01 agosto 2014

CIRCULATION. Coronary Heart Disease. Cost-Effectiveness of Percutaneous Coronary Intervention With Drug-Eluting Stents Versus Bypass Surgery for Patients With 3-Vessel or Left Main Coronary Artery Disease

David J. Cohen, MD, MSc*; Ruben L. Osnabrugge, MSc*; Elizabeth A. Magnuson, ScD; Kaijun Wang, PhD; Haiyan Li, MS; Khaja Chinnakondepalli, MS; Duane Pinto, MD; Mouin S. Abdallah, MD; Katherine A. Vilain, MPH; Marie-Claude Morice, MD; Keith D. Dawkins, MD; A. Pieter Kappetein, MD, PhD; Friedrich W. Mohr, MD; Patrick W. Serruys, MD, PhD; on Behalf of the SYNTAX Trial Investigators

Background: The Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) trial demonstrated that in patients with 3-vessel or left main coronary artery disease, coronary artery bypass graft surgery (CABG) was associated with a lower rate of cardiovascular death, myocardial infarction, stroke, or repeat revascularization compared with percutaneous coronary revascularization with drug-eluting stents (DES-PCI)). The long-term cost-effectiveness of these strategies is unknown.

04 septiembre 2014

CIRCULATION. Interventional Cardiology. Patient Access and 1-Year Outcomes of Percutaneous Coronary Intervention Facilities With and Without On-Site Cardiothoracic Surgery

Thomas M. Maddox, MD, MSc; Maggie A. Stanislawski, MS; Colin O’Donnell, MS; Mary E. Plomondon, PhD; Steven M. Bradley, MD, MPH; P. Michael Ho, MD, PhD; Thomas T. Tsai, MD, MSc; Adhir R. Shroff, MD; Bernadette Speiser, MSN, CCRN; Robert J. Jesse, MD, PhD; John S. Rumsfeld, MD, PhD

Background: The safety of percutaneous coronary intervention (PCI) at medical facilities without on-site cardiothoracic (CT) surgery has been established in clinical trials. However, the comparative effectiveness of this strategy in real-world practice, including impact on patient access and outcomes, is uncertain. The Veterans Affairs (VA) health care system has used this strategy, with strict quality oversight, since 2005, and can provide insight into this question.

04 septiembre 2014

CIRCULATION. Interventional Cardiology. Impact of Annual Operator and Institutional Volume on Percutaneous Coronary Intervention Outcomes

Apurva O. Badheka, MD*; Nileshkumar J. Patel, MD*; Peeyush Grover, MD*; Vikas Singh, MD*; Nilay Patel, MD; Shilpkumar Arora, MD; Ankit Chothani, MD; Kathan Mehta, MD; Abhishek Deshmukh, MD; Ghanshyambhai T. Savani, MD; Achint Patel, MD; Sidakpal S. Panaich, MD; Neeraj Shah, MD; Ankit Rathod, MD; Michael Brown, MD; Tamam Mohamad, MD; Frank V. Tamburrino, MD; Saibal Kar, MD; Raj Makkar, MD; William W. O’Neill, MD; Eduardo De Marchena, MD; Theodore Schreiber, MD; Cindy L. Grines, MD; Charanjit S. Rihal, MD; Mauricio G. Cohen, MD

Background: The relationship between operator or institutional volume and outcomes among patients undergoing percutaneous coronary interventions (PCI) is unclear.

09 septiembre 2014

CIRCULATION. Long-Term Outcomes of Inoperable Patients With Aortic Stenosis Randomly Assigned to Transcatheter Aortic Valve Replacement or Standard Therapy

Samir R. Kapadia, MD; E. Murat Tuzcu, MD; Raj R. Makkar, MD; Lars G. Svensson, MD, PhD; Shikhar Agarwal, MD, MPH; Susheel Kodali, MD; Gregory P. Fontana, MD; John G. Webb, MD; Michael Mack, MD; Vinod H. Thourani, MD; Vasilis C. Babaliaros, MD; Howard C. Herrmann, MD; Wilson Szeto, MD; Augusto D. Pichard, MD; Mathew R. Williams, MD; William N. Anderson, PhD; Jodi J. Akin, MS; D. Craig Miller, MD; Craig R. Smith, MD; Martin B. Leon, MD

Background: The long-term outcomes of transcatheter aortic valve replacement (TAVR) in inoperable patients with severe aortic stenosis remain unknown.

