Objectives The aim of this pooled analysis was to assess the cumulative safety and effectiveness of coronary intravascular lithotripsy (IVL).
Objectives The study sought to compare short-term outcomes in patients with femoropopliteal artery calcification receiving vessel preparation with intravascular lithotripsy (IVL) or percutaneous transluminal angioplasty (PTA) prior to drug-coated balloon (DCB) for symptomatic peripheral artery disease.
Objectives The aim of this trial was to determine whether ultrasound-assisted thrombolysis (USAT) is superior to standard catheter-directed thrombolysis (SCDT) in pulmonary arterial thrombus reduction for patients with submassive pulmonary embolism (sPE).
Percutaneous coronary intervention (PCI) involving the ostial left anterior descending coronary artery (LAD) bears an inherent risk for excessive stent strut protrusion into the distal left main coronary artery (LM), thus potentially creating an area of significant stent malapposition and/or underexpansion, which have been associated with the occurrence of stent thrombosis (1).
Coronary angiography in a 76-year-old woman hospitalized for congestive heart failure revealed severe stenosis and calcification in the mid right coronary artery (Figure 1A). High-pressure expansion using a noncompliant balloon was repeatedly performed for the severely calcified lesion. After balloon dilatation, we deployed 2 overlapping zotarolimus-eluting stents (3.0 × 26 mm and 3.0 × 30 mm; Resolute onyx, Medtronic Vascular, Inc., Galway, Ireland). The overlapping stent struts were located at the site of hinge motion. Finally, percutaneous intervention was completed, establishing a thrombolysis in myocardial infarction grade 3 flow
A 74-year-old man, who 4 years before had received a left ventricular assist device (LVAD) HeartMate3 (Abbott Laboratories, Lake Bluff, Illinois) for post-ischemic end-stage heart failure, was emergently readmitted for acute heart failure, pulmonary edema and acute renal failure. Log-file LVAD analysis demonstrated no alarms generated from the pump, and a flow of 3.9 l/min (5,300 rpm). Computed tomography angiography (CTA) demonstrated obstruction of the outflow graft (OG) (Figures 1A to 1C). An endovascular treatment was planned and an intravascular ultrasound (IVUS) study (Visions PV 0.035, Volcano Corporation; Rancho Cordova, California) was obtained. The imaging confirmed a 75% cross-section lumen area reduction due to external compression between the strain relief and the Dacron graft resulting in OG infolding (Figures 1D to 1F). The obstruction was treated with a covered stent-grafting (BE Graft 14 × 48 mm, Bentley InnoMed, Hechingen, Germany) and noncompliant balloon post-dilation (Atlas Gold 16 × 60 mm, BARD Peripheral Vascular, Tempe, Arizona) (Video 1). The procedure was uneventful and performed without the use of contrast medium. Both intraoperative IVUS (Figures 2D to 2F) and post-operative control CTA (Figures 2A to 2C) confirmed the resolution of OG obstruction.
In the era of percutaneous coronary intervention (PCI), coronary artery perforation is not uncommon; however, acute spontaneous coronary artery rupture (SCAR) without known etiology is a rare condition that clinicians should have greater awareness for the prevention of catastrophic cardiac tamponade (1). A 68-year-old man received successful PCI for troponin-I–elevated acute coronary syndrome over the left anterior descending artery and left circumflex artery with drug-eluting stents (Video 1). Three hours post-intervention, recurrent chest pain was reported along with shock, requiring emergency pericardiocentesis for acute cardiac tamponade. Repeat angiography unexpectedly revealed that the initially mildly diseased and nonintervened right coronary artery (Figure 1A, Video 2) developed SCAR in multiple terminal branches (Figure 1B, Video 3). Repeat pericardiocentesis of bloody effusion, fluid resuscitation, and balloon occlusion for coronary extravasation failed to stabilize the patient. The extravasation was finally sealed by embolization with multiple coils (Figure 1C, Video 4). In the following days, extracorporeal membrane oxygenation was successfully employed to rescue the patient from a potentially complicated clinical course including cardiac arrest, right ventricular global hypokinesia, and frank pulmonary edema. The patient was discharged 27 days later and is in favorable general health at the 5-month follow-up.
A 78-year-old woman with exertional dyspnea was diagnosed with critical aortic stenosis and single-vessel mild left anterior descending coronary artery (LAD) disease in a left dominant system. Multidetector computed tomography showed that left main coronary artery (LM) height (11 mm) and sinotubular junction (13.8 mm) were relatively low (Figure 1, Video 1). Virtual transcatheter heart valve (THV) to coronary distance was 4.9 mm.
A 59-year-old woman with no history of coronary artery disease and a history of heavy smoking, recently recovered (4 weeks previously) from a mild course of ambulatory treated coronavirus disease-2019 (COVID-19), was admitted to our clinic with the diagnosis of anterior wall ST-segment elevation myocardial infarction.
A 66-year-old otherwise healthy woman was admitted to the cardiology department for exercise-induced dyspnea and positive stress electrocardiogram with anterior ST-segment depression. A coronary computed tomography showed an 18-mm-long myocardial bridge (MB) in mid left anterior descending artery with deep encasement (3.9 mm) (Figure 1) (1), without other significant stenosis. At coronary angiography MB was confirmed, although hard to be seen (Figure 2). Functional assessment with instantaneous wave-free ratio (iFR) was obtained showing baseline diastolic flow limitation (iFR 0.86) (Figure 3). After infusion of nitrates, a dobutamine challenge was performed to further assess hemodynamic relevance. During a 5 μg/kg/min dobutamine infusion, iFR further reduced to 0.72 (Figure 4). Because no significant coronary stenosis was detected, the patient was discharged with calcium-channel blocker with complete resolution of symptoms at 3-month follow-up visit.
The use of transseptal puncture continues to rise given the increase in left atrial cardiac interventions. The authors review an anatomic approach to transseptal puncture incorporating multimodality imaging both pre- and intraprocedurally with stepwise escalation algorithms to ensure safe and efficacious large-bore transseptal puncture
Objectives This study aimed to validate a dedicated software for quantitative videodensitometric angiographic assessment of mitral regurgitation (QMR).
Objectives This study reports 2-year outcomes from the multicenter, prospective, single-arm CLASP study with functional mitral regurgitation (FMR) and degenerative MR (DMR) analysis.
Objectives This study investigated patterns of right ventricular (RV) contraction by using cardiac magnetic resonance (CMR) imaging in patients undergoing transcatheter tricuspid valve repair (TTVR).
The aim of this study was to assess the incidence and prognostic impact of early and late postoperative atrial fibrillation or flutter (POAF) in patients with severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR).
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