Accidental Cannulation of the Cardiac Venous System During Pericardiocentesis
J Invasive Cardiol. 2021 Mar;33(3):E225-E226.ABSTRACTA 52-year-old woman presented to another hospital with progressive dyspnea of 10-day duration. The patient was diagnosed with a massive pericardial effusion and underwent pericardiocentesis. However, the patient's symptoms did not improve and she was referred to our hospital with a pericardial sheath in situ. On evaluation, the patient had a large pericardial effusion and evidence of cardiac tamponade, but no fluid could be aspirated from the sheath. This case underscores the importance of image-guided pericardiocentesis.PMID:33646967 (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Anunay Gupta Sourabh Agstam Dinkar Bhasin Nitish Rai Jeetesh Jain H S Isser Sandeep Bansal Source Type: research

Treating Mitral Valve Prolapse in Barlow's Disease by Creation of a Medial MitraClip Bridge and a "New" Lateral Orifice: Rationale for MitraClip NTR Adoption
J Invasive Cardiol. 2021 Mar;33(3):E227-E228.ABSTRACTPercutaneous mitral valve repair with MitraClip XTR (Abbott Vascular) has been proposed in patients with Barlow's disease, as the extended length of the MitraClip XTR may facilitate "grasping" and limit the number of clips. However, the design of the MitraClip XTR includes arms that 3 mm longer than the NTR device as well as 2 additional frictional elements, and requires a patient selection based mainly on mitral valve tissue quality. We summarize our rationale for using the shorter and smaller MitraClip NTR in patients with Barlow's disease.PMID:33646968 (Sour...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Sebastian Feickert Giuseppe D'Ancona Alla Neuhausen Abramkina H üseyin Ince Source Type: research

Percutaneous Management of a Mechanical Complication Post Mitral Valve Surgery in a Child
J Invasive Cardiol. 2021 Mar;33(3):E229.ABSTRACTA 4-year-old girl with congenital mitral regurgitation status post mechanical mitral valve replacement (MVR) using a 16 mm Carbomedics valve (LivaNova) at the age of 5 months underwent a redo MVR using a 21 mm aortic prosthesis implanted in an inverted position for progressed increased mitral valve gradient due to pannus formation. Post operatively, echocardiogram showed good mitral valve prosthesis function with severe depressed left ventricular function (ejection fraction, 19%) and markedly segmental dyskinesia in the lateral wall. Her diagnosis of compression to the proxim...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Ziad Dahdouh Ghassan Siblini Source Type: research

De Winter Pattern Caused by a Large Diagonal Branch Culprit Lesion
J Invasive Cardiol. 2021 Mar;33(3):E230.ABSTRACTA 70-year-old man was referred to the emergency department for an episode of ongoing chest pain during physical activity. Urgent coronary angiogram revealed a 75% stenosis in the left anterior descending coronary artery and a total occlusion of a large diagonal branch. Both stenoses were treated successfully with percutaneous coronary intervention. After reperfusion, the ECG showed a "De Winter" pattern, which was the ECG expression of a culprit lesion located in a large diagonal branch rather than in the left anterior descending.PMID:33646970 (Source: The Journal o...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Andrea Demarchi Laura Frigerio Roberto Rordorf Stefano Cornara Alberto Somaschini Silvana De Martino Gaetano Maria De Ferrari Source Type: research

Giant Aortic Root Aneurysm in Marfan's Syndrome
J Invasive Cardiol. 2021 Mar;33(3):E231-E232.ABSTRACTA 25-year-old man came to our clinic with the complaints of exertional palpitations and dyspnea. He had skeletal features suggestive of Marfan's syndrome. Contrast-enhanced computed tomography confirmed aneurysmal dilation of the aortic root and the proximal part of the ascending aorta. The patient was advised to undergo Bentall procedure for replacement of the aortic valve, aortic root, and ascending aorta. Marfan's syndrome is a connective tissue disorder with autosomal-dominant inheritance. Patients have a predisposition for progressive aortic root and ascending aorti...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Dinkar Bhasin Gaurav Kumar Arora Sourabh Agstam Anunay Gupta H S Isser Sandeep Bansal Source Type: research

