01 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. One-year follow-up of patients treated with new-generation polymer-based 38 mm everolimus-eluting stent: The P38 study

Gregory A. Sgueglia MD, PhD1,*, Flavia Belloni MD2, Francesco Summaria MD3, Micaela Conte MD4, Bernardo Cortese MD5, Pedro Leon Silva MD5, Roberto Ricci MD2, Ernesto Lioy MD3, Edoardo Pucci MD4 andAchille Gaspardone MD, MPhil1

Objectives: To assess the clinical outcome at 1-year follow-up of real-world patients with long coronary lesions treated with the 38 mm Xience Prime (Abbott Vascular) everolimus-eluting stent (EES).

01 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. A novel technique for transcatheter patent ductus arteriosus closure in extremely preterm infants using commercially available technology

Evan M. Zahn MD1,3,*, Phillip Nevin RN3, Charles Simmons MD2 andRuchira Garg MD1,3

Objectives: To describe a new technique for transcatheter patent ductus arteriosus (PDA) closure in extremely preterm infants using commercially available technology.

01 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Unzipping of small diameter stents: An in vitro study

Shyam K. Sathanandam MD*, Lauren M. Haddad MD, Saradha Subramanian MD, Dena Wright RN, Ranjit Philip MD andBenjamin Rush Waller MD

Objective: The purpose of this study was to determine if small-diameter stents can be unzipped in vitro.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. One-year outcome from an all-comers population of patients with ST-segment elevation myocardial infarction treated with biolimus-eluting stent with biodegradable polymer

Fabrizio Tomai MD, FACC, FESC1,*, Leonardo De Luca MD, PHD, FACC1, Luca Altamura MD1, Francesco Versaci MD, FACC2, Mauro Pennacchi MD3, Igino Proietti MD4, Anna S. Ghini MD, PHD1, Pierfrancesco Corvo MD1, Giovanni De Persio MD1, Alessandro Petrolini MD1, Antonella Tommasino MD5 andGennaro Sardella MD3

Objectives: To evaluate the performance of biolimus-eluting stent (BES) in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in a real world clinical scenario.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Sex-based differences in bleeding and long term adverse events after percutaneous coronary intervention for acute myocardial infarction: Three year results from the HORIZONS-AMI trial

Jennifer Yu MBBS1,2, Roxana Mehran MD1,3,*, Liliana Grinfeld MD4, Ke Xu PhD3, Eugenia Nikolsky MD, PhD5, Bruce R. Brodie MD6, Bernhard Witzenbichler MD7, Ran Kornowski MD8, George D. Dangas MD, PhD1,3, Alexandra J. Lansky MD9 andGregg W. Stone MD3,10

Background: Studies have shown sex-based disparities in ST-segment elevation myocardial infarction (STEMI) management and prognosis. We sought to compare women and men undergoing primary percutaneous coronary intervention (PCI) for STEMI in a large, prospective, contemporary context.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Femoral vascular closure device use, bivalirudin anticoagulation, and bleeding after primary angioplasty for STEMI: Results from the HORIZONS-AMI trial

Timothy A. Sanborn MS, MD1,*, Matthew I. Tomey MD2, Roxana Mehran MD2,3, Philippe Généreux MD3,4,5, Bernhard Witzenbichler MD6, Sorin J. Brener MD3,7, Ajay J. Kirtane MD, SM3,4, Thomas C. McAndrew MS3, Ran Kornowski MD8, Dariusz Dudek MD9, Eugenia Nikolsky MD, PhD10 andGregg W. Stone MD3,4

Objective: To assess the relationship of femoral vascular closure device (VCD) use to bleeding and ischemic events in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) via different anticoagulation strategies.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Chronic total occlusion percutaneous coronary intervention case selection and techniques for the antegrade-only operator

Stéphane Rinfret MD, SM1,*, Dominique Joyal MD2, James C. Spratt MD3 andChristopher E. Buller MD4