07 octubre 2014

STROKE. Clinical Sciences. Recurrent Stroke and Patent Foramen Ovale

Aristeidis H. Katsanos, MD; J. David Spence, MDBA, MBA, MD, FRCPC; Chrysi Bogiatzi, MD; John Parissis, MD, PhD; Sotirios Giannopoulos, MD, PhD; Alexandra Frogoudaki, MD, PhD; Apostolos Safouris, MD; Konstantinos Voumvourakis, MD, PhD; Georgios Tsivgoulis, MD, PhD, FESO

Background and Purpose: Recurrent cerebrovascular events are frequent in medically treated patients with patent foramen ovale (PFO), but it still remains unclear whether PFO is a causal or an incidental finding. Further uncertainty exists on whether the size of functional shunting could represent a potential risk factor. The aim of the present study was to evaluate if the presence of PFO is associated with an increased risk of recurrent stroke or transient ischemic attack and to investigate further if this relationship is related to the shunt size.

30 octubre 2014

STROKE. Provoked Right-to-Left Shunt in Patent Foramen Ovale Associates With Ischemic Stroke in Posterior Circulation

Bum Joon Kim, MD; Na-Young Kim, MD; Dong-Wha Kang, MD, PhD; Jong S. Kim, MD, PhD; Sun U. Kwon, MD, PhD

Background and Purpose: Right-to-left shunt (RLS) via the patent foramen ovale is an important cause of cryptogenic stroke. The Valsalva maneuver provokes or enhances RLS, but RLS can also occur during normal respiration. This study examined whether the ischemic lesion pattern differs depending on the character of RLS.

16 agosto 2014

THE LANCET. Bivalirudin versus heparin in patients planned for percutaneous coronary intervention: a meta-analysis of randomised controlled trials

Matthew A Cavender MD a, Prof Marc S Sabatine MD

Background: Bivalirudin is an alternative to heparin in patients undergoing percutaneous coronary intervention (PCI). We aimed to define the effects of a bivalirudin-based anticoagulation regimen compared with a heparin-based anticoagulation regimen on ischaemic and bleeding outcomes.

01 septiembre 2014

THE LANCET. Ultrathin strut biodegradable polymer sirolimus-eluting stent versus durable polymer everolimus-eluting stent for percutaneous coronary revascularisation (BIOSCIENCE): a randomised, single-blind, non-inferiority trial

Thomas Pilgrim MD a †, Dik Heg PhD j †, Prof Marco Roffi MD b, David Tüller MD c, Olivier Muller MD d, André Vuilliomenet MD e, Prof Stéphane Cook MD f, Daniel Weilenmann MD g, Prof Christoph Kaiser MD h, Peiman Jamshidi MD i, Therese Fahrni RN a, Aris Moschovitis MD a, Stéphane Noble MD b, Prof Franz R Eberli MD c, Prof Peter Wenaweser MD a, Prof Peter Jüni MD j, Prof Stephan Windecker MD

Background: Refinements in stent design affecting strut thickness, surface polymer, and drug release have improved clinical outcomes of drug-eluting stents. We aimed to compare the safety and efficacy of a novel, ultrathin strut cobalt-chromium stent releasing sirolimus from a biodegradable polymer with a thin strut durable polymer everolimus-eluting stent.

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. A Registry-Based Randomized Trial Comparing Radial and Femoral Approaches in Women Undergoing Percutaneous Coronary Intervention

Sunil V. Rao, MD∗; Connie N. Hess, MD, MHS∗; Britt Barham, BA∗; Laura H. Aberle, BSPH∗; Kevin J. Anstrom, PhD∗; Tejan B. Patel, MD†; Jesse P. Jorgensen, MD‡; Ernest L. Mazzaferri, MD§; Sanjit S. Jolly, MD‖; Alice Jacobs, MD¶; L. Kristin Newby, MD∗; C. Michael Gibson, MD#; David F. Kong, MD∗; Roxana Mehran, MD∗∗; Ron Waksman, MD††; Ian C. Gilchrist, MD‡‡; Brian J. McCourt∗; John C. Messenger, MD§§; Eric D. Peterson, MD, MPH∗; Robert A. Harrington, MD‖‖; Mitchell W. Krucoff, MD∗

Objectives: This study sought to determine the effect of radial access on outcomes in women undergoing percutaneous coronary intervention (PCI) using a registry-based randomized trial.

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Intravascular Ultrasound-Derived Minimal Lumen Area Criteria for Functionally Significant Left Main Coronary Artery Stenosis

Seung-Jung Park, MD, PhD∗; Jung-Min Ahn, MD∗; Soo-Jin Kang, MD∗; Sung-Han Yoon, MD∗; Bon-Kwon Koo, MD†; Jong-Young Lee, MD∗; Won-Jang Kim, MD∗; Duk-Woo Park, MD∗; Seung-Whan Lee, MD∗; Young-Hak Kim, MD∗; Cheol Whan Lee, MD∗; Seong-Wook Park, MD, PhD∗

Objectives: This study sought to evaluate the intravascular ultrasound (IVUS) minimal lumen area (MLA) for functionally significant left main coronary artery (LMCA) stenosis using fractional flow reserve (FFR) as the standard.

