01 diciembre 2014

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Cost-effectiveness of percutaneous coronary intervention with drug-eluting stents in patients with multivessel coronary artery disease compared to coronary artery bypass surgery five-years after intervention

Lisa Krenn MD1,†, Christoph Kopp MD1,†, Dietmar Glogar MD1, Irene M. Lang MD1, Georg Delle-Karth MD1, Thomas Neunteufl MD1, Gerhard Kreiner MD1, Alexandra Kaider MSc2, Jutta Bergler-Klein MD1, Aliasghar Khorsand MSc1, Mariam Nikfardjam MD1, Günther Laufer MD3, Gerald Maurer MD1 andMariann Gyöngyösi MD, PhD1,*

Objectives: Cost-effectiveness of percutaneous coronary intervention (PCI) using drug-eluting stents (DES), and coronary artery bypass surgery (CABG) was analyzed in patients with multivessel coronary artery disease over a 5-year follow-up.

01 diciembre 2014

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Extended follow-up following “full-metal jacket” percutaneous coronary interventions with drug-eluting stents

Sandeep Basavarajaiah MRCP, MD, Toru Naganuma MD, Azeem Latib MD, Tasuku Hasegawa MD, Andrew Sharp MD, Ahmed Rezq MD, Alessandro Sticchi MD, Filipo Figini MD, Antonio Amato MD* andAntonio Colombo MD

Objectives: To report very long-term follow-up of “Full-Metal Jacket” (FMJ) percutaneous coronary interventions (PCI) in long-diffuse coronary lesions with drug-eluting stents (DES).

01 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Initial experience with the cook formula balloon expandable stent in congenital heart disease

Daniel Quandt MD, Bharat Ramchandani MD, MRCP, Vinay Bhole MD, MRCPCH, Gemma Penford MRCP, Chetan Mehta MD, MRCP, Rami Dhillon MRCP andOliver Stumper MD, PhD*

Introduction: Balloon expandable stents are an integral part in the catheter treatment of congenital heart disease. In the growing child, stents require dilatation to greater diameters over time. The Cook Formula stent is a recent 316 stainless steel open-cell design licensed for peripheral vascular work.

01 enero 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Massive Coronary Aneurysm After Multiple Percutaneous Interventions. An Iatrogenic or Unpreventable Disaster?

Wei-Ting Chang, MD; Cheng-Han Lee, MD, PhD

A 38-year-old man presented at the emergency department with severe chest pain. He had no history of recent trauma or fever but had undergone percutaneous coronary intervention (PCI) several times for 3-vessel disease. Repeat in-stent restenosis (ISR) was detected during his last angioplasty 1 year ago. Electrocardiography revealed diffuse ST-segment elevation (Figure 1A), and coronary angiography, which was performed because of his high-risk status, demonstrated an aneurysm extending from the left main (LM) coronary artery to the left anterior descending (LAD) coronary artery (Figure 1B and Online Video 1). However, he refused surgical intervention until 1 month later, when he underwent treatment because of refractory chest pain and bacteremia caused by Staphylococcus aureus. Surprisingly, pre-operative coronary angiography and chest computed tomography revealed 2 rapidly growing mycotic aneurysms involving the LM coronary artery and the mid-LAD coronary artery. The aneurysms measured up to 29 × 56 mm, and 1 of them drained into the other (Figure 1C and Figure 1D, and Online Video 2). The operation revealed destroyed stents floating inside the massive aneurysms (Figure 1E and Figure 1F). Bypass surgery was performed successfully; however, the patient eventually died of multiorgan failure. An aggressive bacterial infection was detected in the pathological specimens (Figure 1G).

01 febrero 2014

JACC. Percutaneous Interventional Therapies for the Treatment of Patients With Severe Pulmonary Hypertension

Paul Bhamra-Ariza, MBBS, MD∗; Anne M. Keogh, MBBS, PhD∗; David W.M. Muller, MBBS, MD∗

Despite improvements in medical therapy, the overall prognosis of patients with severe pulmonary arterial hypertension remains poor. Heart-lung transplantation or bilateral lung transplantation is the final pathway for a minority. This paper describes both established and novel percutaneous interventional techniques that may palliate or bridge pulmonary hypertension patients to transplantation.

01 febrero 2014

JACC. Impact of Intraprocedural Stent Thrombosis During Percutaneous Coronary Intervention. Insights From the CHAMPION PHOENIX Trial (Clinical Trial Comparing Cangrelor to Clopidogrel Standard of Care Therapy in Subjects Who Require Percutaneous Coronary Intervention)

Philippe Généreux, MD∗; Gregg W. Stone, MD∗; Robert A. Harrington, MD§; C. Michael Gibson, MD‖; Ph. Gabriel Steg, MD¶; Sorin J. Brener, MD†; Dominick J. Angiolillo, MD, PhD∗∗; Matthew J. Price, MD††; Jayne Prats, PhD‡‡; Laura LaSalle, MPH†; Tiepu Liu, MD, PhD††; Meredith Todd, BSc††; Simona Skerjanec, PharmD††; Christian W. Hamm, MD§§; Kenneth W. Mahaffey, MD§; Harvey D. White, DSc‖‖; Deepak L. Bhatt, MD, MPH¶¶

Objectives: This study sought to evaluate the clinical impact of intraprocedural stent thrombosis (IPST), a relatively new endpoint.