Emergency Percutaneous Treatment of Saphenous Vein Graft Perforation After Cardiac Surgery
J Invasive Cardiol. 2021 Mar;33(3):E233-E234.ABSTRACTImmediately post coronary artery bypass graft surgery, a 58-year-old woman developed excessive bleeding through the chest drains and hemodynamic instability, followed by total atrioventricular block requiring use of temporary pacemaker, which precluded electrocardiographic interpretation. She was referred for urgent diagnostic coronary angiography, which demonstrated important contrast leakage from the distal body of the saphenous vein graft to the first marginal branch. Acute saphenous vein graft perforation following coronary artery bypass graft surgery is rare. To the...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Gustavo L Agostini Denise Pellegrini Eduardo Saadi Ricardo Lasevitch Vitor Gomes Diego Pinheiro Ricardo Soccol Paulo Caramori Source Type: research

Accidental Cannulation of the Cardiac Venous System During Pericardiocentesis
J Invasive Cardiol. 2021 Mar;33(3):E225-E226.ABSTRACTA 52-year-old woman presented to another hospital with progressive dyspnea of 10-day duration. The patient was diagnosed with a massive pericardial effusion and underwent pericardiocentesis. However, the patient's symptoms did not improve and she was referred to our hospital with a pericardial sheath in situ. On evaluation, the patient had a large pericardial effusion and evidence of cardiac tamponade, but no fluid could be aspirated from the sheath. This case underscores the importance of image-guided pericardiocentesis.PMID:33646967 (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Anunay Gupta Sourabh Agstam Dinkar Bhasin Nitish Rai Jeetesh Jain H S Isser Sandeep Bansal Source Type: research

Treating Mitral Valve Prolapse in Barlow's Disease by Creation of a Medial MitraClip Bridge and a "New" Lateral Orifice: Rationale for MitraClip NTR Adoption
J Invasive Cardiol. 2021 Mar;33(3):E227-E228.ABSTRACTPercutaneous mitral valve repair with MitraClip XTR (Abbott Vascular) has been proposed in patients with Barlow's disease, as the extended length of the MitraClip XTR may facilitate "grasping" and limit the number of clips. However, the design of the MitraClip XTR includes arms that 3 mm longer than the NTR device as well as 2 additional frictional elements, and requires a patient selection based mainly on mitral valve tissue quality. We summarize our rationale for using the shorter and smaller MitraClip NTR in patients with Barlow's disease.PMID:33646968 (Sour...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Sebastian Feickert Giuseppe D'Ancona Alla Neuhausen Abramkina H üseyin Ince Source Type: research

Percutaneous Management of a Mechanical Complication Post Mitral Valve Surgery in a Child
J Invasive Cardiol. 2021 Mar;33(3):E229.ABSTRACTA 4-year-old girl with congenital mitral regurgitation status post mechanical mitral valve replacement (MVR) using a 16 mm Carbomedics valve (LivaNova) at the age of 5 months underwent a redo MVR using a 21 mm aortic prosthesis implanted in an inverted position for progressed increased mitral valve gradient due to pannus formation. Post operatively, echocardiogram showed good mitral valve prosthesis function with severe depressed left ventricular function (ejection fraction, 19%) and markedly segmental dyskinesia in the lateral wall. Her diagnosis of compression to the proxim...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Ziad Dahdouh Ghassan Siblini Source Type: research

De Winter Pattern Caused by a Large Diagonal Branch Culprit Lesion
J Invasive Cardiol. 2021 Mar;33(3):E230.ABSTRACTA 70-year-old man was referred to the emergency department for an episode of ongoing chest pain during physical activity. Urgent coronary angiogram revealed a 75% stenosis in the left anterior descending coronary artery and a total occlusion of a large diagonal branch. Both stenoses were treated successfully with percutaneous coronary intervention. After reperfusion, the ECG showed a "De Winter" pattern, which was the ECG expression of a culprit lesion located in a large diagonal branch rather than in the left anterior descending.PMID:33646970 (Source: The Journal o...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Andrea Demarchi Laura Frigerio Roberto Rordorf Stefano Cornara Alberto Somaschini Silvana De Martino Gaetano Maria De Ferrari Source Type: research

