MedWorm: Cardiac Catheterization

Echocardiographic Guidance for Neonatal Right Ventricular Outflow Tract Stent Implantation

Congenital Heart Disease — Tue, 07 Feb 2012 05:00:00 +0100

We report the case of a 1.2 kg, hemodynamically unstable neonate with tetralogy of Fallot, in whom we implanted a right ventricular outflow tract stent under primarily echocardiographic guidance. This represents the smallest reported patient in whom a right ventricular outflow tract stent has been placed and the latest application of integrated echocardiography and fluoroscopy in the catheterization laboratory. (Source: Congenital Heart Disease)

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Asymmetric focal pericardial thickening causing physiologically significant constrictive pericarditis

Catheterization and Cardiovascular Interventions — Mon, 06 Feb 2012 05:00:00 +0100

AbstractA 34‐year‐old woman presented with refractory ascites and edema. Echocardiography revealed normal left ventricular function with a restrictive diastolic filling pattern. Tissue Doppler velocities of the mitral annulus were normal. Cardiac magnetic resonance imaging (MRI) revealed a focal region of pericardial thickening anterior to the right ventricle and normal thickness pericardium in the other segments. However, abnormal delayed enhancement MRI (consistent with inflammation) was present in both the thickened and the normal pericardial segments. Invasive hemodynamics confirmed constrictive physiology and the patient underwent successful pericardiectomy. This case highlights the utility of multimodality imaging in the diagnosis of constrictive pericarditis and the underappreci...

Alcohol septal ablation after transaortic valve implantation: The dynamic nature of left outflow tract obstruction

Catheterization and Cardiovascular Interventions — Mon, 06 Feb 2012 05:00:00 +0100

This report highlights the dynamic nature of LVOT obstruction, which was successfully treated in our patient with catheter‐based alcohol septal ablation. The potential to unmask dynamic LVOT obstruction with TAVI should be an important consideration in patient selection for the procedure, and the postoperative assessment of these patients. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

A case report of an accidental vertebral arterial puncture videotaped during central venous catheterization in a child undergoing a ventricular septal defect repair.

Paediatric Anaesthesia — Sun, 05 Feb 2012 17:48:31 +0100

Authors: Kayashima K, Habe K PMID: 22272682 [PubMed - in process] (Source: Paediatric Anaesthesia)

Estimation of Pulmonary Vascular Resistance: Correlation between Echocardiography and Catheterization Data in Patients with Congenital Heart Disease

Echocardiography — Fri, 03 Feb 2012 05:00:00 +0100

Conclusions: There is modest correlation between TRV/TVIRVOT ratio and invasively derived PVR in congenital shunt lesions, especially in PVR < 6 WU. TRV/TVIRVOT ratio could be useful in identifying patients with congenital shunts whose PVR is likely to be <6 WU, and hence, do not need cardiac catheterization. (Echocardiography ****;**:1–6) (Source: Echocardiography)

“From Bench to Practice”, ESC Congress set for Munich this summer

European Society of Cardiology — Thu, 02 Feb 2012 16:43:01 +0100

In response to feedback from delegates, this year’s congress will kick off on Saturday with a fuller day of scientific sessions. The grand finale on Wednesday will be a two-hour highlight session in which world leading experts summarise all the new and exciting developments in basic, clinical and population sciences presented at the congress. Read more about this year's event.... Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of th...

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Stent in the Heart

Journal of the American College of Cardiology — Thu, 02 Feb 2012 13:55:34 +0100

A 56-year-old man who was admitted with acute myocardial infarction developed severe heart failure following stent placement in the left anterior descending artery. Ventricular septal perforation (VSP) was diagnosed. Conventional septal closure was considered high risk due to severe heart and multiple organ failure. We decided to place a stent graft in the left ventricle to exclude the VSP (A and B). The stent was placed retrograde from the ascending aorta through the aortic valve into the left ventricle, and the tip was stabilized to the apex. After stent placement, right ventricular free-wall bulging decreased markedly. Cardiac catheterization showed reduction of shunting to 20%. Three years after the procedure, no increase in shunting was observed. Chest radiograph and computed tomograp...

In vivo characterization of coronary plaques: novel findings from comparing greyscale and virtual histology intravascular ultrasound and near-infrared spectroscopy

European Heart Journal — Wed, 01 Feb 2012 05:00:00 +0100

Conclusion Combining NIRS with IVUS contributes to the understanding of plaque characterization in vivo. Further studies are warranted to determine whether combining NIRS and IVUS will contribute to the assessment of high-risk plaques to predict outcomes in patients with coronary artery disease. (Source: European Heart Journal)

Isoproterenol stress test during catheterization of patients with coarctation of the aorta

Pediatrics International — Wed, 01 Feb 2012 05:00:00 +0100

Conclusions: Significant pressure gradients over the coarctation site develop at IST in pediatric patients with repaired CoA or in preoperative patients with mild coarctation.© 2012 The Authors. Pediatrics International © 2012 Japan Pediatric Society (Source: Pediatrics International)

Quality measurement and improvement in the cardiac catheterization laboratory.

Circulation — Tue, 31 Jan 2012 05:00:00 +0100

Authors: Frey P, Connors A, Resnic FS PMID: 22294706 [PubMed - in process] (Source: Circulation)

Long-term survival of patients with ischemic cardiomyopathy treated by coronary artery bypass grafting versus medical therapy.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:20:40 +0100

CONCLUSIONS: Among a propensity-matched, risk-adjusted, observational cohort of patients with coronary artery disease, left ventricular ejection fraction less than 0.35, and no left main disease of greater than 50%, CABG is associated with a survival advantage over MED through 10 years of follow-up. PMID: 22269720 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

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Aneurysmal aorto-right ventricular tunnel.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:13:45 +0100

Authors: Singh SK, Dwivedi SK, Kumar A, Vijay SK, Rajput N, Devenraj V, Sahni JL Abstract A successful closure of an aneurysmal aorto-right ventricular tunnel (ARVT) in a 16-year-old male patient is reported here. An attempt at device closure had failed in this patient. Diagnosis was confirmed by Doppler echocardiography, 3-dimensional computed tomography, and cardiac catheterization. Surgical closure with a Dacron patch (W.L. Gore & Associates, Flagstaff, AZ) at the aortic end and direct closure at the ventricular end was done successfully with the patient under mild hypothermia. The postoperative echocardiogram showed a competent aortic valve with a closed ARVT. PMID: 22269762 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Effects of ivabradine on heart rate and left ventricular function in healthy cats and cats with hypertrophic cardiomyopathy.

American Journal of Veterinary Research — Sun, 29 Jan 2012 12:45:49 +0100

Conclusions and Clinical Relevance-Ivabradine had significant effects on several cardiovascular variables in anesthetized cats with HCM. Studies in awake cats with HCM are needed to clinically validate these findings. PMID: 22280379 [PubMed - in process] (Source: American Journal of Veterinary Research)

Scavenging of NADPH Oxidase-derived Superoxide Anions Improves Depressed Baroreflex Sensitivity in Spontaneously Hypertensive Rats.

Clinical and Experimental Pharmacology and Physiology — Fri, 27 Jan 2012 05:00:00 +0100

Authors: Guimarães DD, Carvalho CC, Braga VA Abstract 1. In pathological conditions such as hypertension, there is impairment in the autonomic control of blood pressure resulting in changes in baroreflex sensitivity. In the present study we tested the hypothesis that acute superoxide scavenging would restore the depressed baroreflex sensitivity (BRS) in spontaneously hypertensive rats (SHR). 2. Male 10-week-old SHR (n=14) and their controls (WKY, n=14) underwent femoral artery and vein catheterization for conscious blood pressure recording and drug administration. BRS was obtained by the drug-induced method using phenylephrine (8 μg/Kg, i.v.) and sodium nitroprusside (25 μg/Kg, i.v.) before and after the administration of tiron (30 mg/Kg, i.v.), a superoxide dismutase mimetic, o...

Patient Management After Noninvasive Cardiac Imaging: Results From SPARC (Study of Myocardial Perfusion and Coronary Anatomy Imaging Roles in Coronary Artery Disease)

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:11 +0100

Conclusions: Overall, noninvasive testing had only a modest impact on clinical management of patients referred for clinical testing. Although post-imaging use of cardiac catheterization and medical therapy increased in proportion to the degree of abnormality findings, the frequency of catheterization and medication change suggests possible undertreatment of higher risk patients. Patients were more likely to undergo cardiac catheterization after computed tomography angiography than after single-photon emission computed tomography or positron emission tomography after normal/nonobstructive and mildly abnormal study findings. (Study of Perfusion and Anatomy's Role in Coronary Artery [CAD] [SPARC]; NCT00321399) (Source: Journal of the American College of Cardiology)

Effects of Vasodilation in Heart Failure With Preserved or Reduced Ejection Fraction: Implications of Distinct Pathophysiologies on Response to Therapy

Journal of the American College of Cardiology — Thu, 26 Jan 2012 13:57:10 +0100

Conclusions: As compared to patients with HFrEF, patients with HFpEF experience greater blood pressure reduction, less enhancement in cardiac output, and greater likelihood of stroke volume drop with vasodilators. These findings emphasize fundamental differences in the 2 HF phenotypes and suggest that more pathophysiologically targeted therapies are needed for HFpEF. (Source: Journal of the American College of Cardiology)

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A case report of an accidental vertebral arterial puncture videotaped during central venous catheterization in a child undergoing a ventricular septal defect repair

Pediatric Anesthesia — Thu, 26 Jan 2012 12:13:26 +0100

(Source: Pediatric Anesthesia)

Nerve-sparing laparoscopic eradication of deep endometriosis with segmental rectal and parametrial resection: the Negrar method. A single-center, prospective, clinical trial

Surgical Endoscopy — Thu, 26 Jan 2012 06:55:34 +0100

Conclusions Our technique appears to be feasible and offers good results in terms of reduced bladder morbidity and apparently higher satisfaction than the classical technique. Considering that this kind of surgery requires uncommon surgical skills and anatomical knowledge, we believe that it should be performed only in selected reference centers. Content Type Journal ArticlePages 1-17DOI 10.1007/s00464-012-2153-3Authors Marcello Ceccaroni, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-Don Calabria”, Via Don A.Sempreboni no. 5, 37024 Negrar, VR, ItalyRoberto Clarizia, Division of Gynecologic Oncology, International School of Surgical Anatomy, Sacred Heart Hospital, “Ospedale Sacro Cuore-...

