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Left main coronary artery disease

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https://www.readbyqxmd.com/read/29447735/new-onset-atrial-fibrillation-after-pci-or-cabg-for-left-main-disease-the-excel-trial
#1
Ioanna Kosmidou, Shmuel Chen, A Pieter Kappetein, Patrick W Serruys, Bernard J Gersh, John D Puskas, David E Kandzari, David P Taggart, Marie-Claude Morice, Paweł E Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Joseph F Sabik, Thomas McAndrew, Björn Redfors, Ori Ben-Yehuda, Gregg W Stone
BACKGROUND: There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD). OBJECTIVES: This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes. METHODS: In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG...
February 20, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29443766/meta-analysis-study-comparing-percutaneous-coronary-intervention-drug-eluting-stent-versus-coronary-artery-bypass-surgery-of-unprotected-left-main-coronary-artery-disease-clinical-outcomes-during-short-term-versus-long-term-1-year-follow-up
#2
Waleed E Ali, Satyanarayana R Vaidya, Sylvester U Ejeh, Kingsley U Okoroafor
BACKGROUND: Results on the safety and long-term efficacy of drug-eluting stent placement in unprotected left main coronary artery disease (ULMCAD) compared with those of coronary artery bypass surgery (CABG) remain inconsistent across randomized clinical trials and recent meta-analysis studies. We aimed to compare the clinical outcomes and safety over short- and long-term follow-ups by conducting a meta-analysis of large pooled data from randomized controlled trials and up-to-date observational studies...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29443740/clinical-outcomes-of-left-main-coronary-artery-disease-patients-undergoing-three-different-revascularization-approaches
#3
Chieh-Shou Su, Yu-Wei Chen, Ching-Hui Shen, Tsun-Jui Liu, Yen Chang, Wen-Lieng Lee
Significant unprotected left main (LM) coronary artery disease is frequently associated with severe multivessel disease and increased mortality and morbidity compared with non-LM coronary artery disease. This study compared the clinical outcomes of patients with LM disease who received percutaneous coronary intervention (PCI) with stenting, conventional coronary-artery bypass grafting (C-CABG), and robot-assisted CABG (R-CABG).This retrospective study analyzed 472 consecutive LM disease patients who underwent three different revascularization approaches at a tertiary medical center between January 2005 and November 2013...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29430728/plasma-cxcl1-levels-and-traf3ip2-variants-in-patients-with-myocardial-infarction
#4
Safoora Pordel, Mahdi Sajedi Khanian, Mohammad Hossein Karimi, Hossein Nikoo, Mehrnoosh Doroudchi
BACKGROUND: IL-17A plays an important role in inflammatory responses in myocardial infarction (MI). IL-17A signals through its receptor, for which, Act1 (TRAF3IP2) functions as a key upstream adaptor in the pathway. AIM: To compare frequencies of functional polymorphisms of TRAF3IP2 (rs13210247, rs33980500) between patients with MI and healthy controls. METHODS: The selected SNPs were studied in 201 Iranian MI patients and 201 healthy blood donors from Fars Province by PCR-RFLP in association with clinicopathologic criteria of patients...
February 12, 2018: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/29408248/bilateral-opposing-loop-technique-b-o-l-t-for-securing-air-knots
#5
Laura M Seese, Faisal G Bakaeen, Ibrahim Sultan, Danny Chu
Incompletely seated knots (air knots) during surgical aortic valve replacement can be potentially difficult to repair in anatomically challenging areas around the aortic root. This is especially true with mechanical protheses as subvalvular areas are inaccessble once the valve is seated. In this report, we present a novel and simple technique of tightening air knots from within the aortic root without removing the prosthesis. The definitive surgical therapy for aortic valve disease has been in evolution since the advent of cardiopulmonary bypass and the development of aortic valve prostheses...
February 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29406046/effect-of-chronic-total-occlusion-percutaneous-coronary-intervention-on-clinical-outcomes-in-elderly-patients
#6
Hui-Ping Zhang, Hu Ai, Ying Zhao, Hui Li, Guo-Dong Tang, Nai-Xin Zheng, Fu-Cheng Sun, Jing-Hua Liu
BACKGROUND: There are little published data reporting the effect of coronary artery chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on the prognosis of elderly patients with identified CTOs. We sought to evaluate the clinical effect of CTO PCI on the prognosis of elderly patients with CTOs. METHODS: A total of 445 consecutive patients diagnosed with a CTO by angiography from January 2011 to December 2013 were enrolled. We compared long-term clinical outcomes between the elderly group (≥75 years; n = 120, 27...