Giant Aortic Root Aneurysm in Marfan's Syndrome
J Invasive Cardiol. 2021 Mar;33(3):E231-E232.ABSTRACTA 25-year-old man came to our clinic with the complaints of exertional palpitations and dyspnea. He had skeletal features suggestive of Marfan's syndrome. Contrast-enhanced computed tomography confirmed aneurysmal dilation of the aortic root and the proximal part of the ascending aorta. The patient was advised to undergo Bentall procedure for replacement of the aortic valve, aortic root, and ascending aorta. Marfan's syndrome is a connective tissue disorder with autosomal-dominant inheritance. Patients have a predisposition for progressive aortic root and ascending aorti...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Dinkar Bhasin Gaurav Kumar Arora Sourabh Agstam Anunay Gupta H S Isser Sandeep Bansal Source Type: research

Emergency Percutaneous Treatment of Saphenous Vein Graft Perforation After Cardiac Surgery
J Invasive Cardiol. 2021 Mar;33(3):E233-E234.ABSTRACTImmediately post coronary artery bypass graft surgery, a 58-year-old woman developed excessive bleeding through the chest drains and hemodynamic instability, followed by total atrioventricular block requiring use of temporary pacemaker, which precluded electrocardiographic interpretation. She was referred for urgent diagnostic coronary angiography, which demonstrated important contrast leakage from the distal body of the saphenous vein graft to the first marginal branch. Acute saphenous vein graft perforation following coronary artery bypass graft surgery is rare. To the...
Source: The Journal of Invasive Cardiology - March 1, 2021 Category: Cardiology Authors: Gustavo L Agostini Denise Pellegrini Eduardo Saadi Ricardo Lasevitch Vitor Gomes Diego Pinheiro Ricardo Soccol Paulo Caramori Source Type: research

Clinical Impact of Crossover Techniques for Primary Access Hemostasis in Transfemoral Transcatheter Aortic Valve Replacement Procedures.
Authors: Junquera L, Urena M, Latib A, Muñoz-Garcia A, Nombela-Franco L, Faurie B, Alperi A, Serra V, Regueiro A, Fisher Q, Himbert D, Mangieri A, Colombo A, Muñoz García E, Vera Urquiza R, Jiménez-Quevedo P, Pascual I, Garcia Del Blanco B, Sabaté M, Mohammadi S, Freitas-Ferraz AB, Muntané-Carol G, Couture T, Paradis JM, Côté M, Rodés-Cabau J Abstract OBJECTIVES: To determine the occurrence of vascular complications (VCs) following transfemoral transcatheter aortic valve replacement (TAVR) with new-generation devices according to the use of a crossover t...
Source: The Journal of Invasive Cardiology - February 21, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

TIger II vs JUdkins Catheters for Transradial Coronary Angiography (TIJUCA Study): A Randomized Controlled Trial of Radiation Exposure.
CONCLUSION: The Tiger II catheter was able to reduce radiation exposure to patients submitted to TR-CAG through a significant reduction in fluoroscopy time. PMID: 33600354 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 21, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Characteristics and Outcomes of Patients Ineligible for Transcatheter Mitral Valve Replacement (TMVR): Implications for Future Device Innovation.
CONCLUSIONS: Despite growing experience with TMVR, the subset of MR patients anatomically eligible for TMVR is small and many patients are treated medically. Mortality in these patients remains high, underlining an unmet need for adequate therapeutic alternatives. TMVR devices adapting to broader annular size ranges with smaller ventricular profiles might fill this gap. PMID: 33600355 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 21, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Radiation Exposure for Percutaneous Interventions of Chronic Total Coronary Occlusions in a Multicenter Registry: The Influence of Operator Variability and Technical Set-up.
CONCLUSIONS: Radiation exposure decreased during the observation period despite an increase in lesion and procedural complexity. While many operators already achieved a goal of low radiation exposure, there were considerable interoperator differences in radiation management, indicating further potential for improvement. PMID: 33570501 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 12, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Prospective Experience of Pulmonary Embolism Management and Outcomes.
Authors: Lacey ML, Hammad TA, Parikh M, Tefera L, Sharma P, Kahl R, Zemko A, Li J, Carman T, Schilz R, Shishehbor MH Abstract OBJECTIVE: We sought to evaluate the impact of pulmonary embolism (PE) response teams (PERTs) on all consecutive patients with PE. BACKGROUND: Multidisciplinary PERTs have been promoted for the management and treatment of (PE); however, the impact of PERTs on clinical outcomes has not been prospectively evaluated. METHODS: We prospectively studied 220 patients with computed tomography (CT)-confirmed PE between January, 2019 and August, 2019. Baseline characteristics, as well as medic...
Source: The Journal of Invasive Cardiology - February 12, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Comparison of Hemodynamic and Clinical Outcomes After Transcatheter Versus Surgical Therapy in Adults in Coarctation of Aorta.
CONCLUSIONS: These favorable short- and mid-term outcome data support the use of transcatheter therapy as an alternative to surgery in adults with COA. Further studies are required to determine if these favorable outcomes are maintained on long-term follow-up. PMID: 33570503 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 12, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