Changes in treatment and mortality of acute myocardial infarction in Estonian tertiary and secondary care hospitals in 2001 and 2007

BMC Research Notes — Thu, 26 Jan 2012 05:00:00 +0100

Conclusions: AMI treatment improved in both types of hospitals, while the improvement was more pronounced in tertiary care. Still, better treatment did not result in a significantly lower mortality. Higher age and cardiovascular risk are posing a challenge for AMI treatment. (Source: BMC Research Notes)

Iodine Usage In Scans Affects Thyroid Function

Health News from Medical News Today — Wed, 25 Jan 2012 21:00:00 +0100

Using iodinated contrast media in imaging scans has been linked to alterations in thyroid function, which in turn raises the risk of developing hyperthyroidism, researchers from Brigham and Women's Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, reported in Archives of Internal Medicine. The authors explained that iodinated contrast media are utilized in imaging procedures and scans, such as CT scans and cardiac catheterization. The authors wrote, as background information: "Iodinated contrast media (ICM) are commonly administered pharmaceutical agents... (Source: Health News from Medical News Today)

Use Of Iodinated Contrast Media In Imaging Procedures Appears To Affect Thyroid Function

Health News from Medical News Today — Wed, 25 Jan 2012 09:00:00 +0100

Exposure to iodinated contrast media during imaging procedures is associated with changes in thyroid function, and increased risk of developing hyperthyroidism, according to a report in the Archives of Internal Medicine, one of the JAMA/Archives journals. "Iodinated contrast media (ICM) are commonly administered pharmaceutical agents," the authors write as background information. ICM are frequently used in scans and imaging procedures such as cardiac catheterization and computed tomography (CT scans). "Although certain complications of ICM (e.g... (Source: Health News from Medical News Today)

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[Stent implantation in recoarctation of aorta in infant.]

Kardiologia Polska — Wed, 25 Jan 2012 06:54:02 +0100

We present the case of a 12 month-old infant with critical coarctaion of aorta, arch hypoplasia, atrial and ventricular septal defects who underwent interventional treatment with stent implantation due to recoarctation of aorta. In neonatal period the patient went through complete surgical correction. At the age of four months balloon angioplasty of recurrent coractation was conducted. Eight months later the patient was hospitalised with heart failure (HF) symptoms. Clinical and echographic examination confirmed critical stenosis of aortic isthmus. We performed heart catheterisation with stent implantation to transverse and descending arch with immediate reduction of gradient from 45 mm Hg to 0 mm Hg, widening of the isthmus from 2 to 8 mm and gradual regression of HF symptoms. At 3 years ...

Management of Combined Severe Carotid and Coronary Artery Disease

Current Cardiology Reports — Tue, 24 Jan 2012 07:21:02 +0100

Abstract Patients with severe carotid and coronary disease—especially if they require coronary artery bypass grafting (CABG)—are at high risk of cardiac events and stroke. Carotid revascularization should be considered for patients with symptomatic carotid disease and bilateral severe asymptomatic carotid stenosis. In patients with unilateral asymptomatic carotid stenosis, decision to proceed to revascularization should be based more on a perspective of long-term stroke prevention than of perioperative stroke reduction. Compared with endarterectomy, carotid artery stenting is associated with a lower incidence of periprocedural myocardial infarction, an event linked to long-term mortality. This observation may be particularly relevant for patients with advanced coronary...

Aneurysmal Aorto-Right Ventricular Tunnel [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

A successful closure of an aneurysmal aorto-right ventricular tunnel (ARVT) in a 16-year-old male patient is reported here. An attempt at device closure had failed in this patient. Diagnosis was confirmed by Doppler echocardiography, 3-dimensional computed tomography, and cardiac catheterization. Surgical closure with a Dacron patch (W.L. Gore & Associates, Flagstaff, AZ) at the aortic end and direct closure at the ventricular end was done successfully with the patient under mild hypothermia. The postoperative echocardiogram showed a competent aortic valve with a closed ARVT. (Source: The Annals of Thoracic Surgery)

Long-Term Survival of Patients With Ischemic Cardiomyopathy Treated by Coronary Artery Bypass Grafting Versus Medical Therapy [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Among a propensity-matched, risk-adjusted, observational cohort of patients with coronary artery disease, left ventricular ejection fraction less than 0.35, and no left main disease of greater than 50%, CABG is associated with a survival advantage over MED through 10 years of follow-up. (Source: The Annals of Thoracic Surgery)

Refractory Spasm of Coronary Arteries and Grafted Conduits After Isolated Coronary Artery Bypass Surgery [ORIGINAL ARTICLES: ADULT CARDIAC]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

Conclusions Diffuse RVS after CABG is a rare but lethal condition. Our experience, although limited, indicates that in such cases an aggressive treatment, that is, prompt extracorporeal membrane oxygenation institution and controlled cardiocirculatory assistance, represents the preferred solution to face such a dramatic event and may save patient lives. (Source: The Annals of Thoracic Surgery)

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Using the GRACE Risk Scores in Everyday Practice

The American Journal of Medicine — Mon, 23 Jan 2012 23:45:00 +0100

Acute coronary syndromes, a continuum of disease ranging from unstable angina to ST-elevation myocardial infarction, can pose a high degree of uncertainty and acuity on presentation. These patients have varying degrees of risk for death and adverse events. The recently released 2011 Focused Update on the American College of Cardiology and American Heart Association Guidelines for the Management of Unstable Angina and Non-ST Elevation Myocardial Infarction suggest that using a risk-stratification tool can not only help clinicians with prognostication, but also may help them decide which patients warrant higher-risk interventional strategies such as anticoagulation or cardiac catheterization. (Source: The American Journal of Medicine)

Iodinated Contrast Media Raises Risk for Thyroid DysfunctionIodinated Contrast Media Raises Risk for Thyroid Dysfunction

Medscape Today Headlines — Mon, 23 Jan 2012 21:59:35 +0100

Patients receiving iodinated contrast media for CT or cardiac catheterization had an increased risk for incident hyperthyroidism, incident overt hyperthyroidism, and incident overt hypothyroidism. Medscape Medical News (Source: Medscape Today Headlines)

Association Between Iodinated Contrast Media Exposure and Incident Hyperthyroidism and Hypothyroidism [Original Investigation]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

Conclusion Iodinated contrast media exposure is associated with subsequent development of incident hyperthyroidism and incident overt hypothyroidism. (Source: Archives of Internal Medicine)

Improvement in Revascularization Time After Creation of a Coronary Catheterization Laboratory at a Public Hospital [Research Letters]

Archives of Internal Medicine — Mon, 23 Jan 2012 05:00:00 +0100

(Source: Archives of Internal Medicine)

Inappropriate cath lab activation ‘low’

MedWire News - Cardiology — Mon, 23 Jan 2012 00:00:00 +0100

The rate of inappropriate cardiac catheterization laboratory activation by emergency personnel is relatively low, finds a study. (Source: MedWire News - Cardiology)

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Diagnostic Accuracy of Computed Tomography Coronary Angiography According to Pre-Test Probability of Coronary Artery Disease and Severity of Coronary Arterial Calcification: The CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) International Multicenter Study

Journal of the American College of Cardiology — Fri, 20 Jan 2012 13:57:13 +0100

Objectives: The purpose of this study was to assess the impact of patient population characteristics on accuracy by computed tomography angiography (CTA) to detect obstructive coronary artery disease (CAD). Background: The ability of CTA to exclude obstructive CAD in patients of different pre-test probabilities and in presence of coronary calcification remains uncertain. Methods: For the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study, 371 patients underwent CTA and cardiac catheterization for the detection of obstructive CAD, defined as ≥50% luminal stenosis by quantitative coronary angiography (QCA). This analysis includes 80 initially excluded patients with a calcium score ≥600. Area under the receiver-operating characterist...

In vivo comparison of arterial lumen dimensions assessed by co-registered three-dimensional (3D) quantitative coronary angiography, intravascular ultrasound and optical coherence tomography

The International Journal of Cardiovascular Imaging — Fri, 20 Jan 2012 07:07:36 +0100

This study sought to compare lumen dimensions as assessed by 3D quantitative coronary angiography (QCA) and by intravascular ultrasound (IVUS) or optical coherence tomography (OCT), and to assess the association of the discrepancy with vessel curvature. Coronary lumen dimensions often show discrepancies when assessed by X-ray angiography and by IVUS or OCT. One source of error concerns a possible mismatch in the selection of corresponding regions for the comparison. Therefore, we developed a novel, real-time co-registration approach to guarantee the point-to-point correspondence between the X-ray, IVUS and OCT images. A total of 74 patients with indication for cardiac catheterization were retrospectively included. Lumen morphometry was performed by 3D QCA and IVUS or OCT. For quantit...

Central venous catheter-related bloodstream infections in the intensive care unit

Indian Journal of Critical Care Medicine — Fri, 20 Jan 2012 05:00:00 +0100

Conclusions: The overall incidence of CRI was 27.77% (15/54). Catheter-associated BSIs were 47.31 per 1000 catheter-days. CRI was low in the catheters inserted by the experienced venipuncturists, elective procedure and CVC kept in situ for ≤3 days. S. epidermidis was the most common isolate. (Source: Indian Journal of Critical Care Medicine)

Safety and Feasibility of Transradial Approach for Coronary Bypass Graft Angiography and Intervention

Angiology — Mon, 16 Jan 2012 05:00:00 +0100

The transradial approach (TRA) is commonly applied for coronary catheterization. However, there are few reports on the safety and feasibility of transradial catheterization in patients with prior coronary artery bypass graft (CABG) surgery. We retrospectively evaluated 124 consecutive patients who underwent graft angiography and intervention via the transradial (TRA group, n = 68) or transfemoral approach (TFA group, n = 56). The baseline clinical characteristics between the 2 groups were similar except for prior myocardial infarction. No significant difference (P > .05)was observed in procedure time, the success rate of puncture, angiography, and intervention procedure between the 2 groups. There was no significant difference in major adverse cardiac and cerebrovascular events during h...

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Effects of intravenous exenatide in type 2 diabetic patients with congestive heart failure: a double-blind, randomised controlled clinical trial of efficacy and safety

Diabetologia — Fri, 13 Jan 2012 16:55:51 +0100

Conclusions/interpretation Infusion of exenatide in male type 2 diabetic patients with CHF increased the CI as a result of chronotropy, with concomitant favourable effects on PCWP and reasonable tolerability of the drug. The clinical implications of using exenatide in patients with CHF are still not clear and further studies are warranted. Trial registration: www.isrctn.org/ISRCTN47533126 Funding: This study was funded through the regional agreement on medical training and clinical research (ALF) between Stockholm County Council and the Karolinska Institute, by the Swedish Society for Medical Research, the Swedish Society of Medicine, Stiftelsen Serafimerlasarettet, the Swedish Heart and Lung foundation, Eli Lilly Amylin Alliance, ...

