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https://www.readbyqxmd.com/read/28342580/evidence-based-management-of-chylothorax-in-infants
#1
Joseph T Church, Alexis G Antunez, Ashley Dean, Niki Matusko, Kristopher B Deatrick, Mohammad A Attar, Samir K Gadepalli
PURPOSE: Management guidelines for infants with chylothorax lack substantial evidence. We sought to identify variables that impact outcomes in these patients in order to develop an evidence-based management algorithm. METHODS: We retrospectively reviewed the medical records of all infants diagnosed with chylothorax from June 2005 to December 2014 at our institution. Data collected included demographics, chest tube output (CTO), medical and dietary interventions, surgical procedures, and absolute lymphocyte count (ALC)...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28335895/coronary-collaterals-function-and-clinical-outcome-between-patients-with-acute-and-chronic-total-occlusion
#2
Jang Hoon Lee, Chang-Yeon Kim, Namkyun Kim, Se Yong Jang, Myung Hwan Bae, Dong Heon Yang, Yongkeun Cho, Shung Chull Chae, Hun Sik Park
OBJECTIVES: This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). BACKGROUND: The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. METHODS: The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28329240/effect-of-breathing-oxygen-enriched-air-on-exercise-performance-in-patients-with-precapillary-pulmonary-hypertension-randomized-sham-controlled-cross-over-trial
#3
Silvia Ulrich, Elisabeth D Hasler, Stéphanie Saxer, Michael Furian, Séverine Müller-Mottet, Stephan Keusch, Konrad E Bloch
Aims: The purpose of the current trial was to test the hypothesis that breathing oxygen-enriched air increases exercise performance of patients with pulmonary arterial or chronic thrombo-embolic pulmonary hypertension (PAH/CTEPH) and to investigate involved mechanisms. Methods and results: Twenty-two patients with PAH/CTEPH, eight women, means ± SD 61 ± 14 years, resting mPAP 35 ± 9mmHg, PaO2 ambient air >7.3 kPa, underwent four bicycle ergospirometries to exhaustion on different days, while breathing oxygen-enriched (FiO2 0...
March 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325533/a-systematic-review-of-the-views-and-experiences-of-subjects-of-community-treatment-orders
#4
REVIEW
Deborah Corring, Richard O'Reilly, Christina Sommerdyck
OBJECTIVE: CTOS have been the subject of many qualitative and quantitative research studies. Both research approaches add value to our understanding of CTOs. Qualitative studies provide an understanding of CTOs and the experience of being on a CTO that quantitative studies cannot provide. Many qualitative studies that have examined the views of subjects of CTOs have been published. However, authors of these studies continue to note that views and experiences of the subjects of these orders are not well known...
March 18, 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/28325520/percutaneous-revascularization-of-coronary-chronic-total-occlusion-toward-a-reappraisal-of-the-available-evidence
#5
REVIEW
Pasi P Karjalainen, Wail Nammas
Chronic total occlusion (CTO) is a challenging subset of coronary artery disease that is commonly encountered in real-world practice; it is associated with worse long-term prognosis. Observational studies suggest that percutaneous coronary intervention (PCI) for CTO is associated with reduction in myocardial ischemia and improvement in quality of life and left ventricular function. Some observational studies suggested that CTO-PCI is associated with improvement of the 'hard' clinical endpoints; others did not...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28318139/chronic-total-occlusion-is-associated-with-a-higher-incidence-of-malapposition-and-uncovered-stent-struts-oct-findings-at-6-months-following-des-implantation
#6
Haibo Jia, Sining Hu, Huimin Liu, Yinchun Zhu, Chun-Yang Zhe, Lulu Li, Irina Mustafina, Jingbo Hou, Shaosong Zhang, Bo Yu
OBJECTIVES: To compare stent coverage and malapposition in patients with chronic total occlusion (CTO) lesions and non-CTO lesions (including lipid-rich plaque [LRP] and non-lipid-rich plaque [non-LRP]) after drug-eluting stent (DES) implantation by optical coherence tomography (OCT). BACKGROUND: Different initial lesion characteristics may be related to heterogeneous vessel responses after DES implantation. However, the vessel response in patients with CTO and non-CTO lesions after stenting is unclear...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28318134/long-term-clinical-outcomes-of-successful-revascularization-with-drug-eluting-stents-for-chronic-total-occlusions-a-systematic-review-and-meta-analysis
#7
Lei Gao, Yabin Wang, Yuqi Liu, Feng Cao, Yundai Chen
OBJECTIVES: To determine whether successful percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) have beneficial effects on long-term outcomes in patients with chronic total occlusions (CTOs) compared with failed PCIs for CTOs. BACKGROUND: Several observational studies have evaluated the long-term clinical outcomes of successful PCIs using DESs for CTOs. However, the results of these studies were inconsistent and inconclusive. METHODS: We searched five online electronic databases to identify all the publications assessing the long-term outcomes of successful and failed PCIs using DESs for CTOs...
