01 agosto 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Association of Patient-Reported Health Status With Long-Term Mortality After Transcatheter Aortic Valve Replacement. Report From the STS/ACC TVT Registry

Suzanne V. Arnold, MD, MHA, John A. Spertus, MD, MPH, Sreekanth Vemulapalli, MD, Dadi Dai, PhD, Sean M. O’Brien, PhD, Suzanne J. Baron, MD, MSc, Ajay J. Kirtane, MD, SM, Michael J. Mack, MD, Philip Green, MD, Matthew R. Reynolds, MD, MSc, John S. Rumsfeld, MD, PhD and David J. Cohen, MD, MSc

Background: Although transcatheter aortic valve replacement (TAVR) is an effective treatment for aortic stenosis, long-term mortality after TAVR remains high and challenging to predict. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a health status measure, assessed directly from patients, that integrates 2 clinically relevant factors (symptoms and functional status) that may predict TAVR outcomes.

20 enero 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Impact of Mitral Regurgitation on Clinical Outcomes of Patients With Low-Ejection Fraction, Low-Gradient Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation

Crochan J. O’Sullivan, MD*, Stefan Stortecky, MD*, Anne Bütikofer, MD, Dik Heg, PhD, Thomas Zanchin, MD, Christoph Huber, MD, Thomas Pilgrim, MD, Fabien Praz, MD, Lutz Buellesfeld, MD, Ahmed A. Khattab, MD, Stefan Blöchlinger, MD, Thierry Carrel, MD, Bernhard Meier, MD, Stephan Zbinden, MD, Peter Wenaweser, MD and Stephan Windecker, MD*

Background: Up to 1 in 6 patients undergoing transcatheter aortic valve implantation (TAVI) present with low-ejection fraction, low-gradient (LEF-LG) severe aortic stenosis and concomitant relevant mitral regurgitation (MR) is present in 30% to 55% of these patients. The effect of MR on clinical outcomes of LEF-LG patients undergoing TAVI is unknown.

30 diciembre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. New Techniques. Comparison of Histopathologic Analysis Following Renal Sympathetic Denervation Over Multiple Time Points

Kenichi Sakakura, MD, Stefan Tunev, DVM, Kazuyuki Yahagi, MD, Amanda J. O’Brien, DVM, Elena Ladich, MD, Frank D. Kolodgie, PhD, Robert J. Melder, ScD, Michael Joner, MD and Renu Virmani, MD

Background: The pathology of radiofrequency-derived sympathetic renal denervation has not been studied over time and may provide important understanding of the mechanisms resulting in sustained blood pressure reduction. The purpose of this study was to investigate chronological changes after radiofrequency-renal denervation in the swine model.

03 diciembre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Congenital Heart Disease. Percutaneous Pulmonary Valve Implantation: 5 Years of Follow-Up

Sharon Borik, MD, Andrew Crean, MD, FRCPC, Eric Horlick, MDCM, FRCPC, Mark Osten, MD, FRCPC, Kyong-Jin Lee, MD, FRCPC, Rajiv Chaturvedi, MD, PhD, MRCP(UK), Mark K. Friedberg, MD, Brian W. McCrindle, MD, FRCPC, Cedric Manlhiot, BSc and Lee Benson, MD, FRCPC

Background: Percutaneous pulmonary valve implantation (PPVI) is a safe, less invasive alternative to surgical valve replacement for the congenital heart disease patient with right ventricular (RV) outflow tract dysfunction. The aim of this study was to determine whether reverse RV remodeling after PPVI was persistent in the longer term and whether timing of PPVI influenced outcomes.

17 diciembre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Contemporary Reviews in Interventional Cardiology. Coronary Obstruction in Transcatheter Aortic Valve-in-Valve Implantation. Preprocedural Evaluation, Device Selection, Protection, and Treatment

Danny Dvir, MD, Jonathon Leipsic, MD, Philipp Blanke, MD, Henrique B. Ribeiro, MD, Ran Kornowski, MD, Augusto Pichard, MD, Joseph Rodés-Cabau, MD, David A. Wood, MD, Dion Stub, PhD, Itsik Ben-Dor, MD, Gabriel Maluenda, MD, Raj R. Makkar, MD and John G. Webb, MD

The majority of surgical heart valves being implanted during the past decade are bioprosthetic, tissue valves with limited durabiity.1–4 These tissue valves have limited durability.2–4 Recently, implantation of transcatheter valves inside failed surgically implanted aortic bioprostheses (valve-in-valve [VIV]) has been reported as a less-invasive alternative to repeat surgery.5 Although procedural success is achieved in the great majority of patients, this therapy is associated with several potential risks, including ostial coronary occlusion.6,7