What other anomalies? Failure to wean post ventricular septal defect repair secondary to anomalous origin of the left coronary artery from the pulmonary artery

Pediatric Anesthesia — Fri, 13 Jan 2012 12:08:52 +0100

SummaryA six week old infant underwent ventricular septal defect and atrial septal defect closure. Preoperative echocardiography showed evidence of pulmonary hypertension. The post operative course was complicated failure to wean from ventilatory and inotropic support. Echocardiography showed severe left ventricular (LV) dysfunction and suggested some fistulous drainage of the left coronary artery into the right pulmonary artery; this anomalous drainage of the left coronary artery into the right pulmonary artery (ALCAPA) was confirmed with coronary angiogram. Re‐implantation of the left coronary artery into the aorta was performed. Extra‐corporeal membrane oxygenation (ECMO) was required to allow time for ventricular recovery. Supports were weaned gradually, with concurrent evidence of...

Mesothelial/monocytic incidental cardiac excrescence in a patient with antiphospholipid syndrome

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

We describe an additional case of MICE in a 24-year-old female with antiphospholipid syndrome. A mobile hyperechogenic mass attached to the left ventricular surface of the aortic valve was documented by transthoracic echocardiography (TTE). The patient did have cardiac catheterization one month before the cardiac surgery. Histopathologic and immunohistochemical examination showed a lesion composed of histiocytes and mesothelial cells together with fibrin and scattered inflammatory cells. To our knowledge, this is the first case of MICE detected in a patient with antiphospholipid syndrome. (Source: Interactive CardioVascular and Thoracic Surgery)

Tortuous right coronary artery to coronary sinus fistula

Interactive CardioVascular and Thoracic Surgery — Thu, 12 Jan 2012 05:00:00 +0100

We are reporting the successful surgical treatment of a 23-year-old female with a giant right coronary artery to coronary sinus fistula. This woman had complaints of chest pain and dyspnea on exertion for few months. Transthoracic echocardiography (TTE) showed a large tortuous right coronary artery and a dilated coronary sinus. Preoperative multi-detector computed tomography (MDCT) coronary angiography and cardiac catheterization confirmed the diagnosis of a right coronary artery to coronary sinus fistula. The patient underwent surgical closure of the fistula and division of the communication between the right coronary artery and the coronary sinus with the use of cardiopulmonary bypass. The patient was discharged home on postoperative day 5 and at one-year follow-up is symptom-free. (Sour...

Aorto‐Right Atrial Fistula Following Transseptal Catheterization and Catheter Ablation for Atrial Fibrillation

Journal of Cardiovascular Electrophysiology — Wed, 11 Jan 2012 05:00:00 +0100

We report a case of a 61‐year‐old male with history of atrial fibrillation and 2 radiofrequency ablation procedures, referred to us for surgical Cox Maze procedure. Preoperative cardiac computerized tomography revealed a fistulous connection between the aortic root and the right atrium. Later, the patient underwent successful surgical closure of the fistula during the Cox Maze procedure. In this paper, we also discuss the clinical presentation, natural history, anatomy of the interatrial septum, and management of aorto‐cameral fistula. (J Cardiovasc Electrophysiol, Vol. pp. 1–3) (Source: Journal of Cardiovascular Electrophysiology)

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NEW OFFER in General Cardiology - ESC Webinar package

European Society of Cardiology — Tue, 10 Jan 2012 14:29:03 +0100

Access the next 10 ESC Webinars in General Cardiology for only 100€. That’s a saving of 200€ off the standard registration price. Take advantage of our money saving offer to benefit from interactive learning delivered by Europe's leading cardiologists. Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of the Aorta and Trauma to the Aorta and Heart, Echocardiography (Non-invasive imaging), Genetics, Heart Failure (HF), Hypertension...

Effect of individual proton pump inhibitors on cardiovascular events in patients treated with clopidogrel following coronary stenting:

Catheterization and Cardiovascular Interventions — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions: No significant association between PPI use and primary endpoint was observed in the Japanese population, whereas PPI use resulted in a significant reduction in the rate of gastrointestinal bleeding. © 2012 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Fistula between right coronary artery vein graft and right atrium as an immediate complication of percutaneous coronary intervention

Catheterization and Cardiovascular Interventions — Tue, 10 Jan 2012 05:00:00 +0100

We report the first case of a fistula between SVG and the right atrium (RA) as an immediate complication after a percutaneous coronary intervention (PCI) in an 86‐year‐old female. She presented with inferior ST‐elevation myocardial infarction (STEMI) and was treated with thrombolytic therapy in a peripheral hospital, which was unsuccessful. PCI to SVG to the right coronary (RCA) was complicated by a fistula to RA. Cardiac magnetic resonance (CMR) confirmed the site of the fistula and also presence of a significant arteriovenous (AV) shunt. Reversal of anticoagulation had no effect on fistula closure. Therefore, a covered stent was deployed for closure of the fistula to avoid long‐term complications of the significant AV shunt. In summary, the diagnosis and appropriate management of...

Transcatheter closure of atrial septal defect in a geriatric population

Catheterization and Cardiovascular Interventions — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: Transcatheter closure of ASD in geriatric patients can be performed safely. This procedure contributes to significant improvement of symptoms and positive cardiac remodeling. Long‐term follow‐up is mandatory, especially for patients with mitral regurgitation. © 2012 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Simultaneous Right and Left Heart Real-Time, Free-Breathing CMR Flow Quantification Identifies Constrictive Physiology

Journal of the American College of Cardiology: Cardiovascular Imaging — Mon, 09 Jan 2012 05:00:00 +0100

Conclusions Accentuated and discordant respirophasic changes in mitral valve and tricuspid valve inflow velocities characteristic of CP can be identified noninvasively with RT-PC CMR. When incorporated into existing CMR protocols for imaging pericardial morphology, RT-PC CMR provides important hemodynamic evidence with which to make a definite diagnosis of CP. (Source: Journal of the American College of Cardiology: Cardiovascular Imaging)

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Accessory mitral valve tissue: an unusual cause of congenital mitral stenosis

Interactive CardioVascular and Thoracic Surgery — Mon, 09 Jan 2012 05:00:00 +0100

We report here the first and a rarest presentation of the AMVT in a 19-year old female patient diagnosed to have double outlet right ventricle, ventricular septal defect (VSD), infundibular stenosis and congenital mitral stenosis (MS). She presented with a history of shortness of breath and chest pain over 3 years. Diagnosis was made by chest X-ray, transthoracic and transoesophageal echocardiography, which was confirmed by cardiac catheterization, and angiography. A successful closure of the VSD with excision of the right ventricular bundle and excision of the AMVT was done. Post-operative course was uneventful and an echocardiogram before the discharge showed no residual shunt, no right ventricular outflow gradient or mitral regurgitation, and the gradient across the mitral valve was 5/3...

Efficacy of pulmonary vein isolation with a novel hot balloon ablation catheter

Journal of Interventional Cardiac Electrophysiology — Sat, 07 Jan 2012 06:45:11 +0100

Conclusions The hot balloon ablation catheter appears to be a safe and effective tool for PV isolation. Higher temperatures and longer ablation durations are associated with a higher single ablation success rate. Content Type Journal ArticlePages 1-8DOI 10.1007/s10840-011-9646-1Authors Rudolph F. Evonich, Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USADavid M. Nori, Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USADavid E. Haines, Department of Cardiovascular Medicine, Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Journal Journal of Interventional Cardiac ElectrophysiologyOnline ISSN 1572-8595Print ISSN ...

Isolated Left Ventricular Diverticulum in an Adult Patient Presenting With Acute Coronary Syndrome

Journal of the American College of Cardiology — Wed, 04 Jan 2012 18:27:40 +0100

A 54-year-old man presented with acute coronary syndrome. Left heart catheterization found significant left anterior descending (LAD) artery disease and a critical lesion of the distal right coronary artery. Ventriculogram revealed extravasation of dye into a large cavity lateral to the left ventricle (LV) (A, Online Video 1). A stent was placed in the right coronary artery, resolving the presenting symptoms. An echocardiogram confirmed normal left ventricular systolic function and visualized a muscular, saccular structure communicating with the LV (B, Online Video 2). Magnetic resonance imaging demonstrated prominent trabeculation without thrombus (C, Online Video 3). Delayed enhancement images did not suggest scar. The man subsequently underwent elective mammary graft to the LAD artery a...

[Clinical and hemodynamic features of Eisenmenger syndrome patients at the time of first admission: a tertiary referral-center experience.]

Anadolu Kardiyol Der... — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSION: The most common underlying heart disease of ES patients is VSD. In this cases exercise capacity is restricted and this restriction is reflected in laboratory parameters. PMID: 22214737 [PubMed - as supplied by publisher] (Source: Anadolu Kardiyol Der...)

Cardiac catheterization through the radial artery.

The American Journal of Nursing — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Durham KA Abstract An often safer alternative to a traditional procedure. PMID: 22222403 [PubMed - in process] (Source: The American Journal of Nursing)

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Transthoracic impedance accurately estimates pulmonary wedge pressure in patients with decompensated chronic heart failure.

Congestive Heart Failure — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Malfatto G, Blengino S, Perego GB, Branzi G, Villani A, Facchini M, Parati G Abstract Routine cardiac catheterization to assess pulmonary capillary wedge pressure (PCWP) is not recommended in heart failure (HF), and various noninvasive tools have been proposed. The authors evaluated the reliability of echocardiography, brain natriuretic peptide (BNP), and thoracic electrical bioimpedance (TEB) in predicting PCWP in 29 patients (72±4 years, New York Heart Association class 3.5±0.9, ejection fraction 28%±6%) who underwent hemodynamic evaluation for worsening HF. Echocardiography was performed immediately before the hemodynamic study. During clinical stability, PCWP, plasma BNP, and TEB were simultaneously assessed. Among TEB variables, thoracic conductance (thoracic flu...

Feasibility and effectiveness of massage therapy for symptom relief in cardiac catheter laboratory staff: A pilot study.