01 marzo 2014

JACC. Prospective Multicenter Evaluation of the Direct Flow Medical Transcatheter Aortic Valve

Joachim Schofer, MD∗; Antonio Colombo, MD†; Silvio Klugmann, MD‡; Jean Fajadet, MD§; Federico DeMarco, MD‡; Didier Tchétché, MD§; Francesco Maisano, MD†; Giuseppe Bruschi, MD‡; Azeem Latib, MD†; Klaudija Bijuklic, MD∗; Neil Weissman, MD‖; Reginald Low, MD¶; Martyn Thomas, MD∗∗; Christopher Young, MD∗∗; Simon Redwood, MD∗∗; Michael Mullen, MD††; John Yap, MD††; Eberhard Grube, MD‡‡; Georg Nickenig, MD‡‡; Jan-Malte Sinning, MD‡‡; Karl Eugen Hauptmann, MD§§; Ivar Friedrich, MD§§; Michael Lauterbach, MD§§; Michael Schmoeckel, MD‖‖; Charles Davidson, MD¶¶; Thierry Lefevre, MD∗∗∗

Objectives: The study sought a prospective multicenter nonrandomized evaluation of the Direct Flow Medical (DFM) system for the treatment of severe aortic stenosis.

01 marzo 2014

JACC. Impact of Smoking on Long-Term Outcomes in Patients With Atherosclerotic Vascular Disease Treated With Aspirin or Clopidogrel. Insights From the CAPRIE Trial (Clopidogrel Versus Aspirin in Patients at Risk of Ischemic Events)

José L. Ferreiro, MD∗; Deepak L. Bhatt, MD, MPH‡; Masafumi Ueno, MD, PhD∗; Deborah Bauer, MS§; Dominick J. Angiolillo, MD, PhD∗

Objectives: The goal of this study was to investigate the differential efficacy of clopidogrel or aspirin monotherapy according to smoking status in patients with atherosclerotic vascular disease.

01 marzo 2014

JACC. Percutaneous Mitral Valve Repair With the MitraClip System for Severe Mitral Regurgitation in Patients With Surgical Mitral Valve Repair Failure

Carmelo Grasso, MD†; Yohei Ohno, MD†; Guilherme F. Attizzani, MD†; Stefano Cannata, MD†; Sebastiano Immè, MD†; Marco Barbanti, MD†; Anna M. Pistritto, MD†; Margherita Ministeri, MD†; Anna Caggegi, MD†; Marta Chiarandà, MD†; Fabio Dipasqua, MD†; Giuseppe Ronsivalle, MD†; Sarah Mangiafico, MD†; Salvatore Scandura, MD†; Piera Capranzano, MD†; Davide Capodanno, MD†; Corrado Tamburino, MD, PhD†

Surgical mitral valve repair (SMVR) is the preferred intervention for patients with either symptomatic severe mitral regurgitation (MR) or asymptomatic severe MR and left ventricular dysfunction (1). The rate of freedom from severe MR 10 years after SMVR, however, is reported to be 70% (2), leading to a considerable number of mitral valve reinterventions, which carry substantial risk, particularly in elderly patients and in those with significant comorbidities.

01 marzo 2014

JACC. Transcatheter Therapies for Mitral Regurgitation. A Professional Society Overview From the American College of Cardiology, the American Association for Thoracic Surgery, Society for Cardiovascular Angiography and Interventions Foundation, and The Society of Thoracic Surgeons

Patrick T. O´Gara, MD, FACC; John H. Calhoon, MD; Marc R. Moon, MD, FACC; Carl L. Tommaso, MD, FACC, FSCAI

Transcatheter aortic valve replacement (TAVR) has transformed the care of patients with aortic stenosis. The dissemination of this technology after its approval in the United States in the wake of a pivotal randomized trial (1,) has thus far proceeded in a thoughtful and circumspect manner, guided by a coalition of stakeholders dedicated to the delivery of high-quality, patient-centered care. It is anticipated that a number of transcatheter therapies for mitral regurgitation (MR) will also become available for clinical use in selected patients. As an example, the MitraClip device (Abbott Vascular, Santa Clara, California) was approved October 24, 2013, for the reduction of significant (≥3+), symptomatic, degenerative MR in highly anatomically selected patients considered by an experienced heart team to be at prohibitive risk for mitral valve surgery. Other transcatheter approaches in development include mitral annulus–based therapies, transapical neochordal implants, valve-in-valve and valve-in-annuloplasty ring therapies, and valve replacement therapies.

