01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Intravascular Ultrasound Guidance to Minimize the Use of Iodine Contrast in Percutaneous Coronary Intervention. The MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) Randomized Controlled Trial

José Mariani, MD∗; Cristiano Guedes, MD∗; Paulo Soares, MD, PhD∗; Silvio Zalc, MD, PhD∗; Carlos M. Campos, MD∗; Augusto C. Lopes, MD‡; André G. Spadaro, MD∗; Marco A. Perin, MD, PhD∗; Antonio Esteves Filho, MD∗; Celso K. Takimura, MD, PhD∗; Expedito Ribeiro, MD, PhD∗; Roberto Kalil-Filho, MD, PhD∗; Elazer R. Edelman, MD, PhD‡; Patrick W. Serruys, MD, PhD†; Pedro A. Lemos, MD, PhD∗

Objectives: The aim of this study was to evaluate the impact of intravascular ultrasound (IVUS) guidance on the final volume of contrast agent used in patients undergoing percutaneous coronary intervention (PCI).

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Pressure-Wire-Guided Percutaneous Transluminal Pulmonary Angioplasty. A Breakthrough in Catheter-Interventional Therapy for Chronic Thromboembolic Pulmonary Hypertension

Takumi Inami, MD∗; Masaharu Kataoka, MD∗; Nobuhiko Shimura, MD∗; Haruhisa Ishiguro, MD∗; Ryoji Yanagisawa, MD∗; Keiichi Fukuda, MD†; Hideaki Yoshino, MD∗; Toru Satoh, MD∗

Objectives: This study sought to prove the safety and effectiveness of pressure-wire-guided percutaneous transluminal pulmonary angioplasty (PTPA).

01 noviembre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Periprocedural Complications and Long-Term Outcome After Alcohol Septal Ablation Versus Surgical Myectomy in Hypertrophic Obstructive Cardiomyopathy

Robbert C. Steggerda, MD∗; Kevin Damman, MD, PhD†; Jippe C. Balt, MD, PhD‡; Max Liebregts, MD‡; Jurriën M. ten Berg, MD, PhD‡; Maarten P. van den Berg, MD, PhD†

Objectives: This study compared alcohol septal ablation (ASA) and surgical myectomy for periprocedural complications and long-term clinical outcome in patients with symptomatic hypertrophic obstructive cardiomyopathy.

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Stent Thrombosis. A Clinical Perspective. CME

Bimmer E. Claessen, MD, PhD∗; José P.S. Henriques, MD, PhD∗; Farouc A. Jaffer, MD, PhD†; Roxana Mehran, MD‡; Jan J. Piek, MD, PhD∗; George D. Dangas, MD, PhD‡

The invention of intracoronary stents greatly increased the safety and applicability of percutaneous coronary interventions. At this time, >1 million coronary stent implantations are performed each year in the United States. But together with the growing use of stents, stent thrombosis, the most feared complication after stent implantation, has emerged as an important entity to understand and prevent. Adjunct pharmacological therapy, stent design, and deployment technique have been adjusted ever since to reduce its occurrence. The current clinical overview of stent thrombosis ranges from its pathophysiology to current state-of-the-art technical and pharmacological recommendations to avoid this complication.

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Correlates and Outcomes of Late and Very Late Drug-Eluting Stent Thrombosis. Results From DESERT (International Drug-Eluting Stent Event Registry of Thrombosis)

Ron Waksman, MD∗; Ajay J. Kirtane, MD†; Rebecca Torguson, MD∗; David J. Cohen, MD‡; Thomas Ryan, MD§; Lorenz Räber, MD‖; Robert Applegate, MD¶; Sergio Waxman, MD#; Paul Gordon, MD∗∗; Kimberly Kaneshige, BS∗; Martin B. Leon, MD†

Objectives: The aim of this study was to identify clinical, procedural, and angiographic correlates of late/very late drug-eluting stent (DES) thrombosis as well as to determine the clinical outcomes of these events.

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Predictors and Outcomes of Recurrent Stent Thrombosis

Ehrin J. Armstrong, MD, MSc∗; Shiv Sab, MD†; Gagan D. Singh, MD†; Wayland Lim, MD†; Khung-Keong Yeo, MBBS†; Stephen W. Waldo, MD§; Mitul Patel, MD‖; Ryan Reeves, MD‖; John S. MacGregor, MD, PhD¶; Reginald I. Low, MD†; Kendrick A. Shunk, MD, PhD¶; Ehtisham Mahmud, MD‖; Jason H. Rogers, MD†

Objectives: The aim of this study was to determine the incidence, predictors, and outcomes of recurrent stent thrombosis (rST).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Impact of Gene Polymorphisms, Platelet Reactivity, and the SYNTAX Score on 1-Year Clinical Outcomes in Patients With Non–ST-Segment Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention. The GEPRESS Study