Complementary Therapies in Clinical Practice — Fri, 30 Dec 2011 17:56:22 +0100

Authors: Keller SR, Engen DJ, Bauer BA, Holmes DR, Rihal CS, Lennon RJ, Loehrer LL, Wahner-Roedler DL Abstract A pilot study was conducted to assess the feasibility and efficacy of massage therapy for cardiac catheterization laboratory staff. Staff members (N = 50) were randomly assigned to 5 or 10 weekly 30-min massages, followed by outcomes assessment. A control group (n = 10) receiving no massage therapy underwent comparable assessment. Visual analog scales, the t test, and the repeated measures model evaluated fatigue, pain, relaxation, stress/anxiety, tension/discomfort, and scheduling ease at baseline, 5 weeks, and 10 weeks. The Aickin separation test was used to assess feasibility of further research. Overall, 90% (337/375) of massage appointments were used. No significa...

Lung neovascularity in pulmonary arterial hypertension associated with congenital heart defects and idiopathic pulmonary arterial hypertension: study of 198 patients

European Radiology — Thu, 29 Dec 2011 06:42:30 +0100

Conclusions Neovascularity even if not pathognomonic for PAH-CHD, is significantly more common in these patients, especially in Eisenmenger’s syndrome. It is often the first CT sign to indicate the severity of PH in PAH-CHD and IPAH. A neovascularity ≥5 on CT indicates a intermediate or high PH. Key Points • Large retrospective studying specific lung disorders in patients with pulmonary arterial hypertension. • Neovascularity is often the first CT sign indicating the severity of pulmonary hypertension Alterations of lung parenchyma on CT in pulmonary hypertension are described • The first study to assess the severity of pulmonary hypertension by CT • If substantiated, CT might eventually replace some cardiac catheterisati...

Congenital Heart Disease Associated Pulmonary Arterial Hypertension: Preliminary Results From a Novel Registry

Internal Medicine Journal — Thu, 29 Dec 2011 05:00:00 +0100

Conclusions: CHD associated with PAH in adult life has resulted in a new population with unique needs. This registry will allow documentation of clinical course and long‐term outcomes for these patients. (Source: Internal Medicine Journal)

Comparison of stroke work between repaired tetralogy of Fallot and normal right ventricular physiologies

Heart and Vessels — Tue, 27 Dec 2011 17:03:36 +0100

The objective of this study is to evaluate the possibility of using RV body surface area (BSA)-indexed stroke work (SWI) to quantify RV inefficiency in TOF patients. We hypothesized that RV SWI required to push blood to the lungs in rTOF patients is significantly higher than that of normal subjects. Seven patients with rTOF pathophysiology and eight controls with normal RV physiology were registered for this study. Right ventricular volume and pressure were measured using cardiac magnetic resonance imaging and catheterization, respectively. Statistical analysis was performed to quantify the difference in SWI between the RV of the rTOF and control groups. Right ventricular SWI in rTOF patients (0.176 ± 0.055 J/m2) was significantly higher by 93.4% (P = 0.0026) than that of controls (0....

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Silent interrupted aortic arch in an elderly patient.

Cardiology Journal — Sat, 24 Dec 2011 18:12:03 +0100

Authors: Erden I, Kayapinar O, Erden EC, Yalçin S Abstract Patients with complete interruption of the aortic arch (IAA) very rarely reach late adulthood without having undergone surgical intervention. Only a few cases of IAA in adults have been reported in the medical literature. In this case report, we present a late diagnosis of interrupted aortic arch in a 68 year-old male. Our patient was relatively asymptomatic until he presented with fatigue after walking quickly. A guidewire could not be passed to the aortic arch via the femoral approach; descending thoracic aortography revealed complete occlusion of the descending thoracic aorta. Cardiac catheterization via the right brachial artery confirmed the diagnosis of a complete interruption of the aortic arch distal to the left su...

A high dose of dexmedetomidine using the BIS monitor™ for diagnostic and interventional cardiac catheterization in a toddler with congenital heart disease

Journal of Anesthesia — Sat, 24 Dec 2011 16:45:40 +0100

Abstract Dexmedetomidine (DEX) for sedation in diagnostic and interventional cardiac catheterization (DICC) has been reported to require other drugs or rescue drugs because of its insufficient sedative effect when used alone. We administered DEX and adjusted its dose according to the bispectral index (BIS) monitor™ for DICC in a toddler; consequently, a high dose of DEX had to be administered. The patient was a 1-year and 4-month-old boy who was scheduled to undergo DICC after intracardiac repair. We used DEX alone as the sedative because this was expected to avoid oxygen supply and mechanical ventilation and to produce a safe situation for procedures around the neck. DEX was administered at the dose of 1–15 μg/kg/h according to BIS monitor™; administration of ...

Association of soluble tumour necrosis factor-related apoptosis-inducing ligand levels with coronary plaque burden and composition

Heart — Fri, 23 Dec 2011 05:00:00 +0100

Conclusion According to the findings of the present study, in addition to coronary artery disease burden, the sTRAIL concentration is also related to the composition of atheromatous plaques. A significant association is demonstrated between low sTRAIL levels and the presence of TCFA, the IVUS–virtual histology prototype of the vulnerable plaque. (Source: Heart)

Right ventriculo-arterial coupling in pulmonary hypertension: a magnetic resonance study

Heart — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions Right ventriculo-arterial coupling in pulmonary hypertension can be studied with standard RHC and CMR. Arterial load increases with disease severity whereas contractility cannot progress in parallel, leading to severe uncoupling. (Source: Heart)

Pulmonary Atresia With Aortopulmonary and Coronary Artery Collaterals: Precise Depiction by Low-Dose Computed Tomography

Journal of the American College of Cardiology — Thu, 22 Dec 2011 02:25:47 +0100

A 6-year-old female with tetralogy of Fallot whose echocardiogram and cardiac catheterization showed pulmonary atresia, ventricular septal defect, aortopulmonary collaterals, and collaterals from the coronary arteries to the main pulmonary artery. Computed tomography (2 × 64-slice, 0.75-mm reconstruction; Online Video) with prospective electrocardiographic gating showed a large collateral from the right coronary artery ostium and another collateral arising from the left coronary artery ostium supplying a small main pulmonary artery (A and B). There was severe hypoplasia and isolation of the right pulmonary artery before bifurcation into upper and lower lobe branches, which were supplied by multiple aortopulmonary collaterals (A and C). This rare variant of tetralogy of Fallot has been pre...

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Delayed Airway Obstruction after Internal Jugular Venous Catheterization in a Patient with Anticoagulant Therapy

Clinical and Developmental Immunology — Wed, 21 Dec 2011 23:54:28 +0100

Delayed onset of neck hematoma following central venous catheterization without arterial puncture is uncommon. Herein, we present a patient who developed a delayed neck hematoma after repeated attempts at right internal jugular venous puncture and subsequent enoxaparin administration. Progressive airway obstruction occurred on the third day after surgery. Ultrasound examination revealed diffuse hematoma of the right neck, and fibreoptic examination of the airway revealed pharyngeal edema. After emergent surgical removal of the hematoma, the patient was extubated uneventfully. (Source: Clinical and Developmental Immunology)

Might cardiac catheterization influence diurnal rhythm of the steroid stress hormones secretion?

Physiological Research — Tue, 20 Dec 2011 05:00:00 +0100

Authors: Skarlandtová H, Bičíková M, Neužil P, Mlček M, Hrachovina V, Svoboda T, Medová E, Kudlička J, Dohnalová A, Havránek S, Kazihnítková H, Máčová L, Vařejková E, Kittnar O Abstract Glucocorticoids (GCs) are steroid hormones produced by the adrenal cortex in reaction to stress stimuli. GCs production is not stable over a 24-hour period; the plasma concentration peaks in the morning (approximately upon awakening) and then the plasma levels decrease, reaching the nadir in the evening. In our experiments, the levels of cortisol, cortisone, DHEA and DHEAS were tested in young female pigs (n=23) during heart catheterization at two different day times (in the morning and in the afternoon). The non-parametric Mann-Whitney test for statistical analysis was used. We fou...

Unrepaired Tetralogy of Fallot with Major Aortopulmonary Collateral Arteries in an Adult Patient

Congenital Heart Disease — Sun, 18 Dec 2011 05:00:00 +0100

We describe a 36‐year‐old man with unrepaired tetralogy of Fallot with distinctive aortopulmonary collaterals, who underwent complete surgical repair with good outcome. Two‐dimensional echocardiogram, cardiac magnetic resonance imaging, and cardiac catheterization each provided vital details allowing a stepwise approach to defining his unique anatomy for surgical correction. (Source: Congenital Heart Disease)

Contribute to the ESC collection of educational cases

European Society of Cardiology — Fri, 16 Dec 2011 16:43:06 +0100

Share your experience with peers and contribute to Education in cardiology!In two steps, your case can be published on the ESC website and submitted to the European Heart Journal to be published in print and online (subject to the EHJ approval).Don't miss the opportunity to submit a generic clinical case Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Basic Science, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of the Aorta and Trauma to the Aorta and Heart, Echocardiography (Non-invasive imagin...

NEW: European Heart Journal Acute Cardiovascular Care

European Society of Cardiology — Fri, 16 Dec 2011 15:06:27 +0100

The European Heart Journal Acute Cardiovascular Care will be launched in Spring 2012 as the official journal of the ESC Working Group on Acute Cardiac Care. Learn more about this new journal and contribute to its success by submitting a paper. Topics: Acute Coronary Syndromes (ACS), Arrhythmias, Atrial Fibrillation, Cardiac Tumours, Cardiovascular Disease Prevention - Risk Assessment and Management, Cardiovascular Nursing, Cardiovascular Surgery, Chronic Ischaemic Heart Disease (IHD), Clinical pharmacology, Computers in Cardiology, Congenital Heart Disease, Diabetic heart disease, Diseases of the Aorta and Trauma to the Aorta and Heart, Echocardiography (Non-invasive imaging), Genetics, Heart Failure (HF), Hypertension, Infective Endocarditis, Invasi...

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Pulmonary Atresia with Ventricular Septal Defect and Multifocal Pulmonary Blood Supply: Does an Intensive Interventional Approach Improve the Outcome?

Congenital Heart Disease — Fri, 16 Dec 2011 05:00:00 +0100

Conclusions. Combining surgical unifocalization procedures with subsequent early and intensive catheter‐based pulmonary artery rehabilitation may improve vascular growth, ultimately rendering many patients suitable for fenestrated VSD closure. Risk stratification, including intraoperative exit angiography, is essential to determine the need for early transcatheter interventions. (Source: Congenital Heart Disease)

Pulmonary Arterial Hypertension in Systemic Sclerosis Is Associated with Profound Impairment of Microvascular Endothelium-dependent Vasodilatation.

