01 mayo 2013

CIRCULATION. Interventional Cardiology. Adoption of Radial Access and Comparison of Outcomes to Femoral Access in Percutaneous Coronary Intervention

Dmitriy N. Feldman, MD; Rajesh V. Swaminathan, MD; Lisa A. Kaltenbach, MS; Dmitri V. Baklanov, MD; Luke K. Kim, MD; S. Chiu Wong, MD; Robert M. Minutello, MD; John C. Messenger, MD; Issam Moussa, MD; Kirk N. Garratt, MD; Robert N. Piana, MD; William B. Hillegass, MD; Mauricio G. Cohen, MD; Ian C. Gilchrist, MD; Sunil V. Rao, MD

Background: Radial access for percutaneous coronary intervention (r-PCI) is associated with reduced vascular complications; however, previous reports have shown that <2% of percutaneous coronary intervention (PCI) procedures in the United States are performed via the radial approach. Our aims were to evaluate temporal trends in r-PCI and compare procedural outcomes between r-PCI and transfemoral PCI.

01 junio 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Long-Term Outcome After Drug-Eluting Versus Bare-Metal Stent Implantation in Patients With ST-Segment Elevation Myocardial Infarction

Lene Holmvang, MD⁎; Henning Kelbæk, MD⁎; Anne Kaltoft, MD†; Leif Thuesen, MD†; Jens Flensted Lassen, MD†; Peter Clemmensen, MD⁎; Lene Kløvgaard, RN⁎; Thomas Engstrøm, MD⁎; Hans E. Bøtker, MD†; Kari Saunamäki, MD⁎; Lars R. Krusell, MD†; Erik Jørgensen, MD⁎; Hans-Henrik Tilsted, MD†; Evald H. Christiansen, MD†; Jan Ravkilde, MD†; Lars Køber, MD⁎; Klaus Fuglsang Kofoed, MD⁎; Christian J. Terkelsen, MD†; Steffen Helqvist, MD⁎

Objectives: This study sought to compare the long-term effects of drug-eluting stent (DES) compared with bare-metal stent (BMS) implantation in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention.

01 junio 2013

JACC: CARDIOVASCULAR INTERVENTIONS. The Long-Term Clinical Outcome of T-Stenting and Small Protrusion Technique for Coronary Bifurcation Lesions

Toru Naganuma, MD∗; Azeem Latib, MD∗; Sandeep Basavarajaiah, MD∗; Alaide Chieffo, MD∗; Filippo Figini, MD∗; Mauro Carlino, MD∗; Matteo Montorfano, MD∗; Cosmo Godino, MD∗; Santo Ferrarello, MD∗; Tasuku Hasegawa, MD∗; Masanori Kawaguchi, MD∗; Sunao Nakamura, MD‡; Antonio Colombo, MD∗

Objectives: This study sought to report long-term clinical outcomes in patients treated with the provisional T-stenting and small protrusion (TAP) technique.

04 junio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Impact of Coronary Microvascular Function on Long-term Cardiac Mortality in Patients With Acute ST-Segment–Elevation Myocardial Infarction

Tim P. van de Hoef, MD*, Matthijs Bax, MD*, Martijn Meuwissen, MD, PhD, Peter Damman, MD, Ronak Delewi, MD, Robbert J. de Winter, MD, PhD, Karel T. Koch, MD, PhD, Carl Schotborgh, MD, PhD, José P.S. Henriques, MD, PhD, Jan G.P. Tijssen, PhD and Jan J. Piek, MD, PhD

Background: Microvascular function is increasingly being recognized as an important marker of risk in coronary artery disease, and may be accurately assessed by intracoronary Doppler flow velocity measurements. In the setting of ST-segment–elevation myocardial infarction there are limited data regarding the prognostic value of microvascular function in both infarct-related and reference coronary arteries for long-term clinical outcome. We sought to determine the prognostic value of microvascular function, as assessed by Doppler flow velocity measurements, for cardiac mortality after primary percutaneous coronary intervention for acute ST-segment–elevation myocardial infarction.

07 mayo 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Relationship Between ST-Segment Recovery and Clinical Outcomes After Primary Percutaneous Coronary Intervention

Michael E. Farkouh, MD, MSc, James Reiffel, MD, Ovidiu Dressler, MD, Eugenia Nikolsky, MD, PhD, Helen Parise, ScD, Ecatarina Cristea, MD, David A. Baran, MD, Jose Dizon, MD, Jacques P. Merab, MD, Alexandra J. Lansky, MD, Roxana Mehran, MD and Gregg W. Stone, MD

Background: In patients with ST-segment elevation myocardial infarction undergoing thrombolytic therapy, the degree of ST-segment resolution (STR) correlates with long-term cardiovascular mortality. The long-term predictive value of STR after primary percutaneous coronary intervention (PCI) is less well understood. We sought to determine the long-term prognostic value of STR after primary PCI in ST-segment–elevation myocardial infarction.

