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Interventional cardiologist

Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Wail Alkashkari, Amani Alsubei, Ziyad M Hijazi
PURPOSE OF REVIEW: The past couple of decades have brought tremendous advances to the field of pediatric and adult congenital heart disease (CHD). Percutaneous valve interventions are now a cornerstone of not just the congenital cardiologist treating patients with congenital heart disease, but also-and numerically more importantly-for adult interventional cardiologists treating patients with acquired heart valve disease. Transcatheter pulmonary valve replacement (tPVR) is one of the most exciting recent developments in the treatment of CHD and has evolved to become an attractive alternative to surgery in patients with right ventricular outflow tract (RVOT) dysfunction...
March 15, 2018: Current Cardiology Reports
Konstantinos C Koskinas, Masato Nakamura, Lorenz Räber, Roisin Colleran, Kazushige Kadota, Davide Capodanno, William Wijns, Takashi Akasaka, Marco Valgimigli, Giulio Guagliumi, Stephan Windecker, Robert A Byrne
BACKGROUND: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI).Methods and Results:A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69.8% with optical coherence tomography [OCT], and 7...
March 15, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Konstantinos C Koskinas, Masato Nakamura, Lorenz Räber, Roisin Colleran, Kazushige Kadota, Davide Capodanno, William Wijns, Takashi Akasaka, Marco Valgimigli, Giulio Guagliumi, Stephan Windecker, Robert A Byrne
AIMS: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI). METHODS AND RESULTS: A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69...
March 15, 2018: EuroIntervention
Maohuan Lin, Zizhuo Su, Jiajie Li, Ruqiong Nie, Jingfeng Wang
A honeycomb-like structure (HLS) is a rare entity encountered in catheterization laboratories. The etiology of HLS remains elusive. Moreover, no treatment guideline or consensus for HLS has been proposed. However, with more frequent adoption of intravascular imaging modalities, the number of cases of HLS is rising. We herein present a case of HLS and summarize previous reports in the literature with the aim of providing useful information for interventional cardiologists and promoting further research.
January 1, 2018: Journal of International Medical Research
Nicholas Y Tan, Omar Z Yasin, Alan Sugrue, Abdallah El Sabbagh, Thomas A Foley, Samuel J Asirvatham
The left atrial appendage has been implicated as a major nidus for thrombus formation, particularly in atrial fibrillation. This discovery has prompted substantial interest in the development of left atrial appendage exclusion devices aimed at decreasing systemic thromboembolism risk. Its deceptively simple appearance belies the remarkable complexity that characterizes its anatomy and physiology. We highlight the key anatomic features and variations of the left atrial appendage as well as its relationships with surrounding structures...
April 2018: Interventional Cardiology Clinics
Anupam B Jena, Andrew Olenski, Daniel M Blumenthal, Robert W Yeh, Dana P Goldman, John Romley
BACKGROUND: Previous research has found that patients with acute cardiovascular conditions treated in teaching hospitals have lower 30-day mortality during dates of national cardiology meetings. METHODS AND RESULTS: We analyzed 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (overall, ST-segment-elevation myocardial infarction, and non-ST-segment-elevation myocardial infarction) from January 1, 2007, to November 31, 2012, in major teaching hospitals during dates of a major annual interventional cardiology meeting (Transcatheter Cardiovascular Therapeutics) compared with identical nonmeeting days in the ±5 weeks...
March 9, 2018: Journal of the American Heart Association
Roberta Rossini, Giuseppe Tarantini, Giuseppe Musumeci, Giulia Masiero, Emanuele Barbato, Paolo Calabrò, Davide Capodanno, Sergio Leonardi, Maddalena Lettino, Ugo Limbruno, Alberto Menozzi, U O Alfredo Marchese, Francesco Saia, Marco Valgimigli, Walter Ageno, Anna Falanga, Antonio Corcione, Alessandro Locatelli, Marco Montorsi, Diego Piazza, Andrea Stella, Antonio Bozzani, Alessandro Parolari, Roberto Carone, Dominick J Angiolillo
Perioperative management of antithrombotic therapy in patients treated with coronary stents undergoing surgery remains poorly defined. Importantly, surgery represents a common reason for premature treatment discontinuation, which is associated with an increased risk in mortality and major adverse cardiac events. However, maintaining antithrombotic therapy to minimize the incidence of perioperative ischemic complications may increase the risk of bleeding complications. Although guidelines provide some recommendations with respect to the perioperative management of antithrombotic therapy, these have been largely developed according to the thrombotic risk of the patient and a definition of the hemorrhagic risk specific to each surgical procedure, key to defining the trade-off between ischemia and bleeding, is not provided...