Tullio Palmerini, MD∗; Paolo Calabrò, MD†; Federico Piscione, MD‡; Stefano De Servi, MD‖; Marco Cattaneo, MD¶; Diego Maffeo, MD#; Anna Toso, MD∗∗; Antonio Bartorelli, MD††; Cataldo Palmieri, MD‡‡; Marco De Carlo, MD‖‖; Davide Capodanno, MD¶¶; Chiara Barozzi, PhD∗; Luciana Tomasi, PhD∗; Diego Della Riva, MD∗; Andrea Mariani, MD∗; Nevio Taglieri, MD∗; Letizia Bacchi Reggiani, MSc∗; Renatomaria Bianchi, MD†; Roberta De Rosa, MD##; Matteo Mariani, MD‖; GianMarco Podda, MD¶; Philippe Généreux, MD∗∗∗; Gregg W. Stone, MD∗∗∗; Dominick J. Angiolillo, MD, PhD†††

Objectives: The aim of this study was to investigate the association between high on-treatment platelet reactivity (HPR) and the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score (SS) for risk prediction of major adverse cardiovascular events (MACE) in patients with non–ST-segment elevation acute coronary syndrome (NSTEACS) undergoing percutaneous coronary intervention (PCI).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Validation and Comparison of the Long-Term Prognostic Capability of the SYNTAX Score-II Among 1,528 Consecutive Patients Who Underwent Left Main Percutaneous Coronary Intervention

Bo Xu, MBBS∗; Philippe Généreux, MD†; Yuejin Yang, MD∗; Martin B. Leon, MD†; Liang Xu, MSc∗; Shubin Qiao, MD∗; Yongjian Wu, MD∗; Hongbing Yan, MD∗; Jilin Chen, MD∗; Yelin Zhao, MSc∗; Yanyan Zhao, BS∗; Tullio Palmerini, MD§; Gregg W. Stone, MD†; Runlin Gao, MD∗

Objectives: This study sought to evaluate the long-term prognostic capacity of the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score II (SS-II) and compare it with other risk scores among patients undergoing left main percutaneous coronary intervention (LM-PCI).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Cerebrovascular Events Post-Transcatheter Aortic Valve Replacement in a Large Cohort of Patients

Didier Tchetche, MD∗; Bruno Farah, MD∗; Leonardo Misuraca, MD∗; Adele Pierri, MD∗; Olivier Vahdat, MD∗; Corinne Lereun, MSE, BA†; Nicolas Dumonteil, MD‡; Thomas Modine, MD§; Marc Laskar, MD‖; Helene Eltchaninoff, MD¶; Dominique Himbert, MD#; Bernard Iung, MD, PhD#; Emmanuel Teiger, MD∗∗; Karine Chevreul, MD∗∗; Michel Lievre, PhD††; Thierry Lefevre, MD‡‡; Patrick Donzeau-Gouge, MD‡‡; Martine Gilard, MD, PhD§§; Jean Fajadet, MD∗

Objectives: The aim of this study was to analyze the incidence, impact, and predictors of cerebrovascular events (CVEs) in patients undergoing transcatheter aortic valve replacement (TAVR).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Feasibility and Exploratory Efficacy Evaluation of the Embrella Embolic Deflector System for the Prevention of Cerebral Emboli in Patients Undergoing Transcatheter Aortic Valve Replacement. The PROTAVI-C Pilot Study

Josep Rodés-Cabau, MD∗; Philip Kahlert, MD†; Franz-Josef Neumann, MD‡; Gerhard Schymik, MD§; John G. Webb, MD‖; Pierre Amarenco, MD¶; Thomas Brott, MD#; Zsolt Garami, MD∗∗; Gino Gerosa, MD††; Thierry Lefèvre, MD‡‡; Bjoern Plicht, MD†; Stuart J. Pocock, PhD§§; Marc Schlamann, MD†; Martyn Thomas, MD‖‖; Beverly Diamond, PhD¶¶; Ihsen Merioua, MD¶¶; Friedhelm Beyersdorf, MD##; Alec Vahanian, MD¶

Objectives: This study sought to determine the feasibility, safety, and exploratory efficacy of the Embrella Embolic Deflector (EED) system (Edwards Lifesciences, Irvine, California) in patients undergoing transcatheter aortic valve replacement (TAVR).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Transapical Transcatheter Aortic Valve for Severe Aortic Regurgitation

Daniel Wendt, MD, PhD∗; Philipp Kahlert, MD, PhD†; Susanne Pasa, MD∗; Karim El-Chilali, MD†; Fadi Al-Rashid, MD†; Konstantinos Tsagakis, MD∗; Daniel Sebastian Dohle, MD∗; Raimund Erbel, MD, PhD†; Heinz Jakob, MD, PhD∗; Matthias Thielmann, MD, PhD∗

Objectives: This study sought to evaluate the self-expandable ACURATE TA device (Symetis SA, Ecublens, Switzerland) in a cohort of patients with pure aortic regurgitation (AR).

