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Interventional Cardiology Clinics

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https://www.readbyqxmd.com/read/29157530/the-evolving-state-of-care-for-acute-pulmonary-embolism
#1
EDITORIAL
Jay Giri
No abstract text is available yet for this article.
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157529/transcatheter-tricuspid-valve-intervention-addressing-an-unmet-clinical-need
#2
EDITORIAL
Azeem Latib
No abstract text is available yet for this article.
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29157528/catheter-based-embolectomy-for-acute-pulmonary-embolism-devices-technical-considerations-risks-and-benefits
#3
REVIEW
Wissam A Jaber, Michael C McDaniel
A significant number of patients with high-risk pulmonary embolism have contraindications to thrombolytic therapy. Catheter-based therapy may be helpful and consists of a multitude of catheters and techniques, some old and some new. Although there are few data supporting the use of any of these techniques, there has been a recent rise in interest and use of catheter-based pulmonary embolectomy. This text describes the contemporary devices used in pulmonary embolism treatment, discusses their challenges, and proposes some future directions...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157527/catheter-directed-therapy-for-pulmonary-embolism-patient-selection-and-technical-considerations
#4
REVIEW
Bedros Taslakian, Akhilesh K Sista
Acute pulmonary embolism (PE) is the third most common cause of death among hospitalized patients. Treatment escalation beyond anticoagulation therapy is necessary in patients with cardiogenic shock and may be of benefit in select normotensive patients with right heart strain. Percutaneous catheter-based techniques (catheter-directed mechanical thrombectomy, clot maceration, and/or pharmacologic thrombolysis) as an alternative or adjunct to systemic thrombolysis can rapidly debulk central clot in patients with shock...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157526/systemic-thrombolysis-for-pulmonary-embolism-evidence-patient-selection-and-protocols-for-management
#5
REVIEW
Hafeez Ul Hassan Virk, Sanjay Chatterjee, Partha Sardar, Chirag Bavishi, Jay Giri, Saurav Chatterjee
Acute pulmonary embolism presents a clinical challenge for optimal risk stratification. Although associated with significant morbidity and mortality at the population level, the spectrum of presentation in an individual patient varies from mild symptoms to cardiac arrest. Treatment options include anticoagulation, systemic thrombolysis, catheter-based interventions, and surgical embolectomy. In this article, an attempt is made to optimally identify patients who, based on available evidence, may benefit from systemic thrombolytic therapy...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157525/transcatheter-tricuspid-valve-replacement
#6
REVIEW
Amar Krishnaswamy, Jose Navia, Samir R Kapadia
Tricuspid regurgitation (TR) is a common entity, most commonly functional in nature due to right-sided dysfunction in the setting of concomitant cardiac disease or pulmonary hypertension. Patients living with TR often experience numerous limitations as a result of right-sided heart failure symptoms, including functional decline, frequent hospitalizations, liver failure, and kidney failure. Furthermore, patients with significant TR demonstrate worse survival, although a cause-and-effect relationship has not been proven...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157524/caval-valve-implantation
#7
REVIEW
Alexander Lauten, Henryk Dreger, Michael Laule, Karl Stangl, Hans R Figulla
Recently, transcatheter therapy has expanded the treatment options for patients with heart valve disease. With the growing understanding of tricuspid regurgitation and its natural history, it becomes increasingly obvious that this patient population is a heterogeneous cohort presenting for treatment in different stages of a continuous disease process. It is still unclear which interventional approach will result in functional and clinical success and in which subtype of patient population. This article reviews the pathophysiologic background and current evidence for caval valve implantation and examines the potential role of this approach for the treatment of severe tricuspid regurgitation...
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29157523/the-forma-repair-system
#8
REVIEW
Rishi Puri, Josep Rodés-Cabau
Significant tricuspid valve disease affects many patients with left-sided heart disease. Concomitant tricuspid valve surgery for at least moderate tricuspid insufficiency is undertaken far less frequently at the time of left-sided heart surgery. The burden of residual tricuspid disease in high-surgical-risk patients has spawned the evolution of several percutaneous treatment options. A dedicated percutaneously delivered tricuspid Spacer device (FORMA Repair System) has been developed and trialed in humans. This system anchors a Spacer to reduce the regurgitant orifice area, thereby providing a surface for valve leaflet coaptation...
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29157522/tricuspid-clip-step-by-step-and-clinical-data
#9
REVIEW
Gilbert H L Tang
Symptomatic severe tricuspid regurgitation (TR), if untreated, carries a dismal prognosis. These patients are at very high risk for surgical repair or replacement and transcatheter options to treat TR are emerging. More than 300 transcatheter tricuspid repairs with the MitraClip system have been performed worldwide with promising results. The TriClip system, with the MitraClip NT delivered via a dedicated tricuspid steerable guide catheter, is currently under investigation. This article describes the step-by-step technique on using the MitraClip system to perform transcatheter tricuspid repair using echocardiographic and fluoroscopic guidance...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157521/percutaneous-tricuspid-annuloplasty
#10
REVIEW
Antonio Mangieri, Scott Lim, Jason H Rogers, Azeem Latib
The tricuspid valve was ignored for a long time. The prevalence of severe tricuspid regurgitation is not negligible, however, and is associated with poor prognosis. In cases of primary tricuspid regurgitation, surgical options are limited by a high risk of mortality and morbidity. New percutaneous approaches are becoming available to meet this consistent unmet clinical need. This review presents the current available devices that reproduce both the complete and uncomplete surgical annuloplasty techniques.