A Novel Risk Score to Predict One-Year Mortality in Patients Undergoing Complex High-Risk Indicated Percutaneous Coronary Intervention (CHIP-PCI).
Authors: Brener SJ, Cunn GJ, Desai PH, Faroqui M, Ha LD, Handa G, Kutkut I, Raza AS, Sacchi TJ Abstract OBJECTIVE: To identify patients undergoing complex, high-risk indicated percutaneous coronary intervention (CHIP-PCI) and compare their outcomes with non-CHIP patients. We created a CHIP score to risk stratify these patients. BACKGROUND: Risk stratification of PCI patients remains difficult because most scoring systems reflect hemodynamic instability and predict early mortality. METHODS: CHIP-PCI was defined as any of the following: age>80 years; ejection fraction 2 lesions in>1 coronary artery. The...
Source: The Journal of Invasive Cardiology - February 7, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Arterial Anomalies of the Upper Limb and Their Influence on Transradial Coronary Procedures.
Authors: Garg N, Sagar P, Kapoor A, Tewari S, Kumar S, Khanna R, Sahu A, Goel PK Abstract OBJECTIVES: During transradial coronary procedures, arterial anomalies of the upper limb can lead to transradial navigation difficulties. We aimed to evaluate the incidence and impact of these anomalies on transradial procedures. METHODS: In consecutive patients undergoing transradial coronary procedures, antegrade upper-limb arterial angiography was done at the end of the procedure with the catheter tip in the subclavian artery. Radial artery angiography from the sheath was done only if the guidewire or catheter could not...
Source: The Journal of Invasive Cardiology - February 7, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Safety of Conscious Sedation for Transcatheter Aortic Valve Replacement Without an Anesthetist.
CONCLUSIONS: In this modest-sized transfemoral TAVR cohort with a low conversion rate to emergency surgery, TAVR-NA was associated with safety outcomes that were equivalent to TAVR-A. In healthcare systems where access to TAVR may be limited by anesthetic resources, TAVR-NA appears to be a reasonable option to enable the application of this therapy. PMID: 33542161 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 7, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Discordance Between Measured vs Calculated Oxygen Consumption in Adults With Congenital Heart Disease: Limitations and Clinical Implications.
Authors: Agasthi P, Miranda WR, Egbe AC Abstract INTRODUCTION: Oxygen consumption (VO2) is frequently estimated using derived formulas for ease of use. We performed a prospective study to assess the correlation and limits of agreement between measured and assumed VO2 (mL/min) in adults with congenital heart disease (CHD). METHODS: Consecutive adults with CHD who have undergone cardiac catheterization at Mayo Clinic Rochester from January 2018 to December 2019 were retrospectively enrolled in the study. Expired gas analysis was performed to measure VO2. We estimated VO2 using LaFarge (VO2L), Dehmer (VO2D), and B...
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Development of the Minimalist Approach for Transcatheter Aortic Valve Replacement at a Veterans Affairs Medical Center.
CONCLUSIONS: Unlike civilian hospitals, MA with CS/TTE did not reduce overall length of stay in the veteran population; however, it was safe and effective for transfemoral TAVR without impacting clinical outcomes of mortality, major vascular complications, and paravalvular leakage. PMID: 33531442 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Can History of Myocardial Infarction Reliably Indicate Myocardial Viability in Patients With a Coronary Chronic Total Occlusion and Good Collateral Circulation?
Authors: Nikolakopoulos I, Vemmou E, Karacsonyi J, Xenogiannis I, Rangan BV, Garcia S, Burke MN, Brilakis ES Abstract We read with interest the study by Shaikh et al reporting that none of the patients with coronary chronic total occlusions (CTOs) and a prior Q-wave myocardial infarction (MI) in the CTO-supplied territory had viable myocardium even in the presence of good collateral circulation. Based on our large, multicenter registry on CTO in percutaneous coronary intervention, PROGRESS-CTO, we believe viability testing may still be of value in patients with a CTO and a prior MI, especially if their ejection fra...
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Bilateral Distal Transradial Access for Ostial Left Anterior Descending Chronic Total Occlusion Recanalization.