March 12, 2018: JACC. Cardiovascular Interventions
Marco Barbanti, Simona Gulino, Giuliano Costa, Corrado Tamburino
Transcatheter aortic valve implantation (TAVI) is now a widely adopted therapy for the treatment of elderly patients with severe aortic stenosis. Improved pre-procedural screening, increased operators' experience and technology advancement have made this technique highly reliable and standardized. Areas covered: The purpose of this review article is to provide an overview of the strategies that can be adopted to optimize the TAVI procedure (pre-interventional work-up and procedural simplification and early discharge)...
March 9, 2018: Expert Review of Cardiovascular Therapy
Damiano Regazzoli, Daisuke Hachinohe, Ozan M Demir, Mauro Carlino, Julien Lemoine, Satoru Mitomo, Enrico Poletti, Max Amor, Antonio Colombo, Lorenzo Azzalini
Candidates for percutaneous coronary revascularization are becoming progressively older and more complex. A combination of factors related to the patient, lesion, and/or hemodynamic conditions may increase the risk of adverse events. Therefore, when a high-risk procedure is identified, it is crucial to provide the patient with adequate support in order to safely perform percutaneous coronary intervention (PCI). We report the case of a 77-year-old man with moderate left ventricular dysfunction and stage IV chronic kidney disease who underwent successful recanalization of a chronically occluded left anterior descending artery...
February 7, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Luis C L Correia, Guilherme B Barcellos, Vitor Calixto, André Volschan, José A S Barreto-Filho, Renato D Lopes, Anis Rassi, Wendy Levinson, Angelo A V de Paola
Objective: (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Design: Cross-sectional study. Setting: Brazilian Society of Cardiology. Participants: Cardiologists who agree to fill a web questionary. Intervention: A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation...
March 1, 2018: International Journal for Quality in Health Care
Aref A Bin Abdulhak, Mary Vaughan-Sarrzin, Peter Kaboli, Phillip A Horwitz, Hilary Mosher, Gardar Sigurdsson, Nicholas E Walker, Robert Wallace, Jennifer G Robinson
BACKGROUND: The 2013 American College of Cardiology/American Heart Association blood cholesterol guideline recommends high-intensity statin therapy among certain groups of patients, but full implementation of the guideline has not yet been satisfactory. We aimed to investigate the temporal trends and predictors of high-intensity statin therapy among veterans who had been treated with percutaneous coronary intervention (PCI) and followed up by cardiologists within the Veterans Health Administrative system...
March 4, 2018: Journal of the American Heart Association
Jiří Laštůvka, Sabína Oreská, Michal Tomčík, Michal Vrablík
Cardiovascular disease (CVD) risk in patients with rheumatic diseases is increased by 50 % compared to the general population. This is a result of the increased inflammatory activity as well as modification of traditional CVD risk factors by the primary disease. So called lipid paradox, paradoxical decrease of concentrations of atherogenic plasma lipids due to increased inflammatory activity and their rise with successful anti-inflammatory treatment, is of particular importance. CVD risk in rheumatic diseases is further modified by drugs used for their treatment: while some treatment modalities increase the risk (e...
2018: Vnitr̆ní Lékar̆ství
Alfonso Quintero-Quintero, Galo Patiño Camargo, Ángela Soriano Cruz, Juan Diego Palma Copete, Jorge Vilar Palop, Maria Del Carmen Pujades, Nieves Llorca Domaica, Facundo Ballester, Javier Vijande, Cristian Candela-Juan
Fluoroscopy guided interventional procedures provide remarkable benefits to patients. However, the medical staff working near the scattered radiation field may be exposed to high cumulative equivalent doses, thus requiring shielding devices such as lead aprons and thyroid collars. In this situation, it remains an acceptable practice to derive equivalent doses to the eye lenses or other unprotected soft tissues with a dosimeter placed above these protective devices. Nevertheless, the radiation backscattered by the lead shield differs from that generated during dosimeter calibration with a water phantom...