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Initial German Experience With Transapical Implantation of a Second-Generation Transcatheter Heart Valve for the Treatment of Aortic Regurgitation

Moritz Seiffert, MD∗; Ralf Bader, MD†; Utz Kappert, MD‡; Ardawan Rastan, MD§; Stephan Krapf, MD‖; Sabine Bleiziffer, MD¶; Steffen Hofmann, MD#; Martin Arnold, MD∗∗; Klaus Kallenbach, MD††; Lenard Conradi, MD∗; Friederike Schlingloff, MD†; Manuel Wilbring, MD‡; Ulrich Schäfer, MD†; Patrick Diemert, MD∗; Hendrik Treede, MD∗

Objectives: This analysis reports on the initial German multicenter experience with the JenaValve (JenaValve Technology GmbH, Munich, Germany) transcatheter heart valve for the treatment of pure aortic regurgitation.

01 octubre 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Methodological Standardization for the Pre-Clinical Evaluation of Renal Sympathetic Denervation

Kenichi Sakakura, MD∗; Elena Ladich, MD∗; Elazer R. Edelman, MD†; Peter Markham, MS†; James R.L. Stanley, DVM†; John Keating, DVM†; Frank D. Kolodgie, PhD∗; Renu Virmani, MD∗; Michael Joner, MD∗

Transcatheter ablation of renal autonomic nerves is a viable option for the treatment of resistant arterial hypertension; however, structured pre-clinical evaluation with standardization of analytical procedures remains a clear gap in this field. Here we discuss the topics relevant to the pre-clinical model for the evaluation of renal denervation (RDN) devices and report methodologies and criteria toward standardization of the safety and efficacy assessment, including histopathological evaluations of the renal artery, periarterial nerves, and associated periadventitial tissues. The pre-clinical swine renal artery model can be used effectively to assess both the safety and efficacy of RDN technologies. Assessment of the efficacy of RDN modalities primarily focuses on the determination of the depth of penetration of treatment-related injury (e.g., necrosis) of the periarterial tissues and its relationship (i.e., location and distance) and the effect on the associated renal nerves and the correlation thereof with proxy biomarkers including renal norepinephrine concentrations and nerve-specific immunohistochemical stains (e.g., tyrosine hydroxylase). The safety evaluation of RDN technologies involves assessing for adverse effects on tissues local to the site of treatment (i.e., on the arterial wall) as well as tissues at a distance (e.g., soft tissue, veins, arterial branches, skeletal muscle, adrenal gland, ureters). Increasing experience will help to create a standardized means of examining all arterial beds subject to ablative energy and in doing so enable us to proceed to optimize the development and assessment of these emerging technologies.

09 diciembre 2014

CIRCULATION. Prevalence and Long-Term Outcome of Aortic Prosthesis–Patient Mismatch in Patients With Paradoxical Low-Flow Severe Aortic Stenosis

Dania Mohty, MD, PhD; Cyrille Boulogne, MD; Julien Magne, PhD; Philippe Pibarot, DVM, PhD; Najmeddine Echahidi, MD; Elisabeth Cornu, MD; Jean Dumesnil, MD; Marc Laskar, MD; Patrice Virot, MD; Victor Aboyans, MD, PhD

Background: Patients with severe aortic stenosis (AS) and paradoxical low flow (PLF) have worse outcome compared with those with normal flow. Furthermore, prosthesis–patient mismatch (PPM) after aortic valve replacement is a predictor of reduced survival. However, the prevalence and prognostic impact of PPM in patients with PLF-AS are unknown. We aimed to analyze the prevalence and long-term survival of PPM in patients with PLF-AS.

05 agosto 2014

CIRCULATION. Cardiovascular Surgery. Improved Quality of Life After 1 Year With an Invasive Versus a Noninvasive Treatment Strategy in Claudicants

Joakim Nordanstig, MD, PhD; Charles Taft, MD, PhD; Marlene Hensäter, RN; Angelica Perlander, MD; Klas Österberg, MD, PhD; Lennart Jivegård, MD, PhD

Background: The quality of evidence for invasive revascularization in intermittent claudication is low or very low. This prospective, randomized, controlled study tested the hypothesis that an invasive treatment strategy versus continued noninvasive treatment improves health-related quality of life after 1 year in unselected patients with intermittent claudication.