March 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#8
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314674/further-validation-of-the-hybrid-algorithm-for-cto-pci-difficult-lesions-same-success
#9
Mir B Basir, Aris Karatasakis, Mohammad Alqarqaz, Barbara Danek, Bavana V Rangan, Emmanouil S Brilakis, Henry Kim, William W O'Neill, Khaldoon Alaswad
OBJECTIVES: To evaluate the success rates and outcome of the hybrid algorithm for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) by a single operator in two different clinical settings. METHODS: We compared 279 consecutive CTO PCIs performed by a single, high-volume operator using the hybrid algorithm in two different clinical settings. Data were collected through the PROGRESS CTO Registry. We compared 145 interventions performed in a community program (cohort A) with 134 interventions performed in a referral center (cohort B)...
February 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28314672/fenestration-of-a-papyrus-pk-covered-stent-to-recover-the-occluded-left-main-bifurcation-after-sealing-a-left-main-perforation-during-a-cto-procedure
#10
Gerald S Werner, Waqar H Ahmed
Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia...
March 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#11
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28296639/impact-of-chronic-total-occlusions-on-revascularization-scores-and-outcome-prediction
#12
Björn Redfors, Tullio Palmerini, Adriano Caixeta, Girma Minalu Ayele, Dominic P Francese, Roxana Mehran, Emmanouil S Brilakis, Ajay J Kirtane, Dimitri Karmpaliotis, Gregg W Stone, Philippe Généreux
OBJECTIVES: To evaluate the contribution of chronic total occlusion (CTO)-related SYNTAX score (SS) to the overall SS for patients with CTO and compare the traditional SS to a simplified variant. The SS algorithm assigns CTO lesions a greater weight (5× points) than non-CTO lesions (50% to <100% diameter stenosis; 2× points). METHODS: We calculated the SS and the simplified SS (2× points also to CTO lesions) for 4356 patients from the angiographic substudy of the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial...
March 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28296045/one-year-outcomes-after-successful-chronic-total-occlusion-percutaneous-coronary-intervention
#13
W M Wilson, S J Walsh, A Bagnall, A T Yan, C G Hanratty, M Egred, E Smith, K G Oldroyd, M McEntegart, J Irving, H Douglas, J Strange, J C Spratt
We aimed to determine clinical outcomes 1 year after successful chronic total occlusion (CTO) PCI and, in particular, whether use of dissection and re-entry strategies affects clinical outcomes. Hybrid approaches have increased the procedural success of CTO percutaneous coronary intervention (PCI) but longer-term outcomes are unknown, particularly in relation to dissection and re-entry techniques. Data were collected for consecutive CTO PCIs performed by hybrid-trained operators from 7 United Kingdom (UK) centres between 2012 and 2014...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28274578/comparison-of-ct-rector-and-j-cto-scores-to-predict-chronic-total-occlusion-difficulty-for-percutaneous-coronary-intervention
#14
Yahang Tan, Jia Zhou, Wei Zhang, Ying Zhou, Luoshan Du, Feng Tian, Jun Guo, Lian Chen, Feng Cao, Yundai Chen
BACKGROUND: We sought to evaluate the ability of the CT-RECTOR and J-CTO scores to predict time-efficient guidewire (GW) crossing through a chronic total occlusion (CTO) and final procedure success. METHODS: Data from 191 consecutive CTO lesions with pre-procedural coronary computed tomography angiography (CCTA) from our center were analyzed retrospectively. The difficulty of the procedure was classified as easy, intermediate, difficult, or very difficult according to CT-RECTOR and J-CTO scores...