February 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29400656/outcome-after-revascularisation-of-acute-myocardial-infarction-with-cardiogenic-shock-on-extracorporeal-life-support
#7
Pavel Overtchouk, Julien Pascal, Guillaume Lebreton, Jean-Sebastien Hulot, Charles-Edouard Luyt, Alain Combes, Mathieu Kerneis, Johanne Silvain, Olvier Barthelemy, Pascal Leprince, Nicolas Brechot, Gilles Montalescot, Jean-Philippe Collet
AIMS: To identify independent correlates of survival in patients undergoing PCI for refractory cardiogenic shock due to myocardial infarction (RCS-MI) with need for extracorporeal life support (ECLS). METHOD AND RESULTS: This observational single-tertiary-centre study enrolled 106 consecutive patients (52.7±10.4 years) with ECLS placed before or after the PCI. Half of the patients had triple vessel disease and PCI was attempted whenever possible (74.5%). The 30-day mortality rate was 63...
February 6, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29396239/long-term-outcomes-of-new-generation-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-multivessel-and-or-left-main-coronary-artery-disease-a-bayesian-network-meta-analysis-of-randomized-controlled-trials
#8
George S Mina, Hussam Watti, Demiana Soliman, Anand Shewale, Jessica Atkins, Pratap Reddy, Paari Dominic
BACKGROUND: Most data guiding revascularization of multivessel disease (MVD) and/or left main disease (LMD) favor coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI). However, those data are based on trials comparing CABG to bare metal stents (BMS) or old generation drug eluting stents (OG-DES). Hence, it is essential to outcomes of CABG to those of new generation drug eluting stents (NG-DES). METHODS: We searched PUBMED and Cochrane database for trials evaluating revascularization of MVD and/or LMD with CABG and/or PCI...
January 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29395781/editorial-commentary-novel-developments-in-revascularization-for-left-main-coronary-artery-disease
#9
EDITORIAL
Edward T Carreras, Deepak L Bhatt
No abstract text is available yet for this article.
January 26, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29393604/how-the-functional-assessment-of-culprit-and-non-culprit-lesions-may-improve-stratification-and-treatment-of-stemi-patients
#10
Gianluca Campo, Francesco Gallo, Giulia Bugani, Rita Pavasini, Massimo Fineschi
Reperfusion therapy of the infarct-related artery (IRA) with primary percutaneous coronary intervention (pPCI) is the cornerstone for the treatment of patients with ST-elevation myocardial infarction (STEMI). However, up to 30% of STEMI patients present a multi-vessel coronary artery disease. Several methods are now available for the assessment of functional severity of a coronary stenosis both for IRA and non culprit coronary lesions. The functional assessment of the IRA has mainly a prognostic implication in terms of major adverse cardiovascular events (MACEs), recovery of left ventricular function and evaluation myocardial viability...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29390352/coronary-artery-aneurysm-combined-with-other-multiple-aneurysms-at-multiple-locations-a-case-report-and-systematic-review
#11
Li-Cheng Jiang, Jia-Yu Cao, Mao Chen
BACKGROUND: Coronary artery aneurysm (CAA) with concomitant aneurysms at multiple sites is quite unusual and rare. The characteristics and the etiology of this phenomenon are unknown. METHODS: Herein, we present a case with right coronary aneurysm with concomitant abdominal aorta as well as right renal artery aneurysm. A systematic review of the literatures regarding CAA with other coexisting aneurysms at multiple locations was also conducted on Medline and Embase databases...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29378757/systemic-right-ventricle-in-adults-with-congenital-heart-disease-anatomic-and-phenotypic-spectrum-and-current-approach-to-management
#12
REVIEW
Margarita Brida, Gerhard-Paul Diller, Michael A Gatzoulis
The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol...
January 30, 2018: Circulation
https://www.readbyqxmd.com/read/29361323/accuracy-of-the-timi-and-grace-scores-in-predicting-coronary-disease-in-patients-with-non-st-elevation-acute-coronary-syndrome
#13
Rania Hammami, Jihen Jdidi, Fakher Mroua, Rahma Kallel, Mourad Hentati, Leila Abid, Samir Kammoun
INTRODUCTION: The GRACE and TIMI scores have been well validated for assessment of prognosis in non-ST-elevation acute coronary syndrome (NSTE-ACS). However, their value in predicting coronary artery disease (CAD) has been little studied. We aimed to assess the relationship between these scores and the extent of coronary disease. METHODS: We analyzed 238 consecutive patients admitted for NSTE-ACS and undergoing a coronary angiogram during hospitalization. The severity of CAD was assessed using the SYNTAX score...
