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Invasive cardiology

Alison S Witkin, Savanah Harshbarger, Christopher Kabrhel
Pulmonary embolism is a common and often life-threatening event. Treatment options include anticoagulation alone, catheter-directed therapies, and surgical thromboembolectomy. While guidelines exist, there is often controversy over which treatment is most appropriate, particularly for intermediate-risk patients. The traditional care model, in which the primary team is responsible for consulting the appropriate specialists, may be inadequate and inefficient for emergent situations, as ensuring coordination and communication between various consulting services can be a time consuming and confusing process...
October 21, 2016: Seminars in Thrombosis and Hemostasis
Pavol Sajgalik, Vaclav Kremen, Alex R Carlson, Vratislav Fabian, Chul-Ho Kim, Courtney M Wheatley, Vaclav Gerla, John A Schirger, Thomas P Olson, Bruce D Johnson
Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology and anesthesiology. Non-invasive techniques available are technically challenging, and thus difficult to use outside of the clinical or laboratory setting. We propose a novel method of non-invasive CO assessment using a single upper arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20 second intervals of suprasystolic occlusion. This method was evaluated on a cohort of 12 healthy individuals (age of 27...
October 20, 2016: Journal of Applied Physiology
Karolina Adamczyk, Beata Średniawa, Katarzyna Mitręga, Stanisław Morawski, Agata Musialik-Łydka, Zbigniew Kalarus
Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods. Presented case report shows problems of arrythmias diagnostics and imperfections of avaible methods...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Fabio de Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Andrea Lenzi, Gledson Luiz Picharski, Marion Burger
BACKGROUND: Candida species are the primary cause of invasive fungal infection in hospitalized children. There are few data on risk factors for postoperative candidemia in pediatric patients with congenital heart defects. This study aimed to identify risk factors for candidemia in patients with congenital heart defects who underwent cardiac surgery. METHODS: This was a case-control study conducted in patients admitted to a pediatric cardiology intensive care unit from January 2006 to December 2013...
November 2016: Pediatric Infectious Disease Journal
Rashmi Kerr, Cinosh Mathew, Ram Gopal Shahi, Rajneesh Calton
OBJECTIVE: To assess the clinical and angiographic profile of patients with coronary artery ectasias (CAE) and assess their outcomes. METHODS: One year retrospective and one year prospective study was carried out in the Department of Cardiology in CMC, Ludhiana from January 2011 to December 2012 on all patients undergoing coronary angiographies and each patient was followed up for 1 year. Their outcomes were noted and statistical analysis carried out. RESULTS: There were a total of 327 males (66...
June 2016: Journal of the Association of Physicians of India
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Giuseppe Tarantini, Francesco Saia, Piera Capranzano, Bernardo Cortese, Marco Mojoli, Giacomo Boccuzzi, Andrea Cuculo, Salvatore Geraci, Alessio Mattesini, Jacopo Oreglia, Francesco Summaria, Luca Testa, Sergio Berti, Giovanni Esposito, Alessio La Manna, Ugo Limbruno, Alfredo Marchese, Ciro Mauro, Fabio Tarantino, Alessandro Salvi, Gennaro Santoro, Ferdinando Varbella, Roberto Violini, Giuseppe Musumeci
Drug-eluting stents (DES) are the current gold standard for percutaneous treatment of coronary artery disease. However, DES are associated with a non-negligible risk of long-term adverse events related to persistence of foreign material in the coronary artery wall. In addition, DES implantation causes permanent caging of the native vessel, thus impairing normal vasomotricity and the possibility of using non-invasive coronary imaging or preforming subsequent bypass surgery. On the contrary, coronary bioresorbable stents (BRS) may provide temporary mechanical support to coronary wall without compromising the subsequent recovery of normal vascular physiology, and have the potential to prevent late adverse events related to permanent elements...
October 2016: Giornale Italiano di Cardiologia
Nikolaos A Papakonstantinou, Nikolaos G Baikoussis, Panagiotis Dedeilias, Michalis Argiriou, Christos Charitos
A hybrid strategy, firstly performed in the 1990s, is a combination of tools available only in the catheterization laboratory with those available only in the operating room in order to minimize surgical morbidity and face with any cardiovascular lesion. The continuous evolution of stent technology along with the adoption of minimally invasive surgical approaches, make hybrid approaches an attractive alternative to standard surgical or transcatheter techniques for any given set of cardiovascular lesions. Examples include hybrid coronary revascularization, when an open surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery is performed along with stent implantation in non-left anterior descending coronary vessels, open heart valve surgery combined with percutaneous coronary interventions to coronary lesions, hybrid aortic arch debranching combined with endovascular grafting for thoracic aortic aneurysms, hybrid endocardial and epicardial atrial fibrillation procedures, and carotid artery stenting along with coronary artery bypass grafting...