Authors: Oliveira MDP, Lyra FG, Neto VTC, Caixeta A Abstract The adoption of distal transradial access (dTRA) as default approach for coronary angiography and interventions was recently published. As a refinement of conventional (proximal) TRA, this technique has many advantages in terms of patient and operator comfort, access-site bleeding, faster hemostasis, and risk of radial artery occlusion. Bilateral dTRA for complex chronic total occlusion percutaneous coronary intervention by experienced operators is feasible and safe. PMID: 33531444 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Descending Aortic Thrombus Hanging by a Thread: Three-Dimensional Echocardiogram.
Authors: Wani AS, Jan MF, Malik I, Tajik AJ, Khandheria BK Abstract Aortic thrombus is a rarely identified source of distal embolization. A conservative approach with anticoagulation alone carries a significant risk of embolization. Various open surgical approaches have been suggested as therapeutic options, but all of them carry a significant morbidity and mortality risk in this population subgroup. Contemporary endovascular approaches aimed at exclusion of the floating thrombus are now increasingly performed, and have significantly lower periprocedural complications compared with an open surgical approach. PM...
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Intravascular Ultrasound-Guided Coronary Lithotripsy Treatment of In-Stent Restenosis in Saphenous Venous Graft.
Authors: Russo F, Chieffo A, Carlino M, Ancona MB, Bellini B, Ferri LA, Beneduce A, Vella C, Algethami A, Montorfano M Abstract To the best of our knowledge, this is the first description of intravascular-ultrasound guided coronary lithotripsy on saphenous vein graft because of severely calcific in-stent restenosis, showing good result without procedural complications. PMID: 33531446 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Stroke During Hip Surgery.
Authors: Auer J, Primus C Abstract During hip replacement, acetabular and femur bone preparation may cause bone marrow extravasation. Paradoxical fat embolism occurs when emboli pass from the pulmonary to the systemic circulation by either a patent foramen ovale or pulmonary capillaries. Impaired consciousness in the immediate postoperative period of orthopedic surgery frequently results from hypovolemia, anemia, or residual anesthesia. A high index of suspicion is required to consider the possibility of paradoxical fat embolism. PMID: 33531447 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Don't Ignore That Chest Pain: Positionally Dependent Coronary Subclavian Steal Syndrome.
We present a 40-year-old female with a history of triple-vessel CABG who presented with crescendo angina, notably when elevating her arms above her head. Atypical angina related to arm activity following successful LIMA bypass should prompt angiography directed to the left SCA, as well as to the LIMA graft. Typically, cases of CSSS are claudication dependent and not positionally related. This suggests a two-pronged pathophysiological mechanism of both demand ischemia and mechanical obstruction, which is not well described in previous literature. PMID: 33531448 [PubMed - in process] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - February 5, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Optimal Stent Design for High Bleeding Risk Patients: Evidence From a Network Meta-Analysis.
Authors: Chiabrando JG, Vescovo GM, Del Buono MG, Lombardi M, Camilli M, Ravindra K, Montone RA, Niccoli G, Biondi-Zoccai G Abstract OBJECTIVE: To determine the best stent design for high bleeding risk (HBR) patients. BACKGROUND: Polymer-free (PF) drug eluting stent (DES) devices have a proven benefit over bare-metal stent (BMS) devices in previous trials. It is unknown, however, whether polymer-based (PB)-DES devices are as safe as PF-DES devices. METHODS: A network meta-analysis including all randomized controlled trials (RCTs) that compared different stent technology in HBR patients with a 1-month course...
Source: The Journal of Invasive Cardiology - January 23, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Safety of Same-Day Discharge After Percutaneous Coronary Intervention in Selected Patients With Non-ST Elevation Acute Coronary Syndrome.
Authors: Ghanbari F, Lindhardt TB, Charlot MG, Haahr Pedersen S, Olsen NT Abstract OBJECTIVES: We aimed to investigate the safety of same-day discharge (SDD) after percutaneous coronary intervention (PCI) for non-ST segment elevation acute coronary syndrome (NSTEACS), and to investigate the reduction in duration of hospitalization achievable by SDD. BACKGROUND: Previous studies have established the safety of SDD after elective PCI, while the safety of SDD after non-elective PCI for acute coronary syndrome has only been sparsely studied. METHODS: A single-center, observational, retrospective study of 923 con...
