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ABSTRACT


CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. How to deal with atrial septal defect closure from right internal jugular vein: Role of venous‐arterial circuit for sizing and over‐the‐wire device implantation

Gianfranco Butera MD, PhD, Nicusor Lovin MD, Domenica Paola Basile MD

Secundum atrial septum defect (ASD) is the most common congenital heart disease. It is usually treated by a transcatheter approach using a femoral venous access. In case of bilateral femoral vein occlusion, the internal jugular venous approach for ASD closure is an option, in particular in cases where ASD balloon occlusion test and sizing is needed. Here, we report on a new technique for ASD closure using a venous‐arterial circuit from the right internal jugular vein to the femoral artery. Two patients (females, 4 and 10 years of age) had occlusion of both femoral veins because of a previous history of pulmonary atresia and intact ventricular septum, for which they underwent percutaneous radiofrequency perforation and balloon angioplasty. These subjects needed balloon occlusion test of a residual ASD to size the hole and to check for hemodynamic suitability to ASD closure. After performing a venous‐arterial circuit, a 24 mm St Jude ASD sizing balloon catheter was advanced over the circuit and the defect closed for 15 min to check hemodynamics and size the defect. ASD was closed is hemodinamically suitable. This technique was safe and reliable.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Circumflex coronary artery injury after mitral valve surgery: A report of four cases and comprehensive review of the literature

Nick Hiltrop MD, Johan Bennett MD, Walter Desmet MD, PhD

As the LCx is closely related to the mitral valve annulus, it is susceptible to perioperative injury. Various underlying mechanisms, predisposing factors, and therapeutic strategies have been suggested but disagreement exists. Using a MeSH terms‐based PubMed search, 44 cases of mitral valve surgery‐related LCx injury were detected, including our 4 cases. We provide a comprehensive review of current knowledge regarding mitral valve surgery‐related left circumflex coronary artery (LCx) injury. Preoperative coronary angiography was performed in 55% (n = 24). Coronary abnormalities were present in 11% (n = 5). Coronary dominance was reported in 73% (n = 32), predominantly showing left (69%, n = 22) or balanced (19%, n = 6) circulations. Right coronary dominance was present in 12% (n = 4). Ischemia was detected in the perioperative or early postoperative phase in 86% (n = 30). Delayed symptoms were present in 14% (n = 5). Echocardiography demonstrated new regional wall motion abnormalities in 80% (n = 24), but was negative in 20% (n = 6) despite coronary compromise. Electrocardiography showed myocardial ischemia in 97% (n = 34), including regional ST‐segment elevations in 68% (n = 23). Primary treatment was surgical in 42% (n = 15) and percutaneous in 58% (n = 21), reporting success ratios of 87% (n = 13) and 81% (n = 17), respectively. We confirm an augmented risk of mitral valve surgery‐related LCx injury in balanced or left‐dominant coronary circulations. Preoperative knowledge of coronary anatomy does not preclude LCx injury. An anomalous LCx arising from the right coronary cusp was identified as a possible specific high‐risk entity. Electrocardiographic monitoring and intraoperative echocardiography remain paramount to ensure a timely diagnosis and treatment.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Efficacy and safety of a biodegradable polymer Cobalt‐Chromium sirolimus‐eluting stent (EXCEL2) in treating de novo coronary artery disease: A pooled analysis of the CREDIT II and CREDIT III trials

Geng Wang MD, Heyang Wang MD, Bo Xu MBBS, Yuejin Yang MD, Zhiming Yang MD, Hui Li MD, Zheng Zhang MD, Haichang Wang MD, Lixia Yang MD, Yaling Han MD, FACC

Background: The safety and efficacy of the second‐generation biodegradable polymer Cobalt‐Chromium sirolimus‐eluting stent (EXCEL2) in daily clinical practice remains unknown. Additionally, to meet the China Food and Drug Administration requirements, we conducted an objective performance criterion study from the CREDIT II and CREDIT III trials.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Comparison of two biodegradable‐polymer‐based sirolimus‐eluting stents with varying elution and absorption kinetics in patients with acute myocardial infarction: A subgroup analysis of the PANDA III trial

Changdong Guan MSc, Bo Xu MBBS, Shubin Qiao MD, Lei Qin MD, Yi Li MD, Zhanquan Li MD, Yong Guo MD, Zhongwei Sun MSc, Lei Song MD, Runlin Gao MD, on behalf of the PANDA III Investigators

Background: Implantation of early‐generation metallic drug‐eluting stents (DES) in patients with acute myocardial infarction (AMI) is associated with poor vessel wall healing. Use of biodegradable polymer (BP) DES might improve safety outcomes; however, the impact of varying drug elution and polymer absorption kinetics of BP‐DES on clinical outcomes in the AMI population is unknown.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Does minimalist transfemoral transcatheter aortic valve replacement produce better survival in patients with severe chronic obstructive pulmonary disease?

