01 septiembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Clinical and Functional Outcomes Associated With Myocardial Injury After Transfemoral and Transapical Transcatheter Aortic Valve Replacement. A Subanalysis From the PARTNER Trial (Placement of Aortic Transcatheter Valves)

Jean-Michel Paradis, MD∗,†; Hersh S. Maniar, MD‡; John M. Lasala, MD‡; Susheel Kodali, MD†,§; Mathew Williams, MD‖; Brian R. Lindman, MD, MSCI‡; Ralph J. Damiano, Jr., MD‡; Marc R. Moon, MD‡; Raj R. Makkar, MD¶; Vinod H. Thourani, MD#; Vasilis Babaliaros, MD#; Ke Xu, PhD†; Girma Minalu Ayele, PhD†; Lars Svensson, MD, PhD∗∗; Martin B. Leon, MD†,§; Alan Zajarias, MD‡

Objectives: This study sought to clarify the clinical and echocardiographic prognostic implication of myocardial injury after transcatheter aortic valve replacement (TAVR).

01 septiembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of Escalating Loading Dose Regimens of Ticagrelor in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. Results of a Prospective Randomized Pharmacokinetic and Pharmacodynamic Investigation

Francesco Franchi, MD; Fabiana Rollini, MD; Jung Rae Cho, MD; Mona Bhatti, MD; Christopher DeGroat, MD; Elisabetta Ferrante, PhD; Elizabeth C. Dunn, RN; Amit Nanavati, MD; Edward Carraway, MD; Siva Suryadevara, MD; Martin M. Zenni, MD; Luis A. Guzman, MD; Theodore A. Bass, MD; Dominick J. Angiolillo, MD, PhD

Objectives: The goal of this study was to assess the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of escalating ticagrelor loading dose (LD) regimens in primary percutaneous coronary intervention (PPCI).

01 septiembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Prevalence of Coronary Microvascular Dysfunction Among Patients With Chest Pain and Nonobstructive Coronary Artery Disease

Jaskanwal D. Sara, MBChB∗; R. Jay Widmer, MD, PhD∗; Yasushi Matsuzawa, MD, PhD∗; Ryan J. Lennon, MS†; Lilach O. Lerman, MD, PhD‡; Amir Lerman, MD∗

Objectives: This study assessed the prevalence of coronary microvascular abnormalities in patients presenting with chest pain and nonobstructive coronary artery disease (CAD).

01 septiembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Effect of Sex Differences on Invasive Measures of Coronary Microvascular Dysfunction in Patients With Angina in the Absence of Obstructive Coronary Artery Disease

Yuhei Kobayashi, MD; William F. Fearon, MD; Yasuhiro Honda, MD; Shigemitsu Tanaka, MD; Vedant Pargaonkar, MBBS; Peter J. Fitzgerald, MD, PhD; David P. Lee, MD; Marcia Stefanick, PhD; Alan C. Yeung, MD; Jennifer A. Tremmel, MD, MS

Objectives: This study investigated sex differences in coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR) in patients with angina in the absence of obstructive coronary artery disease.

01 septiembre 2015

JACC: CARDIOVASCULAR INTERVENTIONS. ntracoronary Adenosine. Dose–Response Relationship With Hyperemia

Julien Adjedj, MD∗; Gabor G. Toth, MD∗; Nils P. Johnson, MD†; Mariano Pellicano, MD∗; Angela Ferrara, MD∗; Vincent Floré, MD, PhD∗; Giuseppe Di Gioia, MD∗; Emanuele Barbato, MD, PhD∗; Olivier Muller, MD, PhD‡; Bernard De Bruyne, MD, PhD∗

Objectives: The present study sought to establish the dosage of intracoronary (IC) adenosine associated with minimal side effects and above which no further increase in flow can be expected.

01 julio 2015

JACC. Impact of Side Branch Modeling on Computation of Endothelial Shear Stress in Coronary Artery Disease Coronary. Tree Reconstruction by Fusion of 3D Angiography and OCT

Yingguang Li, MSc∗; Juan Luis Gutiérrez-Chico, MD, PhD†; Niels R. Holm, MD‡; Wenjie Yang, MD§; Lasse Hebsgaard, MD‡; Evald H. Christiansen, MD, PhD‡; Michael Mæng, MD, PhD‡; Jens F. Lassen, MD, PhD‡; Fuhua Yan, MD§; Johan H.C. Reiber, PhD∗; Shengxian Tu, PhD‖

Background: Computational fluid dynamics allow virtual evaluation of coronary physiology and shear stress (SS). Most studies hitherto assumed the vessel as a single conduit without accounting for the flow through side branches.

