01 mayo 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Distribution of Calcium in the Ascending Aorta in Patients Undergoing Transcatheter Aortic Valve Implantation and Its Relevance to the Transaortic Approach

Vinayak N. Bapat, FRCS.CTh; Rizwan Q. Attia, MRCS; Martyn Thomas, FRCP

Objectives: This study sought to identify how many patients suitable for transcatheter aortic valve implantation (TAVI) would have a contraindication for the transaortic (TAo) approach due to ascending aortic calcification.

01 abril 2012

JACC. Long-Term Outcome Following Catheter Valvotomy for Pulmonary Atresia With Intact Ventricular Septum

Henry Chubb, MBBS; Erkki Pesonen, MD, PhD; Sivasankaran Sivasubramanian, MD, DM; Shane M. Tibby, MB ChB, MSc (Appl Stat); John M. Simpson, MD; Eric Rosenthal, MD; Shakeel A. Qureshi, MB ChB

Objectives: This study investigated the outcome for all patients undergoing catheter valve perforation for pulmonary atresia with intact ventricular septum (PAIVS) 21 years after the first procedure at their center.

01 mayo 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Transfemoral Aortic Valve Replacement With the Edwards SAPIEN and Edwards SAPIEN XT Prosthesis Using Exclusively Local Anesthesia and Fluoroscopic Guidance. Feasibility and 30-Day Outcomes

Eric Durand, MD, PhD; Bogdan Borz, MD; Matthieu Godin, MD; Christophe Tron, MD; Pierre-Yves Litzler, MD, PhD; Jean-Paul Bessou, MD; Karim Bejar, MD; Chiara Fraccaro, MD; Carlos Sanchez-Giron, MD; Jean-Nicolas Dacher, MD, PhD; Fabrice Bauer, MD, PhD; Alain Cribier, MD; Hélène Eltchaninoff, MD

Objectives: The authors report the feasibility and 30-day outcomes of transfemoral aortic valve replacement (TAVR), using the Edwards SAPIEN (Edwards Lifesciences, Irvine, California) and Edwards SAPIEN XT (Edwards Lifesciences) prosthesis, implanted using exclusively local anesthesia and fluoroscopic guidance.

01 abril 2012

JACC. The Next Frontier of Clinical Trials. Personalized Medicine for Devices

Jalal K. Ghali, MD

Randomized, controlled trials (RCTs) have convincingly proven that in patients with advanced (New York Heart Association functional class III/IV) systolic (left ventricular [LV] ejection fraction ≤35%) heart failure and wide QRS complex (QRS ≥120 ms), cardiac resynchronization therapy (CRT) improves functional status and quality of life (1), decreases heart failure hospitalizations (2), and prolongs survival (3). However, the lack of response to CRT in a substantial portion of patients (one-third) has been a consistent finding (4).

01 abril 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Reduction of Operator Radiation Dose by a Pelvic Lead Shield During Cardiac Catheterization by Radial Access

Helmut W. Lange, MD; Heiner von Boetticher, PhD

Objectives: This study sought to determine the efficacy of patient pelvic lead shielding for the reduction of operator radiation exposure during cardiac catheterization via the radial access in comparison with the femoral access.

01 mayo 2012

JACC. Spotty Calcification as a Marker of Accelerated Progression of Coronary Atherosclerosis. Insights From Serial Intravascular Ultrasound

Yu Kataoka, MD; Kathy Wolski, MPH; Kiyoko Uno, MD, PhD; Rishi Puri, MBBS; E. Murat Tuzcu, MD; Steven E. Nissen, MD; Stephen J. Nicholls, MBBS, PhD

Objectives. The purpose of this study was to determine atheroma progression in patients with spotty calcification.

01 abril 2013

JACC. 5-Year Experience With Transcatheter Transapical Mitral Valve-in-Valve Implantation for Bioprosthetic Valve Dysfunction

Anson Cheung, MD; John G. Webb, MD; Marco Barbanti, MD; Melanie Freeman, MD; Ronald K. Binder, MD; Christopher Thompson, MD; David A. Wood, MD; Jian Ye, MD

Objectives: The study sought to describe the authors experience with mitral transapical transcatheter valve-in-valve implantation (TVIV).

01 mayo 2012

JACC. Patent Foramen Ovale.The Known and the To Be Known

Shelby Kutty, MD; Partho P. Sengupta, MD, DM; Bijoy K. Khandheria, MD

The patent foramen ovale (PFO) is a normal interatrial communication during fetal life that persists after birth in approximately 1 of every 4 adults. PFO is a potential route for embolic transit from the systemic venous circulation to the brain. Though there is compelling circumstantial evidence implicating PFO, the precise role of PFO in the pathogenesis of cryptogenic stroke is not yet established. Several randomized trials of transcatheter PFO closure versus medical management are ongoing. Results of these trials may improve our ability to select the best treatment for individual patients. Further well-designed studies are necessary to address several unresolved issues related to PFO stroke and PFO migraine pathophysiology, and to identify the patients who would most likely benefit from PFO closure. The purpose of this review is to summarize contemporary understanding, discuss current treatments, and explore some of the knowledge gaps pertaining to the clinical significance of PFO.

