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Journal of Invasive Cardiology

Bernard Wong, Seif El-Jack, Ruth Newcombe, Timothy Glenie, Guy Armstrong, Ali Khan
BACKGROUND: Calcified coronary lesions often cause suboptimal stent expansion, which is one of the greatest predictors of adverse outcomes such as stent thrombosis and restenosis. Shockwave intravascular lithotripsy (S-IVL; Shockwave Medical, Inc) is a recently approved technique used in the treatment of heavily calcified coronary lesions. We present our early real-world experience with the S-IVL device. METHODS: All patients treated with S-IVL between October 2018 and January 2019 during their percutaneous coronary intervention (PCI) at our center were included...
February 15, 2019: Journal of Invasive Cardiology
Andrew Peter Vanezis, William Wilson, William Smith
Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using the hybrid algorithm has traditionally been performed femorally using 8 Fr sheaths. Antegrade dissection and re-entry (ADR) has facilitated procedures using 6 and 7 Fr guides via the radial artery. Radial artery dysfunction and occlusion is a recognized complication preventing future radial procedures, but is significantly less common with 5 Fr sheaths. Five Fr contralateral radial access (48% left, 52% right) was used in 33 consecutive patients undergoing elective CTO-PCI in a single United Kingdom (UK) center over a 2-year period...
February 15, 2019: Journal of Invasive Cardiology
Jess T Randall, Osamah Aldoss, Asra Khan, Melissa Challman, Gurumurthy Hiremath, Athar M Qureshi, Manish Bansal
BACKGROUND: Traditional approaches to pediatric cardiac catheterization have relied on femoral venous access. Upper- extremity venous access may enable cardiac catheterization procedures to be performed safely for diagnostic and interventional catheterizations. The objective of this multicenter study was to demonstrate the feasibility and safety of upper-extremity venous access in a pediatric cardiac catheterization laboratory. METHODS: A retrospective chart review of all patients who underwent cardiac catheterization via upper-extremity vascular access was performed...
February 15, 2019: Journal of Invasive Cardiology
Daniela Trabattoni, Franco Fabbiocchi, Piero Montorsi, Stefano Galli, Paolo Ravagnani, Giuseppe Calligaris, Giovanni Teruzzi, Luca Grancini, Sarah Troiano, Cristina Ferrari, Antonio L Bartorelli
BACKGROUND: The safety and effectiveness of the everolimus-eluting stent (EES) have been previously demonstrated. AIMS: To assess very long-term performance and outcomes of the EES in a real-world population. METHODS: This single-center registry prospectively enrolled 6893 patients (mean age, 66 ┬▒ 9.7 years; 81.4% men) undergoing elective coronary intervention with the EES over a decade. Clinical follow-up (FU) was performed at 1 year and then yearly thereafter...
January 15, 2019: Journal of Invasive Cardiology
Yader Sandoval, Peter Tajti, Aris Karatasakis, M Nicholas Burke, Barbara A Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Farouc A Jaffer, Robert W Yeh, Mitul Patel, Ehtisham Mahmud, Oleg Krestyaninov, Dmitrii Khelimskii, James W Choi, Anthony H Doing, Catalin Toma, R Michael Wyman, Barry Uretsky, Santiago Garcia, Michalis Koutouzis, Ioannis Tsiafoutis, Elizabeth Holper, Jeffrey W Moses, Nicholas J Lembo, Manish Parikh, Ajay J Kirtane, Ziad A Ali, Darshan Doshi, David E Kandzari, Judit Karacsonyi, Bavana V Rangan, Craig Thompson, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: For patients needing coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI), a planned, staged intervention has been recommended by experts. Ad hoc CTO-PCI, however, occurs in practice. METHODS: Observational, contemporary, multicenter, international registry. Our goals were to determine the frequency, characteristics, procedural techniques, and outcomes of patients who underwent ad hoc vs planned CTO-PCI. RESULTS: Among 2282 patients who underwent CTO-PCI between 2012 and 2017, 318 (14%) were ad hoc...
January 15, 2019: Journal of Invasive Cardiology
Ashwat S Dhillon, Meena R Narayanan, Han Tun, Antreas Hindoyan, Ray Matthews, Anilkumar Mehra, David M Shavelle, Leonardo C Clavijo
BACKGROUND: Severe coronary artery calcification is a challenge for percutaneous coronary intervention (PCI), particularly in left main coronary artery disease (LM-CAD). Rotational atherectomy (RA) is a useful tool for modification of calcified plaque prior to PCI. We report our experience with RA for severely calcified LM-CAD. METHODS: From January 2008 to January 2017, all patients who underwent RA-assisted LM-PCI were evaluated. The study population included both protected and unprotected LM-CAD patients...
