01 mayo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Pivotal Trial to Evaluate the Safety and Efficacy of the Orbital Atherectomy System in Treating De Novo, Severely Calcified Coronary Lesions (ORBIT II)

Jeffrey W. Chambers, MD∗; Robert L. Feldman, MD†; Stevan I. Himmelstein, MD‡; Rohit Bhatheja, MD§; Augusto E. Villa, MD‖; Neil E. Strickman, MD¶; Richard A. Shlofmitz, MD#; Daniel D. Dulas, MD∗; Dinesh Arab, MD∗∗; Puneet K. Khanna, MD††; Arthur C. Lee, MD‡‡; Magdi G.H. Ghali, MD§§; Rakesh R. Shah, MD‖‖; Thomas P. Davis, MD¶¶; Christopher Y. Kim, MD##; Zaheed Tai, DO∗∗∗; Kirit C. Patel, MD†††; Joseph A. Puma, DO‡‡‡; Prakash Makam, MD§§§; Barry D. Bertolet, MD‖‖‖; Georges Y. Nseir, MD¶¶¶

Objectives: The ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial evaluated the safety and efficacy of the coronary Orbital Atherectomy System (OAS) to prepare de novo, severely calcified coronary lesions for stent placement.

01 mayo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. The Learning Curve in Percutaneous Repair of Paravalvular Prosthetic Regurgitation. An Analysis of 200 Cases

Paul Sorajja, MD∗; Allison K. Cabalka, MD†; Donald J. Hagler, MD†; Charanjit S. Rihal, MD∗

Objectives: This study sought to assess the learning curve for percutaneous repair of paravalvular prosthetic regurgitation.

01 julio 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Effects of Transcatheter Pulmonary Valve Replacement on the Hemodynamic and Ventricular Response to Exercise in Patients With Obstructed Right Ventricle-to-Pulmonary Artery Conduits

Babar S. Hasan, MD; Fatima I. Lunze, MD, ScD, PhD; Ming Hui Chen, MD; David W. Brown, MD; Matthew J. Boudreau, RDCS; Jonathan Rhodes, MD; Doff B. McElhinney, MD

Objectives: This study sought to investigate the effects of exercise on the right ventricle in patients with an obstructed right ventricular outflow tract (RVOT) conduit before and after transcatheter pulmonary valve replacement (TPVR).

01 mayo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Effectiveness of Low Rate Fluoroscopy at Reducing Operator and Patient Radiation Dose During Transradial Coronary Angiography and Interventions

Eltigani Abdelaal, MD∗; Guillaume Plourde, MS∗; Jimmy MacHaalany, MD∗; Jean Arsenault, Eng, MScA∗; Goran Rimac, MS∗; Jean-Pierre Déry, MD∗; Gérald Barbeau, MD∗; Eric Larose, MD∗; Robert De Larochellière, MD∗; Can M. Nguyen, MD∗; Ricardo Allende, MD∗; Henrique Ribeiro, MD∗; Olivier Costerousse, PhD∗; Rosaire Mongrain, Eng, PhD†; Olivier F. Bertrand, MD, PhD∗

Objectives: This study sought to determine the efficacy of low rate fluoroscopy at 7.5 frames/s (FPS) versus conventional 15 FPS for reduction of operator and patient radiation dose during diagnostic coronary angiography (DCA) and percutaneous coronary intervention (PCI) via the transradial approach (TRA).

01 mayo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Relationship of Beam Angulation and Radiation Exposure in the Cardiac Catheterization Laboratory

Shikhar Agarwal, MD, MPH∗; Akhil Parashar, MD∗; Navkaranbir Singh Bajaj, MD†; Imran Khan, MD‡; Imran Ahmad, MD∗; Fredrick A. Heupler, Jr., MD∗; Matthew Bunte, MD∗; Dhruv K. Modi, MD∗; E. Murat Tuzcu, MD∗; Samir R. Kapadia, MD∗

Objectives: The aim of this study was to analyze the relationship between beam angulation and air kerma in a modern cardiac catheterization laboratory.

01 mayo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Radiation Dose Reduction in the Cardiac Catheterization Laboratory Utilizing a Novel Protocol

Anthony W.A. Wassef, MD; Brett Hiebert, MSc; Amir Ravandi, MD, PhD; John Ducas, MD; Kunal Minhas, MD; Minh Vo, MD; Malek Kass, MD; Gurpreet Parmar, MD; Farrukh Hussain, MD

Objectives: This study reports the results a novel radiation reduction protocol (RRP) system for coronary angiography and interventional procedures and the determinants of radiation dose.