January 17, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29361286/gender-specific-differences-in-all-cause-mortality-between-incomplete-and-complete-revascularization-in-patients-with-st-elevation-myocardial-infarction-and-multi-vessel-coronary-artery-disease
#14
Aukelien C Dimitriu-Leen, Maaike P J Hermans, Alexander R van Rosendael, Erik W van Zwet, Bas L van der Hoeven, Jeroen J Bax, Arthur J H A Scholte
The best revascularization strategy (complete vs incomplete revascularization) in patients with ST-elevation myocardial infarction (STEMI) is still debated. The interaction between gender and revascularization strategy in patients with STEMI on all-cause mortality is uncertain. The aim of the present study was to evaluate gender-specific difference in all-cause mortality between incomplete and complete revascularization in patients with STEMI and multi-vessel coronary artery disease. The study population consisted of 375 men and 115 women with a first STEMI and multi-vessel coronary artery disease without cardiogenic shock at admission or left main stenosis...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29356195/acute-coronary-syndrome-of-very-unusual-etiology
#15
Raimundo Barbosa-Barros, Andrés R Pérez-Riera, Kimmo Koivula, Jairo de Carvalho Santos, Luiz C de Abreu, Kjell Nikus
Aortitis is one of many possible manifestations of tertiary syphilis. Aortic disease is the most common of all cardiovascular syphilitic lesions. Aortic diseases caused by tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation and coronary ostial stenosis. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 40-year-old male patient admitted with a clinical picture of acute coronary syndrome (unstable angina)...
January 21, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29354006/findings-of-single-photon-emission-computed-tomography-and-its-relation-with-quantitative-coronary-angiography-in-patients-with-significant-stenosis-of-the-left-main-coronary-artery
#16
Hack-Lyoung Kim, So Won Oh, Hyunjong Lee, Hee Jun Kim, You Nui Kim, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Myung-A Kim, Joo-Hee Zo
Objective: Unrecognized left main coronary artery disease (LMCD) is often fatal; however, accuracy of non-invasive tests for diagnosing LMCD is still unsatisfactory. This study was performed to elucidate single-photon emission computed tomography (SPECT) detection of LMCD using quantitative coronary angiography (QCA) data. Materials and Methods: Fifty-five patients (39 men; mean age, 68.1 ± 10.9 years) diagnosed with significant left main (LM) stenosis (≥ 50%) by invasive coronary angiography (ICA) were retrospectively reviewed...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29344756/the-current-state-of-left-main-percutaneous-coronary-intervention
#17
REVIEW
Harshith R Avula, Andrew N Rassi
PURPOSE OF REVIEW: While coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups...
January 17, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29338862/new-generation-stents-compared-with-coronary-bypass-surgery-for-unprotected-left-main-disease-a-word-of-caution
#18
Umberto Benedetto, David P Taggart, Miguel Sousa-Uva, Giuseppe Biondi-Zoccai, Antonino Di Franco, Lucas B Ohmes, Mohamed Rahouma, Mohamed Kamel, Massimo Caputo, Leonard N Girardi, Gianni D Angelini, Mario Gaudino
BACKGROUND: With the advent of bare metal stents and drug-eluting stents, percutaneous coronary intervention has emerged as an alternative to coronary artery bypass grafting surgery for unprotected left main disease. However, whether the evolution of stents technology has translated into better results after percutaneous coronary intervention remains unclear. We aimed to compare coronary artery bypass grafting with stents of different generations for left main disease by performing a Bayesian network meta-analysis of available randomized controlled trials...
January 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29336945/current-treatment-of-significant-left-main-coronary-artery-disease-a-review
#19
REVIEW
Mariama Akodad, Marie-Claude Morice
Though infrequent, left main stenosis has a major prognostic impact. The management of left main disease has evolved over the last few decades with the growing evidence of the efficacy and safety of percutaneous interventions, as attested by the most recent trials. However, mastery of the technical aspects of left main bifurcation stenting is essential in ensuring optimal results. This review focuses on recent data concerning left main angioplasty results as well as the current technical approaches.
January 5, 2018: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29325843/preoperative-intra-aortic-counterpulsation-in-cardiac-surgery-insights-from-a-retrospective-series-of-588-consecutive-high-risk-patients
#20
Giuseppe Gatti, Laura Morra, Gianluca Castaldi, Luca Maschietto, Florida Gripshi, Enrico Fabris, Andrea Perkan, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: To support a rational use of preoperative intra-aortic balloon pump (IABP) in cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single university hospital. PARTICIPANTS: The study included 588 (mean age 68.5 ± 9.6 yr) consecutive patients who received IABP before cardiac surgery from 1999 to 2016. INTERVENTIONS: Coronary surgery was performed in 573 (97.4%) cases...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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