07 octubre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Spontaneous Coronary Artery Dissection. Association With Predisposing Arteriopathies and Precipitating Stressors and Cardiovascular Outcomes

Jacqueline Saw, MD, Eve Aymong, MD, Tara Sedlak, MD, Christopher E. Buller, MD, Andrew Starovoytov, MD, Donald Ricci, MD, Simon Robinson, MD, Tycho Vuurmans, MD, PhD, Min Gao, PhD, Karin Humphries, PhD and G.B. John Mancini, MD

Background: Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is underdiagnosed and an important cause of myocardial infarction in young women. The frequency of predisposing and precipitating conditions and cardiovascular outcomes remains poorly described.

19 agosto 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Coronary Artery Tortuosity in Spontaneous Coronary Artery Dissection. Angiographic Characteristics and Clinical Implications

Mackram F. Eleid, MD, Raviteja R. Guddeti, MBBS, Marysia S. Tweet, MD, Amir Lerman, MD, Mandeep Singh, MD, MPH, Patricia J. Best, MD, Terri J. Vrtiska, MD, Megha Prasad, MD, Charanjit S. Rihal, MD, MBA, Sharonne N. Hayes, MD and Rajiv Gulati, MD, PhD

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized nonatherosclerotic cause of acute coronary syndrome. The angiographic characteristics of SCAD are largely undetermined. The goal of this study was to determine the prevalence of coronary tortuosity in SCAD and whether it may be implicated in the disease.

30 septiembre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Targeted Temperature Management at 33°C Versus 36°C and Impact on Systemic Vascular Resistance and Myocardial Function After Out-of-Hospital Cardiac Arrest. A Sub-Study of the Target Temperature Management Trial

John Bro-Jeppesen, MD, PhD, Christian Hassager, MD, DMSc, Michael Wanscher, MD, PhD, Morten Østergaard, MD, PhD, Niklas Nielsen, MD, PhD, David Erlinge, MD, PhD, Hans Friberg, MD, PhD, Lars Køber, MD, DMSc and Jesper Kjaergaard, MD, PhD, DMSc

Background: Cardiovascular dysfunction is common after out-of-hospital cardiac arrest as part of the postcardiac arrest syndrome, and hypothermia may pose additional impact on hemodynamics. The aim was to investigate systemic vascular resistance index (SVRI), cardiac index, and myocardial performance at a targeted temperature management of 33°C (TTM33) versus 36°C (TTM36).

07 octubre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Intracoronary Infusion of Encapsulated Glucagon-Like Peptide-1–Eluting Mesenchymal Stem Cells Preserves Left Ventricular Function in a Porcine Model of Acute Myocardial Infarction

Renate de Jong, MD, PhD, Gerardus P.J. van Hout, MD*, Jaco H. Houtgraaf, MD, PhD*, Kushan Kazemi, MD, Christine Wallrapp, PhD, Andrew Lewis, PhD, Gerard Pasterkamp, MD, PhD, Imo E. Hoefer, MD, PhD and Henricus J. Duckers, MD, PhD

Background: Engraftment and survival of stem cells in the infarcted myocardium remain problematic in cell-based therapy for cardiovascular disease. To overcome these issues, encapsulated mesenchymal stem cells (eMSCs) were developed that were transfected to produce glucagon-like peptide-1, an incretin hormone with known cardioprotective effects, alongside MSC endogenous paracrine factors. This study was designed to investigate the efficacy of different doses of intracoronary infusion of eMSC in a porcine model of acute myocardial infarction (AMI).

30 septiembre 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Impact of Aortic Annulus Size on Valve Hemodynamics and Clinical Outcomes After Transcatheter and Surgical Aortic Valve Replacement

Josep Rodés-Cabau, MD, Philippe Pibarot, DVM, PhD, Rakesh M. Suri, MD, DPhil, Susheel Kodali, MD, Vinod H. Thourani, MD, Wilson Y. Szeto, MD, Lars G. Svensson, MD, PhD, Eric Dumont, MD, Ke Xu, PhD, Rebecca T. Hahn, MD and Martin B. Leon, MD

Background: The objective was to evaluate the effects of aortic annulus size on valve hemodynamics and clinical outcomes in those patients included in the Placement of Aortic Transcatheter Valves (PARTNER) randomized controlled trial cohort A and the nonrandomized continued access cohort.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Percutaneous Left Atrial Appendage Closure. Procedural Techniques and Outcomes