13 enero 2016

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Six Versus 12 Months of Dual Antiplatelet Therapy After Implantation of Biodegradable Polymer Sirolimus-Eluting Stent. Randomized Substudy of the I-LOVE-IT 2 Trial

Yaling Han, MD, PhD*, Bo Xu, MBBS*, Kai Xu, MD, Changdong Guan, MSc, Quanmin Jing, MD, Qiangsun Zheng, MD, Xueqi Li, MD, Xianxian Zhao, MD, Haichang Wang, MD, Xuezhong Zhao, MD, Xiaoyan Li, MD, Pengfei Yu, MD, Hongyun Zang, MD, Zhifang Wang, MD, Xuebin Cao, MD, Jun Zhang, MD, Wenyue Pang, MD, Jing Li, MD, Yuejin Yang, MD and George D. Dangas, MD, PhD

Background: There are no reports on a large-scale randomized trial exploring optimal dual antiplatelet therapy (DAPT) duration after biodegradable polymer sirolimus-eluting stent implantation. We sought to report the outcomes of a randomized substudy of the prospective Evaluate Safety and Effectiveness of the Tivoli DES and the Firebird DES for Treatment of Coronary Revascularization (I-LOVE-IT 2) trial.

11 enero 2016

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Impact of Diabetic Status on Outcomes After Revascularization With Drug-Eluting Stents in Relation to Coronary Artery Disease Complexity. Patient-Level Pooled Analysis of 6081 Patients

Konstantinos C. Koskinas, MD, MSc, George C.M. Siontis, MD, Raffaele Piccolo, MD, Anna Franzone, MD, Alan Haynes, PhD, Julie Rat-Wirtzler, MSc, Sigmund Silber, MD, Patrick W. Serruys, MD, Thomas Pilgrim, MD, Lorenz Räber, MD, Dik Heg, PhD, Peter Jüni, MD and Stephan Windecker, MD

Background: Diabetes mellitus and angiographic coronary artery disease complexity are intertwined and unfavorably affect prognosis after percutaneous coronary interventions, but their relative impact on long-term outcomes after percutaneous coronary intervention with drug-eluting stents remains controversial. This study determined drug-eluting stents outcomes in relation to diabetic status and coronary artery disease complexity as assessed by the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) score.

16 diciembre 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Clopidogrel Versus Aspirin as an Antiplatelet Monotherapy After 12-Month Dual-Antiplatelet Therapy in the Era of Drug-Eluting Stents

Taek Kyu Park, MD, Young Bin Song, MD, PhD, Joonghyun Ahn, MS, K.C. Carriere, PhD, Joo-Yong Hahn, MD, PhD, Jeong Hoon Yang, MD, PhD, Seung-Hyuk Choi, MD, PhD, Jin-Ho Choi, MD, PhD, Sang Hoon Lee, MD, PhD and Hyeon-Cheol Gwon, MD, PhD

Background: The use of dual-antiplatelet therapy (DAPT) exceeding 12 months may increase a bleeding risk despite a lower risk of ischemic events. There is no study to compare clinical outcomes in patients treated with a single-antiplatelet drug after DAPT in the era of drug-eluting stents (DES). We sought to investigate the efficacy and safety of clopidogrel versus aspirin monotherapy after 12-month DAPT after DES implantation using an institutional registry.

17 noviembre 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Peripheral Vascular Disease. Bivalirudin Is Associated With Improved In-Hospital Outcomes Compared With Heparin in Percutaneous Vascular Interventions. Observational, Propensity-Matched Analysis From the Premier Hospital Database

Carey Kimmelstiel, MD, Duane Pinto, MD, MPH, Herbert D. Aronow, MD, MPH, Andrew R. Weintraub, MD, George Dangas, MD, PhD, Weihong Fan, PhD, Jayne Prats, PhD, Efthymios N. Deliargyris, MD and Barry T. Katzen, MD

Background: Peripheral vascular interventions are increasingly preferred for the treatment of patients with symptomatic peripheral arterial disease because they are associated with similar clinical outcomes and lower morbidity than open surgical procedures. The objective of this study was to assess the comparative effectiveness of procedural anticoagulation with bivalirudin compared with unfractionated heparin in patients undergoing peripheral vascular interventions.