Source: The Journal of Invasive Cardiology - January 23, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Randomized Trial of VasoStat Versus TR Band Following Radial Artery Access for Catheterization Procedures.
CONCLUSION: Both RCDs achieved hemostasis enabling same-day discharge. VS had significantly shorter time to hemostasis with fewer device manipulations and increased patient-reported comfort. PMID: 33472992 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 23, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Bioresorbable Vascular Scaffold With Optimized Implantation Technique: Long-Term Outcomes From a Single-Center Experience.
Authors: Albani S, Giannini F, Mitomo S, Fabris E, Mangieri A, Ponticelli F, Khokhar AA, Toselli M, Latib A, Colombo A Abstract BACKGROUND: Previous randomized controlled trials demonstrated a higher rate of stent thrombosis with bioresorbable vascular scaffold (BVS) implantation as compared with second-generation drug-eluting stent in selected patients/lesions. However, long-term outcomes of BVS implantations that utilize an optimized technique (OIT) in unselected patients/lesions are lacking. The aim of this study was to assess the real-world, long-term clinical outcomes of BVS (Absorb; Abbott Vascular) with OIT....
Source: The Journal of Invasive Cardiology - January 16, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Feasibility of Same-Day Discharge Approach After Transcatheter Mitral Valve Repair Procedures.
CONCLUSION: Same-day discharge approach can be safely performed in selected patients after TMVRep procedures. However, further studies with larger sample sizes are needed. PMID: 33443488 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 16, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Peripheral Arterial Vessel Prepping With Intravascular Ultrasound and Atherectomy: An Interventionalist's Perspective.
Authors: Shammas NW Abstract BACKGROUND: Vessel prepping is an essential component of an optimal strategy in treating infrainguinal peripheral arterial disease. Vessel prepping with atherectomy can be aggressive in certain lesion morphologies, such as severe calcium, total occlusion, or in-stent restenosis, or can target vessel compliance without aggressive debulking. Drug elution is likely to be enhanced by vessel prepping. Optimal vessel prepping requires precise imaging of the vessel size, plaque morphology, and lesion severity/length which cannot be assessed adequately by angiography. Also, intravascular ultras...
Source: The Journal of Invasive Cardiology - January 16, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Pulmonary Artery Intervention for Submassive Pulmonary Embolism From an Arm Superficial Venous Access.
Authors: Lichaa H Abstract BACKGROUND: Pulmonary embolism (PE) endovascular interventions are often approached from an internal jugular or femoral venous access. There are multiple advantages of right basilic vein (RBV) access for both patient and operator, especially in the setting of morbid obesity. We hereby describe the case of a 48-year-old, morbidly obese man who presented with acute respiratory insufficiency and was found to have bilateral submassive subocclusive PE, worse on the right. The right ventricular to left ventricular ratio was 2.1 and troponin was elevated. A 7 Fr sheath was placed in the RBV unde...
Source: The Journal of Invasive Cardiology - January 10, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Patent Hemostasis Impact in Clinical Routine: Large Monocentric Echo-Doppler Study of Radial Artery Patency After Coronary Catheterization.
Authors: Rougé A, Faurie B, Abdellaoui M, Monségu J Abstract BACKGROUND: Radial access is currently the first line of access in interventional cardiology. Nevertheless, this technique carries a 1%-10% risk of radial artery occlusion (RAO) based on series. METHODS: We conducted a large-scale echo-Doppler evaluation of radial patency including prospectively all patients who underwent coronary angiography and/or angioplasty with radial catheterization at our center in 2018. RESULTS: A total of 1106 patients were enrolled in the cohort. Average patient age was 70 years, 24.5% were females and 75.5...
Source: The Journal of Invasive Cardiology - January 10, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Shockwave Lithotripsy vs Rotational Atherectomy: Mechanistic Differences From Optical Coherence Tomography.