February 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28269441/characteristic-of-a-force-sensing-guide-wire-for-minimally-invasive-cardiac-surgery
#15
N Stefanova, M Hessinger, T Opitz, R Werthschutzky
In minimal invasive cardiac surgery (MICS), the surgeon is missing haptic feedback of the guide wire for navigation through the vessels. A wide range of guide wires with various properties and performance characteristics are available to reduce the risk of complications during the intervention. This paper presents a force sensing guide wire for cardiac catheterization, which provides the surgeon a haptic feedback on the guide wire tip. Three conventional wires for the recanalization of chronic total coronary occlusions (CTO) are investigated and general design requirements for the force sensing guide wire are determined...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28256296/prediction-of-functional-recovery-after-percutaneous-coronary-revascularization-for-chronic-total-occlusion-using-late-gadolinium-enhanced-magnetic-resonance-imaging
#16
Tatsuya Nakachi, Shingo Kato, Hidekuni Kirigaya, Naoki Iinuma, Kazuki Fukui, Naka Saito, Tae Iwasawa, Masami Kosuge, Kazuo Kimura, Kouichi Tamura
BACKGROUND: Limited data are available regarding the prediction for functional recovery using late gadolinium enhanced magnetic resonance imaging (LGE MRI) after coronary revascularization for chronic total occlusion (CTO PCI). METHODS: We studied 59 patients (mean age, 66±11 years) who underwent successful CTO PCI. Two-dimensional echocardiography and strain measurements were performed before and 8±2 months after CTO PCI. The findings of segmental assessment were compared with the extent of LGE MRI using a 16-segment model...
February 27, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28255103/percutaneous-coronary-intervention-of-coronary-chronic-total-occlusions-improves-peak-oxygen-uptake-during-cardiopulmonary-exercise-testing
#17
Shuaib M Abdullah, Jeffrey L Hastings, Suwetha Amsavelu, Fransisco Garcia-Morales, Fury Hendrix, Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Bavana V Rangan, Michele Roesle, Houman Khalili, Subhash Banerjee, Emmanouil S Brilakis
OBJECTIVES: Although coronary chronic total occlusions (CTOs) are treated with percutaneous coronary intervention (PCI) to improve symptoms, studies demonstrating symptom improvement have been mostly limited to questionnaire responses. The current study assessed for changes in peak oxygen uptake during cardiopulmonary exercise testing after CTO-PCI. METHODS: Patients with heart failure or angina symptoms referred for CTO-PCI were prospectively enrolled. The primary outcome of the study was improvement in peak oxygen uptake during cardiopulmonary exercise (CPX) testing 5 months after CTO-PCI...
March 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28244014/gender-based-acute-outcome-in-percutaneous-coronary-intervention%C3%A2-of-chronic-total-coronary-occlusion
#18
J E Guelker, L Bansemir, R Ott, K Kuhr, B Koektuerk, R G Turan, H G Klues, A Bufe
BACKGROUND: Percutaneous coronary intervention (PCI) of total chronic coronary occlusion (CTO) still remains a major challenge. Insignificant data are reported in the literature about gender differences in CTO-PCI in the era of new drug-eluting stents. In this study we analysed the impact of gender on procedural characteristics, complications and acute results. METHODS: Between 2010-2015 we included 780 consecutive patients. They underwent PCI for at least one CTO...
February 27, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28242588/effects-of-successful-percutaneous-coronary-intervention-of-chronic-total-occlusions-on-myocardial-perfusion-and-left-ventricular-function
#19
Wijnand J Stuijfzand, P Stefan Biesbroek, Pieter G Raijmakers, Roel S Driessen, Stefan P Schumacher, Pepijn van Diemen, Jeffrey van den Berg, Robin Nijveldt, Adriaan A Lammertsma, Simon J Walsh, Colm G Hanratty, James C Spratt, Albert C van Rossum, Alexander Nap, Niels van Royen, Paul Knaapen
AIMS: The aim of the present study was to investigate the effects of successful PCI CTO on absolute myocardial blood flow (MBF) and functional recovery. METHODS AND RESULTS: Patients with a documented CTO were prospectively examined for ischemia and viability with H215O positron emission tomography (PET) and late gadolinium enhancement cardiac magnetic resonance imaging (LGE-CMR). Sixty-nine consecutive patients, in whom PCI was successful, underwent follow-up PET and CMR after approximately 12 weeks to evaluate potential improvement of MBF as well as systolic function...
February 28, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28242587/impact-of-crossing-strategy-on-mid-term-outcomes-following-percutaneous-revascularisation-of-coronary-chronic-total-occlusions
#20
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
AIMS: To compare the impact of crossing strategies on mid-term outcomes following chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS AND RESULTS: We compiled a multicentre registry of consecutive patients undergoing successful CTO PCI. Patients were divided in three groups: true-to-true (TTT) approach, modern dissection/re-entry (DR) techniques (CrossBoss/Stingray, reverse CART), and old DR techniques (LAST, STAR, CART). Cox regression was used to identify independent predictors of major adverse cardiac events (MACE: cardiac death, myocardial infarction and target-vessel revascularisation)...
February 28, 2017: EuroIntervention
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