01 junio 2015

JACC. Reducing In-Stent Restenosis. Therapeutic Manipulation of miRNA in Vascular Remodeling and Inflammation

Robert A. McDonald, PhD∗; Crawford A. Halliday, MBChB∗; Ashley M. Miller, PhD∗; Louise A. Diver, PhD∗; Rachel S. Dakin, PhD∗; Jennifer Montgomery, PhD∗; Martin W. McBride, PhD∗; Simon Kennedy, PhD∗; John D. McClure, PhD∗; Keith E. Robertson, MBChB∗; Gillian Douglas, PhD†; Keith M. Channon, MD†; Keith G. Oldroyd, MD‡; Andrew H. Baker, PhD∗

Background: Drug-eluting stents reduce the incidence of in-stent restenosis, but they result in delayed arterial healing and are associated with a chronic inflammatory response and hypersensitivity reactions. Identifying novel interventions to enhance wound healing and reduce the inflammatory response may improve long-term clinical outcomes. Micro–ribonucleic acids (miRNAs) are noncoding small ribonucleic acids that play a prominent role in the initiation and resolution of inflammation after vascular injury.

20 mayo 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Biolimus-Eluting Stents With Biodegradable Polymer Versus Bare-Metal Stents in Acute Myocardial Infarction

Lorenz Räber, MD, Henning Kelbæk, MD, Masanori Taniwaki, MD, Miodrag Ostojic, MD, Dik Heg, MSc, Andreas Baumbach, MD, Clemens von Birgelen, MD, PhD, Marco Roffi, MD, David Tüller, MD, Thomas Engstrøm, MD, Aris Moschovitis, MD, Giovanni Pedrazzini, MD, Peter Wenaweser, MD, Ran Kornowski, MD, Klaus Weber, MD, Thomas F. Lüscher, MD, Christian M. Matter, MD, Bernhard Meier, MD, Peter Jüni, MD and Stephan Windecker, MD for the COMFORTABLE AMI Trial Investigators

Background: This study sought to determine whether the 1-year differences in major adverse cardiac event between a stent eluting biolimus from a biodegradable polymer and bare-metal stents (BMSs) in the COMFORTABLE trial (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction) were sustained during long-term follow-up.

15 abril 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Pharmacology. Heparin Monotherapy or Bivalirudin During Percutaneous Coronary Intervention in Patients With Non–ST-Segment–Elevation Acute Coronary Syndromes or Stable Ischemic Heart Disease

Sripal Bangalore, MD, MHA, Michael J. Pencina, PhD, Neal S. Kleiman, MD and David J. Cohen, MD, MSc

Background: The use of bivalirudin versus unfractionated heparin monotherapy in patients without ST-segment–elevation myocardial infarction is not well defined.

27 mayo 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Congenital Heart Disease. Use and Performance of the Melody Transcatheter Pulmonary Valve in Native and Postsurgical, Nonconduit Right Ventricular Outflow Tracts

Jeffery J. Meadows, MD, Phillip M. Moore, MD, Darren P. Berman, MD, John P. Cheatham, MD, Sharon L. Cheatham, NP, PhD, Diego Porras, MD, Matthew J. Gillespie, MD, Jonathan J. Rome, MD, Evan M. Zahn, MD and Doff B. McElhinney, MD

Background: Melody Transcatheter Pulmonary Valve (TPV) replacement therapy represents an important advance in congenital cardiovascular interventions. The off-label extension of the Melody TPV to patients with nonconduit outflow tracts (right ventricular outflow tract [RVOT]) has the potential to vastly expand the population of patients eligible to benefit from nonsurgical restoration of RVOT function. However, knowledge on the performance of the Melody TPV in this setting is limited.

29 abril 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Relationship Between Valve Calcification and Long-Term Results of Percutaneous Mitral Commissurotomy for Rheumatic Mitral Stenosis

Claire Bouleti, MD, PhD, Bernard Iung, MD, Dominique Himbert, MD, David Messika-Zeitoun, MD, PhD, Eric Brochet, MD, Eric Garbarz, MD, Bertrand Cormier, MD and Alec Vahanian, MD

Background: Indications of percutaneous mitral commissurotomy (PMC) remain debated in calcific mitral stenosis. We analyzed long-term results of PMC for calcific mitral stenosis and the factors associated with late functional results.

