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https://www.readbyqxmd.com/read/28823143/stent-thrombosis-and-optimal-duration-of-dual-antiplatelet-therapy-after-coronary-stenting-in-contemporary-practice
#1
Min Soo Cho, Duk-Woo Park
The introduction of drug-eluting stents (DES) in the practice of percutaneous coronary intervention (PCI) has substantially reduced angiographic and clinical restenosis but is associated with an increasing propensity for very late stent thrombosis (ST). Among several clinical, lesion, or procedure-related predictors of ST, early discontinuation of dual antiplatelet therapy (DAPT) is the most important factor for DES-associated late thrombosis; therefore, the optimal duration of DAPT is a major issue to be critically considered in the current DES era...
August 22, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28823011/guidelines-versus-reality-is-coronary-stent-application-in-three-vessel-disease-standard-or-the-exception
#2
Roland Linder, J Zeidler, F Verheyen, J-M Graf von der Schulenburg, A Haverich, T Schilling
The national guidelines for treatment of chronic coronary heart disease (CHD) recommend surgical coronary aortic bypass grafting (CABG) rather than percutaneous coronary intervention (PCI) for patients with a coronary three-vessel disease. The epidemiology of three-vessel CHD and data about the application of different revascularisation strategies raise suspicion of deviation from the guidelines in the treatment of those patients. Claims data containing records of almost 10 million patients of the largest German statutory health insurance fund (Techniker Krankenkasse) were utilised to measure adherence to the guidelines for treatment of groups of patients with one-, two-, and three-vessel CHD, respectively...
August 19, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28822796/papillary-ductal-plugging-is-a-mechanism-for-early-stone-retention-in-brushite-stone-disease
#3
James C Williams, Michael S Borofsky, Sharon B Bledsoe, Andrew P Evan, Fredric L Coe, Elaine M Worcester, James E Lingeman
PURPOSE: Mechanisms of early stone retention within the kidney are understudied and poorly understood. To date, attachment via Randall's plaque is the only widely accepted theory in this regard, best described in idiopathic calcium oxalate stone formers. Brushite stone formers are known to have distinct papillary morphology relative to calcium oxalate stone formers. As such, we sought to determine whether stone attachment mechanisms in such patients may be similarly unique. MATERIALS AND METHODS: Patients undergoing percutaneous and or ureteroscopic procedures for stone removal were consented for endoscopic renal papillary examination and individual stone collection...
August 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28822520/coronary-artery-dimensions-in-normal-indians
#4
Barendra Kumar Raut, Vijaysinh Namdeo Patil, George Cherian
BACKGROUND: Diameter of coronary artery is an important predictor of outcome after percutaneous coronary interventions and coronary artery bypass graft surgery. There is very limited data available about coronary artery dimensions in an Indian population. AIMS: To study the normal dimensions of the coronary artery segments in Indians without coronary artery disease by using quantitative coronary angiography and also to compare the dimensions in Indians with Western...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28822388/outcomes-following-noncardiac-surgery-in-patients-with-ventricular-assist-devices-a-single-center-experience
#5
Shawna M Kettyle, Nikhil L Chervu, Appajosula Sarada Rao, Salaam Sadi, David Majure, Jack A Sava, Laura S Johnson
the prevalence of ventricular assist devices (VADs) is increasing as advanced cardiac therapies progress. These patients commonly require non-cardiac surgical procedures (NCS), although data are scant regarding the safety, timing, and operations that may safely be performed. We aim to describe our experience with VAD patients undergoing NCS. We retrospectively reviewed records on patients who underwent NCS after VAD implantation between 2013 and 2015 at a single Joint Commission-accredited VAD institution. Data collection included demographics, ischemic cardiomyopathy or nonischemic cardiomyopathy, operative details, and perioperative anticoagulation management and outcomes...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#6
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28821512/protocol-for-an-economic-evaluation-of-the-randomised-controlled-trial-of-culprit-lesion-only-pci-versus-immediate-multivessel-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-culprit-shock-trial
#7
Zahidul Quayyum, Andrew Briggs, Jose Robles-Zurita, Keith Oldroyd, Uwe Zeymer, Steffen Desch, Suzanne de Waha, Holger Thiele
INTRODUCTION: Emergency percutaneous coronary intervention (PCI) of the culprit lesion for patients with acute myocardial infarctions is an accepted practice. A majority of patients present with multivessel disease with additional relevant stenoses apart from the culprit lesion. In haemodynamically stable patients, there is increasing evidence from randomised trials to support the practice of immediate complete revascularisation. However, in the presence of cardiogenic shock, the optimal management strategy for additional non-culprit lesions is unknown...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821444/circumferential-fusion-a-comparative-analysis-between-anterior-lumbar-interbody-fusion-with-posterior-pedicle-screw-fixation-and-transforaminal-lumbar-interbody-fusion-for-l5-s1-isthmic-spondylolisthesis
#8
Erik Y Tye, Joseph E Tanenbaum, Andrea S Alonso, Roy Xiao, Michael P Steinmetz, Thomas E Mroz, Jason W Savage
BACKGROUND CONTEXT: Transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion with percutaneous pedicle screws (ALIFPS) offer significantly higher radiographic fusion rates than other fusion techniques for L5-S1 isthmic spondylolisthesis (IS). As it stands, there is a relative paucity of comparative data of the two techniques. PURPOSE: To define the clinical, radiographic, and financial differences between TLIF and ALIFPS for L5-S1 IS. STUDY DESIGN/SETTING: A retrospective cohort study conducted at a single-tertiary care center...