J Rheumatol — Thu, 15 Dec 2011 05:00:00 +0100

CONCLUSION: Systemic microvascular endothelium-dependent vasodilatation is markedly reduced in SSc complicated by PAH. PMID: 22174212 [PubMed - as supplied by publisher] (Source: J Rheumatol)

How much of the world do you need for meaningful clinical trials? * Christmas Greetings 2011 * Book review: 'Cardiovascular catheterization and intervention' * A Textbook of Coronary, Peripheral, and Structural Heart Disease * The Brazilian Archives of Cardiology is the only cardiology journal in Latino America and the Southern hemisphere with an impact factor * The Mediterranean Diet, Part II * The TIMI story

European Heart Journal — Wed, 14 Dec 2011 05:00:00 +0100

(Source: European Heart Journal)

Echocardiography based estimation of pulmonary vascular resistance in patients with pulmonary hypertension: a simultaneous Doppler echocardiography and cardiac catheterization study

European Journal of Echocardiography — Wed, 14 Dec 2011 05:00:00 +0100

Conclusion The proposed Doppler-derived formula for estimating PVR based on the conventionally used invasive equation strongly correlates with invasive gold standard measures. (Source: European Journal of Echocardiography)

Scott & White Hospital -- Temple receives ACE accreditation for percutaneous coronary intervention

EurekAlert! - Medicine and Health — Mon, 12 Dec 2011 05:00:00 +0100

(Scott & White Healthcare) Scott & White Hospital -- Temple's Cardiac Catheterization Laboratory has become only the fourth cardiac catheterization laboratory in the United States to be accredited for percutaneous coronary intervention by Accreditation for Cardiovascular Excellence (ACE), an organization dedicated to ensuring adherence to the highest quality standards for cardiovascular and endovascular care. ACE accreditation is a professional review of an organization's structure, internal processes, patient safety practices, and clinical outcomes to determine if it meets the standards established by experts in cardiac and endovascular care. (Source: EurekAlert! - Medicine and Health)

Acute haemodynamic changes after percutaneous mitral valve repair: relation to mid-term outcomes

Heart — Mon, 12 Dec 2011 05:00:00 +0100

Conclusion In a heterogeneous population with predominantly functional MR, percutaneous MVR with the Evalve MitraClip system lowers mPCWP, PCWP v-wave and mPAP by 20%, 20% and 8%, respectively, and increases the CI by 32%. (Source: Heart)

Transitioning to the radial artery as the preferred access site for cardiac catheterization: An academic medical center experience

Catheterization and Cardiovascular Interventions — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions: Our observations support the concept that complete transition of a cath lab to a preferred TR strategy is feasible, achieves lower rates of vascular and bleeding complications but with modest increases in overall procedural metrics. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Transcatheter closure of the perimembranous ventricular septal defect—preclinical trial of a new amplatzer device

Catheterization and Cardiovascular Interventions — Mon, 12 Dec 2011 05:00:00 +0100

Conclusions: The success of this animal study confirms safety and feasibility of the Amplatzer pmVSO2 device. Human trials are planned. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Angioplasty and Stenting of a Jugular‐Carotid Fistula Resulting from the Inadvertent Placement of a Hemodialysis Catheter: Case Report and Review of Literature

Seminars In Dialysis — Fri, 09 Dec 2011 05:00:00 +0100

AbstractHemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid‐ to long‐term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular‐carotid fistula (JCF) and a method for rectifying such a vascular conundrum, using endovascular techniques. We describe the technique used to achieve closure of the fistula as well a review of the literature. An 82‐year‐old woman with history of congestive heart failure, chronic renal failure, and diabetes mellitus developed an iatrogenic arteriovenous fistula, following an attempt of canalizing the right IJV. The patient was treated using three different stents, which ach...

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Angioplasty and Stenting of a Jugular-Carotid Fistula Resulting from the Inadvertent Placement of a Hemodialysis Catheter: Case Report and Review of Literature.

Seminars in Dialysis — Fri, 09 Dec 2011 05:00:00 +0100

Authors: Wadhwa R, Toms J, Nanda A, Abreo K, Cuellar H Abstract Hemodialysis catheterization through the right internal jugular vein (IJV) is widely used for mid- to long-term hemodialysis for patients with renal failure. The purpose of this report is to address a serious complication in conjunction with this procedure. This is a case report of an iatrogenic jugular-carotid fistula (JCF) and a method for rectifying such a vascular conundrum, using endovascular techniques. We describe the technique used to achieve closure of the fistula as well a review of the literature. An 82-year-old woman with history of congestive heart failure, chronic renal failure, and diabetes mellitus developed an iatrogenic arteriovenous fistula, following an attempt of canalizing the right IJV. The patie...

Central venous port placement in advanced breast cancer patients: comparison of the anatomic-landmark and ultrasound-guided techniques

The Chinese-German Journal of Clinical Oncology — Thu, 08 Dec 2011 18:17:30 +0100

Conclusion The findings of this study indicate that, in the placement of an internal jugular vein port, the ultrasound (US)-guided technique has several advantages over the anatomic-landmark technique. Content Type Journal ArticlePages 695-698DOI 10.1007/s10330-011-0842-3Authors Nanyan Rao, Department of breast Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guanzhou, 510260 ChinaJiannan Wu, Department of breast Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guanzhou, 510260 ChinaShunrong Li, Department of breast Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guanzhou, 510260 ChinaLiang Jin, Department of breast Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, Guanzhou, 510260 ChinaWeijuan Jia, Depa...

Vacuum thrombectomy of large right atrial thrombus

Catheterization and Cardiovascular Interventions — Thu, 08 Dec 2011 05:00:00 +0100

We report a novel technique for percutaneous removal of the right heart thrombi using a suction cannula. This method allowed complete en bloc removal of the right atrial thrombus avoiding surgical procedure in a high risk patient. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Detached tip of a transseptal sheath during left atrial ablation

Catheterization and Cardiovascular Interventions — Thu, 08 Dec 2011 05:00:00 +0100

We report a case of a 46 year‐old female diagnosed with idiopathic dilated cardiomyopathy that presented with atypical left atrial flutter. During electrophysiologic study, a Swartz braided SL1 (SL‐1) transseptal sheath was used to introduce the ablation catheter to the left atrium. During left atrial mapping, the radiopaque tip of the sheath detached from the rest of the sheath and was seen floating in the LA. After exchanging the SL‐1 sheath with a deflectable sheath, the detached segment was retrieved out of the LA and eventually out of the vascular system using an angioplasty balloon advanced over a wire and inflated distal to the lumen of the detached tip. The root cause of this malfunction was found to be lack of a secondary bonding process that these sheaths generally undergo ...

Acute ST changes during anesthesia induction 10 months after norwood procedure

Catheterization and Cardiovascular Interventions — Thu, 08 Dec 2011 05:00:00 +0100

We report a case of a clinically thriving 10‐month old infant status post bidirectional Glenn who had acute ischemic changes on electrocardiogram (ECG) during induction of anesthesia for elective bilateral herniorrhaphy. A discrete narrowing in the native aorta to neo‐aorta anastomosis was identified. A stent was placed emergently to restore adequate coronary blood flow after failure of simple angioplasty to adequately improve the stenosis. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Bleeding complications in primary percutaneous coronary intervention of ST‐elevation myocardial infarction in a radial center

Catheterization and Cardiovascular Interventions — Thu, 08 Dec 2011 05:00:00 +0100

Conclusions: In the setting of radial primary PCI, the rates and types of bleeding complications are somewhat different from those observed with femoral primary PCI. The gastro‐intestinal tract has become the most frequent site of bleeding after radial primary PCI. The use of radial access appears independently associated with survival. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Left‐ventricular outflow tract ventricular‐tachycardia event following corevalve transcatheter aortic‐valve implantation

Catheterization and Cardiovascular Interventions — Wed, 07 Dec 2011 05:00:00 +0100

We describe a patient with severe aortic stenosis who underwent CoreValve (Medtronic) implantation and presented several days later with a tachyarrhythmic episode. The electrocardiographic features of the arrhythmia were compatible with left‐ventricular outflow tract ventricular‐tachycardia. The life‐threatening event was not associated with ischemia or an electrolyte disorder and was not drug‐induced. A probable cause was the irritation of the myocardium by the prosthetic valve. Clinicians should be aware that the presence of anatomical parameters that increases the risk for myocardial injury and the need for pacemaker implantation might indicate an increased risk of a tachyarrhythmic episode. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Intervention...

Drug eluting stenting in bifurcation coronary lesions long‐term results applying a systematic treatment strategy

Catheterization and Cardiovascular Interventions — Wed, 07 Dec 2011 05:00:00 +0100

Conclusions: Our study revealed favorable long‐term clinical results following DES implantation using a systematic, rather simplified approach towards bifurcation stenting and using either a single or double stenting technique. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Effect of bivalirudin compared with unfractionated heparin plus abciximab on infarct size and myocardial recovery after primary percutaneous coronary intervention: The horizons‐AMI CMRI substudy

Catheterization and Cardiovascular Interventions — Wed, 07 Dec 2011 05:00:00 +0100

Conclusions: In conclusion, in the HORIZONS‐AMI Cardiac magnetic resonance imaging (CMRI) substudy, cardiac magnetic resonance imaging within 7 days and at 6 months after primary percutaneous coronary intervention (PCI) did not demonstrate significant differences in infarct size, MVO, LVEF, or LV volume indices in patients treated with bivalirudin compared with unfractionated heparin plus abciximab. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Downstream resource utilization following hybrid cardiac imaging with an integrated cadmium-zinc-telluride/64-slice CT device

European Journal of Nuclear Medicine and Molecular Imaging — Tue, 06 Dec 2011 06:59:07 +0100

Conclusion Cardiac hybrid imaging in CAD evaluation has a profound impact on patient management and may contribute to optimal downstream resource utilization. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00259-011-1999-2Authors Michael Fiechter, Department of Radiology, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, SwitzerlandJelena R. Ghadri, Department of Radiology, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, SwitzerlandMathias Wolfrum, Department of Radiology, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, SwitzerlandSilke M. Kuest, Department of Radiology, Cardiac Imaging, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, SwitzerlandAju P....