06 abril 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Comparison of Manual Thrombus Aspiration With Rheolytic Thrombectomy in Acute Myocardial Infarction

Guido Parodi, MD, PhD, Renato Valenti, MD, Angela Migliorini, MD, Akiko Maehara, MD, Ruben Vergara, MD, Nazario Carrabba, MD, Gary S. Mintz, MD and David Antoniucci, MD

Background: Manual thrombus aspiration (MTA) is completely ineffective in 30% of cases, and the high profiles of the catheters prevent their use in tortuous and calcified vessels. The rheolytic thrombectomy (RT) device has the potential for improved thrombus removal in acute myocardial infarction as compared with MTA. No data exist on the comparison between the 2 techniques.

22 abril 2014

CIRCULATION. Health Services and Outcomes Research. The Learning Curve for Transradial Percutaneous Coronary Intervention Among Operators in the United States

Connie N. Hess, MD, MHS; Eric D. Peterson, MD, MPH; Megan L. Neely, PhD; David Dai, PhD; William B. Hillegass, MD; Mitchell W. Krucoff, MD; Michael A. Kutcher, MD; John C. Messenger, MD; Samir Pancholy, MD; Robert N. Piana, MD; Sunil V. Rao, MD

Background: Adoption of transradial percutaneous coronary intervention (TRI) in the United States is low and may be related to challenges learning the technique. We examined the relationships between operator TRI volume and procedural metrics and outcomes.

17 abril 2014

CIRCULATION. Health Services and Outcomes Research. Transfer of Patients With ST-Elevation Myocardial Infarction for Primary Percutaneous Coronary Intervention

Laurie J. Lambert, PhD; Kevin A. Brown, MSc; Lucy J. Boothroyd, PhD; Eli Segal, MD; Sébastien Maire, MD; Simon Kouz, MD; Dave Ross, MD; Richard Harvey, MD; Stéphane Rinfret, MD; Yongling Xiao, PhD; James Nasmith, MD; Peter Bogaty, MD

Background: Interhospital transfer of patients with ST-elevation myocardial infarction (STEMI) for primary percutaneous coronary intervention (PPCI) is associated with longer delays to reperfusion, related in part to turnaround (“door in” to “door out,” or DIDO) time at the initial hospital. As part of a systematic, province-wide evaluation of STEMI care, we examined DIDO times and associations with patient, hospital, and process-of-care factors.

11 junio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Transcatheter Aortic Valve Implantation for Patients With Severe Bicuspid Aortic Valve Stenosis

Kentaro Hayashida, MD, PhD, FESC, Erik Bouvier, MD, Thierry Lefèvre, MD, FSCAI, FESC, Bernard Chevalier, MD, FSCAI, FESC, Thomas Hovasse, MD, Mauro Romano, MD, Philippe Garot, MD, FESC, Yusuke Watanabe, MD, Arnaud Farge, MD, Patrick Donzeau-Gouge, MD, Bertrand Cormier, MD and Marie-Claude Morice, MD, FESC

Background: Bicuspid aortic valve (BAV) is regarded as a relative contraindication to transcatheter aortic valve implantation attributable to the risk of uneven expansion of the bioprosthesis. The purpose of this study was to evaluate the efficacy and safety of transcatheter aortic valve implantation in patients with BAV.

04 junio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Infective Endocarditis After Transcatheter Pulmonary Valve Replacement Using the Melody Valve

Doff B. McElhinney, MD, Lee N. Benson, MD, Andreas Eicken, MD, PhD, Jacqueline Kreutzer, MD, Robert F. Padera, MD, PhD and Evan M. Zahn, MD

Background: Transcatheter (percutaneous) pulmonary valve (TPV) replacement has emerged as a viable therapy for right ventricular outflow tract conduit dysfunction. Little is known about the incidence, clinical course, and outcome of infective endocarditis (IE) after TPV implant. We reviewed combined data from 3 ongoing prospective multicenter trials to evaluate the experience with IE among patients undergoing TPV replacement using the Melody valve.

11 junio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Bloodstream Infections Occurring in Patients With Percutaneously Implanted Bioprosthetic Pulmonary Valve

Jonathan Buber, MD, Lisa Bergersen, MD, MPH, James E. Lock, MD, Kimberlee Gauvreau, ScD, Jesse J. Esch, MD, Michael J. Landzberg, MD, Anne Marie Valente, MD, Thomas J. Sandora, MD, MPH and Audrey C. Marshall, MD

Background: Percutaneous pulmonary valve implantation using a stent-based bioprosthetic valve provides an alternative to surgery in select patients. Systemic infections in Melody valve–implanted patients with and without identified valve involvement have been reported, yet the incidence is unknown, and risk factors remain unidentified.

