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https://www.readbyqxmd.com/read/29450741/utility-of-cardiac-computed-tomography-scanning-in-the-diagnosis-and-pre-operative-evaluation-of-patients-with-infective-endocarditis
#1
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29449273/novel-patient-centered-approach-to-facilitate-same-day-discharge-in-patients-undergoing-elective-percutaneous-coronary-intervention
#2
Amit P Amin, Patricia Crimmins-Reda, Samantha Miller, Brandon Rahn, Mary Caruso, Andrew Pierce, Brandy Dennis, Marissa Pendegraft, Katrine Sorensen, Howard I Kurz, John M Lasala, Alan Zajarias, Richard G Bach, Hemant Kulkarni, Jasvindar Singh
BACKGROUND: Same-day discharge (SDD) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in low-risk patients, if at all. To increase the appropriate use of SDD in more complex patients, we implemented a "patient-centered" protocol based on risk of complications at Barnes-Jewish Hospital. METHODS AND RESULTS: Our objectives were as follows: (1) to evaluate time trends in SDD; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by SDD versus no SDD (NSDD); and (3) to compare SDD eligibility by our patient-centered approach versus Society for Cardiovascular Angiography and Interventions guidelines...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29448818/managing-in-hospital-quality-improvement-an-importance-performance-analysis-to-set-priorities-for-st-elevation-myocardial-infarction-care
#3
Daan Aeyels, Deborah Seys, Peter R Sinnaeve, Marc J Claeys, Sofie Gevaert, Danny Schoors, Walter Sermeus, Massimiliano Panella, Luk Bruyneel, Kris Vanhaecht
BACKGROUND: A focus on specific priorities increases the success rate of quality improvement efforts for broad and complex-care processes. Importance-performance analysis presents a possible approach to set priorities around which to design and implement effective quality improvement initiatives. Persistent variation in hospital performance makes ST-elevation myocardial infarction care relevant to consider for importance-performance analysis. AIMS: The purpose of this study was to identify quality improvement priorities in ST-elevation myocardial infarction care...
February 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29443740/clinical-outcomes-of-left-main-coronary-artery-disease-patients-undergoing-three-different-revascularization-approaches
#4
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/29434132/usefulness-of-cutting-balloon-angioplasty-prior-to-stenting-with-intravascular-ultrasound-imaging-guidance-for-spontaneous-multi-vessel-coronary-dissection-including-the-left-main-coronary-artery
#5
Masahiko Noguchi, Kotaro Obunai, Yu Fukui, Hiroshi Okumura, Hiroyuki Watanabe
We report a case of percutaneous coronary intervention for spontaneous multi-vessel coronary dissection including the left main coronary artery. This case suggests that intracoronary imaging is useful for understanding the complex anatomy and for choosing the appropriate management for effective revascularization. Furthermore, cutting balloon angioplasty prior to stenting is useful for preventing the longitudinal extension of the intramural hematoma and avoiding unnecessary stent implantation.
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29409813/duration-of-dual-antiplatelet-therapy-for-stented-patients-an-update-for-the-clinician
#6
REVIEW
Mahesh K Vidula, Eric A Secemsky, Robert W Yeh
Determining the optimal duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention is a complex decision. Randomized controlled trials have shown that while shorter durations of DAPT may lower the risk of bleeding, longer durations of DAPT can reduce the risk of late stent thrombosis and ischemia-related events. In this review article, we will discuss the current guidelines, review contemporary trial data that have evaluated short and extended durations of DAPT, and address common clinical questions...
February 1, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29407008/cardiac-intensive-care-unit-management-of-patients-after-cardiac-arrest-now-the-real-work-begins
#7
REVIEW
Varinder K Randhawa, Brian E Grunau, Derek B Debicki, Jian Zhou, Ahmed F Hegazy, Terry McPherson, A Dave Nagpal
Survival with a good quality of life after cardiac arrest continues to be abysmal. Coordinated resuscitative care does not end with the effective return of spontaneous circulation (ROSC)-in fact, quite the contrary is true. Along with identifying and appropriately treating the precipitating cause, various components of the post-cardiac arrest syndrome also require diligent observation and management, including post-cardiac arrest neurologic injury and myocardial dysfunction, systemic ischemia-reperfusion phenomenon with potential consequent multiorgan failure, and the various sequelae of critical illness...
February 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29398309/percutaneous-axillary-artery-access-for-endovascular-interventions
#8
Emily Harris, Courtney J Warner, Jeffrey C Hnath, Yaron Sternbach, R Clement Darling
BACKGROUND: As endovascular therapy becomes increasingly complex, adjunct techniques such as upper extremity arterial access facilitate visceral branch interventions. The purpose of this study was to assess the viability of axillary artery percutaneous access in endovascular repair. METHODS: Records of all patients undergoing axillary artery percutaneous access as part of an endovascular intervention from December 2015 to December 2016 were examined. Demographics of the patients (age, sex, medical comorbidities, smoking status, and anticoagulation) were documented...