01 julio 2015

JACC. Transcatheter Therapies for the Treatment of Valvular and Paravalvular Regurgitation in Acquired and Congenital Valvular Heart Disease

Carlos E. Ruiz, MD, PhD∗; Chad Kliger, MD∗; Gila Perk, MD∗; Francesco Maisano, MD†; Allison K. Cabalka, MD‡; Michael Landzberg, MD§; Chet Rihal, MD‡; Itzhak Kronzon, MD∗

Transcatheter therapies in structural heart disease have evolved tremendously over the past 15 years. Since the introduction of the first balloon-expandable valves for stenotic lesions with implantation in the pulmonic position in 2000, treatment for valvular heart disease in the outflow position has become more refined, with newer-generation devices, alternative techniques, and novel access approaches.

01 junio 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Transcatheter Mitral Valve Implantation With the FORTIS Device. Insights Into the Evaluation of Device Success

Omar Abdul-Jawad Altisent, MD; Eric Dumont, MD; François Dagenais, MD; Mario Sénéchal, MD; Mathieu Bernier, MD; Kim O’Connor, MD; Jean-Michel Paradis, MD; Sylvie Bilodeau, MD; Sergio Pasian, MD; Josep Rodés-Cabau, MD

A 66-year old man with severe functional mitral regurgitation (Figure 1A) secondary to chronic ischemic cardiomyopathy (previous myocardial infarction and coronary artery bypass grafting) and advanced heart failure (left ventricular ejection fraction: 25%; New York Heart Association [NYHA] functional class III) was considered to be at very high surgical risk and was finally accepted by the Heart Team for transcatheter mitral valve implantation (TMVI) with the FORTIS transcatheter valve (Edwards Lifesciences, Irvine, California)

01 junio 2015

JACC: CARDIOVASCULAR INTERVENTIONS. A Rare Case of Spontaneous Dissection in a Left Internal Mammary Artery Bypass Graft in Acute Coronary Syndrome

Kohei Koyama, MD, PhD; Kihei Yoneyama, MD, PhD; Maya Tsukahara, MD; Shingo Kuwata, MD; Takanobu Mitarai, MD; Ryo Kamijima, MD; Yuki Ishibashi, MD, PhD; Yasuhiro Tanabe, MD; Ken Kongoji, MD, PhD; Tomoo Harada, MD, PhD; Yoshihiro J. Akashi, MD, PhD

A 47-year-old man presented to our hospital after he was successfully resuscitated from ventricular fibrillation. He had experienced chest pain while seated at home. He had undergone successful sequential coronary artery bypass grafting 17 months previously, by the use of left internal mammary artery (LIMA) grafts to the left anterior descending artery and the left circumflex artery and a saphenous vein graft to the right coronary artery. Angiography showed dissection with severe stenosis at the middle body of the LIMA

01 junio 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Percutaneous Closure of a Residual Left Atrial Appendage Leak After Lariat Procedure

Krishan Soni, MD, MBA; Manoj Kesarwani, MD; Nitish Badhwar, MD; Vaikom S. Mahadevan, MD

A 77-year-old man with long-standing persistent atrial fibrillation, coronary artery disease, and systolic heart failure underwent left atrial appendage (LAA) ligation with a Lariat suture delivery device (SentreHEART, Redwood City, California), and subsequent pulmonary vein isolation. One month after the ligation procedure, transesophageal echocardiogram (TEE) demonstrated a residual communication between the left atrium (LA) and the LAA with low-velocity flow across the defect. The residual LAA measured 1.4 × 1.8 cm, and the diameter of the opening, 0.4 cm

01 julio 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Iatrogenic Aortocoronary Arteriovenous Fistula. Percutaneous Management of a Surgical Complication

Zaher Fanari, MD; Jhapat Thapa, MD; Armin Barekatain, MD, MSc; Kevin Copeland, DO; James T. Hopkins, MD

