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https://www.readbyqxmd.com/read/28228950/outcomes-of-coronary-artery-bypass-grafting-versus-percutaneous-coronary-intervention-with-second-generation-drug-eluting-stents-for-patients-with-multivessel-and-unprotected-left-main-coronary-artery-disease
#1
Kyriacos Papadopoulos, Ioannis Lekakis, Evagoras Nicolaides
OBJECTIVES: To compare the efficacy and safety of percutaneous coronary intervention using second-generation drug-eluting stents with those of coronary artery bypass grafting among patients with multivessel disease and/or unprotected left main coronary artery disease in terms of mortality, myocardial infarction, repeat revascularization, and angina. BACKGROUND: Although coronary artery disease is a leading cause of death in the Western world and in many developing countries, its optimal treatment is still a matter of controversy...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28227224/cfd-analysis-of-strut-influence-on-blood-flow-in-stent-implanted-left-main-coronary-artery-bifurcation
#2
Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Yuya Yamada, Takahiro Tsukahara, Masahiro Motosuke, Yusuke Fujino, Takahiro Tsukahara, Yuya Yamada, Yusuke Fujino, Masahiro Motosuke
We numerically studied blood flows in a simulated branching pipe of coronary artery bifurcation, which is affected by stent implantation. We found that stent struts provide effects as guide vanes and blockages on the flow into circumflex branch. The former effect increases the flow rate and shear stress on the arteriosclerosis-prone site. The blockage effect may overwhelm the guide effect depending on a strut position against the inflow.
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226721/overcoming-spatio-temporal-limitations-using-dynamically-scaled-in-vitro-pc-mri-a-flow-field-comparison-to-true-scale-computer-simulations-of-idealized-stented-and-patient-specific-left-main-bifurcations
#3
Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Susann Beier, John Ormiston, Mark Webster, John Cater, Stuart Norris, Pau Medrano-Gracia, Alistair Young, Kathleen Gilbert, Brett Cowan, Stuart Norris, Brett Cowan, Pau Medrano-Gracia, Kathleen Gilbert, Mark Webster, Alistair Young, Susann Beier, John Cater, John Ormiston
The majority of patients with angina or heart failure have coronary artery disease. Left main bifurcations are particularly susceptible to pathological narrowing. Flow is a major factor of atheroma development, but limitations in imaging technology such as spatio-temporal resolution, signal-to-noise ratio (SNRv), and imaging artefacts prevent in vivo investigations. Computational fluid dynamics (CFD) modelling is a common numerical approach to study flow, but it requires a cautious and rigorous application for meaningful results...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28224974/differences-in-outcomes-in-patients-with-stable-coronary-artery-disease-managed-by-cardiologists-versus-non-cardiologists-the-international-prospective-clarify-registry
#4
Zofia Parma, Philippe Gabriel Steg, Nicola Greenlaw, Roberto Ferrari, Ian Ford, Kim Fox, Jean-Claude Tardif, Joao Morais, Marco Alcocer Gamba, Stefan Kääb, Michał Tendera
INTRODUCTION    Clinical outcomes of patients with stable coronary artery disease (SCAD) may differ between those primarily managed by cardiologists versus non-cardiologists.  OBJECTIVES    Our main objective was to analyze the clinical outcomes of outpatients with SCAD in relation to the specialty of the managing physicians.  PATIENTS AND METHODS    We studied 32,468 outpatients with SCAD included in the CLARIFY registry, with up to 4 years follow-up data. Cardiologists provided medical care in 84...
January 20, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28224927/an-age-and-sex-specific-gene-expression-score-is-associated-with-revascularization-and-coronary-artery-disease-insights-from-the-prospective-multicenter-imaging-study-for-evaluation-of-chest-pain-promise-trial
#5
Deepak Voora, Adrian Coles, Kerry L Lee, Udo Hoffmann, James A Wingrove, Brian Rhees, Lin Huang, Susan E Daniels, Mark Monane, Steven Rosenberg, Svati H Shah, William E Kraus, Geoffrey S Ginsburg, Pamela S Douglas
BACKGROUND: Identifying predictors of coronary artery disease (CAD)-related procedures and events remains a priority. METHODS: We measured an age- and sex-specific gene expression score (ASGES) previously validated to detect obstructive CAD (oCAD) in symptomatic nondiabetic patients in the PROMISE trial. The outcomes were oCAD (≥70% stenosis in ≥1 vessel or ≥50% left main stenosis on CT angiography [CTA]) and a composite endpoint of death, myocardial infarction, revascularization, or unstable angina...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28223049/outcomes-of-coronary-artery-bypass-and-stents-for-unprotected-left-main-coronary-stenosis
#6
Yin-Shu Chang, Jia-Xiang Wang, Da-Wei Chang
BACKGROUND: This study assessed the short-, medium-, and long-term outcomes of coronary artery bypass grafting vs stenting for patients with unprotected left main coronary artery disease through a meta-analysis of randomized controlled trials. METHODS: PubMed, Embase, Scopus, Web of Science, Cochrane Library, and major conference proceedings databases were systematically searched for randomized controlled trials of coronary artery bypass grafting compared with stents in unprotected left main coronary artery disease...