01 mayo 2012

JACC. Serial Change in Health-Related Quality of Life Over 1 Year After Transcatheter Aortic Valve Implantation. Predictors of Health Outcomes

Timothy A. Fairbairn, MB, ChB; David M. Meads, MSc; Adam N. Mather, MB, BS; Manish Motwani, MB, ChB; Sue Pavitt, PhD; Sven Plein, PhD; Daniel J. Blackman, MD; John P. Greenwood, PhD

Objectives: The goal of this study was to assess serial changes in patient health-related quality of life (HRQOL) over time and identify predictors of patient benefit.

01 abril 2013

JACC. Quality of Life Assessment in the Randomized PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) Trial of Patients at Risk for Stroke With Nonvalvular Atrial Fibrillation

Oluseun Alli, MD; Shepal Doshi, MD; Saibal Kar, MD; Vivek Reddy, MD; Horst Sievert, MD; Chris Mullin; Vijay Swarup, MD; Brian Whisenant, MD; David Holmes, MD

Objectives: This study sought to assess quality of life parameters in a subset of patients enrolled in the PROTECT AF (Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation) trial.

01 abril 2012

JACC: CARDIOVASCULAR INTERVENTIONS. Relationship Between Fractional Flow Reserve and Angiographic and Intravascular Ultrasound Parameters in Ostial Lesions. Major Epicardial Vessel Versus Side Branch Ostial Lesions

Jin-Sin Koh, MD; Bon-Kwon Koo, MD, PhD; Ji-Hyun Kim, MD; Han-Mo Yang, MD, PhD; Kyung-Woo Park, MD, PhD; Hyun-Jae Kang, MD, PhD; Hyo-Soo Kim, MD, PhD; Byung-Hee Oh, MD, PhD; Young-Bae Park, MD, PhD

Objectives: This study sought to assess the relationship of coronary angiography, intravascular ultrasound (IVUS) and fractional flow reserve (FFR) between major epicardial vessel (MV) and side branch (SB) ostial lesions.

01 mayo 2012

JACC. Intraprocedural Thrombotic Events During Percutaneous Coronary Intervention in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes Are Associated With Adverse Outcomes

Margaret B. McEntegart, MD, PhD; Ajay J. Kirtane, MD, SM; Ecaterina Cristea, MD; Sorin Brener, MD; Roxana Mehran, MD; Martin Fahy, MS; Jeffrey W. Moses, MD; Gregg W. Stone, MD

Objectives: The purpose of this study was to assess the prognostic impact of intraprocedural thrombotic events (IPTE) during percutaneous coronary intervention (PCI).

01 mayo 2012

JACC. Clinical Outcomes Following Stent Thrombosis Occurring In-Hospital Versus Out-of-Hospital. Results From the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) Trial

George D. Dangas, MD, PhD; Bimmer E. Claessen, MD, PhD; Roxana Mehran, MD; Sorin Brener, MD; Bruce R. Brodie, MD; Dariusz Dudek, MD; Bernhard Witzenbichler, MD; Jan Z. Peruga, MD; Giulio Guagliumi, MD, PhD; Jeffrey W. Moses, MD; Alexandra J. Lansky, MD; Ke Xu, PhD; Gregg W. Stone, MD

Objectives The study sought to determine whether rapid access to medical care and reperfusion results in a better prognosis in patients with in-hospital compared with out-of-hospital stent thrombosis (ST) in patients with ST-segment elevation myocardial infarction (STEMI) in the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial.

01 abril 2013

JACC. Colchicine Treatment for the Prevention of Bare-Metal Stent Restenosis in Diabetic Patients

Spyridon Deftereos, MD; Georgios Giannopoulos, MD; Konstantinos Raisakis, MD; Charalambos Kossyvakis, MD; Andreas Kaoukis, MD; Vasiliki Panagopoulou, MD; Metaxia Driva, MD; George Hahalis, MD; Vlasios Pyrgakis, MD; Dimitrios Alexopoulos, MD; Antonis S. Manolis, MD; Christodoulos Stefanadis, MD; Michael W. Cleman, MD

Objectives: This study sought to test the hypothesis that colchicine treatment after percutaneous coronary intervention (PCI) can lead to a decrease in in-stent restenosis (ISR).

01 mayo 2012

JACC. Is Patient Frailty the Unmeasured Confounder That Connects Subacute Stent Thrombosis With Increased Periprocedural Bleeding and Increased Mortality?

Lloyd W. Klein, MD; Carlos Arrieta-Garcia, MD

Stent thrombosis is an uncommon but serious complication of coronary artery stenting that frequently presents as death or nonfatal myocardial infarction (MI), often with ST-segment elevation. Apprehension regarding stent thrombosis influences which patients are candidates for coronary interventions and alters the strategy by which stents are deployed (1). Adjunctive pharmacology is profoundly altered due to these potential consequences: both the routine administration and duration of dual antiplatelet therapy (DAT) and other anticoagulants center on the prevention of stent thrombosis (2).