Coronary chronic total occlusions (CTO) remain a difficult lesion subset to treat. Although CTOs are present at coronary angiography in 15–20% of patients, only a small fraction of eligible patients will be offered percutaneous treatment. Recent publications from centers with dedicated CTO programs using the full range of antegrade and retrograde techniques suggest success rates in the range of 90% even when little anatomic exclusion are used. However, many patients with clinically appropriate CTO targets have simpler anatomy that can predictably be managed without the selected skills and equipment. The purpose of this review is to provide skilled percutaneous coronary intervention operators who have not specialized in complex retrograde CTO techniques, an algorithm for the selection and antegrade management of appropriate CTO cases. Core equipment and techniques are discussed. © 2014 Wiley Periodicals, Inc.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Percutaneous coronary intervention for acute myocardial infarction due to unprotected left main coronary artery occlusion

Michael S. Lee MD* andMufaddal Q. Dahodwala MD

Acute myocardial infarction (AMI) due to unprotected left main coronary artery (ULMCA) occlusion is an uncommon clinical entity, but often leads to severe clinical deterioration, with devastating sequalae including fatal arrhythmias, abrupt and severe circulatory failure, and sudden cardiac death. Recent guidelines have promoted treatment with percutaneous coronary intervention (PCI) as a class IIa recommendation alongside coronary artery bypass grafting (CABG), but the data are still unclear regarding optimal revascularization strategy for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) with ULMCA culprit. PCI has the advantages of offering rapid reperfusion to critically ill patients, often those with prohibitive risk for surgical revascularization, with acceptable short- and long-term outcomes. Recent studies demonstrate that PCI of the ULMCA is a viable alternative to CABG for appropriate patient populations, including those with ULMCA occlusion and those in cardiogenic shock, Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and significant comorbidities. A randomized trial comparing PCI with CABG is needed to clarify the ideal revascularization strategy, though the clinical picture of these critically ill patients may preclude such studies. © 2014 Wiley Periodicals, Inc.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Kidney injury and mortality after transcatheter aortic valve implantation in a routine clinical cohort

Renate B. Schnabel MD, MSC1,†,*, Moritz Seiffert MD1,†, Sandra Wilde BA1, Johannes Schirmer MD2, Dietmar H. Koschyk MD1, Lenard Conradi MD2, Francisco Ojeda Phd1, Stephan Baldus MD3, Hermann Reichenspurner MD2, Stefan Blankenberg MD1, Hendrik Treede MD2 andPatrick Diemert MD1

Objectives: We aimed at identifying predictors of renal impairment and its impact on long-term outcome after transcatheter aortic valve implantation (TAVI).

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Impact of coronary artery disease on left ventricular ejection fraction recovery following transcatheter aortic valve implantation

Xavier Freixa MD, Jason Chan MD, Raoul Bonan MD, Ragui Ibrahim MD, Yoan Lamarche MD, Philippe Demers MD, Arsène Basmadjian MD, Réda Ibrahim MD, Raymond Cartier MD andAnita W. Asgar MD*

Objectives: The objective of the present study was to assess if the presence and severity of CAD is associated with decreased LVEF recovery after TAVI.

15 febrero 2015

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Blood transfusion is associated with impaired outcome after transcatheter aortic valve implantation

Moritz Seiffert MD1,†,*, Lenard Conradi MD2,†, Ann Christine Terstesse BS2, Dietmar Koschyk MD1, Johannes Schirmer MD2, Renate B. Schnabel MD, MSc1, Sandra Wilde BA1, Francisco M. Ojeda PhD1, Hermann Reichenspurner MD, PhD2, Stefan Blankenberg MD1, Ulrich Schäfer MD1, Hendrik Treede MD2 andPatrick Diemert MD1

Objectives: We sought to evaluate the relationship of blood transfusion after transcatheter aortic valve implantation (TAVI) and mid-term outcome to improve patient selection and periprocedural treatment.

