01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Relationship Between Subclinical Cardiac Troponin I Elevation and Culprit Lesion Characteristics Assessed by Optical Coherence Tomography in Patients Undergoing Elective Percutaneous Coronary Intervention

Tetsumin Lee, MD, Tadashi Murai, MD, Taishi Yonetsu, MD, Asami Suzuki, MD, Keiichi Hishikari, MD, Yoshihisa Kanaji, MD, Junji Matsuda, MD, Makoto Araki, MD, Takayuki Niida, MD, Mitsuaki Isobe, MD and Tsunekazu Kakuta, MD

Background: The prevalence of subclinical, cardiac troponin I (cTnI) elevation in stable patients undergoing elective percutaneous coronary intervention and its relationship to culprit lesion characteristics assessed by optical coherence tomography (OCT) are unknown.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Physiologic Assessment and Imaging. Collateral Donor Artery Physiology and the Influence of a Chronic Total Occlusion on Fractional Flow Reserve

Andrew Ladwiniec, MA, MRCP, Michael S. Cunnington, BMedSci, MD, MRCP, Jennifer Rossington, BSc, MRCP, Adam N. Mather, BMedSci, MD, MRCP, Albert Alahmar, MRCP, Richard M. Oliver, DM, FRCP, Sukhjinder S. Nijjer, MRCP, Justin E. Davies, PhD, MRCP, Simon Thackray, MD, MRCP, Farquad Alamgir, MRCP and Angela Hoye, PhD, MRCP

Background: The presence of a concomitant chronic total coronary occlusion (CTO) and a large collateral contribution might alter the fractional flow reserve (FFR) of an interrogated vessel, rendering the FFR unreliable at predicting ischemia should the CTO vessel be revascularized and potentially affecting the decision on optimal revascularization strategy. We tested the hypothesis that donor vessel FFR would significantly change after percutaneous coronary intervention of a concomitant CTO.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Access and Non–Access Site Bleeding After Percutaneous Coronary Intervention and Risk of Subsequent Mortality and Major Adverse Cardiovascular Events

Chun Shing Kwok, MRCP, Muhammad A. Khan, MRCP, Sunil V. Rao, MD, Tim Kinnaird, MD, Matt Sperrin, PhD, Iain Buchan, MD, Mark A. de Belder, MD, Peter F. Ludman, MD, James Nolan, MD, Yoon K. Loke, MD and Mamas A. Mamas, DPhil, MRCP

Background: The prognostic impact of site-specific major bleeding complications after percutaneous coronary intervention (PCI) has yielded conflicting data. The aim of this study is to provide an overview of site-specific major bleeding events in contemporary PCI and study their impact on mortality and major adverse cardiovascular event outcomes.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Anatomic Characteristics and Clinical Implications of Angiographic Coronary Thrombus

Carlos M. Campos, MD, Francesco Costa, MD, Hector M. Garcia-Garcia, MD, PhD, Christos Bourantas, MD, PhD, Pannipa Suwannasom, MD, Marco Valgimigli, MD, PhD, Marie-Angele Morel, BSc, Stephan Windecker, MD, PhD and Patrick W. Serruys, MD, PhD

Background: The distribution of thrombus-containing lesions (TCLs) in an all-comer population admitted with a heterogeneous clinical presentation (stable, ustable angina, or an acute coronary syndrome) and treated with percutaneous coronary intervention is yet unclear, and the long-term prognostic implications are still disputed. This study sought to assess the distribution and prognostic implications of coronary thrombus, detected by coronary angiography, in a population recruited in all-comer percutaneous coronary intervention trials.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Cerebrovascular Events After a Primary Percutaneous Coronary Intervention Strategy for Acute ST-Segment– Elevation Myocardial Infarction

Eugenia Nikolsky, MD, PhD, Roxana Mehran, MD, George D. Dangas, MD, PhD, Ke Xu, PhD, Rupa Parvataneni, MS, Bernhard Witzenbichler, MD, Giulio Guagliumi, MD, Ran Kornowski, MD, Philippe Généreux, MD, Sorin J. Brener, MD and Gregg W. Stone, MD

Background: Patients with ST-segment–elevation myocardial infarction are at increased risk of cerebrovascular events. We assessed the incidence, predictors, and implications of cerebrovascular events in patients with ST-segment–elevation myocardial infarction managed with a primary percutaneous coronary intervention strategy.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Safety and Efficacy of Resolute Zotarolimus-Eluting Stents Compared With Everolimus-Eluting Stents

Raffaele Piccolo, MD*, Giulio G. Stefanini, MD*, Anna Franzone, MD, Ernest Spitzer, MD, Stefan Blöchlinger, MD, Dik Heg, PhD, Peter Jüni, MD and Stephan Windecker, MD