01 febrero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Transcatheter Closure of a Post-Myocardial Infarction Ventricular Septal Rupture Using a Parachute Device

Daxin Zhou, MB∗; Wenzhi Pan, MD∗; Lihua Guan, MB∗; Cuizhen Pan, MB†; Junbo Ge, MD∗

A 58-year-old man with exertional dyspnea (New York Heart Association class II) was admitted to our hospital. He suffered from acute anterior myocardial infarction 1 year earlier and had undergone percutaneous coronary intervention and closure of ventricular septal rupture (VSR) with an Amplatzer Septal Occluder (St. Jude Medical, St. Paul, Minnesota) 9 months before admission.

01 febrero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Early Experimental and Clinical Experience With a Focal Implant for Lower Extremity Post-Angioplasty Dissection

Peter A. Schneider, MD∗; Robert Giasolli, MS†; Adrian Ebner, MD‡; Renu Virmani, MD§; Juan F. Granada, MD‖

Objectives: This study provides preliminary data on the safety and feasibility of the use of a novel focal implant for managing post–percutaneous transluminal balloon angioplasty (post-PTA) dissection.

01 febrero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. When Collateral Damage Does Matter. Iatrogenic Ventricular Septal Rupture After Percutaneous Coronary Intervention of the Left Anterior Descending Artery

Vincent Michiels, MD∗; Martin J. Swaans, MD∗; Bastiaan J. Sorgdrager, MD†; Rolf F. Veldkamp, MD, PhD†; Robin H. Heijmen, MD, PhD‡; Jurrien M. ten Berg, MD, PhD∗

An 83-year old woman with no cardiac history was admitted because of a non–ST-segment elevation myocardial infarction for which she underwent a diagnostic coronary angiography. The culprit lesion was considered to be a 70% stenosis in the mid left anterior descending coronary artery (LAD) just after the origin of a large septal branch

01 enero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Preventive Stenting in Acute Myocardial Infarction

Ari Pollack, MD∗; Bibhu D. Mohanty, MD†; Rishi Handa, MD‡; Patrick M. Looser, MD§; Valentin Fuster, MD, PhD∗; Spencer B. King, III, MD‖; Samin K. Sharma, MD∗

Current practice guidelines advocate culprit vessel intervention alone in patients with ST-segment elevation myocardial infarction (STEMI) found to have multivessel coronary disease during primary percutaneous coronary intervention (PCI). The debate on the timing of noninfarct artery intervention has recently been reinvigorated by the PRAMI (Preventive Angioplasty in Acute Myocardial Infarction) trial, in which patients undergoing preventive PCI of significant nonculprit lesions at the time primary PCI for STEMI had reduced rates of cardiac death, nonfatal myocardial infarction, and refractory angina. Given that previous literature has cautioned against multivessel PCI during STEMI, this raises the question of whether technical and pharmacological advances in PCI may have opened the door to safely revisit this issue with additional clinical rigor.

01 enero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. MitraClip Implantation in a Previous Surgical Mitral Valve Edge-to-Edge Repair

Vera E. Bottari, MD∗; Gloria Tamborini, MD∗; Antonio L. Bartorelli, MD∗; Francesco Alamanni, MD∗; Mauro Pepi, MD∗

Percutaneous mitral valve repair (PMVR) with MitraClip (Abbott Laboratories, Abbott Park, Illinois) has emerged as a therapeutic option for severe mitral regurgitation (MR) in high surgical risk patients (1). Echocardiography is fundamental in patient selection, in guiding MitraClip implantation procedure, and in assessing procedural results (2). Previous cases of PMVR, after failure of surgical mitral valve (MV) annuloplasty (3,4) have been reported. To our knowledge, this is the first case of clip implantation in a patient with severe MR after a surgical repair with the edge-to-edge technique.

01 enero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Giant Coronary Aneurysm Diagnosed as Incidental Mediastinal Mass

Roderick C. Deaño, MD, MPH∗; Ashish M. Shah, MD∗; Zarrish S. Khan, MD†; Geoffrey Bergman, MD∗; Mary J. Roman, MD∗; Rajesh V. Swaminathan, MD∗; Luke K. Kim, MD∗; Dmitriy N. Feldman, MD∗; Robert M. Minutello, MD∗; S. Chiu Wong, MD∗; Navneet Narula, MD‡; Arash Salemi, MD†; Harsimran S. Singh, MD, MSc∗

A 41-year-old man with epigastric pain and nephrolithiasis was found to have an incidental large anterior mediastinal mass on computed tomography (Figure 1A). Transthoracic echocardiography was suggestive of a giant coronary aneurysm (GCA) versus pericardial cyst