In the prospective, randomized Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial, implantation of paclitaxel-eluting stents (PES) safely reduced the rates of ischemic target lesion revascularization (TLR) compared with bare metal stents (BMS) in patients with ST-segment–elevation myocardial infarction (STEMI) undergoing primary percutaneous intervention. Diabetes mellitus is a known predictor of adverse outcomes after percutaneous intervention in STEMI. We therefore sought to assess the impact of PES in diabetic patients with STEMI from the HORIZONS-AMI trial. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632
As a substudy of the large, randomized ZEST (Comparison of the Efficacy and Safety of Zotarolimus- Eluting Stent with Sirolimus-Eluting and PacliTaxel-Eluting Stent for Coronary Lesions) trial comparing first- and second-generation drug-eluting stents, we evaluated intimal hyperplasia (IH) and vascular changes using volumetric intravascular ultrasound analysis. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632
Aims: To compare the tissue coverage of a hydrophilic polymer-coated zotarolimus-eluting stent (ZES) vs. a fluoropolymer-coated everolimus-eluting stent (EES) at 13 months, using optical coherence tomography (OCT) in an all-comers population of patients, in order to clarify the mechanism of eventual differences in the biocompatibility and thrombogenicity of the devices. European Heart Journal (2011) 32, 2454–2463. Published on behalf of the European Society of Cardiology. All rights reserved. & The Author 2011.
A new generation of balloon-expandable valves (e.g. Edwards SAPIEN XT) enables the use of a decreased sheath size using the NovaFlexTM delivery system for transfemoral transcatheter aortic valve implantation (TAVI). However, there are few data analysing the efficacy and safety of this new prosthesis. Archives of Cardiovascular Disease (2012) 105, 132—140. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
In April 2002, the first human percutaneous aortic valve implantation was performed in Rouen [1]. Different approaches quickly became feasible and, despite the historical use of the antegrade transseptal approach, the retrograde approach became popular during 2005, with the development of the RetroFlex catheter [2]. Due to the large diameter of the first models of the RetroFlex catheter (22/24 F) and the presence, in numerous patients, of small-calibre vessels or vascular disease, the idea of a transapical approach emerged. In 2005, after an animal feasibility study [3], the first patients were implanted via a small anterolateral mini thoracotomy [4,5]. In July 2007, the first transapical implantation in France was performed in our department. Since this time, 61 patients have been implanted using this approach. We report the 4-year outcomes of these patients. Archives of Cardiovascular Disease (2012) 105, 141—145. Copyright © 2012 Published by Elsevier Masson SAS.
Patient selection plays a crucial role in the success of transcatheter aortic valve implantation (TAVI). It requires meticulous attention to the smallest of details and needs to be performed in a systematic manner for every patient. In essence, the patient must be assessed from access to implantation site. Becoming over ‘‘complacent’’ and ‘‘routine’’ may lead to failure and impact patient safety. TAVI is indicated for high or prohibitive surgical risk patients with severe aortic stenosis. Some patients, however, are too high risk even for TAVI. In addition to patient risk evaluation, anatomical selection criteria need to be considered. Multimodality imaging, using a combination of angiography, echocardiography and multislice computed tomography, is necessary to determine the anatomical suitability for the procedure. Archives of Cardiovascular Disease (2012) 105, 165—173. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Percutaneous left atrial appendage (LAA) closure can be an alternative to coumadin treatment in patients with atrial fibrillation (AF) at high risk for thromboembolic events and/or bleeding complications. We report the initial experience with this new technique. Neth Heart J (2012) 20:161–166. Copytight Springer Media / Bohn Stafleu van Loghum 2012
Objectives: The current study sought to examine inflammation at the stented segments of Nobori (Terumo Corporation, Tokyo, Japan) and Cypher (Cordis, Miami, Florida) drug-eluting stents (DES), as well as free radical production and endothelial function of the adjacent nonstented segments in a pig coronary model.
Objectives: The goal of this study was to describe the neointimal healing on the abluminal side (ABL) of malapposed (ISA) struts and nonapposed side-branch (NASB) struts in terms of coverage by optical coherence tomography (OCT) and in comparison with the adluminal side (ADL).
New-generation coronary stents that release zotarolimus or everolimus have been shown to reduce the risk of restenosis. However, it is unclear whether there are differences in efficacy and safety between the two types of stents on the basis of prospectively adjudicated end points endorsed by the Food and Drug Administration. The New England Journal of Medicine. Copyright © 2010 Massachusetts Medical Society. All rights reserved.
Pathology studies on fatal cases of very late stent thrombosis have described incomplete neointimal coverage as common substrate, in some cases appearing at side-branch struts. Intravascular ultrasound studies have described the association between incomplete stent apposition (ISA) and stent thrombosis, but the mechanism explaining this association remains unclear. Whether the neointimal coverage of nonapposed side-branch and ISA struts is delayed with respect to well-apposed struts is unknown. Copyright © 2011 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
Vessel angulation and large changes in vessel geometry after stent implantation have been associated with an increased risk of target lesion failure (TLF) using bare-metal stents. Second-generation drug-eluting stents (DES)offer superior conformability and inhibition of neointima. The aim of the study is to investigate the relationship between pre and post-implant vessel geometry and the occurrence of TLF at 1 year after treatment with second-generation DES; and to compare the conformability of Resolute and Xience stents. American Heart Journal Volume 162. Copytight © 2011, Mosby, Inc. All rights reserved.
The development of transcatheter aortic valve implantation (TAVI) by our group has been a 20-year odyssey. In 1993, postmortem studies validated the concept of intravalvular stenting in calcific aortic stenosis. The first prototypes of balloon-expandable valves were tested in an animal model in 2000. The first-in-man implantation was performed in Rouen in 2002, rapidly followed by two prospective series in compassionate cases in our centre. TAVI took flight in 2004 in the hands of Edwards Lifesciences, with major improvements in devices and approaches. At the same time, the self-expanding CoreValve was launched. Thousands of highsurgical- risk patients were enrolled in feasibility studies, leading to the Conformité Européenne (CE) mark being granted in 2007 for the two devices. Archives of Cardiovascular Disease (2012) 105, 146—152. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Transcatheter aortic valve implantation (TAVI), introduced 10 years ago by Alain Cribier, has now been performed in more than 50,000 patients worldwide. Our vision of the main directions for the future are fourfold. Firstly, the ‘Heart Team’ is and will remain, essential for patient selection and the performance of the procedure. Careful training and controlled diffusion of the technique to medico-surgical centres are also keys to success. Secondly, patient selection must be refined, in order to predict the risk of surgery and that of TAVI. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
We report on an obstruction of the left main coronary artery which occurred after completion of an uneventful transapical aortic valve implantation (TAVI) procedure. This delayed subtotal coronary obstruction was detected by routine final transesophageal echocardiographic examination. Emergency implantation of a coronary stent eliminated myocardial ischemia. This case demonstrated that coronary artery obstruction can occur not only during the TAVI procedure but also some time later. This finding reinforces the idea that these patients must also be carefully evaluated in the early post-procedure period. Interactive CardioVascular and Thoracic Surgery 12 (2011) 57–60. Copyright © 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
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