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https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#1
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28920099/fast-virtual-fractional-flow-reserve-based%C3%A2-upon-steady-state-computational-fluid-dynamics-analysis-results-from-the-virtu-fast-study
#2
Paul D Morris, Daniel Alejandro Silva Soto, Jeroen F A Feher, Dan Rafiroiu, Angela Lungu, Susheel Varma, Patricia V Lawford, D Rodney Hose, Julian P Gunn
Fractional flow reserve (FFR)-guided percutaneous intervention is superior to standard assessment but remains underused. The authors have developed a novel "pseudotransient" analysis protocol for computing virtual fractional flow reserve (vFFR) based upon angiographic images and steady-state computational fluid dynamics. This protocol generates vFFR results in 189 s (cf >24 h for transient analysis) using a desktop PC, with <1% error relative to that of full-transient computational fluid dynamics analysis...
August 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/28918897/colchicine-for-primary-prevention-of-atrial-fibrillation-after-open-heart-surgery-systematic-review-and-meta-analysis
#3
Carsten Lennerz, Manish Barman, Mahmoud Tantawy, Mark Sopher, Peter Whittaker
BACKGROUND: Atrial fibrillation occurs frequently after open-heart surgery. It is associated with increased morbidity and mortality, longer hospital stays, and increased healthcare costs. Prophylactic administration of colchicine may mitigate post-operative atrial fibrillation (POAF). METHODS: We searched PubMed, ClinicalTrials.gov and CENTRAL databases to identify randomized controlled trials (RCTs) that; (1) compared prophylactic use of colchicine to placebo, or usual care, in patients with sinus rhythm who underwent elective open-heart surgery and (2) reported POAF-incidence...
September 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28918807/endoscopic-ultrasonography-guided-drainage-of-pancreatic-collections-including-the-role-of-necrosectomy
#4
REVIEW
Ryan Law, Todd H Baron
In recent years, the management of symptoms of pancreatic fluid collections has shifted from surgical and percutaneous interventions to endoscopic techniques. Available data show that endoscopic drainage can be achieved with minimal morbidity and procedural-related mortality, a high degree of technical and clinical success, and acceptable risk of adverse events. Although endoscopic management of walled-off necrosis provides a durable, minimally invasive treatment option, it is still generally performed only in tertiary care medical centers because of the overall complexity of this clinical scenario...
October 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28913730/current-treatment-strategies-for-tricuspid-regurgitation
#5
REVIEW
Mohammed Al-Hijji, Erin A Fender, Abdallah El Sabbagh, David R Holmes
PURPOSE OF REVIEW: Tricuspid regurgitation is common; however, recognition and diagnosis, clinical outcomes, and management strategies are poorly defined. Here, we will describe the etiology and natural history of tricuspid regurgitation (TR), evaluate existing surgical outcomes data, and review the evolving field of percutaneous interventions to treat TR. RECENT FINDINGS: Previously, the only definitive corrective therapy for TR was surgical valve repair or replacement which is associated with significant operative mortality...
September 14, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28913651/outcomes-of-percutaneous-portal-vein-intervention-in-a-single-uk-paediatric-liver-transplantation-programme
#6
Ravi Patel, Jeevan Mahaveer, Nasim Tahir, Sanjay Rajwal, Patricia McClean, Jai V Patel
INTRODUCTION: Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution. MATERIALS AND METHODS: 227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention...
September 14, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28903623/endovascular-stenting-of-mid-aortic-syndrome-due-to-takayasu-arteritis
#7
Ali Dogan, Kenan Sever, Emrah Ozdemir, Denyan Mansuroglu, Nuri Kurtoglu
Introduction-patients: Takayasu arteritis may involve various parts of the aorta and its major branches. It leads to occlusive or aneurysmal disease of the vessel. It can be treated either with surgery or percutaneous intervention. We report a successful endovascular treatment of stenosis of the descending thoracic and abdominal aorta in a 19-year-old female. Methods-results-conclusions: Self-expandable nitinol stent was deployed and adequate opening of the aorta was obtained in this patient. Long-term durability of endovascular approach is a matter of debate...
September 13, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28891376/long-term-outcomes-of-a-telementoring-program-for-distant-teaching-of-endovascular-aneurysm-repair
#8
Alessandra Pia Porretta, Mario Alerci, Rolf Wyttenbach, Francesco Antonucci, Mattia Cattaneo, Marcel Bogen, Marco Toderi, Adriano Guerra, Fabio Sartori, Marcello Di Valentino, Paolo Tutta, Costanzo Limoni, Augusto Gallino, Ludwig K von Segesser
PURPOSE: To prospectively evaluate the long-term outcomes after a telementoring program for distant teaching of endovascular aneurysm repair (EVAR) and the degree of EVAR procedure assimilation into routine practice. METHODS: A telementoring protocol using stepwise introduction of EVAR was implemented between a university care center and a remote vascular health care site; from March 1999 to October 2003, 49 EVAR patients (mean age 72 years; 48 men) were treated during telementoring at the remote center...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28890877/pulmonary-hypertension-diagnosis-imaging-techniques-and-novel-therapies
#9
REVIEW
Alan B Goldberg, Wojciech Mazur, Dinesh K Kalra
Pulmonary hypertension (PH), defined as the elevation of mean pulmonary arterial pressure (mPAP) above 25 mmHg, has numerous causes, which the World Health Organization (WHO) has divided into five distinct categories based upon the underlying mechanism of action. This review will explore the pathophysiology, diagnostic testing, and treatment of PH. Identification of PH depends on a strong clinical suspicion, a detailed history, and a thorough physical exam. We review the evidence supporting experimental and clinical laboratory parameters for diagnosis and monitoring of PH...