February 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28220463/can-we-improve-the-outcomes-of-multivessel-disease-using-modified-syntax-and-residual-syntax-scores
#7
REVIEW
Alfredo E Rodriguez, Carlos Fernandez-Pereira, Juan Mieres, Javier Mendoza, Florencia Sartori
PURPOSE OF REVIEW: In spite of the benefits of drug eluting (DES), these advantages were not translated to better outcome when percutaneous coronary interventions (PCI) were compared with coronary artery bypass surgery. PCI strategy allowing stent deployment in all intermediate lesions including small vessels together with DES design may be the reasons of these findings. RECENT FINDINGS: Recently randomized and observational studies demonstrated using functional flow reserve analysis, residual Syntax score risk, or residual ERACI score after PCI that a reasonably incomplete revascularization was associated with good long-term outcome and low events rate at follow-up...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28219921/predictive-value-of-dobutamine-stress-perfusion-echocardiography-in-contemporary-end-stage-liver-disease
#8
Bipul Baibhav, Chetaj A Mahabir, Feng Xie, Valerie K Shostrom, Timothy M McCashland, Thomas R Porter
BACKGROUND: The assessment of cardiac risk in contemporary liver transplantation (LT) has required more sensitive testing for the detection of occult coronary artery disease as well as microvascular and functional cardiac abnormalities. Because dobutamine stress perfusion echocardiography provides an assessment of both regional systolic and diastolic function as well as microvascular perfusion (MVP), we sought to examine its incremental value in this setting. METHODS AND RESULTS: We evaluated the predictive value of dobutamine stress perfusion echocardiography in 296 adult patients with end-stage liver disease and preserved systolic function who underwent LT between 2008 and 2014...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#9
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28213402/a-novel-method-of-standardized-myocardial-infarction-in-aged-rabbits
#10
Patrick J Morrissey, Kevin R Murphy, Jean M Daley, Lorraine Schofield, Nilufer N Turan, Karuppiah Arunachalam, J Dawn Abbott, Gideon Koren
The incidence of myocardial infarction (MI) and sudden cardiac death increases with age. Here we describe the development of a minimally invasive large animal model of MI that can be applied to young or aged animals. We demonstrate that rabbit coronary anatomy is highly variable, more so than described in previous literature. In this work we categorize the coronary pattern of 37 young and 63 aged rabbits. Aged rabbits had a higher degree of branching from the left main coronary artery. Standardizing the model across age cohorts required a new approach, targeting an area of myocardium rather than a specific vessel...
February 17, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28210637/anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-an-uncommon-coronary-anomaly-with-serious-implications-in-adulthood
#11
Venkat Gangadharan, Kamesh Sivagnanam, Ghulam Murtaza, Michael Ponders, Otto Teixeira, Timir Paul
A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28208917/early-post-operative-coronary-thrombosis-following-repair-of-a-proximal-coronary-artery-fistula
#12
Yashasvi Chugh, Bryan Lau, Cynthia C Taub
Patients with aneurysmal coronary artery fistulas are often a treatment challenge. We hereby, report a case of aneurysmal left main coronary artery to coronary sinus fistula repair, complicated by an early post-operative thrombosis of the left main coronary artery, necessitating an orthotropic heart transplant. Routine use of peri-procedural and long-term anti-coagulation is usually not a standard recommendation in these cases; however, early institution of the same may prevent flow stasis, thrombus formation and unfavourable outcomes pre- or post-operatively...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208116/factors-determining-left-main-coronary-artery-luminal-area
#13
Konstantinos Dean Boudoulas, Peter M Bittenbender, Haikady N Nagaraja, Omar Kahaly, Jennifer A Dickerson, Subha V Raman, Ernest L Mazzaferri, Charles A Bush
BACKGROUND: A certain minimal luminal cross-sectional area has been traditionally used in clinical practice as a cut-off value to determine severity of left main coronary artery (LMCA) stenosis. The severity of stenosis, however, depends on the baseline luminal area (ie, area prior to stenosis), which may vary among individuals. The present study was undertaken to define normal LMCA luminal area using current technology in vivo. METHODS: LMCA luminal area was determined using multislice computed tomography coronary angiography...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28205276/positive-t-wave-in-lead-avr-as-an-independent-predictor-for-1-year-major-adverse-cardiac-events-in-patients-with-first-anterior-wall-st-segment-elevation-myocardial-infarction
#14
Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Yumiko Kanei
BACKGROUND: Positive T wave in lead aVR has been shown to predict an adverse in-hospital outcome in patients with anterior wall ST-segment elevation myocardial infarction (STEMI). However, the prognostic value of positive T wave in lead aVR on a long-term outcome has not been fully explored. METHODS: We performed a retrospective analysis of 190 consecutive patients with first anterior wall STEMI who underwent an emergent coronary angiogram. Patients were divided into those with positive T wave > 0 mV and those with negative T wave ≦ 0 mV in lead aVR...
