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Left main coronary artery disease

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https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#1
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27899140/transapical-transcatheter-aortic-valve-replacement-in-patients-with-or-without-prior-coronary-artery-bypass-graft-operation
#2
Konstantinos V Voudris, S Chiu Wong, Ryan Kaple, Polydoros N Kampaktsis, Andreas R de Biasi, Jonathan S Weiss, Richard Devereux, Karl Krieger, Luke Kim, Rajesh V Swaminathan, Dmitriy N Feldman, Harsimran Singh, Nikolaos J Skubas, Robert M Minutello, Geoffrey Bergman, Arash Salemi
BACKGROUND: Transapical approach (TA) is an established access alternative to the transfemoral technique in patients undergoing transcatheter aortic valve replacement (TAVR) for treatment of symptomatic aortic valve stenosis. The impact of prior coronary artery bypass grafting (CABG) on clinical outcomes in patients undergoing TA-TAVR is not well defined. METHODS: A single center retrospective cohort analysis of 126 patients (male 41%, mean age 85.8 ± 6.1 years) who underwent TA balloon expandable TAVR (Edwards SAPIEN, SAPIEN XT or SAPIEN 3) was performed...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27891374/effect-of-enhanced-external-counter-pulsation-treatment-on-aortic-blood-pressure-arterial-stiffness-and-ejection-fraction-in-patients-with-coronary-artery-disease
#3
Ramasamy Subramanian, Sushma Nayar, Chokkalingam Meyyappan, N Ganesh, Arumugam Chandrakasu, Pradeep G Nayar
INTRODUCTION: Enhanced External Counter Pulsation (EECP) is a non-invasive treatment option for patients with Coronary Artery Disease (CAD). The treatment has shown to augment diastolic pressure and reduce Left Ventricular (LV) after-load by reducing systemic vascular resistance. The effect of EECP in standard brachial blood pressure and central haemodynamic parameters are not known. AIM: We hypothesized that EECP may have differential effect in CAD patients with low systolic blood pressure when compared to normal systolic pressure and the mechanism underlying this differential effect may be due to improvement in LV function...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27884354/computing-methods-for-composite-clinical%C3%A2-endpoints-in-unprotected-left-main-coronary-artery-revascularization-a-post-hoc-analysis-of-the-delta-registry
#4
Davide Capodanno, Giuseppe Gargiulo, Sergio Buccheri, Alaide Chieffo, Emanuele Meliga, Azeem Latib, Seung-Jung Park, Yoshinobu Onuma, Piera Capranzano, Marco Valgimigli, Inga Narbute, Raj R Makkar, Igor F Palacios, Young-Hak Kim, Pawel E Buszman, Tarun Chakravarty, Imad Sheiban, Roxana Mehran, Christoph Naber, Ronan Margey, Arvind Agnihotri, Sebastiano Marra, Martin B Leon, Jeffrey W Moses, Jean Fajadet, Thierry Lefèvre, Marie-Claude Morice, Andrejs Erglis, Ottavio Alfieri, Patrick W Serruys, Antonio Colombo, Corrado Tamburino
OBJECTIVES: The study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease. BACKGROUND: TTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance. METHODS: The TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 international centers...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27878406/diagnostic-value-of-layer-specific-global-longitudinal-strain-during-adenosine-stress-in-patients-suspected-of-coronary-artery-disease
#5
June A Ejlersen, Steen H Poulsen, Jesper Mortensen, Ole May
Speckle tracking global longitudinal strain (GLS) from dobutamine stress echocardiography (SE) predicts coronary artery disease (CAD). The diagnostic value of GLS from vasodilator SE and the additional value of layer-specific speckle tracking analysis are unclear. We explored the usefulness of layer-specific GLS and non-layer-specific strain (automated functional imaging, AFI) from adenosine SE. The included 132 patients (67% male, 62.6 (9.0) years), of which 46 (35%) had CAD defined as ≥1 stenosis ≥70% (≥50% in the left main), underwent adenosine SE and invasive coronary angiography...