Jose F. Condado MD, MS, Moosa N. Haider MD, MBA, Stamatios Lerakis MD, Patricia Keegan NP, Hope Caughron BA, Vinod H. Thourani MD, Chandan Devireddy MD, Bradley Leshnower MD, Kreton Mavromatis MD, Eric L. Sarin MD, James Stewart MD, Robert Guyton MD, Jessica Forcillo MD, Ateet Patel MD, Amy Simone PA, Peter C. Block MD, Vasilis Babaliaros MD

Objectives: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF‐TAVR) in patients with severe chronic obstructive pulmonary disease (COPD).

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Left atrial appendage closure: A single center experience and comparison of two contemporary devices

Filippo Figini, Patrizio Mazzone, Damiano Regazzoli, Giulia Porata, Neil Ruparelia, Francesco Giannini, Stefano Stella, Francesco Ancona, Eustachio Agricola, Nicoleta Sora, Alessandra Marzi, Andrea Aurelio, Nicola Trevisi, Paolo Della Bella, Antonio Colombo, Matteo Montorfano

Objectives: To compare indications and clinical outcomes of two contemporary left atrial appendage (LAA) percutaneous closure systems in a “real‐world” population.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Closure of very large PDA with pulmonary hypertension: Initial clinical case‐series with the new Occlutech® PDA occluder

Anja Lehner MD, Sarah Ulrich MD, Christoph M. Happel MD, PhD, Marcus Fischer MD, Marinos Kantzis MD, Ingram Schulze‐Neick MD, PhD, Nikolaus A. Haas MD, PhD

Objective. We report our recent experience with the new Occlutech® PDA Occluder, which seems suitable especially for closure of large patent ductus arteriosus (PDA) sizes with elevated pulmonary artery pressure (PAH).

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Stenting of the ductus arteriosus in infants with functionally univentricular heart disease and ductal‐dependent pulmonary blood flow: A single‐center experience

Ahmet Celebi MD, Ilker Kemal Yucel MD, Mustafa Orhan Bulut MD, Mehmet Kucuk MD, Sevket Balli MD

Objective: To determine the short‐ and medium‐term outcomes of ductal stenting (DS) in patients with functionally univentricular hearts (FUHs) and ductal‐dependent pulmonary blood flow.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Techniques for transcatheter retrieval of the occlutech ASD device United Kingdom–European multicenter report

Suhair O Shebani MBBCh, MSc, FRCPCH, Rizwan Rehman MBChB MRCPCH, Demetris Taliotis MBCHB, MRCPCH, Alan Magee MBBCh, MD, FRCP, Nicholas J Hayes BSc, MBChB, MRCPCH , Osman Baspinar MD, Zunzunegui Martínez JD, MD, Nikolaus Haas MD, PhD, FRACP, Christopher Duke MBChB, FRCP

Aims: To gather current experience in Occlutech ASD device retrieval, to determine whether snaring is an effective technique and to highlight alternative retrieval techniques.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS. Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview

Erhan Tenekecioglu MD, Felipe N. Albuquerque MD, Yohei Sotomi MD, Yaping Zeng MD, PhD, Pannipa Suwannasom MD, Hiroki Tateishi MD, PhD, Rafael Cavalcante MD, PhD, Yuki Ishibashi MD, Shimpei Nakatani MD, Mohammad Abdelghani MD, Jouke Dijkstra PhD, Christos Bourantas MD, PhD, Carlos Collet MD, Antonios Karanasos MD, Maria Radu MD, PhD, Ancong Wang PhD, Takashi Muramatsu MD, PhD, Ulf Landmesser MD, PhD, Takayuki Okamura MD, PhD, Evelyn Regar MD, PhD, Lorenz Räber MD, PhD, Giulio Guagliumi MD, Robert T. Pyo MD, Yoshinobu Onuma MD, PhD, Patrick W. Serruys MD, PhD

By providing valuable information about the coronary artery wall and lumen, intravascular imaging may aid in optimizing interventional procedure results and thereby could improve clinical outcomes following percutaneous coronary intervention (PCI). Intravascular optical coherence tomography (OCT) is a light‐based technology with a tissue penetration of approximately 1 to 3 mm and provides near histological resolution. It has emerged as a technological breakthrough in intravascular imaging with multiple clinical and research applications. OCT provides detailed visualization of the vessel following PCI and provides accurate assessment of post‐procedural stent performance including detection of edge dissection, stent struts apposition, tissue prolapse, and healing parameters. Additionally, it can provide accurate characterization of plaque morphology and provides key information to optimize post‐procedural outcomes. This manuscript aims to review the current clinical and research applications of intracoronary OCT and summarize the analytic OCT imaging software packages currently available.

CATHETERIZATION & CARDIOVASCULAR INTERVENTIONS.First reported use of drug‐coated balloon for bioresorbable in‐scaffold restenosis

Roberto Adriano Latini MD, Dario Buccheri MD, Bernardo Cortese MD

This is the first documented case of a drug‐coated balloon strategy for the treatment of bioresorbable in‐scaffold restenosis caused by diffuse neointimal proliferation. This case can provide an alternative treatment option in this setting, avoiding potential problems related to further bulky metallic stents in a patient where a different strategy was initially planned.

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