10 octubre 2013

ORIGINAL. Indirect meta-analysis of Tryton side branch® stent versus a provisional single stent technique for patients with a bifurcation coronary lesion

Luciano Consuegra Sánchez

Background: Several trials and meta-analysis have addressed whether bifurcations lesions require stenting of both the main vessel and side branch. The Tryton side brach stent is a bifurcation system that secures the side branch and provides ostial protection. Uncertainty remains on the benefits of such Tryton Stent versus a single (provisional) stenting with regards to the occurrence of periprocedural myocardial infarction (periMI).

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20 octubre 2013

ORIGINAL. Niveles plasmáticos de antígeno carbohidrato 125 en insuficiencia cardiaca. ¿Utilidad en la práctica clínica diaria?

Julio Núñez

Asumiendo que los niveles plasmáticos de CA125 son un marcador asociado a el grado de congestión sistémica, sugerimos que su determinación podría tener algun papel en la optimización del tratamiento diurético en pacientes con IC

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01 julio 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Implantation of a Drug-Eluting Stent With a Different Drug (Switch Strategy) in Patients With Drug-Eluting Stent RestenosisResults From a Prospective Multicenter Study (RIBS III [Restenosis Intra-Stent: Balloon Angioplasty Versus Drug-Eluting Stent])

Fernando Alfonso, MD; Maria J. Pérez-Vizcayno, MD; Jaime Dutary, MD; Javier Zueco, MD; Angel Cequier, MD; Arturo García-Touchard, MD; Vicens Martí, MD; Iñigo Lozano, MD; Juan Angel, MD; José M. Hernández, MD; José R. López-Mínguez, MD; Rafael Melgares, MD; Raúl Moreno, MD; Bernhard Seidelberger, MD; Cristina Fernández, MD; Rosana Hernandez, MD

Objectives: This study sought to assess the effectiveness of a strategy of using drug-eluting stents (DES) with a different drug (switch) in patients with DES in-stent restenosis (ISR).

01 septiembre 2012

CIRCULATION. Comparison of Everolimus-Eluting and Sirolimus-Eluting Coronary Stents. 1-Year Outcomes from the Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial (RESET)

Takeshi Kimura, MD; Takeshi Morimoto, MD; Masahiro Natsuaki, MD; Hiroki Shiomi, MD; Keiichi Igarashi, MD; Kazushige Kadota, MD; Kengo Tanabe, MD; Yoshihiro Morino, MD; Takashi Akasaka, MD; Yoshiki Takatsu, MD; Hideo Nishikawa, MD; Yoshito Yamamoto, MD; Yoshihisa Nakagawa, MD; Yasuhiko Hayashi, MD; Masashi Iwabuchi, MD; Hisashi Umeda, MD; Kazuya Kawai, MD; Hisayuki Okada, MD; Kazuo Kimura, MD; Charles A. Simonton, MD; Ken Kozuma, MD on behalf of the RESET Investigators

Background—Several recent randomized trials comparing everolimus-eluting stent (EES) and sirolimus-eluting stent (SES) reported similar outcomes. However, only 1 trial was powered for a clinical end point, and no trial was powered for evaluating target-lesion revascularization.

01 septiembre 2013

JACC. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension. The Single-Center, Prospective, First-in-Man PADN-1 Study (First-in-Man Pulmonary Artery Denervation for Treatment of Pulmonary Artery Hypertension)

Shao-Liang Chen, MD; Feng-Fu Zhang, MD; Jing Xu, MD; Du-Jiang Xie, MD; Ling Zhou, MD; Thach Nguyen, MD; Gregg W. Stone, MD

Objectives: This study was designed to test the safety and efficacy of pulmonary artery (PA) denervation (PADN) for patients with idiopathic PA hypertension (IPAH) not responding optimally to medical therapy.

