01 febrero 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Immediate Results and Long-Term Clinical Outcome of Patients With Unprotected Distal Left Main Restenosis. The CORPAL Registry (Córdoba and Las Palmas)

Soledad Ojeda, MD, PhD∗; Manuel Pan, MD, PhD∗; Pedro Martín, MD, PhD†; Francisco Mazuelos, MD, PhD∗; Javier Suárez de Lezo, MD, PhD∗; Miguel Romero, MD, PhD∗; José Segura, MD, PhD∗; Djordje Pavlovic, MD, PhD∗; Alfonso Medina, MD, PhD†; Jose Suárez de Lezo, MD, PhD∗

Objectives: The goal of this study was to assess the immediate and long-term outcomes in patients undergoing percutaneous coronary intervention (PCI) for in-stent restenosis (ISR) in an unprotected distal left main coronary artery (UDLM).

01 febrero 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Effect of Valve Design on the Stent Internal Diameter of a Bioprosthetic Valve. A Concept of True Internal Diameter and Its Implications for the Valve-in-Valve Procedure

Vinayak N. Bapat, MD; Rizwan Attia, MD; Martyn Thomas, MD

The goal of this study was to provide a measurement of the true internal diameter (ID) of various surgical heart valves (SHV) to facilitate the valve-in-valve (VIV) procedure. During a VIV procedure, it is important to choose the right of the transcatheter heart valve (THV). Most users use the stent ID of an SHV to select the appropriate THV size. Echocardiography and computed tomography measurements are not yet standardized for measuring the ID of a variety of SHVs. Hence, we measured the true ID of SHV to assess the effect of valve design on the stent ID. Thirteen types of stented and 3 types of stentless valves were evaluated. True ID measurements were obtained using calipers and Hegar dilators. These were compared with the stent ID measurements. Fluoroscopy was used to confirm the impact of SHV designs on the true ID. Caliper measurements were found to be inaccurate and are hence not recommended. Hegar dilator measurements revealed a trend of reduction in stent ID. Porcine valves were most affected by their design, with reduction in the stent ID by at least 2 mm; pericardial valves with leaflets sutured inside the stent had the stent ID reduced by at least 1 mm, and SHV with leaflets sutured outside the stent had no effect on stent ID. In the majority of SHV designs, there is a reduction in the stent ID as a result of leaflet tissue. This is important in borderline sizes to avoid problems associated with oversizing and also to confirm suitability for the VIV procedure in the smaller label sizes of SHV.

01 febrero 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of New-Onset Persistent Left Bundle Branch Block on Late Clinical Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation With a Balloon-Expandable Valve

Marina Urena, MD∗; John G. Webb, MD†; Asim Cheema, MD‡; Vicenç Serra, MD§; Stefan Toggweiler, MD†; Marco Barbanti, MD†; Anson Cheung, MD†; Jian Ye, MD†; Eric Dumont, MD∗; Robert DeLarochellière, MD∗; Daniel Doyle, MD∗; Hatim A. Al Lawati, MD†; Marc Peterson, MD‡; Robert Chisholm, MD‡; Albert Igual, MD§; Henrique Barbosa Ribeiro, MD∗; Luis Nombela-Franco, MD∗; François Philippon, MD∗; Bruno Garcia del Blanco, MD§; Josep Rodés-Cabau, MD∗

Objectives: The aim of this study was to determine the impact of new-onset persistent left bundle branch block (NOP-LBBB) on late outcomes after transcatheter aortic valve implantation (TAVI).

01 febrero 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Left Bundle Branch Block After Transcatheter Aortic Valve Implantation. Still a Matter of Concern?

Laurent Roten, MD; Bernhard Meier, MD

Transcatheter aortic valve implantation (TAVI) has experienced unprecedented growth since its first description by Alain Cribier in 2002 1 and is now routinely performed in many institutions worldwide. New-onset left bundle branch block (LBBB) or atrioventricular (AV) block necessitating permanent pacemaker implantation (PPI) are among the most frequent complications of TAVI (2,3,4,5). Case reports describing late occurrence of complete AV block and the fact that LBBB has been associated with a worse outcome after surgical aortic valve implantation led clinicians to adopt a generous strategy of pacemaker implantation after TAVI. This strategy was further enhanced by the urge to ambulate patients early after TAVI instead of prolonged monitoring for resolution of AV conduction impairment. Improvement of valve design and implant strategy has lowered the rate of AV conduction abnormalities, but they continue to be a matter of concern. Moreover, new-onset LBBB after TAVI was associated with increased mortality in a study by Houthuizen et al. (3), whereas others have found no association (4,6,7,8). Additional insights into the outcome of patients with LBBB after TAVI are therefore needed.