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Survival of Transcatheter Mitral Valve Repair Compared With Surgical and Conservative Treatment in High-Surgical-Risk Patients

Martin J. Swaans, MD∗; Annelies L.M. Bakker, MD∗; Arash Alipour, MD, PhD∗; Martijn C. Post, MD, PhD∗; Johannes C. Kelder, MD, PhD∗; Thom L. de Kroon, MD†; Frank D. Eefting, MD∗; Benno J.W.M. Rensing, MD, PhD∗; Jan A.S. Van der Heyden, MD, PhD∗

Objectives: The goal of this study was to compare survival between transcatheter mitral valve (MV) repair using MitraClip system (Abbott Vascular, Santa Clara, California), MV-surgery, and conservative treatment in high-surgical-risk patients symptomatic with severe mitral valve regurgitation (MR).

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Quantity and Location of Aortic Valve Complex Calcification Predicts Severity and Location of Paravalvular Regurgitation and Frequency of Post-Dilation After Balloon-Expandable Transcatheter Aortic Valve Replacement

Omar K. Khalique, MD∗; Rebecca T. Hahn, MD∗; Hemal Gada, MD∗; Tamim M. Nazif, MD∗; Torsten P. Vahl, MD∗; Isaac George, MD∗; Bindu Kalesan, PhD, MPH∗; Molly Forster, BA∗; Mathew B. Williams, MD∗; Martin B. Leon, MD∗; Andrew J. Einstein, MD, PhD∗; Todd C. Pulerwitz, MD∗; Gregory D.N. Pearson, MD, PhD∗; Susheel K. Kodali, MD∗

Objectives: This study sought to determine the impact of quantity and location of aortic valve calcification (AVC) on paravalvular regurgitation (PVR) and rates of post-dilation (PD) immediately after transcatheter aortic valve replacement (TAVR).

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Comparison of Transfemoral Transcatheter Aortic Valve Replacement Performed in the Catheterization Laboratory (Minimalist Approach) Versus Hybrid Operating Room (Standard Approach)

Vasilis Babaliaros, MD∗; Chandan Devireddy, MD∗; Stamatios Lerakis, MD∗; Robert Leonardi, MD∗; Sebastian A. Iturra, MD†; Kreton Mavromatis, MD∗; Bradley G. Leshnower, MD†; Robert A. Guyton, MD†; Mihir Kanitkar, MD∗; Patricia Keegan, NP∗; Amy Simone, PA†; James P. Stewart, MD∗; Nima Ghasemzadeh, MD∗; Peter Block, MD∗; Vinod H. Thourani, MD†

Objectives: The aim of this study was to compare transfemoral transcatheter aortic valve replacement (TF TAVR) performed in a catheterization laboratory (minimalist approach [MA]) with TF TAVR performed in a hybrid operating room (standard approach [SA]).

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Results of the U.S. Food and Drug Administration Continued Access Clinical Trial of the GORE HELEX Septal Occluder for Secundum Atrial Septal Defect

Alexander J. Javois, MD∗; Jonathan J. Rome, MD‡; Thomas K. Jones, MD§; Evan M. Zahn, MD‖; Craig E. Fleishman, MD¶; Ricardo H. Pignatelli, MD#; Larry A. Latson, MD∗∗

Objectives: This report describes the immediate, 1-, and 5-year follow-up results of the U.S. Food and Drug Administration Continued Access clinical trial of the GORE HELEX Septal Occluder (W. L. Gore & Associates, Inc., Flagstaff, Arizona) for closure of secundum atrial septal defect.

01 agosto 2014

JACC: CARDIOVASCULAR INTERVENTIONS. Predictors of Recurrent Events in Patients With Cryptogenic Stroke and Patent Foramen Ovale Within the CLOSURE I (Evaluation of the STARFlex Septal Closure System in Patients With a Stroke and/or Transient Ischemic Attack Due to Presumed Paradoxical Embolism Through a Patent Foramen Ovale) Trial

Sammy Elmariah, MD, MPH∗; Anthony J. Furlan, MD‡; Mark Reisman, MD§; David Burke, MD†; Moshe Vardi, MD†; Neil J. Wimmer, MD‖; Shuqiong Ling, MS†; Xiaohua Chen, MA†; David M. Kent, MD, MSc¶; Joseph Massaro, PhD†; Laura Mauri, MD, MSc†

Objectives: This study sought to identify predictors of recurrent ischemic neurologic events within the CLOSURE I (Evaluation of the STARFlex Septal Closure System in Patients With a Stroke and/or Transient Ischemic Attack Due to Presumed Paradoxical Embolism Through a Patent Foramen Ovale) trial.