We present an unusual case of extensive sever right coronary artery calcified stenosis, in which both rotational atherectomy (RA) and non-compliant balloons failed to dilate the lesion and finally the Shockwave lithotripsy balloon offered optimal lesion dilation and successful stent deployment. Furthermore, optical coherence tomography provided mechanistic insight into the differential effect of Shockwave balloon versus RA for extensively calcified lesions. PMID: 33414357 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 10, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Clinical Impact of Medical Therapy Versus Revascularization in Patients With Chronic Coronary Total Occlusions.
Authors: Álvarez-Contreras L, Flores-Umanzor E, Cepas-Guillen P, Ferreira-González I, Freixa X, Regueiro A, Brugaletta S, Sabaté M, Martín-Yuste V Abstract BACKGROUND: Chronic total occlusions (CTOs) are prevalent angiographic findings in patients with suspected coronary artery disease. Conflicting results of randomized controlled trials and registries have not clarified the therapeutic approach for patients with CTO in clinical practice. Therefore, we sought to analyze variables influencing the decision-making process and their relationship with clinical outcomes according to the type o...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Predicting Significant Iliac Vein Compression Using a Probability Scoring System Derived From Minimal Luminal Area on Computed Tomography Angiography in Patients 65 Years of Age or Younger.
We present a revised and improved scoring system following an additional number of patients and limited to patients 65 years of age and younger. METHODS: Patients were included from retrospective (n = 52) and prospective (n = 18) registries of consecutive patients who underwent computed tomography angiography (CTA) of the pelvis with venous filling and IVUS within a few weeks apart to evaluate for symptomatic ILVC at a single cardiovascular practice. Quantitative vascular analysis was performed on all images obtained. MLA and age were used to calculate a score derived from a previously published logistic regression for...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Prognosis of Patients With Left Circumflex Artery Acute Myocardial Infarction in Relation to ST-Segment on Admission Electrocardiogram.
CONCLUSION: Patients suffering from NSTEMI and STEMI related to LCX occlusion or stenosis have similar 1-year mortality. Left dominant circulation was associated with higher short- and long-term mortality. These results suggest that a substantial population of patients who present as NSTEMI should be treated as promptly and aggressively as STEMI patients. PMID: 33385982 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Intravascular Lithotripsy for the Treatment of Calcium-Mediated Coronary In-Stent Restenoses.
Authors: Brunner FJ, Becher PM, Waldeyer C, Zengin-Sahm E, Schnabel RB, Clemmensen P, Westermann D, Blankenberg S, Seiffert M Abstract BACKGROUND: Coronary intravascular lithotripsy (IVL) has recently been evaluated for the treatment of severely calcified native coronary lesions. Evidence for its use in in-stent restenosis is sparse and is still an off-label indication. Therefore, we aimed to evaluate the feasibility, safety, and acute and mid-term angiographic outcomes after IVL for the treatment of calcium-mediated coronary in-stent restenosis. METHODS: A retrospective, single-center analysis was performed fo...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Preventing or Minimizing Acute Kidney Injury in Patients Undergoing Transcatheter Aortic Valve Replacement.
Authors: Tandar A, Sharma V, Ibrahim M, Jones T, Morgan D, Montzingo C, Lee J, Birgenheier N, Silverton N, Abraham A, Welt FGP, Glotzbach JP Abstract BACKGROUND: Transcatheter aortic valve implantation (TAVI) is now routinely performed in patients with aortic stenosis with low mortality and complication rates. Although periprocedural risks have been substantially minimized, procedure- and contrast-induced acute kidney injury (AKI) remains a major concern. AKI remains a frequent complication of contrast-guided interventional procedures and is associated with a significantly adverse prognosis. We review the currently...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Preserved Left Atrial Function Following Left Atrial Appendage Closure for Stroke Prevention.