February 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29395703/long-term-outcomes-of-percutaneous-coronary-intervention-for-chronic-total-occlusion-in-patients-who-have-undergone-coronary-artery-bypass-grafting-vs-those-who-have-not
#9
Lorenzo Azzalini, Soledad Ojeda, Aris Karatasakis, Joren Maeremans, Masaki Tanabe, Alessio La Manna, Rustem Dautov, Luiz F Ybarra, Susanna Benincasa, Barbara Bellini, Luciano Candilio, Ozan M Demir, Francisco Hidalgo, Judit Karacsonyi, Giacomo Gravina, Eligio Miccichè, Guido D'Agosta, Giuseppe Venuti, Corrado Tamburino, Manuel Pan, Mauro Carlino, Joseph Dens, Emmanouil S Brilakis, Antonio Colombo, Stéphane Rinfret
BACKGROUND: We aimed to investigate the procedural and long-term outcomes of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) in patients who had undergone previous coronary artery bypass grafting (CABG) vs those who had not, and to evaluate the role of the Registry of CrossBoss and Hybrid procedures in France, the Netherlands, Belgium, and United Kingdom (RECHARGE) score in predicting acute and long-term outcomes. METHODS: We compiled a multicentre registry of consecutive patients undergoing CTO PCI at 7 centres between January 2009 and April 2017...
December 26, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29393600/temporal-trends-in-frequency-management-and-outcomes-of-coronary-perforations
#10
Agustín Fernández-Cisnal, Rafael Romaguera, Marcos Ñato, Josep Gómez-Lara, José L Ferreiro, Luis Teruel, Gerard Roura, Guillem Muntané-Carol, José González-Costello, Francisco Jacobi, Montserrat Gracida, Joan A Gómez-Hospital, Ángel Cequier
BACKGROUND: Coronary perforations (CP) have been described as a rare but potentially fatal complication in percutaneous coronary interventions (PCI). Our aim is to compare temporal trends in frequency, management and outcomes of coronary perforations (CP). METHODS: All cases of CP recorded in our prospective institutional percutaneous coronary intervention (PCI) registry from 2003 to 2015 were included. Patients were divided in 2 groups according to the time frame in which the CP occurred: the early period (before 2009, when the chronic total occlusions and primary PCI programs started) and the current period...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29392967/sedation-in-the-coronary-intensive-care-unit-an-adapted-algorithm-for-critically-ill-cardiovascular-patient
#11
A L Schenone, K Chen, K Andress, M Militello, L Cho
In the current era, cardiovascular intensive care units care for more complex patients who are far sicker than historical post-myocardial infarction patients, and sedation has become a common intervention in these units. Current sedation best practices derive mainly from non-cardiac units which limits their generalization to the critically ill cardiac patient. Thus, a great variability in sedation protocols, especially the selection of sedative agents, is commonly seen in daily practice across cardiac units...
February 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29382630/motivational-interviewing-and-medication-review-in-coronary-heart-disease-mimeric-intervention-development-and-protocol-for-the-process-evaluation
#12
Malin Johansson Östbring, Tommy Eriksson, Göran Petersson, Lina Hellström
BACKGROUND: Trials of complex interventions are often criticized for being difficult to interpret because the effects of apparently similar interventions vary across studies dependent on context, targeted groups, and the delivery of the intervention. The Motivational Interviewing and Medication Review in Coronary heart disease (MIMeRiC) trial is a randomized controlled trial (RCT) of an intervention aimed at improving pharmacological secondary prevention. Guidelines for the development and evaluation of complex interventions have recently highlighted the need for better reporting of the development of interventions, including descriptions of how the intervention is assumed to work, how this theory informed the process evaluation, and how the process evaluation relates to the outcome evaluation...
January 30, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29378972/impact-of-the-use-of-intravascular-imaging-on-patients-who-underwent-orbital-atherectomy
#13
Michael S Lee, Evan Shlofmitz, Jeremy Kong, Gentian Lluri, Pratyaksh K Srivastava, Richard Shlofmitz
OBJECTIVES: We assessed the impact of intravascular ultrasound (IVUS)/optical coherence tomography (OCT) on outcomes of patients who underwent orbital atherectomy. BACKGROUND: Intravascular imaging provides enhanced lesion morphology assessment and optimization of percutaneous coronary intervention (PCI) outcomes. Severe coronary artery calcification increases the complexity of PCI and is associated with worse clinical outcomes. Orbital atherectomy modifies calcified plaque, facilitating stent delivery and optimizing stent expansion...
February 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29376402/cost-assessment-of-treatment-of-acute-myocardial-infarction-and-angiographically-visible-coronary-thrombus
#14
Katarzyna Pigoń, Edyta Nowak-Radzik, Tomasz Młyńczak, Grzegorz Banasik, Ewa Nowalany-Kozielska, Andrzej Tomasik
AIM: Study was aimed to assess the real-world costs of manual thrombectomy (MT) in selected ST segment-elevation myocardial infarction patients with intracoronary thrombus (IT). METHODS: Study group (IT+) comprised 51 patients with MT applied and control group (IT-) comprised 56 patients without IT who underwent angioplasty alone. Costs comprised hospital care and cost of disposable materials used during primary angioplasty. RESULTS: Complex management of patients with IT is more expensive, though allows to achieve clinical outcomes comparable to low-risk ST segment-elevation myocardial infarction patients without IT...