November 22, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27871628/updated-evidence-for-left-main-coronary-artery-disease-practice-versus-the-consensus
#6
EDITORIAL
Zhe Zheng, Heng Zhang, Bo Xu
No abstract text is available yet for this article.
October 28, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27867541/percutaneous-coronary-intervention-versus-bypass-grafting-in-left-main-coronary-artery-disease
#7
EDITORIAL
Stine Munkholm-Larsen, Tristan D Yan
No abstract text is available yet for this article.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863290/cardiorenal-acute-kidney-injury-epidemiology-presentation-causes-pathophysiology-and-treatment
#8
REVIEW
Luca Di Lullo, Antonio Bellasi, Domenico Russo, Mario Cozzolino, Claudio Ronco
Cardiovascular disease and major cardiovascular events represent main cause of death in both acute and chronic kidney disease patients. Kidney and heart failure are common and frequently co-exist; this organ - organ interaction, also called organ cross-talk led to well-known definition of cardiorenal syndrome (CRS). Here we'll describe cardiovascular involvement in patients with acute kidney injury (AKI). Also known as type-3 CRS or acute reno-cardiac CRS, it occurs when AKI contributes and/or precipitates development of acute cardiac injury...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27853160/coronary-artery-disease-cabg-surgery-or-pci-for-left-main-cad
#9
Irene Fernández-Ruiz
No abstract text is available yet for this article.
November 17, 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27829641/arterial-stiffness-is-significantly-associated-with-left-ventricular-diastolic-dysfunction-in-patients-with-cardiovascular-disease
#10
Takayuki Namba, Nobuyuki Masaki, Yuki Matsuo, Atsushi Sato, Toyokazu Kimura, Shunpei Horii, Risako Yasuda, Hirotaka Yada, Akio Kawamura, Bonpei Takase, Takeshi Adachi
Left ventricular (LV) diastolic dysfunction is considered the main cause of heart failure with preserved ejection fraction (HFpEF). There have been few reports on the correlation between LV diastolic dysfunction and arterial stiffness in patients with clinical cardiovascular disease.This cross-sectional study enrolled 100 patients (67 men, 33 women; mean age, 70 years). All participants were diagnosed with cardiovascular disease. A total of 89 (89%) patients had coronary artery disease or HF. Patients with reduced EF and valvular disease were excluded...
November 9, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27828828/anatomic-relationship-between-left-coronary-artery-and-left-atrium-in-patients-undergoing-atrial-fibrillation-ablation
#11
Matteo Anselmino, Federica Torri, Federico Ferraris, Leonardo Calò, Davide Castagno, Sebastiano Gili, Chiara Rovera, Carla Giustetto, Fiorenzo Gaita
BACKGROUND: Atrial fibrillation transcatheter ablation (TCA) is, within available atrial fibrillation rhythm control strategies, one of the most effective. To potentially improve ablation outcome in case of recurrent atrial fibrillation after a first procedure or in presence of structural myocardial disease, isolation of the pulmonary veins may be associated with extensive lesions within the left atrium. To avoid rare, but potentially life-threatening, complications, thorough knowledge and assessment of left atrium anatomy and its relation to structures in close proximity are, therefore, mandatory...
November 8, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27816171/reliable-exclusion-of-prognostically-significant-coronary-disease-in-left-ventricular-dysfunction-by-cardiac-mri
#12
A C M Thompson, J G Crilley, D W Wilson, A P S Hungin, A Fuat, J J M Murphy
AIM: To assess the ability of cardiac magnetic resonance (CMR) to exclude prognostically significant coronary artery disease (CAD) in patients with left ventricular systolic dysfunction (LVSD). MATERIALS AND METHODS: A cohort of patients who underwent both X-ray angiography and CMR since 2006 was reviewed retrospectively. Records of those with European criteria for LVSD (left ventricular ejection fraction [LVEF] <50% or LV end-diastolic volume index [LVEDVI] ≥97 ml/m(2)) on CMR or transthoracic echo were analysed...