October 8, 2016: Journal of Cardiology
Laura Cluzol, Jennifer Cautela, Pierre Michelet, Antoine Roch, François Kerbaul, Julien Mancini, Marc Laine, Michael Peyrol, Floriane Robin, Franck Paganelli, Laurent Bonello, Franck Thuny
BACKGROUND: Acute heart failure (AHF) is a life-threatening medical emergency for which no new effective therapies have emerged in recent decades. No previous study has exhaustively described the entire course of care of AHF patients from first medical contact to hospital discharge or assessed its impact on prognosis. AIM: To fully describe the course of care and analyze its influence on outcomes in patients hospitalized with an AHF syndrome in an academic university center...
September 29, 2016: Archives of Cardiovascular Diseases
Markus Schwaiger, Karl Kunze, Christoph Rischpler, Stephan G Nekolla
After the successful introduction of PET/CT as a multimodality imaging technique, PET/MR has subsequently emerged as an attractive instrumentation for applications in neurology, oncology, and cardiology. Simultaneous data acquisition combining structural, functional, and molecular imaging provides a unique platform to link various aspects of cardiac performance for the non-invasive characterization of cardiovascular disease phenotypes. Specifically, tissue characterization by MR techniques with and without contrast agents allows for functional parameters such as LGE, myocardial perfusion, and T1 maps as well as an estimate of extracellular volume...
September 22, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Arif Zulqarnain, Muhammad Younas, Tariq Waqar, Ahsan Beg, Touseef Asma, Mirza Ahmad Raza Baig
OBJECTIVES: Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus (PDA) with surgical ligation of PDA. METHODS: This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus (PDA) closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Isabel Montilla Padilla, Roberto Martín-Asenjo, Héctor Bueno
The mean age of patients presenting with acute coronary syndrome (ACS) has been increasing steadily in the last decades, so managing very old patients has become common practice. The oldest patients are under-represented in clinical trials, so specific evidence is scarce. Still, antithrombotic therapy and invasive strategy are the pillars of appropriate treatment even in the oldest patients. However, the elderly population is a heterogeneous group showing important divergences between chronological and biological age, which needs specific evaluation...
August 25, 2016: Heart, Lung & Circulation
Fiorenza De Rose, Antonella Fogliata, Davide Franceschini, Piera Navarria, Elisa Villa, Cristina Iftode, Giuseppe D'Agostino, Luca Cozzi, Francesca Lobefalo, Pietro Mancosu, Stefano Tomatis, Marta Scorsetti
BACKGROUND: To report toxicity and early clinical outcomes of hypofractionated simultaneous integrated boost (SIB) approach with Volumetric Modulated Arc Therapy (VMAT) as adjuvant treatment after breast-conserving surgery. METHODS: Patients presenting early-stage breast cancer were enrolled in a phase II trial. ELIGIBILITY CRITERIA: age > 18 years old, invasive cancer or ductal carcinoma in situ (DCIS), Stage I-II (T < 3 cm and N ≤ 3), breast-conserving surgery without oncoplastic reconstruction...
September 17, 2016: Radiation Oncology
Józefa Dąbek, Mariusz Bałys, Michał Majewski, Zbigniew T Gąsior
BACKGROUND: Patients with diabetes mellitus (DM) and acute myocardial infarction (AMI) are heterogeneous individuals with different clinical status compared to patients without DM. OBJECTIVES: The aim of this study was to analyze the group of diabetic patients with ST-segment elevation MI (STEMI) or non-ST-segment elevation infarction (NSTEMI) including risk factors, medical history, laboratory findings, advancement of coronary vessel atherosclerosis, and diagnostics and therapeutic modalities performed...