August 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28887254/factors-affecting-patency-following-successful-percutaneous-intervention-for-dysfunctional-hemodialysis-vascular-access
#10
Sung Min Kim, Heung Kyu Ko, Minsu Noh, Gi-Young Ko, Min-Ju Kim, Tae-Won Kwon, Hee Jin Kim, Yong-Pil Cho
OBJECTIVE: This study aimed to investigate the patency following initial successful percutaneous transluminal angioplasty (PTA) for untreated dysfunctional hemodialysis vascular access and to identify predictors of PTA durability. METHODS: This retrospective observational study included data of 132 consecutive initial PTA of hemodialysis vascular access in 126 patients who showed immediate technical and clinical success and had at least 1 year of follow-up data...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883734/prognostic-impact-of-blood-pressure-and-heart-rate-at-admission-on-in-hospital-mortality-after-primary-percutaneous-intervention-for-acute-myocardial-infarction-with-st-segment-elevation-in-western-romania
#11
Diana Aurora Bordejevic, Florina Caruntu, Cristian Mornos, Ioan Olariu, Lucian Petrescu, Mirela Cleopatra Tomescu, Ioana Citu, Adelina Mavrea, Sorin Pescariu
BACKGROUND: The purpose of this retrospective study was to evaluate the prognostic impact of systolic blood pressure (SBP) and heart rate (HR) on in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) patients, after primary percutaneous intervention (PCI). PATIENTS AND METHODS: The study included 294 patients admitted for STEMI. They were divided into five groups according to the SBP at admission: group I, <105 mmHg; group II, 105-125 mmHg; group III, 126-140 mmHg; group IV, 141-158 mmHg; and group V, ≥159 mmHg...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28862481/utilization-of-the-impella-for-hemodynamic-support-during-percutaneous-intervention-and-cardiogenic-shock-an-insight
#12
Nikhil Nalluri, Nileshkumar Patel, Samer Saouma, Viswajit Reddy Anugu, Dixitha Anugula, Deepak Asti, Varshil Mehta, Varun Kumar, Varunsiri Atti, Sushruth Edla, Rasleen K Grewal, Hafiz M Khan, Ritesh Kanotra, Gregory Maniatis, Ruben Kandov, James C Lafferty, Michael Dyal, Carlos E Alfonso, Mauricio G Cohen
Abstract/Summary Impella is a catheter-based micro-axial flow pump placed across the aortic valve, and it is currently the only percutaneous left ventricular assist device approved for high-risk percutaneous coronary intervention and cardiogenic shock. Even though several studies have repeatedly demonstrated the excellent hemodynamic profile of Impella in high-risk settings, it remains underutilized. Here we aim to provide an up-to-date summary of the literature as well as the practical aspects of its usage during percutaneous interventions...