November 2, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27810964/comparison-between-1-and-2-stent-strategies-in-unprotected-distal-left-main-disease-the-milan-and-new-tokyo-registry
#13
Kensuke Takagi, Toru Naganuma, Alaide Chieffo, Yusuke Fujino, Azeem Latib, Satoko Tahara, Hisaaki Ishiguro, Matteo Montorfano, Mauro Carlino, Hiroyoshi Kawamoto, Naoyuki Kurita, Koji Hozawa, Shotaro Nakamura, Sunao Nakamura, Antonio Colombo
BACKGROUND: There are only little data available on the comparison of clinical outcomes between a 1-stent strategy (1-SS) and a 2-stent strategy (2-SS) for percutaneous coronary intervention in unprotected distal left main disease. METHODS AND RESULTS: Between April 2005 and August 2011, we recruited 937 consecutive unprotected distal left main patients treated with drug-eluting stents (1-SS, 608 patients; 2-SS, 329 patients). Major adverse cardiovascular events were defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR) during the median follow-up period of 1592 days...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27810312/percutaneous-coronary-angioplasty-versus-coronary-artery-bypass-grafting-in-treatment-of-unprotected-left-main-stenosis-noble-a-prospective-randomised-open-label-non-inferiority-trial
#14
Timo Mäkikallio, Niels R Holm, Mitchell Lindsay, Mark S Spence, Andrejs Erglis, Ian B A Menown, Thor Trovik, Markku Eskola, Hannu Romppanen, Thomas Kellerth, Jan Ravkilde, Lisette O Jensen, Gintaras Kalinauskas, Rikard B A Linder, Markku Pentikainen, Anders Hervold, Adrian Banning, Azfar Zaman, Jamen Cotton, Erlend Eriksen, Sulev Margus, Henrik T Sørensen, Per H Nielsen, Matti Niemelä, Kari Kervinen, Jens F Lassen, Michael Maeng, Keith Oldroyd, Geoff Berg, Simon J Walsh, Colm G Hanratty, Indulis Kumsars, Peteris Stradins, Terje K Steigen, Ole Fröbert, Alastair N J Graham, Petter C Endresen, Matthias Corbascio, Olli Kajander, Uday Trivedi, Juha Hartikainen, Vesa Anttila, David Hildick-Smith, Leif Thuesen, Evald H Christiansen
BACKGROUND: Coronary artery bypass grafting (CABG) is the standard treatment for revascularisation in patients with left main coronary artery disease, but use of percutaneous coronary intervention (PCI) for this indication is increasing. We aimed to compare PCI and CABG for treatment of left main coronary artery disease. METHODS: In this prospective, randomised, open-label, non-inferiority trial, patients with left main coronary artery disease were enrolled in 36 centres in northern Europe and randomised 1:1 to treatment with PCI or CABG...
October 31, 2016: Lancet
https://www.readbyqxmd.com/read/27806560/topical-vasodilator-response-is-significantly-higher-in-skeletonized-internal-mammary-artery
#15
Nida Butt, Sarah Hamid, Mujtaba Hussain, Ali Alam, Hala Soomro, Tahreem Ahmad, Madiha Ahmed, Ekta Golani, Janta Devi Ukrani, Faisal Iftikhar, Rehmat Tufail, Maha Begg, Samar Saleem, Ayyaz Alam Sultan, Rohail Jameel, Waqas Shahnawaz, Zohaib Farrukh, Asadullah Khan
AIM: Coronary artery bypass graft surgery is the gold standard for the treatment of multi-vessel and left main coronary artery disease. However, there is considerable debate that whether left internal mammary artery (IMA) should be taken as pedicled or skeletonized. This study was conducted to assess the difference in blood flow after application of topical vasodilator in skeletonized and pedicled IMA. METHODS: In this study, each patient underwent either skeletonized (n=25) or pedicled IMA harvesting (n=25)...