August 15, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28821224/patients-with-symptoms-and-characteristics-consistent-with-obstructive-sleep-apnea-are-at-a-higher-risk-for-acute-and-subacute-stent-thrombosis-after-percutaneous-coronary-stent-implantation-a-single-center-case-control-study
#9
Yanhua Li, Shanshan Yang, Si Chen, Xinhong Guo, Yundai Chen
BACKGROUND: To determine if obstructive sleep apnea (OSA) is a risk factor for early stent thrombosis (EST; within 30 days) after percutaneous coronary intervention (PCI). METHODS: This case-control study involved 23 patients with angiographically confirmed EST after PCI (case group) and 92 PCI patients (control group) who did not develop stent thrombosis during a 2-year follow-up. Patients with symptoms and characteristics consistent with OSA (hereinafter referred to as OSA) were identified using the Berlin questionnaire, and the general characteristics of the patients and their treatments as well as outcomes were recorded...
August 18, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28820731/emphysematous-infections-of-the-urinary-tract-an-audit-of-20-patients-with-review-of-literature
#10
REVIEW
Sasanka Kumar Barua, Somor Jyoti Bora, Puskal Kumar Bagchi, Debanga Sarma, Mandeep Phukan, Saumar Jyoti Baruah, Thekampadum Puthenveetil Rajeev
Emphysematous infection of the urinary tract is a rapidly progressive, necrotizing infection which results into collection of gas and subsequent destruction of the tissues. Although very rare among general population, such necrotizing infection is common, particularly among those with compromised immune status. With the rising trend of people afflicted with diabetes mellitus globally, this fulminating infection may pose a serious threat to the medical fraternity. A high index of suspicion and abdominal CT scan usually helps to establish the diagnosis at an early stage and thereby facilitating aggressive antimicrobial therapy and percutaneous drainage where indicated...
August 18, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28820559/percutaneous-mitral-balloon-valvuloplasty-in-a-pregnant-patient-under-guidance-of-three-dimensional-transesophageal-echocardiography-and-right-atrial-mapping-without-using-fluoroscopy
#11
Begum Uygur, Hamdi Pusuroglu, Aydin Yildirim
Mitral stenosis is the most common valvular pathology complicating pregnancy. Herein are reported the details of a 26-week pregnant patient with severe mitral stenosis and NYHA class 3-4 symptoms. Percutaneous mitral balloon valvuloplasty was performed under guidance of three-dimensional transesophageal echocardiography and right atrial mapping, without using fluoroscopy. Video 1: Two-dimensional transesophageal echocardiography. The four-chamber view shows limited opening of the rheumatic mitral valve. Video 2: Two-dimensional transesophageal echocardiography while the balloon is inflated...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820558/young-patient-with-advanced-heart-failure-no-longer-a-candidate-for-heart-transplantation-after-mitraclip%C3%A3-%C3%A2-procedure
#12
Cosmo Godino, Andrea Scotti, Eustachio Agricola, Carlo A Pivato, Mauro Chiarito, Stefano Stella, Massimo Maccherini, Alberto Margonato, Antonio Colombo
In Europe, mitral regurgitation (MR) is the second most common form of valvular heart disease requiring surgical treatment. The case is presented of a 36-year-old woman with end-stage heart failure secondary to chemotherapy-induced cardiotoxicity, complicated by severe MR. She was listed for heart transplantation and underwent percutaneous MitraClip® implantation in order to preclude further clinical deterioration while awaiting a suitable donor. The one-year follow-up showed a strong improvement of symptoms and mostly reverse left ventricular remodelling, with consequent removal from the heart transplantation list...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820547/incidence-and-clinical-impact-of-cerebral-lesions-after-the-mitraclip%C3%A3-%C3%A2-procedure
#13
Sebastian Barth, Karsten Hamm, Stefan Fodor, Wilko Reents, Sebastian Kerber, Philipp Halbfass, Martina B Hautmann, Bernhard Schieffer, Hassan Soda
BACKGROUND: Clinically silent brain injury detected with cerebral magnetic resonance imaging (MRI) is well known after various cardiovascular interventions. Thus far, only one study has examined the periprocedural risk of cerebral ischemic events in patients undergoing percutaneous mitral valve reconstruction. The study aim was to examine the incidence and clinical impact of cerebral embolic events in patients undergoing percutaneous mitral valve reconstruction using the MitraClip® system...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820546/initial-results-of-combined-mitraclip%C3%A3-%C3%A2-implantation-and-left-atrial-appendage-occlusion