Background: Although new-generation drug-eluting stents represent the standard of care among patients undergoing percutaneous coronary intervention, there remains debate about differences in efficacy and the risk of stent thrombosis between the Resolute zotarolimus-eluting stent (R-ZES) and the everolimus-eluting stent (EES). The aim of this study was to evaluate the safety and efficacy of the R-ZES compared with EES in patients undergoing percutaneous coronary intervention.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Cardiac Catheterization. Efficacy and Safety of a Novel Bioabsorbable Polymer-Coated, Everolimus-Eluting Coronary Stent

Dean J. Kereiakes, MD, Ian T. Meredith, AM, MBBS, PhD, Stephan Windecker, MD, R. Lee Jobe, MD, Shamir R. Mehta, MD, Ian J. Sarembock, MBChB, MD, Robert L. Feldman, MD, Bernardo Stein, MD, Christophe Dubois, MD, PhD, Timothy Grady, DO, Shigeru Saito, MD, Takeshi Kimura, MD, Thomas Christen, MD, PhD, Dominic J. Allocco, MD and Keith D. Dawkins, MD

Background: Drug eluting stents with durable polymers may be associated with hypersensitivity, delayed healing, and incomplete endothelialization, which may contribute to late/very late stent thrombosis and the need for prolonged dual antiplatelet therapy. Bioabsorbable polymers may facilitate stent healing, thus enhancing clinical safety. The SYNERGY stent is a thin-strut, platinum chromium metal alloy platform with an ultrathin bioabsorbable Poly(D,L-lactide-co-glycolide) abluminal everolimus-eluting polymer. We performed a multicenter, randomized controlled trial for regulatory approval to determine noninferiority of the SYNERGY stent to the durable polymer PROMUS Element Plus everolimus-eluting stent.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Structural Heart Disease. Consequence of Cerebral Embolism After Transcatheter Aortic Valve Implantation Compared With Contemporary Surgical Aortic Valve Replacement

Akhlaque Uddin, MBChB, Timothy A. Fairbairn, PhD, Ibrahim K. Djoukhader, MBBS, Mark Igra, MBBS, Ananth Kidambi, BM, BCh, Manish Motwani, MBChB, Bernhard Herzog, MD, David P. Ripley, MBChB, Tarique Al Musa, MBBS, Anthony J.P. Goddard, FRCR, Daniel J. Blackman, MD, Sven Plein, PhD and John P. Greenwood, PhD

Background: Incidence of cerebral microinfarcts is higher after transcatheter aortic valve implantation (TAVI) compared with surgical aortic valve replacement (SAVR). It is unknown whether these lesions persist and what direct impact they have on health-related quality of life. The objective was to identify predictors of cerebral microinfarction and measure their effect on health-related quality of life during 6 months after TAVI when compared with SAVR.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Myocardial Infarction. Prospective, Multicenter, Randomized, Controlled Pilot Trial of Peritoneal Hypothermia in Patients With ST-Segment— Elevation Myocardial Infarction

Graham Nichol, MD, MPH, Warren Strickland, MD, David Shavelle, MD, Akiko Maehara, MD, Ori Ben-Yehuda, MD, Philippe Genereux, MD, Ovidiu Dressler, MD, Rupa Parvataneni, MS, Melissa Nichols, MS, John McPherson, MD, Gérald Barbeau, MD, Abhay Laddu, MD, Jo Ann Elrod, PhD, Griffeth W. Tully, MD, Russell Ivanhoe, MD and Gregg W. Stone, MD; for the VELOCITY Investigators

Background: Systemic hypothermia may reduce infarct size if established before reperfusion. The large surface area of the bowel may facilitate rapid hypothermia. We therefore examined the feasibility, safety, and efficacy of hypothermia induced by an automated peritoneal lavage system in patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Physiologic Assessment and Imaging. Doppler-Derived Intracoronary Physiology Indices Predict the Occurrence of Microvascular Injury and Microvascular Perfusion Deficits After Angiographically Successful Primary Percutaneous Coronary Intervention

Paul F.A. Teunissen, MD, Guus A. de Waard, MD, Maurits R. Hollander, MD, Lourens F.H.J. Robbers, MD, Ibrahim Danad, MD, P. Stefan Biesbroek, MD, Raquel P. Amier, MD, Mauro Echavarría-Pinto, MD, Alicia Quirós, PhD, Christopher Broyd, MD, PhD, Martijn W. Heymans, PhD, Robin Nijveldt, MD, PhD, Adriaan A. Lammertsma, PhD, Pieter G. Raijmakers, PhD, Cornelis P. Allaart, MD, PhD, Jorrit S. Lemkes, MD, Yolande E. Appelman, MD, PhD, Koen M. Marques, MD, PhD, Jean G.F. Bronzwaer, MD, PhD, Anton J.G. Horrevoets, PhD, Albert C. van Rossum, MD, PhD, Javier Escaned, MD, PhD, Aernout M. Beek, MD, PhD, Paul Knaapen, MD, PhD and Niels van Royen, MD, PhD