February 16, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28203572/symptomatic-type-iv-dual-left-anterior-descending-coronary-artery
#15
Kyriacos Papadopoulos, Georgios M Georgiou, Evagoras Nicolaides
Dual left anterior descending coronary artery is a rare congenital anomaly with 4 subtypes. Double left anterior descending coronary artery originating from the left main stem and the right coronary artery (type IV dual left anterior descending artery) has been reported to occur in 0.01% to 0.7% of patients undergoing cardiac catheterization. We report a case of a 49-year-old woman who was found to have this anomaly during coronary angiography. The patient had been complaining of chest pain that mimics angina pectoris and exercise tolerance test was positive for myocardial ischemia...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28194409/a-variant-in-cox-2-gene-is-associated-with-left-main-coronary-artery-disease-and-clinical-outcomes-of-coronary-artery-bypass-grafting
#16
Hanning Liu, Zhengxi Xu, Cheng Sun, Dachuan Gu, Xiao Teng, Yan Zhao, Zhe Zheng
As a particular severe phenotype of coronary artery disease (CAD), left main coronary artery disease (LMCAD) is heritable. Genetic variants related to prostaglandin metabolism are associated with LMCAD. Cyclooxygenase-2 (COX-2), a key synthase in prostaglandin pathways, displays high density in atherosclerotic lesions and promotes early atherosclerosis in CAD progression. We hypothesized that genetic variants in COX-2 gene contribute to LMCAD phenotype susceptibility compared to more peripheral coronary artery disease (MPCAD)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28191682/aortic-root-thrombus-complicated-by-left-main-coronary-artery-occlusion-visualized-by-3d-echocardiography-in-a-patient-with-continuous-flow-left-ventricular-assist-device
#17
Monique S Tanna, Alex Reyentovich, Leora B Balsam, John A Dodson, Alan F Vainrib, Ricardo J Benenstein, Barry P Rosenzweig, Muhamed Saric
Aortic root thrombus is an uncommon complication of continuous-flow left ventricular assist devices (LVAD). We present the case of a 71-year-old man with ischemic cardiomyopathy who underwent destination therapy HeartMate II LVAD placement. Eighteen months later, he presented with a cerebrovascular accident followed by myocardial infarction. Transesophageal echocardiography revealed an aortic root thrombus spanning the left and noncoronary cusps and obliterating the left main coronary artery. We discuss the incidence, risk factors, and management of aortic root thrombus in LVAD patients...
February 13, 2017: Echocardiography
https://www.readbyqxmd.com/read/28189040/an-anti-%C3%AE-v%C3%AE-3-antibody-inhibits-coronary-artery-atherosclerosis-in-diabetic-pigs
#18
L A Maile, W H Busby, G Xi, K P Gollahan, W Flowers, N Gafbacik, S Gafbacik, K Stewart, E P Merricks, T C Nichols, D A Bellinger, D R Clemmons
BACKGROUND AND AIMS: Diabetes is a major risk factor for the development of atherosclerosis. Hyperglycemia stimulates vascular smooth muscle cells (VSMC) to secrete ligands that bind to the αVβ3 integrin, a receptor that regulates VSMC proliferation and migration. This study determined whether an antibody that had previously been shown to block αVβ3 activation and to inhibit VSMC proliferation and migration in vitro, inhibited the development of atherosclerosis in diabetic pigs. METHODS: Twenty diabetic pigs were maintained on a high fat diet for 22 weeks...
January 27, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28186284/coronary-obstruction-after-valve-in-valve-transcatheter-aortic-valve-implantation-salvage-with-stent-in-the-left-main-stem
#19
Lars Oliver Conzelmann, Uwe Mehlhorn, Claus Schmitt, Gerhard Schymik
No abstract text is available yet for this article.
February 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28185417/left-main-coronary-angioplasty-of-a-9-year-old-child-with-bioresorable-vascular-scaffold
#20
Hasmukh Ravat, Swati Garekar, Vishal Changela
Familial hypercholesterolemia is an autosomal dominant disorder due to mutations in the low-density lipoprotein receptor gene, characterized by skin and tendon xanthomas, xanthelasmas, and increased risk of premature coronary artery disease. Here, we report a case of 9-year-old girl who presented with angina and dyspnoea on exertion with xanthomas and an elevated serum cholesterol and triglyceride. She had severe stenosis of the left main coronary artery (LMCA) requiring angioplasty and placement of Bioresorbable vascular scaffold (BVS)...
February 10, 2017: Catheterization and Cardiovascular Interventions
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