01 marzo 2014

JACC. Pre-Operative Risk Factors of Bleeding and Stroke During Left Ventricular Assist Device Support. An Analysis of More Than 900 HeartMate II Outpatients

Andrew J. Boyle, MD∗; Ulrich P. Jorde, MD†; Benjamin Sun, MD‡; Soon J. Park, MD§; Carmelo A. Milano, MD‖; O. Howard Frazier, MD¶; Kartik S. Sundareswaran, PhD#; David J. Farrar, PhD#; Stuart D. Russell, MD∗∗

Objectives: This study sought to determine the pre-operative risk factors related to late bleeding, stroke, and pump thrombosis in patients with HeartMate II (HMII) left ventricular assist devices (LVADs) (Thoratec Corporation, Pleasanton, California) that might influence tailored improvements in patient management.

01 marzo 2014

JACC. Stratification of Outcomes After Transcatheter Aortic Valve Replacement According to Surgical Inoperability for Technical Versus Clinical Reasons

Raj R. Makkar, MD∗; Hasan Jilaihawi, MD∗; Michael Mack, MD†; Tarun Chakravarty, MD∗; David J. Cohen, MD, MSc‡; Wen Cheng, MD∗; Gregory P. Fontana, MD§; Joseph E. Bavaria, MD‖; Vinod H. Thourani, MD¶; Howard C. Herrmann, MD‖; Augusto Pichard, MD#; Samir Kapadia, MD∗∗; Vasilis Babaliaros, MD¶; Brian K. Whisenant, MD††; Susheel K. Kodali, MD‡‡; Mathew Williams, MD‡‡; Alfredo Trento, MD∗; Craig R. Smith, MD‡‡; Paul S. Teirstein, MD§§; Mauricio G. Cohen, MD‖‖; Ke Xu, PhD‡‡; E. Murat Tuzcu, MD#; John G. Webb, MD¶¶; Martin B. Leon, MD‡‡

Objectives: The goal of this study was to examine the impact of reasons for surgical inoperability on outcomes in patients undergoing transcatheter aortic valve replacement (TAVR).

01 marzo 2014

JACC. Off-Pump Transapical Implantation of Artificial Neo-Chordae to Correct Mitral Regurgitation. The TACT Trial (Transapical Artificial Chordae Tendinae) Proof of Concept

Joerg Seeburger, MD, PhD∗; Mauro Rinaldi, MD, PhD†; Sten Lyager Nielsen, MD‡; Stefano Salizzoni, MD†; Ruediger Lange, MD, PhD§; Markus Schoenburg, MD‖; Ottavio Alfieri, MD, PhD¶; Michael Andrew Borger, MD, PhD∗; Friedrich Wilhelm Mohr, MD, PhD∗; Audrius Aidietis, MD, PhD#

Objectives: The goal of this study was to evaluate the safety and performance of the NeoChord DS1000 system (NeoChord, Inc., Minneapolis, Minnesota).

01 marzo 2014

JACC. Procedural Volume and Outcomes With Radial or Femoral Access for Coronary Angiography and Intervention

Sanjit S. Jolly, MD, MSc∗; John Cairns, MD†; Salim Yusuf, MBBS, DPhil∗; Kari Niemela, MD, PhD‡; Philippe Gabriel Steg, MD§; Matthew Worthley, MD‖; Emile Ferrari, MD¶; Warren J. Cantor, MD#; Anthony Fung, MD†; Nicholas Valettas, MD, MSc∗; Michael Rokoss, MD∗; Goran K. Olivecrona, MD, PhD∗∗; Petr Widimsky, MD††; Asim N. Cheema, MD, PhD‡‡; Peggy Gao, MSc∗; Shamir R. Mehta, MD, MSc∗

Objectives: The study sought to evaluate the relationship between procedural volume and outcomes with radial and femoral approach.

01 marzo 2014

JACC. ST-Segment Elevation Myocardial Infarction Treated by Radial or Femoral Approach in a Multicenter Randomized Clinical Trial. The STEMI-RADIAL Trial

Ivo Bernat, MD, PhD∗; David Horak, MD†; Josef Stasek, MD, PhD‡; Martin Mates, MD, PhD§; Jan Pesek, MD∗; Petr Ostadal, MD, PhD§; Vlado Hrabos, MD†; Jaroslav Dusek, MD, PhD‡; Jiri Koza, MD∗; Zdenek Sembera, MD†; Miroslav Brtko, MD, PhD‡; Ondrej Aschermann, MD§; Michal Smid, MD, PhD∗; Pavel Polansky, MD‡; Abdul Al Mawiri, MD‡; Jan Vojacek, MD, PhD‡; Josef Bis, MD‡; Olivier Costerousse, PhD‖; Olivier F. Bertrand, MD, PhD‖; Richard Rokyta, MD, PhD∗

Objectives: This study sought to compare radial and femoral approaches in patients presenting with ST-segment elevation myocardial infarction (STEMI) and undergoing primary percutaneous coronary intervention (PCI) by high-volume operators experienced in both access sites.