01 agosto 2012

JACC. Transcatheter Aortic Valve Replacement With the St. Jude Medical Portico Valve. First-in-Human Experience

Alexander B. Willson, MBBS, MPH; Josep Rodès-Cabau, MD; David A. Wood, MD; Jonathon Leipsic, MD; Anson Cheung, MD; Stefan Toggweiler, MD; Ronald K. Binder, MD; Melanie Freeman, MBBS; Robert DeLarochellière, MD; Robert Moss, MBBS; Luis Nombela-Franco, MD; Eric Dumont, MD; Karolina Szummer, MD; Gregory P. Fontana, MD; Raj Makkar, MD; John G. Webb, MD

Objectives: The purpose of this study was to demonstrate the feasibility and procedural outcomes with a new self-expanding and repositionable transcatheter heart valve.

EUROPEAN HEART JOURNAL. Transcatheter aortic valve implantation 10-year anniversary: review of current evidence and clinical implications

Philippe Généreux, Stuart J. Head, David A. Wood, Susheel K. Kodali, Mathew R. Williams, Jean-Michel Paradis, Marco Spaziano, A. Pieter Kappetein, John G. Webb, Alain Cribier and Martin B. Leon

Abstract: Surgical aortic valve replacement (SAVR) is currently the standard of care to treat patients with severe symptomatic aortic stenosis (AS) and is generally accepted to alleviate symptoms and prolong survival. Based on the results of randomized trials, transcatheter aortic valve implantation (TAVI) is the new standard of care for patients with symptomatic AS who are deemed ‘inoperable’. Debatably, TAVI is also an alternative to SAVR in selected patients who are at high risk but operable. As we approach 10 years of clinical experience with TAVI, with over 50 000 implantations in 40 countries, a review of the current literature and clinical outcomes with this rapidly evolving technology is appropriate.

EUROPEAN HEART JOURNAL. Transcatheter aortic valve implantation: 10-year anniversary. Part II: clinical implications

Philippe Généreux, Stuart J. Head, David A. Wood, Susheel K. Kodali, Mathew R. Williams, Jean-Michel Paradis, Marco Spaziano, A. Pieter Kappetein, John G. Webb, Alain Cribier and Martin B. Leon

Abstract: Transcatheter aortic valve implantation (TAVI) has been increasingly recognized as a curative treatment for severe aortic stenosis (AS). Despite important improvements in current device technology and implantation techniques, specific complications still remain and warrant consideration. Vascular complications and peri-procedural neurological events were the first concerns to emerge with this new technology. Recently, significant post procedural para-valvular leak has been shown to be more frequent after TAVI than after surgical aortic valve replacement (SAVR), and its potential association with worse long-term prognostic has raised concerns. In moving toward treatment of lower risk populations, structural integrity and long-term durability of heat valve prosthesis are becoming of central importance. Emerging technologies and newer generations of devices seem promising in dealing with these matters.

01 septiembre 2012

CIRCULATION. Risk of Elective Major Noncardiac Surgery After Coronary Stent Insertion. A Population-Based Study

Duminda N. Wijeysundera, MD, PhD; Harindra C. Wijeysundera, MD, PhD; Lingsong Yun, MSc; Marcin Wąsowicz, MD, PhD; W. Scott Beattie, MD, PhD; James L. Velianou, MD; Dennis T. Ko, MD, MSc

Background—Guidelines recommend that noncardiac surgery be delayed until 30 to 45 days after bare-metal stent implantation and 1 year after drug-eluting stent implantation.

01 septiembre 2013

JACC: CARDIOVASCULAR INTERVENTIONS. Automated 3-Dimensional Aortic Annular Assessment by Multidetector Computed Tomography in Transcatheter Aortic Valve Implantation

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

Objectives: This study sought to evaluate the accuracy, reproducibility, and predictive value for post-procedural aortic regurgitation (AR) of an automated multidetector computed tomography (MDCT) post-processing imaging software, 3mensio Valves (version 5.1.sp1, 3mensio Medical Imaging BV, the Netherlands), in the assessment of patients undergoing transcatheter aortic valve implantation (TAVI).