01 febrero 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Usefulness of Baseline Activated Clotting Time–Guided Heparin Administration in Reducing Bleeding Events During Transfemoral Transcatheter Aortic Valve Implantation

Chiara Bernelli, MD∗; Alaide Chieffo, MD∗; Matteo Montorfano, MD∗; Francesco Maisano, MD†; Gennaro Giustino, MS∗; Gill Louise Buchanan, MBChB∗; Jaclyn Chan, MBBS∗; Charis Costopoulos, MD∗; Azeem Latib, MD∗; Filippo Figini, MD∗; Ermelinda De Meo, MS∗; Francesco Giannini, MD∗; Remo Daniel Covello, MD†; Chiara Gerli, MD†; Annalisa Franco, MD†; Eustachio Agricola, MD‡; Pietro Spagnolo, MD†; Micaela Cioni, MD†; Ottavio Alfieri, MD†; Paolo Guido Camici, MD‡; Antonio Colombo, MD∗

Objectives: This study sought to evaluate the impact of baseline activated clotting time (ACT)–guided heparin administration on major bleeding after transfemoral transcatheter aortic valve implantation (TAVI).

01 febrero 2014

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Outcomes Causes of Short-Term Readmission After Percutaneous Coronary Intervention

Jason H. Wasfy, MD, MPhil, Jordan B. Strom, MD, Cashel O’Brien, BA, Adrian H. Zai, MD, PhD, MPH, Jennifer Luttrell, MBA, Kevin F. Kennedy, MS, John A. Spertus, MD, MPH, Katya Zelevinsky, BA, Sharon-Lise T. Normand, PhD, Laura Mauri, MD, MSc and Robert W. Yeh, MD, MSc

Background: Rehospitalization within 30 days after an admission for percutaneous coronary intervention (PCI) is common, costly, and a future target for Medicare penalties. Causes of readmission after PCI are largely unknown.

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Percutaneous Left Atrial Appendage Occlusion for Stroke Prophylaxis in Nonvalvular Atrial Fibrillation. A Systematic Review and Analysis of Observational Studies

Navkaranbir Singh Bajaj, MD∗; Akhil Parashar, MD†; Shikhar Agarwal, MD, MPH†; Nishtha Sodhi, MD‡; Kanhaiya Lal Poddar, MD†; Aatish Garg, MD‡; E. Murat Tuzcu, MD†; Samir R. Kapadia, MD†

Objectives: The goal of this study was to provide a systematic review and analysis of observational studies on percutaneous left atrial appendage (LAA) occlusion for stroke prophylaxis in nonvalvular atrial fibrillation (NVAF).

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Intravascular Ultrasound-Guided Implantation of Drug-Eluting Stents to Improve Outcome

Jae-Sik Jang, MD, PhD∗; Yeo-Jeong Song, MD∗; Wook Kang, MD∗; Han-Young Jin, MD∗; Jeong-Sook Seo, MD, PhD∗; Tae-Hyun Yang, MD, PhD∗; Dae-Kyeong Kim, MD, PhD∗; Kyoung-Im Cho, MD, PhD†; Bo-Hyun Kim, MD, PhD‡; Yong Hyun Park, MD, PhD§; Hyung-Gon Je, MD, PhD§; Dong-Soo Kim, MD, PhD∗

Objectives: The aim of this study was to systematically review and perform a meta-analysis of randomized trials and observational studies of intravascular ultrasound (IVUS)-guided versus angiography-guided implantation of drug-eluting stents (DES).

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Clinical Impact of Intravascular Ultrasound Guidance in Drug-Eluting Stent Implantation for Unprotected Left Main Coronary Disease

Jose M. de la Torre Hernandez, MD, PhD∗; José A. Baz Alonso, MD†; Joan A. Gómez Hospital, MD, PhD‡; Fernando Alfonso Manterola, MD, PhD§; Tamara Garcia Camarero, MD∗; Federico Gimeno de Carlos, MD, PhD‖; Gerard Roura Ferrer, MD‡; Angel Sanchez Recalde, MD¶; Íñigo Lozano Martínez-Luengas, MD, PhD#; Josep Gomez Lara, MD‡; Felipe Hernandez Hernandez, MD∗∗; María J. Pérez-Vizcayno, MD§; Angel Cequier Fillat, MD, PhD‡; Armando Perez de Prado, MD††; Agustín Albarrán Gonzalez-Trevilla, MD∗∗; Manuel F. Jimenez Navarro, MD, PhD‡‡; Josepa Mauri Ferre, MD§§; Jose A. Fernandez Diaz, MD‖‖; Eduardo Pinar Bermudez, MD, PhD¶¶; Javier Zueco Gil, MD∗

Objectives: This study sought to investigate the clinical impact of the use of intravascular ultrasound (IVUS) during revascularization of patients with left main coronary artery (LM) disease with drug-eluting stents (DES).