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29157520/interventional-imaging-of-the-tricuspid-valve
#11
REVIEW
Francesco Ancona, Eustachio Agricola, Stefano Stella, Cristina Capogrosso, Claudia Marini, Alberto Margonato, Rebecca T Hahn
Nowadays, reasonable transcatheter tricuspid valve (TV) interventions are emerging as therapeutic options for functional tricuspid regurgitation (TR). The preprocedural planning is based on a multimodality imaging approach, which aims to (1) define the mechanisms of TR, (2) characterize TV morphology, (3) analyze the anatomic relationship between the TV apparatus and other structures, and (4) determine the size of the tricuspid annulus and vena cavae. Intraprocedural guidance is based mainly on transesophageal echocardiography (seldom transthoracic) and fluoroscopy, with the recent introduction of fusion imaging...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157519/inferior-vena-cava-filters-current-and-future-concepts
#12
REVIEW
John Andrew Kaufman
The inferior vena cava filter clinical environment is notable for the degree of controversy, uncertainty, and fear associated with these devices by both physicians and the public. This article reviews some of the more important current issues with these devices as well as emerging and future trends.
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29157518/mechanical-circulatory-support-for-high-risk-pulmonary-embolism
#13
REVIEW
Mahir Elder, Nimrod Blank, Adi Shemesh, Mohit Pahuja, Amir Kaki, Tamam Mohamad, Theodore Schreiber, Jay Giri
Temporary mechanical circulatory support (MCS) devices have a role in treating high-risk patients with pulmonary embolism with cardiogenic shock. Mechanical circulatory device selection should be made based on center experience and device-specific features. All current devices are effective in decreasing right arterial pressure and providing circulatory support of 4 to 5 L/min. The pulmonary artery pulsatility index may prove to be an unreliable method to assess right ventricular function. Careful clinical evaluation on an individual patient basis should determine the need for MCS...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157517/balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#14
REVIEW
Ehtisham Mahmud, Omid Behnamfar, Lawrence Ang, Mitul P Patel, David Poch, Nick H Kim
Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with several risk factors but is most frequently seen as a rare consequence of an acute pulmonary embolism. Surgical pulmonary thromboendarterectomy (PTE) is potentially curative for CTEPH with the best outcomes seen for the treatment of primarily proximal, accessible lobar or segmental disease. For surgically inoperable patients, percutaneous balloon pulmonary angioplasty (BPA) is feasible and has good short- to mid-term efficacy outcomes...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/29157516/anatomy-of-the-tricuspid-valve-pathophysiology-of-functional-tricuspid-regurgitation-and-implications-for-percutaneous-therapies
#15
REVIEW
Nicola Buzzatti, Michele De Bonis, Neil Moat
The tricuspid valve is a complex dynamic apparatus made up of many different closely linked structures: the annulus, the three leaflets, the chordae, the papillary muscles and the right ventricle. Other nearby structures, such as the coronary sinus ostium, the conduction system, the membranous septum, and the right coronary artery must be taken into account when dealing with the tricuspid. Annulus dilation and leaflet tethering due to right ventricular remodeling are the 2 major mechanisms responsible for most tricuspid regurgitation cases...
January 2018: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886847/transcatheter-closure-of-patent-foramen-ovale
#16
EDITORIAL
Matthew J Price
No abstract text is available yet for this article.
October 2017: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/28886846/transcatheter-closure-of-patent-foramen-ovale-devices-and-technique
#17
REVIEW
Matthew J Price
Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886845/patent-foramen-ovale-closure-for-hypoxemia
#18
REVIEW
Jonathan M Tobis, Deepika Narasimha, Islam Abudayyeh
A patent foramen ovale (PFO) is a common anatomic finding in 20% of the normal population. Significant hypoxemia can occur in circumstances in which hemodynamic or anatomic changes predispose to increased right-to-left intra-atrial shunting. The subsequent hypoxemia produces substantial dyspnea that may affect the patient's quality of life, independent of underlying pulmonary disease. Profound hypoxemia caused by right-to-left shunt across the interatrial septum usually responds to percutaneous PFO closure...
October 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28886844/patent-foramen-ovale-and-migraine-headache
#19
REVIEW
David Hildick-Smith, Timothy M Williams
Migraine headache is a common and debilitating disease that has a demonstrable association with the presence of patent foramen ovale (PFO) in multiple case series. Closure of PFO has been performed to try to treat migraine with aura, with variable results. Although early trials suggested benefit to PFO closure, these were of poor quality, and subsequent randomized trials have failed to yield positive results. This article discusses the evidence of an association with PFO and migraine headache, and the trials that have so far been performed to assess the benefits of closure...
October 2017: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/28886843/current-dataset-for-patent-foramen-ovale-closure-in-cryptogenic-stroke-randomized-clinical-trials-and-observational-studies
#20
REVIEW
Olufunso W Odunukan, Matthew J Price
Approximately one-third of all strokes have no apparent cause. A patent foramen ovale (PFO) is present in as many as 60% of these patients with cryptogenic strokes, which is significantly more frequent than that of the general population. The presumed biologic mechanisms of ischemic stroke in the setting of a PFO are paradoxic embolism from the peripheral venous system through this interatrial shunt or embolism from in situ thrombosis. In this review, the authors summarize and critically assess the contemporary studies evaluating the efficacy and safety of PFO closure for prevention of recurrent cryptogenic strokes...
October 2017: Interventional Cardiology Clinics
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