01 agosto 2013

JACC. Impact of Permanent Pacemaker Implantation on Clinical Outcome Among Patients Undergoing Transcatheter Aortic Valve Implantation

Lutz Buellesfeld, MD; Stefan Stortecky, MD; Dik Heg, PhD; Sven Hausen, MD; Ralf Mueller, MD; Peter Wenaweser, MD; Thomas Pilgrim, MD; Steffen Gloekler, MD; Ahmed A. Khattab, MD; Christoph Huber, MD; Thierry Carrel, MD; Balthasar Eberle, MD; Bernhard Meier, MD; Peter Boekstegers, MD; Peter Jüni, MD; Ulrich Gerckens, MD; Eberhard Grube, MD; Stephan Windecker, MD

Objectives: This study sought to assess the impact of permanent pacemaker (PPM) implantation on clinical outcomes among patients undergoing transfemoral transcatheter aortic valve implantation (TAVI).

01 julio 2013

AMERICAN HEART JOURNAL. Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: In vivo assessment with optical coherence tomography

Juan Luis Gutiérrez-Chico, MD, PhD, FESC, FACC , Lorenz Räber, MD , Evelyn Regar, MD, PhD, FESC , Takayuki Okamura, MD, PhD , Carlo di Mario, MD, PhD, FESC, FACC , Gerrit-Anne van Es, MSc, PhD , Stephan Windecker, MD, PhD, FESC , Patrick W. Serruys, MD, PhD, FESC, FACC

Background: Histologic experimental studies have reported incomplete neointimal healing in overlapping with respect to nonoverlapping segments in drug-eluting stents (DESs), but these observations have not been confirmed in human coronary arteries hitherto. On the contrary, angiographic and optical coherence tomography studies suggest that DES overlap elicits rather an exaggerated than an incomplete neointimal reaction.

EUROPEAN HEART JOURNAL. Clinical outcomes after myocardial revascularization according to operator training status: cohort study of 22 697 patients undergoing percutaneous coronary intervention or coronary artery bypass graft surgery

Daniel A. Jones, Sean Gallagher, Krishnaraj Rathod, Ajay K. Jain, Anthony Mathur, Rakesh Uppal, Mark Westwood, Kit Wong, Martin T. Rothman, Alex Shipolini, Elliot J. Smith, Peter G. Mills, Adam D. Timmis, Charles J. Knight, R. Andrew Archbold and Andrew Wragg

Aims Myocardial revascularization by either coronary artery bypass graft surgery (CABG) or percutaneous coronary intervention (PCI) carries the risk of serious complications. Observational data suggest that outcomes may be improved by experienced operators, but there are few studies that have analysed the relationship between mortality and primary operator grade. The aim of this study was to investigate the effect of operator grade (trainee vs. consultant) upon outcomes of revascularization procedures.

01 agosto 2012

JACC. Health-Related Quality of Life After Transcatheter or Surgical Aortic Valve Replacement in High-Risk Patients With Severe Aortic Stenosis. Results From the PARTNER (Placement of AoRTic TraNscathetER Valve) Trial (Cohort A)

Matthew R. Reynolds, MD, MSc; Elizabeth A. Magnuson, ScD; Kaijun Wang, PhD; Vinod H. Thourani, MD; Mathew Williams, MD; Alan Zajarias, MD; Charanjit S. Rihal, MD; David L. Brown, MD; Craig R. Smith, MD; Martin B. Leon, MD; David J. Cohen, MD, MSc

Objectives: This study sought to compare health status and quality-of-life outcomes for patients with severe aortic stenosis (AS) and high surgical risk treated with either transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (AVR).

01 agosto 2013

AMERICAN HEART JOURNAL. Temporal trends in percutaneous coronary intervention outcomes among older patients in the United States

Sunil V. Rao, MD , Connie N. Hess, MD , David Dai, PhD, MS , Cynthia L. Green, PhD , Eric D. Peterson, MD, MPH , Pamela S. Douglas, MD

Background: New percutaneous coronary intervention (PCI) device technologies are often rapidly adopted into clinical practice, yet few studies have examined the overall impact of these new technologies on patient outcomes in community practice.