01 junio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Microvascular Dysfunction After ST-Segment–Elevation Myocardial Infarction

Andy S.C. Yong, MBBS, PhD and William F. Fearon, MD

Variable degrees of coronary microvascular dysfunction occur at the time of ST-segment–elevation myocardial infarction (STEMI) correlating with infarct size and long-term prognosis. Angiographic methods for assessing microvascular dysfunction in the cardiac catheterization laboratory at the time of STEMI include thrombolysis in myocardial infarction flow grade, thrombolysis in myocardial infarction frame count, and thrombolysis in myocardial infarction myocardial perfusion grade. More recently, coronary wire-based methods measuring Doppler-derived parameters, such as the coronary flow velocity reserve (CFVR), or measuring thermodilution-derived parameters, such as the index of microcirculatory resistance, have been shown to be more powerful predictors of acute left ventricular dysfunction, myocardial viability, and subsequent adverse outcomes.

01 junio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Implications of Bicuspid Aortic Valves for Transcatheter Aortic Valve Implantation

Crochan J. O’Sullivan, MB BCh and Stephan Windecker, MD

Introduction: Bicuspid aortic valve (BAV) occurs in 0.5% to 2% of the general population, with strong male predilection.1 Valvular complications include aortic stenosis, aortic regurgitation (AR), and infective endocarditis. Vascular complications comprise aortic dilatation, aneurysm formation, and aortic dissection. Coarctation of the aorta and left coronary artery dominance are also associated with BAV.1 BAV consists of 2 cusps, usually of unequal size.2 The larger cusp may contain 1 or 2 raphes—fibrous ridges extending from the malformed commissure to the free edge of the 2 conjoint cusps.2 An anatomic classification distinguishes BAV types principally by the number of raphes (Figure).2 Because a raphe can be missed on echocardiography, Schaefer et al3 proposed 3 types based instead on the pattern of leaflet fusion. Clinical presentation of BAV is variable. Some patients present with severe disease in infancy, whereas others present with asymptomatic disease in old age.1 In a recent series of 642 asymptomatic adults with BAV referred to a tertiary center, 25% had a primary cardiac event at mean follow-up of 9 years.4 Aortic valve or ascending aorta intervention comprised most (22%) events.4 In another series of 212 asymptomatic adults with BAV recruited from the community, primary cardiac outcomes occurred in 42% at 20-year follow-up.5 Overall survival rates were similar to the general population

11 junio 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Vasodilatory Capacity of the Coronary Microcirculation is Preserved in Selected Patients With Non–ST-Segment–Elevation Myocardial Infarction

Jamie Layland, MBChB, David Carrick, MBChB, Margaret McEntegart, MBChB, PhD, Nadeem Ahmed, BSc, Alex Payne, MBChB, John McClure, PhD, Arvind Sood, MBChB, MD, Ross McGeoch, MBChB, MD, Andrew MacIsaac, MBBS, MD, Robert Whitbourn, MBBS, Bsc, Andrew Wilson, MBBS, PhD, Keith Oldroyd, MBChB, MD and Colin Berry, MBChB, PhD

Background: The use of fractional flow reserve in patients with non–ST-segment–elevation myocardial infarction (NSTEMI) is a controversial issue. We undertook a study to assess the vasodilatory capacity of the coronary microcirculation in patients with NSTEMI when compared with a model of preserved microcirculation (stable angina [SA] cohort: culprit and nonculprit vessel) and acute microcirculatory dysfunction (ST-segment–elevation myocardial infarction [STEMI] cohort). We hypothesized that the vasodilatory response of the microcirculation would be preserved in NSTEMI.

21 mayo 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Residual Ischemia After Revascularization in Multivessel Coronary Artery Disease. Insights From Measurement of Absolute Myocardial Blood Flow Using Magnetic Resonance Imaging Compared With Angiographic Assessment

Jayanth R. Arnold, BMBCh, MA, MRCP, DPhil, Theodoros D. Karamitsos, MD, PhD, William J. van Gaal, MD, Luca Testa, MD, PhD, Jane M. Francis, DCRR, DNM, Paul Bhamra-Ariza, MBBS, BSc, MRCP, Ali Ali, MBBS, MRCPI, FCPS, Joseph B. Selvanayagam, MBBS, DPhil, FRACP, FESC, Steve Westaby, MBBS, FRCS, PhD, FESC, FECTS, Rana Sayeed, MBBS, FRCS, Michael Jerosch-Herold, PhD, Stefan Neubauer, MD, FRCP, FMedSci and Adrian P. Banning, MBBS, MD, FRCP, FESC

Background: Revascularization strategies for multivessel coronary artery disease include percutaneous coronary intervention and coronary artery bypass grafting. In this study, we compared the completeness of revascularization as assessed by coronary angiography and by quantitative serial perfusion imaging using cardiovascular magnetic resonance.