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coronary artery revascularization

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https://www.readbyqxmd.com/read/28542076/comparative-analysis-of-perioperative-and-mid-term-results-of-tecab-and-midcab-for-revascularization-of-anterior-wall
#1
Markus Kofler, Thomas Schachner, Sebastian J Reinstadler, Lukas Stastny, Julia Dumfarth, Dominik Wiedemann, Gudrun Feuchtner, Guy Friedrich, Johannes Bonatti, Nikolaos Bonaros
OBJECTIVE: Totally endoscopic coronary artery bypass (TECAB) and minimally invasive direct coronary artery bypass (MIDCAB) grafting through minithoracotomy are currently the two minimally invasive surgical techniques of left ventricular anterior wall revascularization. We aimed to compare both techniques in terms of perioperative and mid-term results. METHODS: Arrested heart TECAB was carried out in 204 patients with a median (range) age of 60 (53-76) years and a median (range) EuroSCORE I of 2 (0-3)...
May 24, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28541601/the-approach-to-coronary-bifurcation-treatment-and-its-outcomes-in-poland-the-single-center-experience
#2
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Rakesh Jalali, Jerzy Górny, Jacek Bil
BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland. METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®)...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28541597/patients-with-acute-myocardial-infarction-and-severe-target-lesion-calcifications-undergoing-percutaneous-coronary-intervention-have-poor-long-term-prognosis
#3
Wojciech Jan Zimoch, Piotr Kubler, Michał Kosowski, Brunon Tomasiewicz, Justyna Krzysztofik, Anna Langner, Ewa Anita Jankowska, Krzysztof Reczuch
BACKGROUND: To assess the influence of severe target lesion calcification (TLC) on outcomes of patients undergoing percutaneous coronary interventions (PCI) due to acute myocardial infarction (AMI). AIM: Contemporary data concerning coronary artery calcifications (CAC) are based on pooled analyses from randomized trials with short follow up. We still lack the knowledge on how CAC in target lesions affect long term prognosis of patients with AMI in everyday practice...
May 25, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28540075/fractional-flow-reserve-to-guide-surgical-coronary-revascularization
#4
REVIEW
Tara Shah, Joshua D Geleris, Ming Zhong, Rajesh V Swaminathan, Luke K Kim, Dmitriy N Feldman
Coronary angiography has traditionally been used as the final diagnostic tool in the evaluation of coronary artery disease (CAD). However, conventional angiography identifies anatomically obstructive coronary disease, but it is limited in its ability to identify hemodynamically significant lesions. The emergence of fractional flow reserve (FFR) technology, in conjunction with angiography, offers a functional, as well as anatomic, assessment of epicardial coronary obstructions. Several pivotal studies have demonstrated that FFR-guided coronary revascularization is a safe and effective in patients with single and multivessel CAD...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28539596/intravascular-ultrasound-guidance-improves-the-long-term-prognosis-in-patients-with-unprotected-left-main-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#5
Jian Tian, Changdong Guan, Wenyao Wang, Kuo Zhang, Jue Chen, Yongjian Wu, Hongbing Yan, Yanyan Zhao, Shubin Qiao, Yuejin Yang, Gary S Mintz, Bo Xu, Yida Tang
This study compared the long term outcomes in patients with unprotected left main coronary artery (LMCA) disease who underwent stenting under the guidance of intravascular ultrasound (IVUS) or conventional angiography at a large single center. The primary outcome was the composite of all-cause death and myocardial infarction (MI) at 3 years. Target vessel revascularization (TVR) at 3 years was one of the secondary outcomes. Between January 2004 and December 2011, a total of 1,899 patients who underwent IVUS-guided (n = 713, 37...