Jacqueline Saw, MD; Mathieu Lempereur, MD

Percutaneous left atrial appendage closure technology for stroke prevention in patients with atrial fibrillation has significantly advanced in the past 2 decades. Several devices are under clinical investigation, and a few have already received Conformité Européene (CE)-mark approval and are available in many countries. The WATCHMAN device (Boston Scientific, Natick, Massachusetts) has the most supportive data and is under evaluation by the U.S. Food and Drug Administration for warfarin-eligible patients. The Amplatzer Cardiac Plug (St. Jude Medical, Plymouth, Minnesota) has a large real-world experience over the past 5 years, and a randomized trial comparing Amplatzer Cardiac Plug with the WATCHMAN device is anticipated in the near future. The Lariat procedure (SentreHEART Inc., Redwood City, California) has also gained interest lately, but early studies were concerning for high rates of serious pericardial effusion and major bleeding. The current real-world experience predominantly involves patients who are not long-term anticoagulation candidates or who are perceived to have high bleeding risks. This pattern of practice is expected to change when the U.S. Food and Drug Administration approves the WATCHMAN device for warfarin-eligible patients. This paper reviews in depth the procedural techniques, safety, and outcomes of the current leading devices.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Risk of Cerebrovascular Events in Patients With Patent Foramen Ovale and Intracardiac Devices

Kanhaiya L. Poddar, MD∗; Vijaiganesh Nagarajan, MD†; Amar Krishnaswamy, MD∗; Navkaranbir S. Bajaj, MD†; Meera Kumari, MBBS∗; Hazem Bdair, MD∗; Dhruv Modi, MD∗; Shikhar Agarwal, MD, MPH, CPH∗; Sachin S. Goel, MD∗; Akhil Parashar, MD†; E. Murat Tuzcu, MD∗; Samir R. Kapadia, MD∗

Objectives: This study investigated whether patients with patent foramen ovale (PFO) have an increased risk of stroke due to permanent pacemaker (PPM)/implantable cardioverter-defibrillator (ICD) implantation.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Periprocedural Complications and Long-Term Outcome After Alcohol Septal Ablation Versus Surgical Myectomy in Hypertrophic Obstructive Cardiomyopathy. A Single-Center Experience

Robbert C. Steggerda, MD∗; Kevin Damman, MD, PhD†; Jippe C. Balt, MD, PhD‡; Max Liebregts, MD‡; Jurriën M. ten Berg, MD, PhD‡; Maarten P. van den Berg, MD, PhD†

Objectives: This study compared alcohol septal ablation (ASA) and surgical myectomy for periprocedural complications and long-term clinical outcome in patients with symptomatic hypertrophic obstructive cardiomyopathy.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Outcomes After Transfemoral Transcatheter Aortic Valve Replacement. A Comparison of the Randomized PARTNER (Placement of AoRTic TraNscathetER Valves) Trial With the NRCA (Nonrandomized Continued Access) Registry

William F. Fearon, MD∗; Susheel Kodali, MD†; Darshan Doshi, MD†; Michael P. Fischbein, MD, PhD∗; Alan C. Yeung, MD∗; E. Murat Tuzcu, MD‡; Charanjit S. Rihal, MD§; Vasilis Babaliaros, MD‖; Alan Zajarias, MD¶; Howard C. Herrmann, MD#; David L. Brown, MD∗∗; Michael Mack, MD††; Paul S. Teirstein, MD‡‡; Brian K. Whisenant, MD§§; Raj Makkar, MD‖‖; Samir Kapadia, MD‡; Martin B. Leon, MD∗

Objectives: This study sought to determine whether outcomes for transfemoral (TF) transcatheter aortic valve replacement (TAVR) differ between the randomized controlled trial (RCT) and the subsequent NRCA (Nonrandomized Continued Access) registry of the PARTNER (Placement of AoRTic TraNscathetER Valves) trial.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. One-Year Follow-Up of the Melody Transcatheter Pulmonary Valve Multicenter Post-Approval Study

Aimee K. Armstrong, MD∗; David T. Balzer, MD†; Allison K. Cabalka, MD‡; Robert G. Gray, MD§; Alexander J. Javois, MD‖; John W. Moore, MD¶; Jonathan J. Rome, MD#; Daniel R. Turner, MD∗∗; Thomas M. Zellers, MD††; Jacqueline Kreutzer, MD‡‡