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ESC Webinar on Imaging inside the cath lab. The new challenges

European Society of Cardiology — Mon, 05 Dec 2011 16:23:32 +0100

Attend Prof. Zamorano & Dr. Badano's webinar and learn how to use imaging for assessing transcatheter aortic valve implantation (TAVI), prosthetic leaks and clips implantation. Register and join them on 16 January 2012, 19:00-20:00 (CET) Topics: Invasive Imaging: Cardiac Catheterisation and Angiography (Source: European Society of Cardiology)

Mesothelial/monocytic incidental cardiac excrescence in a patient with antiphospholipid syndrome [Case report - Cardiac general]

Interactive CardioVascular and Thoracic Surgery — Mon, 05 Dec 2011 05:00:00 +0100

Tortuous right coronary artery to coronary sinus fistula [Case report - Congenital]

Interactive CardioVascular and Thoracic Surgery — Mon, 05 Dec 2011 05:00:00 +0100

High-Sensitivity C-Reactive Protein is a Predictor of In-Hospital Cardiac Events in Acute Myocardial Infarction Independently of GRACE Risk Score

Angiology — Sun, 04 Dec 2011 05:00:00 +0100

High-sensitivity CRP (hsCRP) is being increasingly used as a marker for cardiac risk assessment and as a prognostic tool in acute coronary syndrome. We analyzed the relation between hsCRP values at admission and in-hospital outcomes in 98 consecutive patients with acute myocardial infarction (AMI) undergoing catheterization. Patients with cardiac events had more advanced Killip class, more proportion of depressed left ventricular ejection fraction (LVEF), higher Global Registry of Acute Coronary Events (GRACE) risk score, and higher hsCRP levels. High-sensitivity CRP and GRACE risk score showed a significant positive correlation (r = .320, P = .002). In multivariate analysis, hsCRP resulted as a predictor of worse in-hospital outcomes independently of GRACE risk score (OR 1.122, CI95%:1.00...

Peripheral augmentation index as a biomarker of vascular aging: an invasive hemodynamics approach

European Journal of Applied Physiology — Fri, 02 Dec 2011 17:28:25 +0100

Abstract We compared two measures of vascular function obtained from digital volume waveforms with measures of target organ damage and novel invasive measures of vascular function as they relate to vascular aging. Aortic pulse pressure amplification, pulsatility, form factor and extent of coronary atherosclerosis (modified Gensini score) were obtained invasively in 59 patients undergoing left heart catheterization. Digital volume waveforms were captured via peripheral arterial tone (PAT) and used to derive augmentation index (AIx) and the pulse wave amplitude-reactive hyperemia index (PWA-RHI). AIx was associated with age (r = 0.50, p < 0.05) and aortic pulsatility (r = 0.45, p < 0.05) and inversely associated with estimated glom...

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Diffusion-weighted MRI determined cerebral embolic infarction following transcatheter aortic valve implantation: assessment of predictive risk factors and the relationship to subsequent health status

Heart — Fri, 02 Dec 2011 05:00:00 +0100

Conclusion Multiple small cerebral infarcts occurred in 77% of patients with TAVI. The majority of infarcts were ‘silent’ with clinical stroke being associated with a both higher infarct number and volume. Increased age and the severity of aortic arch atheroma were independent risk factors for the development of new cerebral infarcts. Overall HRQoL improved and there was no association between the number of new cerebral infarcts and altered health status. (Source: Heart)

What is the acceptable rate of false positives for STEMI within a primary PCI network? Insights from a metropolitan system with direct ambulance-based access

International Journal of Cardiology — Fri, 02 Dec 2011 05:00:00 +0100

In recent years percutaneous coronary intervention (PCI) has become the preferred treatment for patients with ST elevation acute myocardial infarction (STEMI) and regional PCI networks have been widely developed in many countries . In this context, the problem of “false-positive” (FP) cardiac catheterization laboratory activations is emerging as a relevant issue (average rate of 12.7%, ranging from 6.4% to 22.7%) potentially leading to resource wasting . The extent to which the type of network organization influences the prevalence of FP is currently unknown and minimum and maximum acceptable FP rates have yet to be established. Direct ambulance-based access to the catheterization lab for example, which has been shown to reduce pre-balloon time on one hand , on the other may increase t...

Clopidogrel pre-treatment is associated with reduced in-hospital mortality in primary percutaneous coronary intervention for acute ST-elevation myocardial infarction

European Heart Journal — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion Clopidogrel pre-treatment before arrival at the PCI centre is associated with reduced mortality in a real world setting of primary PCI. These results strongly support the recommendation of clopidogrel treatment ‘as soon as possible’ in patients with STEMI undergoing pimary PCI. (Source: European Heart Journal)

Effect of upstream clopidogrel treatment in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

European Heart Journal — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion This large observational study suggests that upstream clopidogrel treatment prior to arrival at the catheterization lab is associated with a reduction in the combined risk of death or MI as well as death alone in patients with STEMI treated with primary PCI. (Source: European Heart Journal)

Is cardiac catheterization necessary before initial management of patients with stable ischemic heart disease? Results from a Web-based survey of cardiologists

American Heart Journal — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Most surveyed cardiologists were willing to enroll SIHD patients with at least moderate ischemia into a trial with an initial noninvasive strategy arm. These findings support the feasibility of planning a large-scale trial to test the role of cardiac catheterization and revascularization in the initial management of SIHD patients with moderate or severe ischemia. (Source: American Heart Journal)

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Incidence of thrombotic and bleeding complications during cardiac catheterization in children: comparison of high‐dose vs. low‐dose heparin protocols

Journal of Thrombosis and Haemostasis — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: The incidences of TE and bleeding during CC in children were low. There were no differences between the high‐dose and the low‐dose UFH protocols studied. Although Heparin Anticoagulation Randomized Trial in Cardiac Catheterization (HEARTCAT) was not designed as non‐inferiority trial, low‐dose UFH (50 units kg−1 bolus) appears sufficient for thromboprophylaxis during CC. (Source: Journal of Thrombosis and Haemostasis)

Non‐invasive assessment of liver fibrosis in patients after the Fontan operation

Pediatrics International — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: No specific parameter that reflects the progress in liver fibrosis was identified in this study. The possibility exists that type IV collagen reflects the degree of hepatic congestion. (Source: Pediatrics International)

Persistent left superior vena cava: Experience of a tertiary health‐care center

Pediatrics International — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Transthoracic echocardiography usually visualizes dilated coronary sinus in association with PLSVC. However, SVC injection should be performed in patients undergoing angiography so that morbidity and mortality related with persistent left superior vena cava can be avoided during cardiovascular surgery. (Source: Pediatrics International)

Percutaneous revascularization of total or subtotal left main occlusion in the setting of acute myocardial infarction.

Turk Kardiyoloji Dernegi arsivi — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: Percutaneous coronary intervention in patients with LMCO complicated by AMI is feasible and effective, and offers a good mid-term outcome for hospital survivors. PMID: 22257804 [PubMed - in process] (Source: Turk Kardiyoloji Dernegi arsivi)

Left Radial versus Right Radial Approach for Coronary Artery Catheterization: A Prospective Comparison

Journal of Interventional Cardiology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions:The left radial approach in our series was demonstrated to be safe and feasible in daily practice, and in this study was associated with a reduction in fluoroscopy time and number of catheters used. (J Interven Cardiol 2012;**:1–7) (Source: Journal of Interventional Cardiology)

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Percutaneous Transvenous Melody Valve-in-Ring Procedure for Mitral Valve Replacement

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

Objectives: The purpose of this study was to demonstrate the feasibility of percutaneous transvenous mitral valve-in-ring (VIR) implantation using the Melody valve in an ovine model.Background: The recurrence of mitral regurgitation following surgical mitral valve (MV) repair in both adult and pediatric patients remains a significant clinical problem. Mitral annuloplasty rings are commonly used in MV repair procedures and may serve as secure landing zones for percutaneous valves.Methods: Five sheep underwent surgical MV annuloplasty (24 mm, n = 2; 26 mm, n = 2; 28 mm, n = 1). Animals underwent cardiac catheterization with VIR implantation via a transfemoral venous, transatrial septal approach 1 week following surgery. Hemodynamic, angiographic, and echocardiographic data were recorded befo...

Progressive Right Ventricular Dysfunction in Patients With Pulmonary Arterial Hypertension Responding to Therapy

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

Conclusions: After PAH-targeted therapy, RV function can deteriorate despite a reduction in PVR. Loss of RV function is associated with a poor outcome, irrespective of any changes in PVR. (Source: Journal of the American College of Cardiology)

Predicting Long-Term Survival in Pulmonary Arterial Hypertension: More Than Just Pulmonary Vascular Resistance⁎

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

“In the long run, men hit only what they aim at.Therefore, though they should fail immediately,they had better aim at something high”—Henry David Thoreau () Despite considerable advances in medical therapy for pulmonary arterial hypertension (PAH), long-term mortality remains high (), largely as a result of right heart failure. It is well established that measures of right ventricular (RV) performance, rather than pulmonary artery pressure, are the key determinants of survival (). Hence, a major focus of current research efforts is characterizing and understanding RV dysfunction. An important contribution is the paper in this issue of the Journal by van de Veerdonk et al. (). This group of investigators, who have an established track record in cardiac magnetic resonance imaging (MRI...

A Worrisome Interventricular Septum: More Than Meets the Eye

Journal of the American College of Cardiology — Thu, 01 Dec 2011 02:26:22 +0100

A 59-year-old woman with known enteropathy-associated T-cell lymphoma (EATL) presented with weakness and malaise. An electrocardiogram demonstrated sinus tachycardia, right bundle branch block, and anterior ST-segment elevations (A). Cardiac catheterization showed patent coronary arteries (B, Online Videos 1 and 2). Echocardiography and cine cardiac magnetic resonance imaging (MRI) demonstrated asymmetric septal hypertrophy (Online Videos 3 and 4), whereas delayed-enhancement cardiac MRI tissue characterization showed patchy epicardial and mid-myocardial hyperenhancement, suggestive of hypertrophic cardiomyopathy (C). (Source: Journal of the American College of Cardiology)

Amplatzer septal occluder to treat iatrogenic cardiac perforations

Catheterization and Cardiovascular Interventions — Wed, 30 Nov 2011 05:00:00 +0100

Conclusions: Percutaneous device occlusion of iatrogenic heart perforation seems to be a safe and efficient method to treat iatrogenic heart perforation. In order to perform this elegant method, it is however imperative not to prematurely withdraw the perforating catheter to maintain access to the hole for closure. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Coronary Malperfusion due to Flap Suffocation after Acute Type A Dissection Surgery.