September 1, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28861424/cystic-adventitial-disease-case-series-and-review-of-literature
#13
Shuo Li, Brian N King, Noel Velasco, Yogesh Kumar, Nishant Gupta
Cystic adventitial disease (CAD) is a rare vascular disorder that involves the arteries and rarely the veins, most commonly found in the popliteal artery of male patients. Etiology of CAD is uncertain and currently without a consensus agreement. Clinically, the most common presenting symptom is claudication. Diagnosis requires a strong clinical suspicion in patients with intermittent claudication, but without other risk factors for atherosclerotic disease. Angiography, ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) can all be used for diagnosis...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28851720/fully-transradial-versus-transfemoral-approach-for-percutaneous-intervention-of-coronary-chronic-total-occlusions-applying-the-hybrid-algorithm-insights-from-recharge-registry
#14
Erik Jan Bakker, Joren Maeremans, Carlo Zivelonghi, Benjamin Faurie, Alexandre Avran, Simon Walsh, James C Spratt, Paul Knaapen, Colm G Hanratty, Erwan Bressollette, Peter Kayaert, Alan J Bagnall, Mohaned Egred, David Smith, Margaret B McEntegart, William H T Smith, Paul Kelly, John Irving, Elliot J Smith, Julian W Strange, Joseph Dens, Pierfrancesco Agostoni
BACKGROUND: Small observational studies demonstrate the feasibility of transradial approach for chronic total occlusion (CTO) percutaneous coronary intervention. The aim of the current study is to assess technical success, complication rates, and procedural efficiency in fully transradial approach (fTRA) and transfemoral approach (TFA) in a large prospective European registry adopting the hybrid algorithm for CTO percutaneous coronary intervention (Registry of CrossBoss and Hybrid Procedures in France, the Netherlands, Belgium and United Kingdom, RECHARGE registry)...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28845861/-hybrid-percutaneous-coronary-intervention-with-drug-eluting-stent-in-combination-with-bioresorbable-vascular-scaffolds-for-complex-coronary-lesions
#15
Massimo Fineschi, Arcangelo Carrera, Carlo Pierli
Drug-eluting stents (DES) have significantly improved the outcome of percutaneous coronary intervention (PCI); however, several concerns remain regarding late adverse events associated with the presence of a permanent rigid metallic cage that might impair the natural healing process of the coronary vessel wall. Recently, PCI with bioresorbable vascular scaffolds (BVS) has emerged as an interesting alternative with several potential advantages related to the complete resorption process that occurs within 3-5 years...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28843330/adult-congenital-heart-disease-intervention-the-canadian-landscape
#16
MULTICENTER STUDY
Claudia Frankfurter, Anita W Asgar, John G Webb, Warren J Cantor, James L Velianou, François Gobeil, Albert W Chan, Robert C Welsh, Michael P Love, David A Wood, Kevin McKenzie, Eric M Horlick
Once considered a childhood disease, the number of adults living with congenital heart disease (CHD) has now exceeded the number of pediatric patients. The landscape of percutaneous intervention for adult congenital heart disease (ACHD) has evolved over the past decade and has yet to be characterized in Canada. The aim of this study was to begin to understand the current infrastructure underlying ACHD interventions in Canada and to characterize the type and number of interventions being carried out across the country...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28840470/congenital-and-acquired-valvular-heart-disease-in-pregnancy
#17
REVIEW
Sarah A Goldstein, Cary C Ward
PURPOSE OF REVIEW: The number of pregnancies complicated by valvular heart disease is increasing. This review describes the hemodynamic effects of clinically important valvular abnormalities during pregnancy and reviews current guideline-driven management strategies. RECENT FINDINGS: Valvular heart disease in women of childbearing age is most commonly caused by congenital abnormalities and rheumatic heart disease. Regurgitant lesions are well tolerated, while stenotic lesions are associated with a higher risk of pregnancy-related complications...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28830237/the-persistence-of-open-stone-surgery-in-the-united-states-in-the-21st-century
#18
Jessica N Lange, Ryan Terlecki
INTRODUCTION: In the era of minimally-invasive surgery, endoscopic and percutaneous interventions for urinary tract stones have become a mainstay, and the need for open stone surgery (OSS) has decreased. We sought to determine the contemporary incidence of OSS among urologists in the United States. METHODS: Case logs submitted for certification to the American Board of Urology from 2005-2015 were queried for Current Procedural Terminology codes relevant to OSS. Cases were analyzed for the associated practice type, practice area population, geographic region, provider subspecialty, and certifying status of the reporting urologist...
August 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28829743/intracoronary-electrocardiogram-to-guide-percutaneous-interventions-in-coronary-bifurcations-a-proof-of-concept-the-fiesta-ffr-vs-icecgsta-study
#19
Dobrin Vassilev, Liubomir Dosev, Carlos Collet, Kiril Karamfiloff, Jivka Stoikova, Ralica Pancheva, Monika Shumkova, Galina Zlatancheva, Vladimir Naunov, Gianluca Rigatelli, Ghassan S Kassab, Robert J Gil, Patrick W Serruys
AIMS: The aim of this study was to determine the accuracy of the intracoronary electrocardiogram (icECG) to detect ischemia during bifurcation lesions percutaneous coronary intervention (PCI) with fractional flow reserve (FFR) as a reference. METHODS AND RESULTS: Patients with significant bifurcation lesions defined as FFR≤0.80 were included. FFR and icECG were performed in the main vessel (MV) and side branch (SB) before and after provisional stenting. icECG was recorded with a uninsulated proximal wire end connected to a unipolar lead...
August 22, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28826799/high-sensitivity-c-reactive-protein-and-long-term-reperfusion-success-of-primary-percutaneous-intervention-in-st-elevation-myocardial-infarction
#20
Hilde E Groot, Jacco C Karper, Erik Lipsic, Dirk J van Veldhuisen, Iwan C C van der Horst, Pim van der Harst
AIMS: In STEMI patients, success of reperfusion of primary PCI predicts cardiac remodeling and clinical outcome. This success may depend on inflammation. We aimed to investigate the association between inflammation and reperfusion success, left ventricular function and long-term mortality in STEMI patients. METHODS: In 376 consecutive STEMI patients of the GIPS-III trial hs-CRP levels were measured at baseline, 2weeks, 7weeks and 4months post-PCI. Myocardial blush grade was used to determine success of myocardial reperfusion...
August 10, 2017: International Journal of Cardiology
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