May 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28539570/usefulness-and-safety-of-a-novel-modification-of-the-retrograde-approach-for-the-long-tortuous-chronic-total-occlusion-of-coronary-arteries
#6
Zehan Huang, Bin Zhang, Weilu Chai, Dunliang Ma, Hongtao Liao, Zhian Zhong, Feng Wang, Jingye Lin
The aim of this study was to evaluate the feasibility and efficacy of the Guidezilla guide extension catheter in a reverse controlled antegrade and retrograde subintimal tracking (CART) technique for chronic total occlusion (CTO) recanalization.We retrospectively collected 80 CTO cases using reverse CART technology from January 2015 to October 2015 and 20 CTO cases using Guidezilla reverse-CART technology from October 2015 to March 2016. Guidezilla was applied in cases when it was difficult to advance a retro-guidewire through an occlusion segment into the antegrade guide catheter...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28539560/prognostic-value-of-combination-of-plasma-d-dimer-concentration-and-estimated-glomerular-filtration-rate-in-predicting-long-term-mortality-of-patients-with-stable-coronary-artery-disease
#7
Hiroyuki Naruse, Junnichi Ishii, Hiroshi Takahashi, Fumihiko Kitagawa, Ryuunosuke Okuyama, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Sadako Motoyama, Shigeru Matsui, Mutsuharu Hayashi, Masayoshi Sarai, Eiichi Watanabe, Hideo Izawa, Yukio Ozaki
BACKGROUND: A modestly elevated circulating D-dimer level may be relevant to coronary artery disease (CAD), but its prognostic value, both independently and in combination with estimated glomerular filtration rate (eGFR), for long-term death has not been fully evaluated in stable CAD patients.Methods and Results:Baseline plasma D-dimer levels and eGFR were measured in 1,341 outpatients (mean age: 65 years) with prior myocardial infarction (MI), coronary revascularization, and/or angiographic evidence of a significant stenosis (>50%) for at least one of the major coronary arteries...
May 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28538000/revascularization-for-patients-with-diabetes-mellitus-and-stable-ischemic-heart-disease-an-update
#8
G B John Mancini, Michael Farkouh, Subodh Verma
PURPOSE OF REVIEW: To provide an update on the management of patients with diabetes mellitus and requiring coronary revascularization. RECENT FINDINGS: Evidence continues to show that patients with diabetes mellitus and ischemic heart disease represent a very high-risk group of patients. Choice of stent appears important for minimizing target lesion and target vessel adverse events with everolimus eluting stents having the best performance, particularly in patients being treated with insulin...
May 19, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28537939/current-perspectives-on-revascularization-in-multivessel-st-elevation-myocardial-infarction
#9
Guy Witberg, Ran Kornowski
Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) are found to have multivessel coronary artery disease. These patients have a worse prognosis compared with the overall STEMI population. Two revascularization strategies are possible for these patients: treating the infarct-related artery percutaneous coronary intervention (IRA-PCI) only or achieving Complete revascularization (CR), either through an immediate multivessel PCI during the index angiography or during a second-staged procedure...
May 19, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28536852/the-role-of-sglt-2-inhibitors-as-part-of-optimal-medical-therapy-in-improving-cardiovascular-outcomes-in-patients-with-diabetes-and-coronary-artery-disease
#10
Wassim Mosleh, Abhinav Sharma, Mandeep S Sidhu, Brian Page, Umesh C Sharma, Michael E Farkouh
The optimal treatment approach to patients with coronary artery disease (CAD), including those with type 2 diabetes mellitus (T2DM), has been extensively evaluated. Several trials of stable ischemic heart disease including patients with T2DM have demonstrated that medical management is comparable to revascularization in terms of mortality and rates of major adverse cardiovascular events (MACE). There has been a growing appreciation for optimal medical therapy's (OMT) role in improving clinical outcomes. It is vital to target T2DM patients to prevent or delay MACE events through advanced OMT, ultimately delaying if not avoiding the need for revascularization...
May 24, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28532984/prognostic-impact-of-residual-syntax-score-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-analysis-of-an-8-year-all-comers-registry
#11
Carlos Galvão Braga, Ana Belén Cid-Alvarez, Alfredo Redondo Diéguez, Belén Alvarez Alvarez, Diego López Otero, Raymundo Ocaranza Sánchez, Xoan Sanmartin Pena, Violeta González Salvado, Ramiro Trillo-Nouche, José R González-Juanatey
BACKGROUND: The residual SYNTAX score (rSS) was designed and validated to quantify the burden of residual coronary artery disease after percutaneous coronary intervention (PCI). The aim of this study was to assess the prognostic impact of rSS in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease undergoing primary-PCI. METHODS: This retrospective cohort study included 1499 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2015...