Annals of Thoracic and Cardiovascular Surgery — Wed, 30 Nov 2011 05:00:00 +0100

Authors: Isoda S, Osako M, Kimura T, Mashiko Y, Yamanaka N, Nakamura S, Maehara T Abstract A 24-year-old man presented with chest pain. He was diagnosed as having a type A acute aortic dissection and an annulo-aortic aneurysm. After emergency surgery for an aortic root replacement, his electrocardiogram showed ST-segment depression and T-wave inversion. Echocardiography showed asynergy of the left ventricle without coronary ostial pathology. Heart catheterization revealed no coronary stenosis, but the true lumen of the residual ascending aorta had extreme diastolic narrowing due to flap suffocation. This resulted in coronary malperfusion. The pullback pressure curve confirmed the mechanism. The patient underwent a surgical re-intervention for a total arch repair, which diminished t...

A deflectable guiding catheter for real‐time MRI‐guided interventions

Journal of Magnetic Resonance Imaging — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion:Kevlar and short nitinol component substitutions preserved mechanical properties. The active design offered the best visibility and usability but reintroduced metal conductors. We describe versatile deflectable guiding catheters with a 0.057” lumen for interventional MRI catheterization. Implementations are feasible using active, inductive, and passive visualization strategies to suit application requirements. J. Magn. Reson. Imaging 2011. © 2011 Wiley Periodicals, Inc. (Source: Journal of Magnetic Resonance Imaging)

Pulmonary arterial hypertension therapy may be safe and effective in patients with systemic sclerosis and borderline pulmonary pressures

Arthritis and Rheumatism — Tue, 29 Nov 2011 05:00:00 +0100

Conclusion:In systemic sclerosis patients with borderline pulmonary hemodynamics, resting and exercise pulmonary arterial pressure may significantly increase within one year of observation. Bosentan might be safe and effective to attenuate these changes. Randomised controlled trials are warranted to confirm these explorative findings of a hypothesis generating study. (Source: Arthritis and Rheumatism)

MR Imaging-Guided Cardiovascular Interventions in Young Children

Magnetic Resonance Imaging Clinics of North America — Mon, 28 Nov 2011 20:47:26 +0100

This article describes MR image-guided or MR image-assisted cardiac catheterization procedures for diagnosis and intervention in children. (Source: Magnetic Resonance Imaging Clinics of North America)

Improvement in Revascularization Time After Creation of a Coronary Catheterization Laboratory at a Public Hospital [Research Letters]

Archives of Internal Medicine — Mon, 28 Nov 2011 05:00:00 +0100

(Source: Archives of Internal Medicine)

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Use of 4 mitraclip devices in a patient with ischemic cardiomyopathy and mitral regurgitation – 'zipping by clipping'

Catheterization and Cardiovascular Interventions — Sat, 26 Nov 2011 22:21:07 +0100

In this report we portray a 72 year‐old gentleman presenting with endstage systolic heart failure and severe functional MR as a consequence of long‐standing coronary artery disease. Recently, his clinical course was complicated by intractable hemodynamic instability and recurrent pulmonary oedema. High predicted mortality and progressive physical decay rendered this moribund patient a candidate for salvage percutaneous mitral valve repair. During the endovascular procedure a central systolic coaptation gap of 7 mm proved to be too wide for adequate simultaneous grasping of both leaflets. Consideration was given to an alternative approach by means of our novel ‘zipping‐technique’. Via transseptal route, medial to lateral approximation of the tethered leaflets was successfully achi...

Feasibility and procedure-related patient discomfort of peripheral venous access for coronary sinus cannulation during electrophysiology procedures

Journal of Interventional Cardiac Electrophysiology — Fri, 25 Nov 2011 17:56:38 +0100

Conclusion This small, randomized study indicates that peripheral venous access for CS catheter placement during EP procedures is feasible, with equivalent success rate to the central venous access approach, and associated with lower levels of self-reported patient discomfort. Content Type Journal ArticlePages 1-5DOI 10.1007/s10840-011-9635-4Authors Spyridon Deftereos, Department of Cardiology, Athens General Hospital “G. Gennimatas”, 154 Mesogeion Ave., 11527 Athens, GreeceGeorgios Giannopoulos, Department of Cardiology, Athens General Hospital “G. Gennimatas”, 154 Mesogeion Ave., 11527 Athens, GreeceCharalambos Kossyvakis, Department of Cardiology, Athens General Hospital “G. Gennimatas”, 154 Mesogeion Ave., 11527 Athens, GreeceKonstantinos Raisakis, D...

Contrast-induced Nephropathy Risk Assessment in Real World Practice

The American Journal of Medicine — Fri, 25 Nov 2011 12:06:30 +0100

A 56-year-old woman with a history of coronary artery disease with previous 3-vessel coronary artery bypass grafting, ischemic cardiomyopathy, and diabetes mellitus presented with several months of exertional chest discomfort. She was referred for cardiac catheterization after reversible inferior ischemia was demonstrated on a stress myocardial perfusion scan. The catheterization showed an occluded saphenous vein graft to the right coronary artery and focal right coronary artery stenosis. Overlapping drug-eluting stents were placed in the right coronary artery utilizing a total of 200 cc of iodixanol during both the diagnostic and interventional procedure. At baseline, her serum creatinine was 1.2 mg/dL for an estimated glomerular filtration rate of 46 mL/min/1.73 m2, and her hemoglobin wa...

The XIENCE nano ™ everolimus eluting coronary stent system for the treatment of small coronary arteries: The SPIRIT small vessel trial

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions:Based on the 1‐year clinical and 8‐month angiographic SPIRIT SV data, the XIENCE nano EECSS is considered safe and effective in the treatment of small vessels. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

The prognostic role of mitral regurgitation after primary percutaneous coronary intervention for acute ST‐elevation myocardial infarction

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions:Following primary PCI for STEMI, echocardiographic detected MR in the first 72 hours following PCI stratifies mortality risk. However, when accounting for age, MR is not an independent predictor of mortality. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Use of intraprocedural CT imaging to guide alcohol septal ablation of hypertrophic cardiomyopathy in the cardiac catheterization laboratory

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

AbstractAlcohol septal ablation is a common treatment for hypertrophic cardiomyopathy. The success of the procedure is dependent on targeting a small dose of alcohol to the appropriate septal perforator in order to cause a myocardial infarction in the septum at the point of mitral valve contact. Typically, this is identified by injecting echocardiographic contrast into a septal vessel and using echocardiography to confirm that the area of septal‐SAM contact is highlighted. Rotational angiography using the C‐arm in the catheterization laboratory acquires a 3‐dimensional “CT‐like” image, and has shown promise in providing anatomic guidance in coronary and structural heart disease interventions. We demonstrate here a novel application of intraprocedural CT imaging to localize the ...

Percutaneous coronary intervention with rotational atherectomy for severely calcified unprotected left main : Immediate and two years follow‐up results

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

CONCLUSION:In a group of high surgical risk patients, rotational atherectomy on severely calcified left main stenosis is feasible and, in spite of high mortality rates, could pose the only possible effective treatment. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Predictors of treatment in acute coronary syndromes in the elderly: Impact on decision making and clinical outcome after interventional vs. conservative treatment

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

ConclusionIn this retrospective analysis, we indentified age as the main predictor for a conservative treatment strategy in elderly patients, albeit an invasive strategy was associated with a significantly better outcome. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

The XIENCE nano™ everolimus eluting coronary stent system for the treatment of small coronary arteries: The SPIRIT small vessel trial

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions: Based on the 1‐year clinical and 8‐month angiographic SPIRIT SV data, the XIENCE nano EECSS is considered safe and effective in the treatment of SVs. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Use of four MitraClip devices in a patient with ischemic cardiomyopathy and mitral regurgitation

Catheterization and Cardiovascular Interventions — Fri, 25 Nov 2011 05:00:00 +0100

In this report, we portray a 72‐year‐old man presenting with end‐stage systolic heart failure and severe functional MR as a consequence of long‐standing coronary artery disease. Recently, his clinical course was complicated by intractable hemodynamic instability and recurrent pulmonary edema. High predicted mortality and progressive physical decay rendered this moribund patient a candidate for salvage percutaneous mitral valve repair. During the endovascular procedure, a central systolic coaptation gap of 7 mm proved to be too wide for adequate simultaneous grasping of both leaflets. Consideration was given to an alternative approach by means of our novel “zipping technique.” Through the trans‐septal route, medial to lateral approximation of the tethered leaflets was successf...

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Cognition and Ischemic Microlesions After CatheterizationCognition and Ischemic Microlesions After Catheterization

Medscape Today Headlines — Thu, 24 Nov 2011 11:50:25 +0100

What are the correlates with cognition and microlesions between catheterization and cardiac surgery? American Heart Journal (Source: Medscape Today Headlines)

Economic evaluation of increasing population rates of cardiac catheterization

BMC Health Services Research — Thu, 24 Nov 2011 05:00:00 +0100

Conclusion: A strategy of increasing cardiac catheterization rates among eligible patients is associated with a cost per QALY similar to that of other funded interventions. However, there is significant model uncertainty. A decision to increase population rates of catheterization requires consideration of the accompanying opportunity costs, and careful thought towards the most appropriate strategy. (Source: BMC Health Services Research)

A multi-region assessment of population rates of cardiac catheterization and yield of high-risk coronary artery disease

BMC Health Services Research — Thu, 24 Nov 2011 05:00:00 +0100

Conclusions: Our study demonstrates a consistent finding, over time and across jurisdictions, of linearly increasing detection of high-risk CAD as population rates of cardiac catheterization increase. This internationally-relevant finding can inform country-level planning of invasive cardiac care services. (Source: BMC Health Services Research)

Complications of transradial catheterization

Cardiovascular Revascularization Medicine — Thu, 24 Nov 2011 05:00:00 +0100

Abstract: Cardiac catheterization via the transradial approach has increased in the United States over the past few years; however, wide-scale adoption still lags in comparison to many international health care systems. Transradial catheterization has a unique set of complications and risks that each operator must appreciate. Radial artery spasm and radial artery occlusion are the most common complications, while bleeding complications such as hematomas and perforations are much less frequent. Each of these issues can be managed successfully with minor changes to one's practice. In this review of the current state of the art, the reader will develop an appreciation for the prevalence of each of the common complications as well as the less common, but potentially highly morbid, events. Thro...