Objectives: This study sought to confirm that the short-term hemodynamic effectiveness of the Melody transcatheter pulmonary valve (TPV) (Medtronic, Inc., Minneapolis, Minnesota) achieved by real-world providers is equivalent to the historical results established in the initial 5-center Investigational Device Exemption trial.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of the Complexity of Bifurcation Lesions Treated With Drug-Eluting Stents. The DEFINITION Study (Definitions and impact of complEx biFurcation lesIons on clinical outcomes after percutaNeous coronary IntervenTIOn using drug-eluting steNts)

Shao-Liang Chen, MD∗; Imad Sheiban, MD†; Bo Xu, MBBS‡; Nigel Jepson, MD§; Chitprapai Paiboon, MD‖; Jun-Jie Zhang, PhD¶; Fei Ye, MD¶; Teugh Sansoto, MD#; Tak W. Kwan, MD∗∗; Michael Lee, MD††; Ya-Ling Han, MD‡‡; Shu-Zheng Lv, MD§§; Shang-Yu Wen, MD‖‖; Qi Zhang, MD¶¶; Hai-Chang Wang, MD##; Tie-Ming Jiang, MD∗∗∗; Yan Wang, MD†††; Liang-Long Chen, MD‡‡‡; Nai-Liang Tian, MD∗; Feng Cao, MD##; Chun-Guang Qiu, MD§§§; Yao-Jun Zhang, PhD¶; Martin B. Leon, MD‖‖‖

Objectives: The present study established criteria to differentiate simple from complex bifurcation lesions and compared 1-year outcomes stratified by lesion complexity after provisional stenting (PS) and 2-stent techniques using drug-eluting stents.

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Hybrid Revascularization for Multivessel Coronary Artery Disease

Mariusz Gąsior, MD∗; Michael Oscar Zembala, MD, PhD†; Mateusz Tajstra, MD, PhD∗; Krzysztof Filipiak, MD, PhD†; Marek Gierlotka, MD∗; Tomasz Hrapkowicz, MD, PhD†; Michał Hawranek, MD, PhD∗; Lech Poloński, MD∗; Marian Zembala, MD†

Objectives: The aim of this study was to assess the feasibility of hybrid coronary revascularization (HCR) in patients with multivessel coronary artery disease (MVCAD) referred for standard coronary artery bypass grafting (CABG).

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Intravascular Ultrasound Guidance to Minimize the Use of Iodine Contrast in Percutaneous Coronary Intervention. The MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) Randomized Controlled Trial

José Mariani, Jr., MD∗; Cristiano Guedes, MD∗; Paulo Soares, MD, PhD∗; Silvio Zalc, MD, PhD∗; Carlos M. Campos, MD∗; Augusto C. Lopes, MD‡; André G. Spadaro, MD∗; Marco A. Perin, MD, PhD∗; Antonio Esteves Filho, MD∗; Celso K. Takimura, MD, PhD∗; Expedito Ribeiro, MD, PhD∗; Roberto Kalil-Filho, MD, PhD∗; Elazer R. Edelman, MD, PhD‡; Patrick W. Serruys, MD, PhD†; Pedro A. Lemos, MD, PhD∗

Objectives: The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI).

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Pressure-Wire-Guided Percutaneous Transluminal Pulmonary Angioplasty. A Breakthrough in Catheter-Interventional Therapy for Chronic Thromboembolic Pulmonary Hypertension

Takumi Inami, MD∗; Masaharu Kataoka, MD∗; Nobuhiko Shimura, MD∗; Haruhisa Ishiguro, MD∗; Ryoji Yanagisawa, MD∗; Keiichi Fukuda, MD†; Hideaki Yoshino, MD∗; Toru Satoh, MD∗

Objectives: This study sought to prove the safety and effectiveness of pressure-wire-guided percutaneous transluminal pulmonary angioplasty (PTPA).

01 diciembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Shedding Light on Scaffold Vascular Response

Bill (Vasileios) D. Gogas, MD, PhD; Habib Samady, MD

Arterial healing or vascular response after percutaneous coronary interventions (PCIs) describes a reparative mechanism to acute procedural injury attributed to balloon barotrauma and/or stent deployment itself (2,3). Early vascular responses after bare metal stent or drug-eluting stent (DES) placement are driven by fibrin- and platelet-rich thrombi depositions and migration of smooth muscle cells. In contrast, late vascular responses to DES are primarily attributed to delayed strut healing subsequent to drug toxicity, polymer-induced inflammation followed by hypersensitivity reactions, and in-stent neoatherosclerosis leading to late target lesion revascularization (TLR) or late stent thrombosis.