January 15, 2019: Journal of Invasive Cardiology
Muhammad S Panhwar, Jun Li, David A Zidar, Joshua Clevenger, Jerry Lipinski, Toral R Patel, Adham Karim, Petar Saric, Sandeep M Patel, Ankur Kalra, Guilherme Attizzani
OBJECTIVES: To investigate the effect of TAVR technique on in-hospital and 30-day outcomes in patients with aortic stenosis (AS) and reduced ejection fraction (EF). BACKGROUND: Patients with AS and concomitant low EF may be at risk for adverse hemodynamic effects from general anesthesia utilized in transcatheter aortic valve replacement (TAVR) via the conventional strategy (CS). These patients may be better suited for the minimally invasive strategy (MIS), which employs conscious sedation...
December 15, 2018: Journal of Invasive Cardiology
Barbara D Lawson, M Zubair Khan, Richard H Cooke, J Emilio Exaire, Luis A Guzman, Zachary M Gertz
OBJECTIVES: The aim of this study was to evaluate the safety of calcium-channel blockers (CCBs) during radial artery catheterization in two populations with a contraindication to their use. BACKGROUND: Cardiac catheterization performed via the radial approach has become increasingly common worldwide, but adoption has been slow in the United States. One possible explanation is concern over radial artery vasospasm, which can complicate procedures. Spasmolytic drugs, typically intra-arterial CCBs, are used to prevent spasm, but their safety is not well established in high-risk populations, such as those with ST-segment elevation myocardial infarction (STEMI) or systolic heart failure (HF), in which CCB may be contraindicated...
December 15, 2018: Journal of Invasive Cardiology
Hetal H Mehta, Mackenzie Morris, David L Fischman, John J Finley, Nicholas Ruggiero, Paul Walinsky, Melissa McCarey, Michael P Savage
OBJECTIVE: An under-recognized cause of chest pain, the coronary slow-flow (CSF) phenomenon is characterized by delayed coronary opacification during diagnostic angiography in the absence of epicardial coronary artery disease (CAD). Given its angiographic resemblance to no-reflow during percutaneous coronary intervention, a condition associated with microvascular spasm responsive to calcium-channel blockers, we hypothesized that spontaneous CSF may similarly be reversed by intracoronary (IC) nicardipine...
December 15, 2018: Journal of Invasive Cardiology
Nachiket J Patel, Divya R Verma, Radha Gopalan, Richard R Heuser, Ashish Pershad
This is the first reported case of full biventricular mechanical circulatory support with the combination of Impella and Protek Duo, which is a dual-lumen cannula inserted via the right internal jugular vein, with its proximal inflow lumen positioned in the right atrium and distal lumen positioned in the main pulmonary artery. These lumens are connected with the paracorporeal TandemHeart pump allowing flows up to 5 L/min. The alternative percutaneous option for right ventricular support is the Impella RP (Abiomed), which has to be placed in the femoral vein, preventing ambulation...
February 2019: Journal of Invasive Cardiology
Bruno da Silva Matte, Felipe Pereira Lima Marques, Gustavo Neves de Araujo, Sandro Cadaval Gon├žalves
To our knowledge, this is the first report of primary percutaneous coronary intervention in a patient with a superdominant left circumflex artery, in which the entire right coronary artery myocardium territory is provided by the left circumflex. Coronary angiographic images of our 80-year-old male patient illustrate this anomaly. Single coronary arteries are among the most rare anatomic coronary anomalies, and the absence of right coronary artery ostium has been described as the rarest of these anomalies. Coronary events in such cases can be catastrophic due to the large amount of myocardium at risk...
February 2019: Journal of Invasive Cardiology
Yasuhiro Tanabe, Yukio Sato, Masaki Izumo, Yuki Ishibashi, Takumi Higuma, Tomoo Harada, Yoshihiro J Akashi
The current guidelines recommend a minimum of 6 months of antithrombotic and antibiotic prophylaxis following septal occluding device placement for transcatheter closure of atrial septal defect. Full neoendothelialization is thought to be completed within 6 months of device implantation; however, there is no method available that can assess the level of neoendothelialization in vivo. This report therefore evaluates endothelialization in vivo and demonstrates that 6 months of postimplantation prophylactic therapy may not provide sufficient time for adequate endothelialization...
February 2019: Journal of Invasive Cardiology
Konstantinos Aznaouridis, Maria Bonou, Konstantina Masoura, Sophia Vaina, Charalambos Vlachopoulos, Dimitris Tousoulis
A 66-year-old man with refractory angina was admitted for percutaneous coronary intervention (PCI) through a tortuous saphenous vein graft sequentially anastomosed with a diagonal and a first marginal branch. Our target was a critical stenosis at the retrograde limb of the first marginal proximal to saphenous vein graft anastomosis. Stent delivery to our target lesion mandated tracking through sequential angulations. In this case, we enhanced the support of the guide catheter and delivered a stent on the retrograde limb of the first marginal branch with very deep intubation of the guide catheter into the saphenous vein graft and use of a buddy wire, which is a cheaper and relatively safer maneuver than complex techniques such as the double guide-catheter extension technique...