July 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Andrea Lovece, Pamela Milito, Emanuele Asti, Luigi Bonavina
Leiomyoma is the most common oesophageal tumour and is symptomatic in about half of the patients. Dysphagia is the most common symptom. A 41-year-old woman presented with recent onset of severe orthostatic hypertension. During the cardiological work-up, a mediastinal mass was found at transthoracic echocardiogram. Further investigation (upper gastrointestinal endoscopy, endoscopic ultrasonography, CT scan and cardiac MRI) confirmed the diagnosis of a large oesophageal submucosal mass compressing the supradiaphragmatic inferior vena cava...
2016: BMJ Case Reports
S Orde, S J Huang, A S McLean
Echocardiography is developing rapidly. Speckle tracking echocardiography is the latest semi-automatic tool that has potential to quantitatively describe cardiac dysfunction that may be unrecognised by conventional echocardiography. It is a non-Doppler, angle-independent, feasible and reproducible method to evaluate myocardial function in both non-critically ill and critically ill populations. Increasingly it has become a standard measure of both left and right ventricle function in specific patient groups, e...
September 2016: Anaesthesia and Intensive Care
Raúl J Domenech, Víctor M Parra
The contractile state of the heart is the result of myocardial contractility, the intrinsic mechanism that regulates the force and the shortening of the ventricle and determines the ventricular ejection volume. However, the ejection volume is also modulated by ventricular preload (diastolic ventricular volume) and afterload (resistance to ejection). Accordingly, a decrease in contractility may be masked by changes in preload or afterload, maintaining a normal ejection volume and delaying the diagnosis of myocardial damage...
June 2016: Revista Médica de Chile
Humberto Rodríguez-Reyes, Antonio Arauz-Góngora, Enrique Asensio-Lafuente, Manuel de Jesús Celaya-Cota, Alejandro Cordero-Cabra, Milton Guevara-Valdivia, Raúl Izaguirre-Avila, Susano Lara-Vaca, Vitelio Mariona-Moreno, Enrique Martínez-Flores, Santiago Nava-Townsend, Gerardo Pozas-Garza, Gerardo Rodríguez-Diez
Knowing the real impact of atrial fibrillation in the stroke, the Sociedad Mexicana of Electrofisiología y Estimulación Cardiaca (SOMEEC) had the initiative to develop a multidisciplinary meeting of experts the with the purpose to update the available scientific evidence from clinical practice guidelines, meta-analyses, controlled clinical trials, and complementing with the experience and views of a group of experts. To meet this goal, SOMEEC gathered a group of specialists in the area of cardiology, electrophysiology, neurology and hematology that given their experience in certain areas, they share the scientific evidence with the panel of experts to leave open a discussion about the information presented in this article...
August 27, 2016: Archivos de Cardiología de México
Zivile Valuckiene, Martynas Jurenas, Inga Cibulskaite
Ionizing radiation management is among the most important safety issues in interventional cardiology. Multiple radiation protection measures allow the minimization of x-ray exposure during interventional procedures. Our purpose was to assess the utilization and effectiveness of radiation protection and optimization techniques among interventional cardiologists in Lithuania. Interventional cardiologists of five cardiac centres were interviewed by anonymized questionnaire, addressing personal use of protective garments, shielding, table/detector positioning, frame rate (FR), resolution, field of view adjustment and collimation...
August 24, 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Michael J Reardon, Neal S Kleiman, David H Adams, Steven J Yakubov, Joseph S Coselli, G Michael Deeb, Daniel O'Hair, Thomas G Gleason, Joon Sup Lee, James B Hermiller, Stan Chetcuti, John Heiser, William Merhi, George L Zorn, Peter Tadros, Newell Robinson, George Petrossian, G Chad Hughes, J Kevin Harrison, Brijeshwar Maini, Mubashir Mumtaz, John V Conte, Jon R Resar, Vicken Aharonian, Thomas Pfeffer, Jae K Oh, Jian Huang, Jeffrey J Popma
Importance: Transcatheter aortic valve replacement (TAVR) is now a well-accepted alternative to surgical AVR (SAVR) for patients with symptomatic aortic stenosis at increased operative risk. There is interest in whether TAVR would benefit patients at lower risk. Objective: The Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM) has trended downward in US TAVR trials and the STS/American College of Cardiology Transcatheter Valve Therapy Registry. We hypothesized that if the Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM) alone is sufficient to define decreased risk, the contribution to survival based on the degree of invasiveness of the TAVR procedure will decrease, making it more difficult to show improved survival and benefit over SAVR...
August 17, 2016: JAMA Cardiology
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