#14
Xavier Freixa, Rodrigo Estévez-Loureiro, Fernando Carrasco-Chinchilla, Dabit Arzamendi, Pilar Jiménez-Quevedo, Luis Nombela-Franco, Ignacio Cruz-González, Ignacio J Amat-Santos, Manel Sabaté
BACKGROUND: Atrial fibrillation is present in 30-50% of patients undergoing percutaneous mitral valve repair. The presence of a formal contraindication to oral anticoagulation is also very common in these patients. In this context, percutaneous left atrial appendage occlusion (LAAO) may be a valid alternative for these patients. The study aim was to assess the feasibility, safety, and technical considerations of the combination of percutaneous mitral valve repair using the MitraClip system and LAAO...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#15
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820540/endoscopic-port-access-surgery-for-late-orthotopic-cardiac-transplantation-atrioventricular-valve-disease
#16
Johan van der Merwe, Filip Casselman, Bernard Stockman, Yvette Vermeulen, Ivan Degrieck, Frank Van Praet
BACKGROUND: The study aim was to present details of the perioperative and long-term outcomes of redo-endoscopic port access surgery (REPAS) for late atrioventricular valve disease (AVVD) in orthotopic cardiac transplant (OCT) patients. METHODS: Between February 2004 and October 2015, REPAS was performed for late AVVD in seven consecutive OCT patients (mean age 57.9 ± 17.2 years; EuroSCORE II 21.2 ± 14.7%) at the authors' institution. The mean OCT-REPAS time interval was 7...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820484/platelet-aggregometry-testing-molecular-mechanisms-techniques-and-clinical-implications
#17
REVIEW
Katalin Koltai, Gabor Kesmarky, Gergely Feher, Antal Tibold, Kalman Toth
Platelets play a fundamental role in normal hemostasis, while their inherited or acquired dysfunctions are involved in a variety of bleeding disorders or thrombotic events. Several laboratory methodologies or point-of-care testing methods are currently available for clinical and experimental settings. These methods describe different aspects of platelet function based on platelet aggregation, platelet adhesion, the viscoelastic properties during clot formation, the evaluation of thromboxane metabolism or certain flow cytometry techniques...
August 18, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28820396/the-role-of-mtor-inhibitors-and-hmg-coa-reductase-inhibitors-on-young-and-old-endothelial-cell-functions-critical-for-re-endothelialisation-after-percutaneous-coronary-intervention-an-in-vitro-study
#18
K Korybalska, E Kawka, A Breborowicz, J Witowski
Percutaneous coronary intervention (PCI) has become a standard treatment in patients with acute coronary syndrome. However, it is associated with endothelial cell denudation, which may predispose to in-stent thrombosis and restenosis. Pharmacological methods which prevent restenosis can delay post-PCI re-endothelialisation. We have therefore examined how atorvastatin (HMG-CoA reductase inhibitor), sirolimus and everolimus (mTOR inhibitors) affect young and old endothelial cell functions which are responsible for wound healing after PCI...
June 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28819481/misplaced-subclavian-central-venous-catheter
#19
Negussie Alula Bekele, Worknehe Agegnehu Abebe, Jemal Zeberga Shifa
Percutaneous Central Venous Catheter (CVC) insertion using internal jugular and Subclavian veins routes is common procedure for all intensive care admitted patients and some patients in the ward as demand arises in central and referral hospitals of Botswana. This is a case report of a patient on whom a third attempt of re-inserting a CVC for fluid and total parenteral nutrition (TPN) was made. X-ray showed that left Subclavian inserted catheter was mis-directed to internal jugular vein of the same side creating discomfort to the patient...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28819476/-giant-idiopathic-hydronephrosis-toward-a-two-step-therapeutic-approach
#20
Taher Ismail Boudhaye, Mohamed Sidimalek, Cheikhani Jdoud
Giant hydronephrosis is rare. It is usually caused by ureteropelvic junction syndrome. We here report the unusual case of a patient hospitalized with giant hydronephrosis associated with impaired general condition. Diagnosis was based on CT scan. The patient underwent deferred nephrectomy after percutaneous drainage.
2017: Pan African Medical Journal
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