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Differential Prognostic Impact of Treatment Strategy Among Patients With Left Main Versus Non–Left Main Bifurcation Lesions Undergoing Percutaneous Coronary Intervention. Results From the COBIS (Coronary Bifurcation Stenting) Registry II

Young Bin Song, MD, 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∗; Myung-Ho Jeong, MD, PhD†; Hyo-Soo Kim, MD, PhD‡; Jae-Hwan Lee, MD, PhD§; Cheol Woong Yu, MD, PhD‖; Seung Woon Rha, MD, PhD¶; Yangsoo Jang, MD, PhD#; Jung Han Yoon, MD, PhD∗∗; Seung-Jea Tahk, MD, PhD††; Ki Bae Seung, MD, PhD‡‡; Ju Hyeon Oh, MD, PhD§§; Jong-Seon Park, MD, PhD‖‖; Hyeon-Cheol Gwon, MD, PhD∗

Objectives: The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions.

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of Nonculprit Vessel Myocardial Perfusion on Outcomes of Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndromes. Analysis From the ACUITY Trial (Acute Catheterization and Urgent Intervention Triage Strategy)

Alexandra J. Lansky, MD∗; Vivian G. Ng, MD∗; Stephanie Meller, MD∗; Ke Xu, PhD†; Martin Fahy, MSc†; Frederick Feit, MD‡; E. Magnus Ohman, MD§; Harvey D. White, MD‖; Roxana Mehran, MD¶; Michel E. Bertrand, MD#; Walter Desmet, MD∗∗; Martial Hamon, MD††; Gregg W. Stone, MD†

Objectives: This study evaluated the impact of nonculprit vessel myocardial perfusion on outcomes of non–ST-segment elevation acute coronary syndromes (NSTE-ACS) patients.

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Utilization of Radial Artery Access for Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in New York

Edward L. Hannan, PhD∗; Louise Szypulski Farrell, MS∗; Gary Walford, MD†; Peter B. Berger, MD‡; Nicholas J. Stamato, MD§; Ferdinand J. Venditti, MD‖; Alice K. Jacobs, MD¶; David R. Holmes, MD#; Samin Sharma, MD∗∗; Spencer B. King, MD††

Objectives: This study sought to determine the utilization and outcomes for radial access for percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in common practice.

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Aortic Regurgitation After Transcatheter Aortic Valve Implantation With Balloon- and Self-Expandable Prostheses

Mohamed Abdel-Wahab, MD∗; Thomas Comberg, MD†; Heinz Joachim Büttner, MD†; Mohamed El-Mawardy, MD∗; Kenichi Chatani, MD∗; Michael Gick, MD†; Volker Geist, MD∗; Gert Richardt, MD∗; Franz-Josef Neumann, MD†

Objectives: This study sought to assess aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) with the self-expandable Medtronic CoreValve (MCV) (Medtronic Inc., Minneapolis, Minnesota) versus balloon-expandable Edwards Sapien XT valve (ESV) (Edwards Lifesciences, Irvine, California).

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Comparison of Medtronic CoreValve and Edwards Sapien XT for Transcatheter Aortic Valve Implantation. The Need for an Imaging-Based Personalized Approach in Device Selection

Javaid Iqbal, PhD†; Patrick W. Serruys, MD, PhD†

Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of symptomatic severe aortic stenosis in patients at a high risk of surgical valve replacement 1. The 2 main devices in clinical use at present are the self-expandable Medtronic CoreValve (MCV) (Medtronic, Minneapolis, Minnesota) and balloon-expandable Edwards SAPIEN XT valve (ESV) (Edwards Lifesciences, Irvine, California). Paravalvular aortic regurgitation (AR) is not an uncommon complication after TAVI, and suboptimal device sizing and positioning are the main culprits

01 marzo 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Evaluation of the Biodegradable Peripheral Igaki-Tamai Stent in the Treatment of De Novo Lesions in the Superficial Femoral Artery. The GAIA Study

Martin Werner, MD∗; Antonio Micari, MD, PhD†; Angelo Cioppa, MD‡; Giuseppe Vadalà, MD†; Andrej Schmidt, MD∗; Horst Sievert, MD§; Paolo Rubino, MD‡; Annalisa Angelini, MD‖; Dierk Scheinert, MD∗; Giancarlo Biamino, MD, PhD†

Objectives: This study sought to evaluate the safety and performance of the Igaki-Tamai (Igaki Medical Planning Company, Kyoto, Japan) biodegradable stent in patients with occlusive superficial femoral artery (SFA) disease.