,333...
October 31, 2017: Catheterization and Cardiovascular Interventions
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