CONCLUSION: LA function is crucial for cardiovascular function and recurrence of AF. Our study provides evidence that LA appendage closure preserves LA function, determined by strain imaging in patients with paroxysmal AF and sinus rhythm during echocardiography. PMID: 33385985 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Impaired Myocardial Perfusion on Stress CMR Correlates With Invasive FFR in Children With Coronary Anomalies.
Authors: Agrawal H, Wilkinson JC, Noel CV, Qureshi AM, Masand PM, Mery CM, Sexson-Tejtel SK, Molossi S Abstract BACKGROUND: Invasive fractional flow reserve (FFR) is considered the gold standard to evaluate coronary artery flow. Stress cardiovascular magnetic resonance (sCMR) is an emerging non-invasive tool to evaluate myocardial perfusion in children. We sought to compare sCMR with FFR to determine impaired intracoronary flow in children with anomalous aortic origin of a coronary artery (AAOCA) and/or myocardial bridge (MB) who presented concern for myocardial ischemia. METHODS: From December 2012 to May 2019...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Complex Chronic Total Occlusion Revascularization - A Comparison of Biradial Versus Femoral Access.
Authors: Meah MN, Ding WY, Joseph T, Hasleton J, Shaw M, Palmer ND Abstract BACKGROUND: Complex chronic total occlusion (CTO) cases often require dual access. Evidence suggests that radial access is associated with lower success rates in complex CTOs. Our primary outcome was to determine efficacy of biradial access compared with femoral access. METHODS: This was a retrospective, single-center, observational study. Patients who underwent dual-access CTO percutaneous coronary intervention (PCI) between January 2014 and January 2018 were enrolled. They were separated into biradial and femoral access groups. Data o...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Association Between Primary Coronary Slow-Flow Phenomenon and Epicardial Fat Tissue.
Authors: Weferling M, Vietheer J, Keller T, Fischer-Rasokat U, Hamm CW, Liebetrau C Abstract BACKGROUND: Primary coronary slow-flow phenomenon (CSFP) is defined as delayed opacification of contrast media in at least 1 coronary vessel in the absence of obstructive epicardial coronary artery disease (CAD) during coronary angiography. Epicardial fat tissue (EFT) surrounding coronary vessels provides paracrine effects. Released cytokines diffusing in the vessel wall may induce local inflammatory reactions that potentially result in endothelial dysfunction. The latter is thought to be the underlying cause of primary CSF...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Complex Coronary Intervention Via Right Distal Transradial Access With Lusoria Subclavian Artery Under Refractory Electrical Storm: A Really Challenging Case.
We report herein a very challenging case of coronary angiography followed by complex percutaneous coronary intervention via right distal TRA, with aberrant (lusoria) subclavian artery, in the setting of non-ST segment elevation acute myocardial infarction complicated by refractory electrical storm. PMID: 33385989 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Shockwave Intravascular Lithotripsy of Undilatable STEMI Lesion in Primary PCI.
Authors: Tsiafoutis I, Katsanou K, Koutouzis M, Katsivas A Abstract Percutaneous coronary intervention in STEMI patients may be complicated by the presence of calcium. The Shockwave IVL technique seems to be a safe and useful option, even in STEMI cases, to achieve procedural success. Nevertheless, extra support techniques may be needed in order to deliver the Shockwave balloon. PMID: 33385990 [PubMed - as supplied by publisher] (Source: The Journal of Invasive Cardiology)
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research

Balloon Angioplasty of the Radial Artery to Solve a Challenging Radial Sheath Insertion.
Authors: Talanas G, Guarino S, Canonico ME, Parodi G Abstract The inability to advance the dedicated wire of the transradial sheath in a radial artery with a good pulsatile blood flow is a very rare event. In this case, the advancement of a high-performance 0.014 inch coronary wire is the only option to gain the vessel. Then, if the transradial sheath is stuck in the proximal radial artery wall, balloon angioplasty of the radial artery may allow successful reinsertion of the transradial sheath. This technique allows the preservation of radial artery access, avoiding a shift to an alternative arterial approach. ...
Source: The Journal of Invasive Cardiology - January 3, 2021 Category: Cardiology Tags: J Invasive Cardiol Source Type: research