March 2, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Laurent Faroux, Thierry Blanpain, Pierre Nazeyrollas, Sophie Tassan-Mangina, Virginie Heroguelle, Christophe Tourneux, Florian Baudin, Damien Metz
Exposure of operators to ionising radiation in interventional cardiology has likely diminished, but data confirming the magnitude of the reduction are lacking. The aim of this study was to compare the dose of radiation received by interventional cardiology operators at 11 years interval (2006 vs 2017). The study population comprised all interventional coronary procedures performed by a single operator in one catheterization laboratory (cathlab) of a large university hospital in north-eastern France. Exposure was compared between two periods, namely period 1 (from October 2005 to March 2006) and period 2 (from March 2017 to June 2017)...
February 9, 2018: International Journal of Cardiology
Peter Covens, Jérémie Dabin, Olga De Troyer, Octavian Dragusin, Jan Maushagen, Lara Struelens
The European epidemiological study EURALOC aimed to establish a dose response relationship for low dose radiation induced eye lens opacities using interventional cardiologists as the study group. Within the EURALOC project, two dosimetry methodologies were developed serving as the basis for cumulative eye lens dose assessment. Besides being the cornerstone of the epidemiological part of the project, these dosimetry methodologies were also used to develop two calculation tools, "mEyeDose" and "mEyeDose_X" which enable to track, calculate, optimise and analyse eye lens doses in interventional cardiology...
February 28, 2018: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
David B Bekelman, Larry A Allen, Connor F McBryde, Brack Hattler, Diane L Fairclough, Edward P Havranek, Carolyn Turvey, Paula M Meek
Importance: Many patients with chronic heart failure experience reduced health status despite receiving conventional therapy. Objective: To determine whether a symptom and psychosocial collaborative care intervention improves heart failure-specific health status, depression, and symptom burden in patients with heart failure. Design, Setting, and Participants: A single-blind, 2-arm, multisite randomized clinical trial was conducted at Veterans Affairs, academic, and safety-net health systems in Colorado among outpatients with symptomatic heart failure and reduced health status recruited between August 2012 and April 2015...
February 26, 2018: JAMA Internal Medicine
Mohammad A Helwani, Amit Amin, Paul Lavigne, Srikar Rao, Shari Oesterreich, Eslam Samaha, Jamie C Brown, Peter Nagele
BACKGROUND: The objective of this investigation was to determine the etiology of perioperative acute coronary syndrome with a particular emphasis on thrombosis versus demand ischemia. METHODS: In this retrospective cohort study, adult patients were identified who underwent coronary angiography for acute coronary syndrome within 30 days of noncardiac surgery at a major tertiary hospital between January 2008 and July 2015. Angiograms were independently reviewed by two interventional cardiologists who were blinded to clinical data and outcomes...
February 26, 2018: Anesthesiology
Nathan Lo, Jorge Antonio Gutierrez, Rajesh V Swaminathan
PURPOSE OF REVIEW: The goal of this review is to describe the benefits and limitations of robotic-assisted percutaneous coronary intervention (PCI), the most important and recent clinical data, and the future applications as robotic technology continues to develop. RECENT FINDINGS: Robotic-assisted PCI can reduce occupational hazards of ionizing radiation exposure and orthopedic injury to the interventional cardiologist while offering increased precision and fine control that may confer benefit to the patient...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
J E Ngaile, P K Msaki, R Mvungi, L J Schreiner
Although contemporary cardiac X-ray exams are typically set so benefits outweighs the risk, the growing use and increasing complexity of the cardiovascular interventional radiological (CVIR) procedures does increase the risk of radiation-related tissue effects and stochastic effects to the individual patients and the population. In view of these radiological concerns there is a need to investigate factors that influence the doses received by the patients and enable optimisation needed. The air kerma area product (KAP), cumulative air kerma (CAK) and fluoroscopy time (FT) to patients from two major CVIR procedures: coronary angiography (CA) and percutaneous coronary interventions (PCI), were obtained from two major hospitals in Tanzania...
February 21, 2018: Radiation Protection Dosimetry
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