September 28, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27801305/spontaneous-coronary-artery-dissection-after-minimally-invasive-mitral-valve-repair
#16
Mirko Muretti, Mario Manca, Francesco Massi, Michele Portoghese
Spontaneous coronary artery dissection is a rare condition usually encountered in young women without risk factors for atherosclerotic disease but with tortuous coronary artery or contemporary presence of fibromuscular dysplasia. Sometimes spontaneous coronary dissection occurs in patients with atherosclerotic disease, although without significant epicardial coronary artery stenosis. We report a case of a patient who underwent minimally invasive mitral valve repair, whose initially uneventful postoperative course was complicated by spontaneous coronary artery dissection of the left main causing a life threatening condition...
October 31, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27797298/treatment-of-left-main-coronary-artery-disease
#17
Eugene Braunwald
No abstract text is available yet for this article.
October 31, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27797291/everolimus-eluting-stents-or-bypass-surgery-for-left-main-coronary-artery-disease
#18
Gregg W Stone, Joseph F Sabik, Patrick W Serruys, Charles A Simonton, Philippe Généreux, John Puskas, David E Kandzari, Marie-Claude Morice, Nicholas Lembo, W Morris Brown, David P Taggart, Adrian Banning, Béla Merkely, Ferenc Horkay, Piet W Boonstra, Ad J van Boven, Imre Ungi, Gabor Bogáts, Samer Mansour, Nicolas Noiseux, Manel Sabaté, José Pomar, Mark Hickey, Anthony Gershlick, Pawel Buszman, Andrzej Bochenek, Erick Schampaert, Pierre Pagé, Ovidiu Dressler, Ioanna Kosmidou, Roxana Mehran, Stuart J Pocock, A Pieter Kappetein
Background Patients with obstructive left main coronary artery disease are usually treated with coronary-artery bypass grafting (CABG). Randomized trials have suggested that drug-eluting stents may be an acceptable alternative to CABG in selected patients with left main coronary disease. Methods We randomly assigned 1905 eligible patients with left main coronary artery disease of low or intermediate anatomical complexity to undergo either percutaneous coronary intervention (PCI) with fluoropolymer-based cobalt-chromium everolimus-eluting stents (PCI group, 948 patients) or CABG (CABG group, 957 patients)...
October 31, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27784884/second-vs-first-drug-eluting-stents-in-complex-lesions-subsets-3-years-follow-up-of-eraci-iv-study
#19
Alfredo E Rodriguez, Omar Santaera, Miguel Larribau, Ricardo Sarmiento, Carlos Haiek, Juan F Del Pozo, Hernan Pavlovsky, Alfredo M Rodriguez-Granillo
BACKGROUND: Although PCI with 1° generation drug eluting stents (DES-1) did not showed a benefit in terms of death and myocardial infarction (MI) in comparison with by-pass surgery (CABG) in the last years a large improvement in the DES platforms were seen, including a significant increase in safety and efficacy observed in RCT and observational studies compared with DES-1 in patients with coronary artery disease (CAD). One year results from ERACI IV registry using a 2° generation DES (DES-2) demonstrated a significant better efficacy and safety in patients with multiple vessel CAD, including diabetics, compared to DES-1...
October 21, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27777957/optimal-revascularization-strategy-on-medina-0-1-0-left-main-bifurcation-lesions-in-type-2-diabetes
#20
Xuwei Zheng, Hongyu Peng, Donghui Zhao, Qin Ma, Kun Fu, Guo Chen, Qian Fan, Jinghua Liu
Aim. Diabetes mellitus (DM) is a major risk factor for cardiovascular disease. The implications of a diagnosis of DM are as severe as the diagnosis of coronary artery disease. For many patients with complex coronary artery disease, optimal revascularization strategy selection and optimal medical therapy are equally important. In this study, we compared the hemodynamic results of different stenting techniques for Medina 0,1,0 left main bifurcation lesions. Methods. We use idealized left main bifurcation models and computational fluid dynamics analysis to evaluate hemodynamic parameters which are known to affect the risk of restenosis and thrombosis at stented bifurcation...
2016: Journal of Diabetes Research
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