Background: Older women presenting with ST-segment elevation myocardial infarction (STEMI) are less likely to receive revascularization and have worse outcomes relative to their male counterparts.
Abstract: Bioprosthetic valve use has increased significantly. Considering their limited durability, there will remain an ongoing clinical need for repairing or replacing these prostheses in the future. The current standard of care for treating bioprosthetic valve degeneration involves redo open-heart surgery. However, repeat cardiac surgery may be associated with significant morbidity and mortality. With the rapid evolution of transcatheter heart valve therapies, the feasibility and safety of implanting a transcatheter heart valve within a failed tissue valve has been established. We review the historical perspective of transcatheter valve-in-valve therapy, as well as the main procedural challenges and clinical outcomes associated with this new less invasive treatment option.
Background: Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown.
Background: Up to 65% of patients with ST-segment elevation myocardial infarction (STEMI) have multivessel coronary artery disease (MVCAD). Long-term health status of STEMI patients after multivessel revascularization is unknown.
Abstract: Due to recurrent right ventricular outflow tract (RVOT) dysfunction, patients with complex congenital heart disease of the RVOT traditionally require multiple surgical interventions during their lifetimes. Percutaneous pulmonary valve implantation (PPVI) has been developed as a nonsurgical alternative for the treatment of right ventricular to pulmonary artery stenosis or pulmonary regurgitation. PPVI has been shown to be a safe and effective procedure in patients with dysfunctional surgical RVOT conduits. In this population, PPVI has the potential to improve symptoms, functional capacity, and biventricular hemodynamics. However, limitations to the anatomical substrate and size of the RVOT currently restrict PPVI eligibility to less than one-quarter of patients with RVOT dysfunction. The current review discusses contemporary practices in PPVI, evidence supporting the procedure, and future technologies and developments in the field.
Background: Balloon catheters have been designed to facilitate pulmonary vein (PV) isolation in patients with paroxysmal atrial fibrillation (AF). The visually guided laser balloon (VGLB) employs laser energy to ablate tissue under direct visual guidance.
Background: A mechanism to stratify patients resuscitated from a cardiac arrest according to the likelihood of an acute coronary lesion would have significant utility. We thus sought to develop and validate a risk prediction model for the presence of an acute coronary lesion among patients resuscitated from an arrest.
Background: Whether to perform or not an immediate percutaneous coronary intervention (PCI) after out-of-hospital cardiac arrest is still debated. We aimed to evaluate the impact of PCI on short- and long-term survival in out-of-hospital cardiac arrest patients admitted after successful resuscitation.
Background: Although out-of-hospital cardiac arrest is common because of acute myocardial infarction, it is unknown whether early coronary angiography is associated with improved survival in these patients.
Background: We aimed to investigate coronary angiographic findings in unselected out-of-hospital cardiac arrest patients referred to immediate coronary angiography (ICA) irrespective of their first postresuscitation ECG and to determine whether this ECG is useful to select patients with no need of ICA.
Background: Everolimus-eluting bioresorbable vascular scaffolds have been developed to improve late outcomes after coronary interventions. However, recent registries raised concerns regarding an increased incidence of scaffold thrombosis (ScT). The mechanism of ScT remains unknown.
Background: Current guidelines limit the use of high oxygen tension after return of spontaneous circulation after cardiac arrest, focusing on neurological outcome and mortality. Little is known about the impact of hyperoxia on the ischemic heart. Oxygen is frequently administered and is generally expected to be beneficial. This study seeks to assess the effects of hyperoxia on myocardia oxygenation in the presence of severe coronary artery stenosis in swine.
Introduction: Reperfusion therapy via percutaneous coronary intervention (PCI) as the preferred method of treatment for an acute ST-segment–elevation myocardial infarction (STEMI) requires the use of potent antiplatelet agents (eg, aspirin, P2Y12 inhibitors, and GPIIb/IIIa antagonists) and anticoagulant therapies, including heparin or bivalirudin,1 both of which have potential risk of bleeding. An increased bleeding risk in some patients with STEMI makes the use of antiplatelet/anticoagulant agents a relative or absolute contraindication to PCI.
The patient is a 74-year-old woman with a history of paroxysmal atrial fibrillation, hypertension, and dyslipidemia, who initially presented to an outside hospital in 2009 with a transient ischemic attack. Evaluation identified a patent foramen ovale; a percutaneous closure of the patent foramen ovale was performed using a StarFLEX atrial septal occluder device.
Pulmonary arterial hypertension (PAH) is a disease of progressive distal pulmonary artery remodeling that leads to increased pulmonary vascular resistance, right ventricular failure, and premature death. The diagnosis of PAH is made by right heart catheterization when the mean pulmonary artery pressure is ≥25 mm Hg at rest with a pulmonary vascular resistance of >3 Wood units and a pulmonary capillary wedge pressure of <15 mm Hg.1 Once diagnosed with PAH, the 1- and 5-year survival rates are 86.3% and 61.2%, respectively, with a median survival of only 7 years.
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