03 junio 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Acute Changes of Mitral Valve Geometry During Interventional Edge-to-Edge Repair With the MitraClip System Are Associated With Midterm Outcomes in Patients With Functional Valve Disease

Robert Schueler, MD, Diana Momcilovic, MD, Marcel Weber, MD, Armin Welz, MD, Nikos Werner, MD, Cornelius Mueller, MD, Alexander Ghanem, MD, Georg Nickenig, MD and Christoph Hammerstingl, MD

Background: Transcatheter mitral valve repair (TMVR) is a treatment option in patients with symptomatic functional or degenerative mitral regurgitation (DMR) at high surgical risk. The acute effect of MitraClip procedure on mitral valve (MV) annular geometry and its relation to functional outcomes is unclear. We sought to assess immediate effect of TMVR on MV annular geometry with 3-dimensional (3D) transesophageal echocardiography and the association of MV diameter reduction with functional response after 6 months.

01 septiembre 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Contemporary Reviews in Interventional Cardiology. Percutaneous Transcatheter Mitral Valve Replacement. An Overview of Devices in Preclinical and Early Clinical Evaluation

Ole De Backer, MD, PhD, Nicolo Piazza, MD, PhD, Shmuel Banai, MD, Georg Lutter, MD, PhD, Francesco Maisano, MD, Howard C. Herrmann, MD, Olaf W. Franzen, MD and Lars Søndergaard, MD, DMSc

Introduction: Mitral regurgitation (MR) is one of the most prevalent valvular heart diseases in Western countries. The current estimated prevalence of moderate and severe MR in the United States is 2 to 2.5 million, and it is expected that this number will rise to 5 million by 2030.1 Surgical intervention is recommended for symptomatic severe MR or asymptomatic severe MR with left ventricular (LV) dysfunction.2 Treatment of degenerative MR has evolved from mitral valve (MV) replacement to MV repair because of superior long-term outcomes after repair.2–4 For functional MR, however, the benefit over MV replacement is less certain.5 In addition, minimally invasive MV surgery has become a well-established and increasingly used option for managing patients with MV pathology.6

01 septiembre 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Images and Case Reports in Interventional Cardiology. Bilateral Embolic Protection Devices for High-Risk Cardiac Surgery in a Patient With Recent Embolic Stroke

Peter Downey, MD, Adrian Zalewski, BSc, Hiroo Takayama, MD, Ajay Kirtane, MD, Anthony Pucillo, MD, William Gray, MD and Ziad A. Ali, MD, DPhil

Introduction: Cerebral embolic protection devices (EPDs) such as carotid filters were first introduced as an adjunct to carotid artery stenting out of concern for increased rates of procedure-related atheromatous plaque embolization compared with carotid endarterectomy. Here, we report the use of a carotid filter device for embolic protection during high-risk coronary artery bypass grafting and ventricular assist device explantation in a patient with a recent history of embolic cerebrovascular accident from severe aortic atherosclerosis.

01 septiembre 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Images and Case Reports in Interventional Cardiology. Percutaneous Transjugular Removal of an Intracardial Bone Cement Fragment After Dorsal Stabilization

Stephan Wiedemann, MD, Bernd Ebner, MD, Karim Ibrahim, MD, Lisa Scherf, MD, Felix M. Heidrich, MD and Ruth H. Strasser, MD, PhD

Introduction: A 79-year-old woman was admitted to our center for atypical angina pectoris with chest pains worse at coughing. Her medical history revealed a dorsal stabilization of 3 lumbar vertebral bodies, 5 months ago. Laboratories showed moderate elevation of high-sensitive troponin T. Therefore, a coronary angiography was performed and ruled out significant coronary artery stenoses. However, fluoroscopy showed a toothpick-shaped structure of ≈9 cm reaching from the superior vena cava down to the diaphragmal base of the right ventricle (RV; Figure [A] and [B]). Chest x-ray and 3-dimensional echocardiography confirmed the presence of a toothpick-like structure within the RV, along with a small pericardial effusion (Figure [C–E]; see Movie IA and IB in the Data Supplement). In-depth investigation of the patient’s medical record revealed usage of bone cement (polymethylmethacrylate [PMMA]) during the orthopedic procedure 5 months ago. A computed tomographic scan was performed, and 3-dimensional reconstruction showed multiple pulmonary emboli of identical Hounsfield units in addition to the structure in the RV (Figure [F] and [G]). Considering the patient’s medical history, we hypothesized the visualized structures being PMMA fragments accidentally penetrating into the paravertebral venous system causing consecutive cardiopulmonary embolism after the orthopedic procedure. For retrieval, open heart surgery was declined by the patient.