April 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28532780/meta-analysis-comparing-coronary-artery-bypass-grafting-to-drug-eluting-stents-and-to-medical-therapy-alone-for-left-main-coronary-artery-disease
#12
Rahman Shah, Mohamed S Morsy, Darryl S Weiman, George W Vetrovec
Historically, coronary artery bypass graft (CABG) surgery has been the standard revascularization method for unprotected left main coronary artery (LMCA) disease. Over the last decade, several randomized controlled trials (RCTs) have shown favorable results for percutaneous coronary intervention (PCI) with drug-eluting stent (DES) compared with CABG; however, no RCT has been conducted directly comparing DESs with medical therapy alone (MTA). Furthermore, the 2 most recently reported larger RCTs, using new-generation DESs reached somewhat conflicting conclusions comparing the 2 revascularization strategies...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28531282/near-infrared-spectroscopy-derived-lipid-core-burden-index-predicts-adverse-cardiovascular-outcome-in-patients-with-coronary-artery-disease-during-long-term-follow-up
#13
Anne-Sophie Schuurman, Maxime Vroegindewey, Isabella Kardys, Rohit M Oemrawsingh, Jin M Cheng, Sanneke de Boer, Hector M Garcia-Garcia, Robert-Jan van Geuns, Evelyn S Regar, Joost Daemen, Nicolas M van Mieghem, Patrick W Serruys, Eric Boersma, K Martijn Akkerhuis
Aims: Near-infrared spectroscopy (NIRS) is able to quantify cholesterol within coronary arteries by the lipid core burden index (LCBI). We studied the prognostic value of NIRS-derived LCBI in patients with coronary artery disease (CAD) for adverse cardiac outcome during long-term follow-up. Methods and results: During 2009-2013, NIRS was performed in a non-culprit artery of 275 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina...
May 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28530070/-the-coronary-sinus-reducer-a-devicebased-therapy-for-refractory-angina
#14
REVIEW
Maayan Konigstein, Shmuel Banai
Alongside the remarkable progress in therapeutic strategies destined to patients with coronary artery disease (CAD), a growing number of patients who suffer from severe and diffuse CAD not amenable for revascularization, continue to experience severe debilitating angina despite optimal medical therapy. The Coronary Sinus (CS) Reducer has emerged as a novel therapeutic strategy for patients with refractory angina pectoris. The Reducer is a stainless steel, balloon-expandable, hourglass shaped device implanted percutaneously through the right internal jugular vein in the coronary sinus...
November 2016: Harefuah
https://www.readbyqxmd.com/read/28529094/outcomes-of-patients-with-myocardial-infarction-who-underwent-orbital-atherectomy-for-severely-calcified-lesions
#15
Michael S Lee, Evan Shlofmitz, Gentian Lluri, Jeremy Kong, Natalya Neverova, Richard Shlofmitz
OBJECTIVES: This study analyzed the outcomes of patients who presented with non-ST-elevation myocardial infarction (NSTEMI) and subsequently underwent orbital atherectomy for severe coronary artery calcification (CAC). BACKGROUND: Patients who present with NSTEMI have increased risk for death and recurrent MI after percutaneous coronary intervention (PCI). Patients with severe CAC have worse outcomes after PCI.Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
May 7, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28529093/revascularization-methods-in-spontaneous-coronary-artery-dissection-a-focused-review
#16
REVIEW
Regina Lee, Itsik Ben-Dor
Spontaneous coronary artery dissection (SCAD) is becoming widely recognized as an important cause of myocardial infarction, particularly in younger women. Tendency toward conservative management has been primarily based on observational data. Intervention is recommended when coronary blood flow is compromised and high risk features such as left main involvement, ongoing ischemia, or hemodynamic or electrical instability are present. Unlike the atherosclerotic process where the superiority of stenting compared with plain old balloon angioplasty has been established in the acute setting, randomized studies for revascularization strategies for spontaneous coronary dissection are currently lacking...