01 diciembre 2014

JACC Incidence, Predictors, and Prognostic Impact of Late Bleeding Complications After Transcatheter Aortic Valve Replacement

Philippe Généreux, MD∗; David J. Cohen, MD, MSc§; Michael Mack, MD‖; Josep Rodes-Cabau, MD¶; Mayank Yadav, MD†; Ke Xu, PhD†; Rupa Parvataneni, MS†; Rebecca Hahn, MD∗; Susheel K. Kodali, MD∗; John G. Webb, MD#; Martin B. Leon, MD∗

Background: The incidence and prognostic impact of late bleeding complications after transcatheter aortic valve replacement (TAVR) are unknown.

01 diciembre 2014

JACC. The Evolution of Percutaneous Mitral Valve Repair Therapy. Lessons Learned and Implications for Patient Selection

Roy Beigel, MD∗; Nina C. Wunderlich, MD§; Saibal Kar, MD∗; Robert J. Siegel, MD∗

Abstract: Mitral regurgitation (MR) is the most common valve disease in the United States. However, a significant number of patients are denied surgery due to increased age, poor ventricular function, or associated comorbidities, putting them at high risk for adverse events. Moreover, the benefit of surgery for MR is unclear in patients with functional (secondary) MR. Recently, percutaneous repair of the mitral valve with a particular device (MitraClip, Abbott, Menlo Park, California) has emerged as a novel therapeutic option for patients with secondary MR or those deemed to be high risk for surgery. We review data from its initial concept through clinical trials and current data available from several registries. We focused on lessons learned regarding adequate patient selection, along with current and future perspectives on the use of device therapy for the treatment of MR.

01 enero 2015

JACC. Cost-Effectiveness of Revascularization Strategies. The ASCERT Study

Zugui Zhang, PhD∗; Paul Kolm, PhD∗; Maria V. Grau-Sepulveda, MD, MPH†; Angelo Ponirakis, PhD‡; Sean M. O’Brien, PhD†; Lloyd W. Klein, MD§; Richard E. Shaw, PhD‖; Charles McKay, MD¶; David M. Shahian, MD#; Frederick L. Grover, MD∗∗; John E. Mayer, MD‡‡; Kirk N. Garratt, MD, MSc§§; Mark Hlatky, MD‖‖; Fred H. Edwards, MD¶¶; William S. Weintraub, MD∗

Background: ASCERT (American College of Cardiology Foundation and the Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies) was a large observational study designed to compare the long-term effectiveness of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) to treat coronary artery disease (CAD) over 4 to 5 years.

01 enero 2015

JACC. Bivalirudin Versus Heparin With or Without Glycoprotein IIb/IIIa Inhibitors in Patients With STEMI Undergoing Primary Percutaneous Coronary Intervention. Pooled Patient-Level Analysis From the HORIZONS-AMI and EUROMAX Trials

Gregg W. Stone, MD∗; Roxana Mehran, MD†; Patrick Goldstein, MD‡; Bernhard Witzenbichler, MD§; Arnoud van’t Hof, MD‖; Giulio Guagliumi, MD¶; Christian W. Hamm, MD#; Philippe Généreux, MD∗∗; Peter Clemmensen, MD‡‡; Stuart J. Pocock, PhD§§; Bernard J. Gersh, MB, ChB, DPhil‖‖; Debra Bernstein, PhD¶¶; Efthymios N. Deliargyris, MD¶¶; Philippe Gabriel Steg, MD##

Background: In the HORIZONS-AMI (Harmonizing Outcomes with RevasculariZatiON and Stents in Acute Myocardial Infarction) trial, 3,602 patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) treated with bivalirudin had lower bleeding and mortality rates, but higher acute stent thrombosis rates compared with heparin + a glycoprotein IIb/IIIa inhibitor (GPI). Subsequent changes in primary PCI, including the use of potent P2Y12 inhibitors, frequent radial intervention, and pre-hospital medication administration, were incorporated into the EUROMAX (European Ambulance Acute Coronary Syndrome Angiography) trial, which assigned 2,218 patients to bivalirudin versus heparin ± GPI before primary PCI.