January 29, 2018: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29374935/-therapeutic-efficacy-of-paclitaxel-coated-balloon-for-de-novo-coronary-lesions-with-diameters-larger-than-2-8-mm
#15
X Yu, F S Ji, F Xu, W D Zhang, X Y Wang, D Lu, T Xu
Objective: To evaluate the efficacy of paclitaxel-coated balloon for de novo coronary lesions with diameters ≥ 2.8 mm. Methods: This prospective study included 215 consecutive patients with 238 de novo lesions, who received paclitaxel-coated balloon angioplasty in Beijing Hospital from May 2014 to June 2016. According to the reference vessel diameter, the patients were divided into large vessel disease (LVD) group (reference vessel diameter≥2.8 mm, 85 patients and 90 lesions) and small vessel disease (SVD) group (reference vessel diameter<2...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29374175/three-dimensional-reconstruction-and-nurbs-based-structured-meshing-of-coronary-arteries-from-the-conventional-x-ray-angiography-projection-images
#16
Arso M Vukicevic, Serkan Çimen, Nikola Jagic, Gordana Jovicic, Alejandro F Frangi, Nenad Filipovic
Despite its two-dimensional nature, X-ray angiography (XRA) has served as the gold standard imaging technique in the interventional cardiology for over five decades. Accordingly, demands for tools that could increase efficiency of the XRA procedure for the quantitative analysis of coronary arteries (CA) are constantly increasing. The aim of this study was to propose a novel procedure for three-dimensional modeling of CA from uncalibrated XRA projections. A comprehensive mathematical model of the image formation was developed and used with a robust genetic algorithm optimizer to determine the calibration parameters across XRA views...
January 26, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29372164/prenatal-diagnosis-of-isolated-coronary-arteriovenous-fistula
#17
Uisoo Chae, Mi-Young Lee, Hyerim Kim, Hye-Sung Won, Ki-Soo Kim, Hyun-Woo Goo, Jae-Kon Ko, Jeong-Jun Park
Coronary arteriovenous fistula (CAVF) is a rare condition defined as an anomalous termination of the coronary arteries. The etiology of CAVF is either congenital or acquired, and iatrogenic CAVF is most commonly caused by cardiovascular surgery or percutaneous intervention. Most of the prenatally diagnosed CAVFs were related to complex heart disease, and only few cases of an isolated CAVF have been reported to date. We successfully diagnosed an isolated CAVF by fetal echocardiography at 25.3 weeks of gestation...
January 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29370923/the-role-of-mechanical-circulatory-support-during-percutaneous-coronary-intervention-in-patients-without-severely-depressed-left-ventricular-function
#18
Khaldoon Alaswad, Mir Babar Basir, Akshay Khandelwal, Theodore Schreiber, William Lombardi, William O'Neill
Currently, there are no data on the use of mechanical circulatory support (MCS) in patients without severely depressed left ventricular ejection fraction (LVEF) during high-risk percutaneous coronary intervention (PCI). We analyzed data from the global catheter-based ventricular assist device (cVAD) registry on the clinical use of MCS in high-risk PCI in patients without severely depressed LVEF, defined as LVEF > 35%. Patients without cardiogenic shock from the catheter-based ventricular assist device registry, who underwent elective or urgent PCI with an Impella 2...
December 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29368394/complex-coronary-bifurcation-treatment-by-a-novel-stenting-technique-bench-test-fluid-dynamic-study-and-clinical-outcomes
#19
Gianluca Rigatelli, Marco Zuin, Fabio Dell'Avvocata, Dobrin Vassilev, Ramesh Daggubati, Thach Nguyen, Minh Trí Nhân Nguyễn, Nicolas Foin
OBJECTIVES: We assess the mid-term outcomes of ultrathin biodegradable polymer double stenting using a very minimal crushing (Nano-Crush) technique in large complex coronary bifurcation. BACKGROUND: Complex bifurcations have been suggested to be better approached by a planned double stent technique. METHODS: Two hundred and five consecutive patients (107 males and 98 females) referred for large complex coronary bifurcation percutaneous coronary interventions were enrolled...
January 25, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29368241/femoral-access-site-closure-without-prior-femoral-angiography-a%C3%A2-retrospective-analysis
#20
Christoph Brenner, Julian Margreitter, Alexandra Gratl, Josef Klocker, Rudolf Kirchmair, Peter Marschang, Guy Friedrich, Bernhard Metzler, Nicolas Moes
AIMS AND BACKGROUND: Although guideline recommendations have shifted towards a transradial route, femoral puncture is still an established vascular access, especially for complex coronary interventions. The FemoSeal™ vascular closure device (FVCD) helps to reduce femoral compression time and access site complications after removal of the catheter sheath. To ensure safe use, an angiography of the femoral artery prior to FVCD deployment is recommended by the manufacturer. We postulate that omitting this angiography does not relevantly increase the risk for vascular complications...
January 24, 2018: Wiener Klinische Wochenschrift
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