May 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28521888/clinical-significance-of-lipid-rich-plaque%C3%A2-detected-by-optical-coherence%C3%A2-tomography-a%C3%A2-4-year-follow-up-study
#17
Lei Xing, Takumi Higuma, Zhao Wang, Aaron D Aguirre, Kyoichi Mizuno, Masamichi Takano, Harold L Dauerman, Seung-Jung Park, Yangsoo Jang, Chong-Jin Kim, Soo-Joong Kim, So-Yeon Choi, Tomonori Itoh, Shiro Uemura, Harry Lowe, Darren L Walters, Peter Barlis, Stephen Lee, Amir Lerman, Catalin Toma, Jack Wei Chieh Tan, Erika Yamamoto, Krzysztof Bryniarski, Jiannan Dai, Thomas Zanchin, Shaosong Zhang, Bo Yu, Hang Lee, James Fujimoto, Valentin Fuster, Ik-Kyung Jang
BACKGROUND: Lipid-rich plaque (LRP) is thought to be a precursor to cardiac events. However, its clinical significance in coronary arteries has never been systematically investigated. OBJECTIVES: This study investigated the prevalence and clinical significance of LRP in the nonculprit region of the target vessel in patients undergoing percutaneous coronary intervention (PCI). METHODS: The study included 1,474 patients from 20 sites across 6 countries undergoing PCI, who had optical coherence tomography (OCT) imaging of the target vessel...
May 23, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28520861/influence-of-practice-patterns-on-outcome-among-countries-enrolled-in-the-syntax-trial-5-year-results-between-percutaneous-coronary-intervention-and-coronary-artery-bypass-grafting%C3%A2
#18
Milan Milojevic, Stuart J Head, Michael J Mack, Friedrich W Mohr, Marie-Claude Morice, Keith D Dawkins, David R Holmes, Patrick W Serruys, Arie Pieter Kappetein
OBJECTIVES: To examine differences among participating countries in baseline characteristics, clinical practice, medication strategies and outcomes of patients randomized to coronary artery bypass grafting and percutaneous coronary intervention in the SYNTAX trial. METHODS: In SYNTAX, centres in 18 different countries enrolled 1800 patients, of which 8 countries enrolled ≥80 patients, what was projected to be a large enough sample size to be included in the analysis...
May 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28515826/successful-restoration-of-complete-heart-block-to-normal-sinus-rhythm-by-primary-angioplasty-of-dual-left-anterior-descending-artery
#19
Santosh Kumar Sinha, Vikas Mishra, Mukesh Jitendra Jha, Mahmadula Razi, Nasar Abdali, Anupam Mahrotra, Mohammad Asif, Lokendra Rekwal, Vikas Chaturvedi, Shravan Singh, Vinay Krishna
Dual left anterior descending (LAD) artery is a rare coronary anomaly. We present a patient with a rare case of dual LAD, smaller one arising from the left main coronary stem and larger one from right coronary artery who presented with acute anterior wall myocardial infarction with complete heart block (CHB). Temporary pacemaker was implanted and coronary angiogram revealed critical occlusion of proximal LAD which was subsequently revascularized by primary angioplasty using drug-eluting stent (Xience prime, 2...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515822/primary-percutaneous-coronary-intervention-angioplasty-of-occluded-twin-circumflex-coronary-artery-in-a-patient-of-acute-inferior-wall-myocardial-infarction-a-rare-anomaly
#20
Santosh Kumar Sinha, Vikas Mishra, Nasar Abdali, Mukesh Jitendra Jha, Mahmadula Razi, Shravan Singh, Lokendra Rekwal, Vikas Chaturvedi, Chandra Mohan Varma, Ramesh Thakur
Anomalies of the coronary arteries are reported in 1-2% of patients among diagnostic angiogram. Dual origin of a circumflex from both sinuses is extremely rare among them. We report a case of a patient who underwent primary percutaneous coronary intervention for acute inferior wall myocardial infarction where left coronary injection demonstrated normal obtuse marginal and right coronary injection demonstrated normal right coronary artery (RCA). On further probing, an anomalous left circumflex (LCx) artery was seen arising from RCA ostium which was subsequently cannulated and revascularized by deployment of 2...
April 2017: Cardiology Research
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