When should you question your wedge and use a long iron (transseptal needle) instead?

Catheterization and Cardiovascular Interventions — Wed, 23 Nov 2011 20:59:39 +0100

(Source: Catheterization and Cardiovascular Interventions)

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Time to clean up

Catheterization and Cardiovascular Interventions — Wed, 23 Nov 2011 20:59:36 +0100

(Source: Catheterization and Cardiovascular Interventions)

Learning curve for transcatheter aortic valve replacement

Catheterization and Cardiovascular Interventions — Wed, 23 Nov 2011 20:59:27 +0100

(Source: Catheterization and Cardiovascular Interventions)

Combined anterior mitral valve leaflet retention plasty and septal myectomy in patients with hypertrophic obstructive cardiomyopathy [Original articles]

European Journal of Cardio-Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: Combined subaortic septal myectomy and ALRP is a safe and effective therapy in HOCM patients with significant SAM. ALRP can help prevent residual or recurrent LVOT obstruction and improves mitral regurgitation. (Source: European Journal of Cardio-Thoracic Surgery)

Candidaemia in a European Paediatric University Hospital: A 10 Year Observational Study

Clinical Microbiology and Infection — Wed, 23 Nov 2011 05:00:00 +0100

AbstractIn this retrospective observational study covering 1998 through 2008, 32 patients (mean age: 7.50 years) were identified that had 35 episodes of candidaemia (0.47 cases/1000 hospital discharges). Cancer / allogeneic HSCT (43%) and congenital malformations / syndromes (21%) were the predominant underlying conditions. Central venous catheterization (90%), a history of antibacterial therapy (69%) and prior bacteraemia (54%) were frequent comorbidities. C. albicans (46%) was most common, followed by C. parapsilosis (17%) and C. glabrata (14%). Resistance was infrequent and limited to non‐albicans Candida spp. The 30‐ and 100 day mortality rates were 11.4%. (Source: Clinical Microbiology and Infection)

Nonfatal myocardial infarction and long-term outcomes in coronary artery disease

American Heart Journal — Wed, 23 Nov 2011 05:00:00 +0100

Conclusions: Nonfatal MIs occurring within the first 3 and 6 months after diagnostic catheterization are associated with a significant increase in the risk for subsequent clinical events. Clinical studies with limited follow-up periods may underestimate the long-term value of therapies that reduce early MI rates as downstream benefits continue to accrue over time. (Source: American Heart Journal)

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Candidaemia in a European Paediatric University Hospital: a 10‐year observational study

Clinical Microbiology and Infection — Wed, 23 Nov 2011 05:00:00 +0100

Clin Microbiol InfectAbstractIn this retrospective observational study covering 1998 to 2008, 32 patients (mean age: 7.50 years) were identified that had 35 episodes of candidaemia (0.47 cases/1000 hospital discharges). Cancer/allogeneic haematopoietic stem cell transplantation (43%) and congenital malformations/syndromes (21%) were the predominant underlying conditions. Central venous catheterization (90%), a history of antibacterial therapy (69%) and previous bacteraemia (54%) were frequent comorbidities. Candida albicans (46%) was most common, followed by Candida parapsilosis (17%) and Candida glabrata (14%). Resistance was infrequent and limited to non‐albicans Candida spp. The 30‐day and 100‐day mortality rates were 11.4%. (Source: Clinical Microbiology and Infection)

Venous Access Salvage Techniques

Techniques in Vascular and Interventional Radiology — Tue, 22 Nov 2011 20:38:43 +0100

For patients who need long-term central venous access but who have developed obstruction of the usual central veins, “salvage” access techniques offer successful alternatives. These techniques include translumbar inferior vena cava access, transhepatic inferior vena cava access, catheterization of small venous collaterals, and recanalization of occluded veins. Inferior vena cava access techniques allow a range of devices to be placed, including ports, infusion catheters, and hemodialysis catheters. Collateral vessels may be too small to allow for large-caliber devices, such as hemodialysis catheters. Success rates for these access techniques are high and complications are infrequent. These access routes are in general quite durable. Adults and children can be treated. Once placed, devi...

Minimally invasive insertion of an equine stented pulmonary valve with a built‐in sinus portion in a sheep model

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionsThe newly developed hydraulic release system allowed for safe and reliable insertion of an equine stented‐valve with a sinus portion, through a right transventricular approach on a beating heart, in a sheep survival model. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Randomized comparison of cost‐saving and effectiveness of oral rapamycin plus bare‐metal stents with drug‐eluting stents: Three‐year outcome from the randomized oral rapamycin in Argentina (ORAR) III trial

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:At 3 years follow‐up there were no differences in effectiveness between the 2 strategies and DES strategy was not more cost‐effective as compared to OR plus BMS. (word count 250) © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Prognostic implications of early and long‐term bleeding events in patients on one‐year dual antiplatelet therapy following drug‐eluting stent implantation

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:In DES treated patients on prolonged dual antiplatelet therapy, major bleeding occurring at one‐year and up to 4 years following DES implantation in patients on prolonged dual antiplatelet therapy is associated with poor long‐term prognosis. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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Incidence of periprocedural myocardial infarction following stent implantation: Comparison between first and second generation drug‐eluting stents

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusion:Using the revised ARC definition, we found no significant difference in PMI between first and second generation DES. Overall, PMI occurred in 4.75%, which is 58% lower than with use of the historical PMI definition. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Comparison of two‐year clinical outcomes between zotarolimus‐, sirolimus‐, and paclitaxel‐eluting stents in real life clinical practice

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:This observational study shows that the use of SES is superior to PES or ZES for the TLF in the overall and matched analysis. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Two melodies in concert: Transcatheter double‐valve replacement

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

We report on the first successful percutaneous transcatheter double valve replacement using two Melody valves in the pulmonary and tricuspid position, respectively. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Clinical outcomes and predictors of unprotected left main stem culprit lesions in patients with acute ST segment elevation myocardial infarction

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusion:Patients with STEMI and a LMCA had poor clinical outcomes, which is attributable to hemodynamic deterioration during the peri‐procedural period. However, after that time, mid‐term MACEs of the survivors following the peri‐procedural period may not be different between STEMI due to LMCA and non‐LMCA. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

A comparison between dual axis rotational coronary angiography and conventional coronary angiography

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionsThe advantages of such systems are obvious to both patient and healthcare provider, and DARA may prove to be an important and useful tool in the refinement of diagnostic coronary angiography by reducing patient contrast and radiation doses and reducing procedure time. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

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The fellows stitch: Large calibre venous haemostasis in paediatric practice

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:A subcutaneous figure of eight suture haemostasis strategy can provide a safe and efficient method for large calibre venous haemostasis in a paediatric practice with improved haemostasis times and no additional morbidity. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

MGUard versus bAre‐metal stents plus manual thRombectomy in ST‐elevation myocarDial Infarction pAtieNts ‐ (GUARDIAN) Trial: study design and rationale

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:If MGS implantation is non‐inferior to a strategy of MT pretreatment followed by BMS deployment, it will lend support to the use of this treatment as another possible option for STEMI patients undergoing PCI. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Implantation of a melody® valve in triscuspid position

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

AbstractA transcatheter pulmonary valve (Melody®) was implanted within a stenotic biological valve prosthesis in tricuspid position, as an alternative to the fourth major cardiac surgery in a 12‐year‐old girl. There were no complications. The post interventional result was very good. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Real‐world use of the impella 2.5 circulatory support system in complex high‐risk percutaneous coronary intervention: The uspella registry

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions:The use of Impella 2.5 in high‐risk PCI appeared feasible and safe in the real‐world setting. The utilization of the Impella 2.5 was successful, resulting in favorable short‐ and mid‐term angiographic, procedural and clinical outcomes. © 2011 Wiley‐Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

Incidence of periprocedural myocardial infarction following stent implantation: Comparison between first‐ and second‐generation drug‐eluting stents

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusion: Using the revised ARC definition, we found no significant difference in PMI between first‐ and second‐generation DES. Overall, PMI occurred in 4.75%, which is 58% lower than with use of the historical PMI definition. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

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The fellows stitch

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions: A subcutaneous figure of eight suture hemostasis strategy can provide a safe and efficient method for large caliber venous hemostasis in a pediatric practice with improved hemostasis times and no additional morbidity. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Transcatheter aortic valve implantation with a self‐expanding nitinol bioprosthesis

Catheterization and Cardiovascular Interventions — Tue, 22 Nov 2011 05:00:00 +0100

Conclusions: Conduction abnormalities are frequently observed after TAVI with self‐expandable bioprosthesis and definitive pacing is required in about a third of the patients, with a clear association with depth of implant and small interventricular septum thickness. © 2011 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)

Prevalence, risk factors and mortality of pulmonary hypertension defined by right heart catheterization in patients with sickle cell disease.

Respiratory Care — Tue, 22 Nov 2011 04:48:13 +0100

Authors: Gladwin MT Abstract Evaluation of: Parent F, Bachir D, Inamo J et al. A hemodynamic study of pulmonary hypertension in sickle cell disease. N. Engl. J. Med. 365(1), 44?53 (2011); Fonseca GH, Souza R, Salemi VM, Jardim CV, Gualandro SF. Pulmonary hypertension diagnosed by right heart catheterization in sickle cell disease. Eur. Respir. J. doi:10.1183/09031936.00134410 (2011) (Epub ahead of print). Three new large screening studies of patients with sickle cell disease for pulmonary hypertension have now been published. Two of these studies included comprehensive right heart catheterization of all patients with an elevation in the estimated pulmonary artery systolic pressure. Together, these studies show that pulmonary hypertension, defined by a mean pulmonary artery pressur...

Median nerve palsy: a complication of brachial artery cardiac catheterization.

Hand Surgery — Tue, 22 Nov 2011 02:06:03 +0100

Authors: Ikeda K, Osamura N Abstract The patient, an 83-year-old male with ischemic cardiac disease, was examined using a periodical left brachial artery cardiac catheterization. Six hours after the examination, complete median nerve palsy appeared. Four months later, the median nerve was explored and found to be compressed by a hematoma in the brachial artery. The location of the hematoma was at 6 cm proximal to the puncturing point, because the catheter may have penetrated the brachial artery from the lumen. The median nerve was released and the hematoma removed. One year after surgery, the median nerve palsy had disappeared. PMID: 22072472 [PubMed - in process] (Source: Hand Surgery)