Cardiac Catheterization This is an OPML file. It can be used to export all the MedWorm RSS feeds on this topic into your personal RSS reader (usually you have to save this file to your own computer before clicking on an Import OPML command in your own feed reader to upload the file which will then import all the feeds) or it can be used by webmasters to integrate MedWorm feeds with their own website. This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader, such as GoogleReader, or to display this data on your own website or blog. Subscribe to this data using MyMedWorm.Subscribe to this data using GoogleReader.Subscribe to this data using Bloglines.Subscribe to this data using MyYahoo.

This page shows you the latest news and research items in this category.

Pericardial Effusion and Cardiac Tamponade in Neonates: Sudden Unexpected Death Associated with Total Parenteral Nutrition via Central Venous Catheterization.
Conclusions Right atria in PCE/CT demonstrated marked interstitial edema and dilated fine vascular channels. Endocardial injury with permeation of hyperosmotic TPN fluid into the interstitium and egress into the pericardial sac is hypothesized as the etiology of PCE/CT. Recognition of PCE and impending CT in neonates with CVCs for TPN with expedient intervention may avoid sudden unexpected deaths. PMID: 23694791 [PubMed - in process] (Source: Annals of Clinical and Laboratory Science)
Source: Annals of Clinical and Laboratory Science - May 23, 2013 Category: Laboratory Medicine Authors: Warren M, Thompson KS, Popek EJ, Vogel H, Hicks J Tags: Ann Clin Lab Sci Source Type: research

IL-6 and its receptors in coronary artery disease and acute myocardial infarction.
Abstract Biomarkers such as interleukin-6 (IL-6), soluble interleukin-6 receptor (sIL-6R), and high sensitive C-reactive protein (hsCRP) have been reported to be elevated in acute myocardial infarction (AMI). The aim of this study is to determine the relationship between these markers during AMI, as well as their relationship to clinical parameters in an effort to discern their predictive potential in cardiac events. Serum was collected from 73 patients with; AMI, stable coronary artery disease (CAD), and controls during cardiac catheterization. Biomarker levels were determined and correlated with clinical data. IL...
Source: Cytokine - May 23, 2013 Category: Molecular Biology Authors: Anderson DR, Poterucha JT, Mikuls TR, Duryee MJ, Garvin RP, Klassen LW, Shurmur SW, Thiele GM Tags: Cytokine Source Type: research

Fluid loss, venous congestion, and worsening renal function in acute decompensated heart failure
Conclusion Smaller early net fluid loss is associated with increased risk for WRF. RAP is not a reliable surrogate of the magnitude of decongestion and risk of WRF. Future research is necessary to determine if targeting congestion may help prevent WRF. (Source: European Journal of Heart Failure)
Source: European Journal of Heart Failure - May 22, 2013 Category: Cardiology Authors: Aronson, D., Abassi, Z., Allon, E., Burger, A. J. Tags: SYMPTOMS Source Type: research

Development of mitral stenosis after single mitraclip insertion for severe mitral regurgitation
We report the first case of mitral stenosis following Mitra‐Clip insertion in a patient with symptomatic NYHA IV heart failure, secondary to severe mitral regurgitation (MR). A 79 year old female with a history of prior aortic valve replacement underwent percutaneous mitral valve repair. A single clip was advanced coaxially down onto the mitral valve under TOE guidance, with the anterior and posterior leaflets clipped together between A2 and P2. TOE confirmed a significant reduction in MR (grade 4 to grade 1). Despite initial symptomatic relief, she represented 3 months later with similar symptoms. Repeat TOE confirmed a...
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: James Cockburn, Paraskevi Fragkou, David Hildick‐Smith Tags: Case Report Source Type: research

A pathologic study of explanted parachute devices from seven heart failure patients following percutaneous ventricular restoration
Conclusions: The percutaneous Parachute device appears as a promising adjunctive treatment for patients suffering from severe HF. The pathologic changes are those of organizing thrombus with and without inflammation with minor complications of foot and strut fracture. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Elena Ladich, Fumiyuki Otsuka, Renu Virmani Tags: Original Studies Source Type: research