Background: A total of 40% to 50% of patients with ST-segment–elevation myocardial infarction develop microvascular injury (MVI) despite angiographically successful primary percutaneous coronary intervention (PCI). We investigated whether hyperemic microvascular resistance (HMR) immediately after angiographically successful PCI predicts MVI at cardiovascular magnetic resonance and reduced myocardial blood flow at positron emission tomography (PET).

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Coronary Interventions. Temporal Trends in Revascularization Strategy and Outcomes in Left Main Coronary Artery Stenosis

Seung-Jung Park, MD, PhD*, Jung-Min Ahn, MD*, Young-Hak Kim, MD, PhD, Duk-Woo Park, MD, PhD, Sung-Cheol Yun, PhD, Sung-Han Yoon, MD, Hyun Woo Park, MD, Mineok Chang, MD, Jong-Young Lee, MD, PhD, Soo-Jin Kang, MD, PhD, Seung-Whan Lee, MD, PhD, Cheol Whan Lee, MD, PhD and Seong-Wook Park, MD, PhD

Background: Changes over time in revascularization strategies and outcomes among patients with unprotected left main coronary artery stenosis remain largely unknown.

01 mayo 2015

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Congenital Heart Disease. Percutaneous Fetal Cardiac Catheterization Technique for Stenting the Foramen Ovale in a Midgestation Lamb Model

Andrew Edwards, MBBS, Alex Veldman, MD, Ilias Nitsos, PhD, Yuen Chan, MBBS, Nadine Brew, PhD, Mark Teoh, MBBS, Samuel Menahem, MD, Dietmar Schranz, MD* and Flora Y. Wong, PhD*

Background: Intact or highly restricted intra-atrial septum can be reliably diagnosed in the human fetus as early as 22 to 24 weeks of gestation. Fetal interventions targeting the atrial septum have used a direct approach through the atrial wall. Here, we report stenting of the foramen ovale with a large, open-cell stent via percutaneous access through the fetal hepatic vein in a sheep model.

01 marzo 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Transatrial Intrapericardial Tricuspid Annuloplasty

Toby Rogers, BM, BCh∗; Kanishka Ratnayaka, MD∗; Merdim Sonmez, PhD∗; Dominique N. Franson, BS∗; William H. Schenke, BA∗; Jonathan R. Mazal, MS∗; Ozgur Kocaturk, PhD∗; Marcus Y. Chen, MD∗; Anthony Z. Faranesh, PhD∗; Robert J. Lederman, MD∗

Objectives: This study sought to demonstrate transcatheter deployment of a circumferential device within the pericardial space to modify tricuspid annular dimensions interactively and to reduce functional tricuspid regurgitation (TR) in swine.

01 marzo 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Percutaneous Closure of a Large Ascending Aorta Pseudoaneurysm Due to Mediastinitis Using an Amplatzer Occluder Device

Manolis Vavuranakis, MD, PhD; Konstantinos Kalogeras, MD; Carmen Moldovan, MD; Sophia Vaina, MD, PhD; Dimitrios Vrachatis, MD; Maria Kariori, MD; Evelina Mpei, MD; Dimitrios Tousoulis, MD, PhD; Christodoulos Stefanadis, MD, PhD

A 63-year old man presented with chest pain. He had undergone coronary artery bypass graft surgery 15 years earlier and mitral valve repair due to severe regurgitation 6 months earlier with a simultaneous right internal mammary artery (RIMA) to left anterior descending artery graft. The early postoperative period was complicated by mediastinitis, which required surgical drainage. Due to persistent infection, a vacuum device was used to drain inflammatory fluid.

01 marzo 2015

JACC: CARDIOVASCULAR INTERVENTIONS. Severe Valve Deformation Following Cardiopulmonary Resuscitation in a Patient With a Transcatheter Aortic Valve

Creighton W. Don, MD, PhD; James M. McCabe, MD; Corinne L. Fligner, MD

An 87-year-old patient with severe aortic stenosis underwent transapical transcatheter aortic valve replacement with a 26-mm Edwards Sapien valve (Edwards Lifesciences, Irvine, California). Pre-operative imaging was notable for severe asymmetric calcification along the posterolateral aspect of the left ventricular outflow tract (LVOT) involving the intravalvular fibrous curtain (Figure 1).