February 2019: Journal of Invasive Cardiology
Chak-Yu So, Yat-Yin Lam, Gary Shing-Him Cheung, Kevin Ka-Ho Kam, Anna Kin-Yin Chan, Alex Pui-Wai Lee, Bryan P Yan
Although reported failure rates of the Watchman device are low, the ballshaped device is not suitable for shallow and multilobed left atrial appendages (LAAs). The LAmbre device is available in two configurations - standard (cover 4-6 mm larger in diameter than the umbrella) and special (cover 12- 14 mm larger than the umbrella) - which allows the closure of a wide range of LAA anatomies. This case illustrates that the LAmbre device can be used for complex LAA anatomies that are not suitable for the Watchman device...
February 2019: Journal of Invasive Cardiology
Simone Grotti, Gianni Dall'Ara, Fabio Tarantino, Cristina Bachetti, Filippo Ottani, Marcello Galvani
A 31-year-old man with Noonan syndrome who suffered an out-of-hospital cardiac arrest presented at our institution with severe postanoxic coma (Glasgow coma scale 3), but normalized electrocardiogram and stable hemodynamics. Coronary angiography documented a giant right coronary artery supplying collateral flow to the left coronary artery, which presented a left main functional occlusion.
February 2019: Journal of Invasive Cardiology
Francesco Burzotta, Osama Shoeib, Cristina Aurigemma, Carlo Trani
Many techniques are based on fluoroscopic, angiographic, and echocardiographic guidance to achieve the ideal femoral artery puncture, which is important to decrease vascular-related complications. We report an original technique for femoral access integrating angiographic, guidewire, and ultrasound (AGU) guidance, working together to obtain the best femoral artery stick according to individual patient's anatomy. This technique is designed to facilitate large-sheath femoral access in procedures requiring ancillary arterial access...
February 2019: Journal of Invasive Cardiology
Yasuhiro Ichibori, Jun Li, Toral Patel, Jerry Lipinski, Thomas Ladas, Petar Saric, Daniel Kobe, Takahiro Tsushima, Matthew Peters, Sandeep Patel, Angela Davis, Alan H Markowitz, Hiram G Bezerra, Marco A Costa, Ankur Kalra, Guilherme F Attizzani
OBJECTIVES: Urgent transcatheter aortic valve replacement (TAVR) is associated with worse short-term outcomes compared with elective TAVR; however, little is known about long-term outcomes or the safety of the minimalist strategy in this setting. This study investigated the short-term and long-term outcomes of urgent TAVR compared with elective TAVR under a minimalist strategy (transfemoral [TF] approach with conscious sedation and no transesophageal echocardiography guidance). METHODS: After excluding 2 emergent patients requiring immediate procedures, a total of 474 consecutive patients underwent elective TF-TAVR (396 patients; 83...
February 2019: Journal of Invasive Cardiology
Charles Everett Wilkins, Tammie Lynn Herrera, Monica Kwai Nagahiro, Luther Basil Weathers, Sudhakar Virendra Girotra, Faraz Sandhu
AIMS: Impella 2.5 and Impella CP (Abiomed) are percutaneous left ventricular assist devices that can be easily deployed in the cardiac catheterization laboratory without need for surgery and provide effective hemodynamic support. The utility of Impella devices for management of acute myocardial infarction complicated by cardiogenic shock (AMI-CS) at a rural community hospital without on-site surgical back-up has not been reported. METHODS: We retrospectively reviewed all consecutive patients who underwent percutaneous coronary intervention (PCI) with Impella support between 2012 and 2017 for AMI-CS at our institution...
February 2019: Journal of Invasive Cardiology
Yoshio Maeno, Yigal Abramowitz, Sharjeel Israr, Sung-Han Yoon, Shunsuke Kubo, Takahiro Nomura, Masaki Miyasaka, Hiroyuki Kawamori, Yoshio Kazuno, Nobuyuki Takahashi, Tarun Chakravarty, Mamoo Nakamura, Rahul P Sharma, Hasan Jilaihawi, Raj R Makkar
BACKGROUND: Data are limited regarding the clinical impact of permanent pacemaker implantation (PPI) in patients with low left ventricular ejection fraction (LVEF) after transcatheter aortic valve replacement (TAVR). The aim of this study was to determine the impact of new PPI in patients with baseline low LVEF at 2-year follow-up after TAVR. METHODS: A total of 659 patients undergoing TAVR between January 2013 and December 2015 were included in the study. Patients were divided into two groups according to the need for PPI after TAVR...
February 2019: Journal of Invasive Cardiology
Oh-Hyun Lee, Sung-Jin Hong, Chul-Min Ahn, Jung-Sun Kim, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong
OBJECTIVES: The impact of age on the incidence and timing of non-cardiac surgery after coronary stent implantation is unknown. We evaluated the incidence and timing of non-cardiac surgery after drug-eluting stent (DES) implantation according to patient age. METHODS: A total of 37,915 consecutive patients treated by DES implantation between February 2003 and April 2014 were included in this study. The number of patients who underwent non-cardiac surgery were as follows: 4263 (11...
February 2019: Journal of Invasive Cardiology
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