Iatrogenic aortocoronary arteriovenous fistula (ACAVF) resulting from placement of an arterial graft to a cardiac vein is a rare complication of coronary artery bypass grafting (CABG) (1,2). Most patients present post-operatively with angina as a result of residual ischemia that is due to either an unbypassed artery or a coronary steal syndrome (CSS). A 74-year-old woman presented with recurrence of angina with a history of multivessel coronary artery disease status post-CABG in 2006 with a left internal mammary artery (LIMA) Y graft to the left anterior descending and first diagonal coronary arteries, and sequential saphenous vein graft (SVG) to the circumflex obtuse marginal (OM) and the posterior descending artery (PDA), and recurrent angina secondary to an occluded SVG resulting in a second CABG with a free radial graft anastomosed to the LIMA and then placed sequentially to the OM and PDA.

01 julio 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Tricuspid Valve Replacement. A Percutaneous Transfemoral Valve-in-Ring Approach

Alduz S. Cabasa, MD∗; Mackram F. Eleid, MD†; Charanjit S. Rihal, MD†; Hector R. Villarraga, MD†; Thomas A. Foley, MD‡; Rakesh M. Suri, MD, DPhil∗

We describe a percutaneous transcatheter tricuspid valve-in-ring implantation using the Sapien XT prosthesis (Edward Lifesciences, Irvine, California) (1,2). A 68-year-old woman with rheumatic heart disease and 2 previous sternotomies including tricuspid valve repair with a 32-mm Carpentier-Edwards (Irvine, California) annuloplasty ring presented 2 years prior with severe tricuspid valve regurgitation (annulus dilation and tenting of the leaflet) and pulmonary hypertension (right ventricular systolic pressure of 46 mm Hg) related to left ventricular diastolic dysfunction. After multidisciplinary evaluation, a percutaneous approach was recommended to avoid increased risk of third-time redo sternotomy.

07 julio 2016

EUROPEAN HEART JOURNAL. Catheter ablation in patients with persistent atrial fibrillation

Paulus Kirchhof, Hugh Calkins

Abstract: Catheter ablation is increasingly offered to patients who suffer from symptoms due to atrial fibrillation (AF), based on a growing body of evidence illustrating its efficacy compared with antiarrhythmic drug therapy. Approximately one-third of AF ablation procedures are currently performed in patients with persistent or long-standing persistent AF. Here, we review the available information to guide catheter ablation in these more chronic forms of AF. We identify the following principles: Our clinical ability to discriminate paroxysmal and persistent AF is limited.

05 julio 2016

EUROPEAN HEART JOURNAL. Cryoballoon or radiofrequency ablation for symptomatic paroxysmal atrial fibrillation: reintervention, rehospitalization, and quality-of-life outcomes in the FIRE AND ICE trial

Karl-Heinz Kuck, Alexander Fürnkranz, K.R. Julian Chun, Andreas Metzner, Feifan Ouyang, Michael Schlüter, Arif Elvan, Hae W. Lim, Fred J. Kueffer, Thomas Arentz, Jean-Paul Albenque, Claudio Tondo, Michael Kühne, Christian Sticherling, Josep Brugada on behalf of the FIRE AND ICE Investigators

Aims: The primary safety and efficacy endpoints of the randomized FIRE AND ICE trial have recently demonstrated non-inferiority of cryoballoon vs. radiofrequency current (RFC) catheter ablation in patients with drug-refractory symptomatic paroxysmal atrial fibrillation (AF). The aim of the current study was to assess outcome parameters that are important for the daily clinical management of patients using key secondary analyses. Specifically, reinterventions, rehospitalizations, and quality-of-life were examined in this randomized trial of cryoballoon vs. RFC catheter ablation.

17 mayo 2016

EUROPEAN HEART JOURNAL. Outcomes of transfemoral transcatheter aortic valve implantation at hospitals with and without on-site cardiac surgery department: insights from the prospective German aortic valve replacement quality assurance registry (AQUA) in 17 919 patients

Holger Eggebrecht, Maike Bestehorn, Michael Haude, Axel Schmermund, Kurt Bestehorn, Thomas Voigtländer, Karl-Heinz Kuck, Rajendra H. Mehta

Aims: Performing transcatheter aortic valve implantation (TAVI) at hospitals with only cardiology department but no cardiac surgery (CS) on-site is at great odds with current Guidelines.