Catheterization based intervention in low birth weight infants less than 2.5 kilograms with acute and long‐term outcome
Conclusion: Interventional catheterization is feasible with low procedural morbidity and mortality in high risk infants < 2.5 kilograms. Catheterization primarily serves as a palliative procedure to stabilize infants for definitive treatment. Balloon valvuloplasty may be effective for isolated valvar pulmonary stenosis in infants < 2.5 kilograms. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Daisuke Kobayashi, Salaam Sallaam, Sanjeev Aggarwal, Harinder R. Singh, Daniel R. Turner, Thomas J. Forbes, Srinath T. Gowda Tags: Original Studies Source Type: research

3‐Dimensional multidetector computed tomography versus conventional 2‐dimensional transesophageal echocardiography for annular sizing in transcatheter aortic valve replacement: Influence on post‐procedural paravalvular aortic regurgitation
ConclusionMDCT‐based annular sizing in TAVR significantly reduces post‐procedural PAR, and THV oversizing appears pivotal in this aspect. Further delineation of the optimal degree of THV oversizing is needed. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Nicolaj C. Hansson, Leif Thuesen, Vibeke E. Hjortdal, Jonathon Leipsic, Henning R. Andersen, Steen H. Poulsen, John G. Webb, Evald H. Christiansen, Lars E. Rasmussen, Lars R. Krusell, Kim Terp, Kaj E. Klaaborg, Mariann Tang, Jens F. Lassen, Hans E. Bøtke Tags: Original Studies Source Type: research

The presence of angiographic collaterals in non‐ST elevation myocardial infarction is a predictor of long‐term clinical outcomes
Conclusions: In patients with NSTEMI the presence of angiographic coronary collaterals is a predictor of long‐term clinical outcomes primarily driven by increased rates of surgical revascularization. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Angela M. Kloepfer, Lewis C. Lipson, Ellen C. Keeley Tags: Original Studies Source Type: research

Coil embolization of a symptomatic left internal mammary arteriovenous fistula
We present an unusual case of a patient who presented with ventricular arrhythmias and heart failure symptoms due to a left internal mammary artery AVF that formed after open heart surgery. The patient ultimately underwent percutaneous embolization of the fistulous connection. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Candice Y. Lee, Peter A. Knight, Frederick S. Ling Tags: Case Report Source Type: research

Estimation of oxygen consumption in elderly patients with aortic stenosis
Conclusions: When estimating VO2 in an elderly population with aortic stenosis, the best equations are 2.5*Weight and 100*BSA. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Zachary M. Gertz, Brian D. McCauley, Amresh Raina, William O'Donnell, Charlene Shellenberger, Judi Willhide, Paul R. Forfia, Howard C. Herrmann Tags: Original Studies Source Type: research

Morphology of the patent ductus arteriosus (PDA) does not preclude successful PDA stent implantation in high risk patients undergoing hybrid stage I palliation: Recommendations to optimize ductal stent positioning
Conclusions: Mid to long term follow‐up indicates that PDA stents remain widely patent regardless of ductal morphology until comprehensive stage II repair. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Michael R. Recto, Sandy Doyle, Vitor C. Guerra, Song Gui Yang, Thomas Yeh Tags: Original Studies Source Type: research

Transcatheter closure of perimembranous ventricular septal defect with the amplatzer® membranous VSD occluder 2: Initial world experience and one‐year follow‐up
CONCLUSIONS: This early cohort experience using a novel adapted transcatheter closure device for pmVSD suggests that the procedure is feasible, safe, and effective. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 22, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Apostolos Tzikas, Reda Ibrahim, Daniel Velasco‐Sanchez, Xavier Freixa, Marcela Alburquenque, Paul Khairy, John L. Bass, Juan Ramirez, Daniel Aguirre, Joaquim Miro Tags: Original Studies Source Type: research

Severe Left Main Coronary Artery Stenosis with Abnormal Branching Pattern in a Patient with Mild Supravalvar Aortic Stenosis and Williams‐Beuren Syndrome
Abstract Williams–Beuren syndrome (WBS) is a multisystem genetic disorder comprising of craniofacial, developmental, and cardiac malformations. The most common cardiac defects found are supravalvar aortic stenosis and peripheral pulmonary stenosis. However, WBS should be regarded as a general arteriopathy consisting of stenoses of medium‐ and large‐sized arteries including the coronary arteries. Cardiac manifestations are often the initial reason for referral and careful cardiovascular assessment is important as coronary artery involvement confers a significant anesthetic risk and may be associated with ischemia and ...
Source: Congenital Heart Disease - May 22, 2013 Category: Cardiology Authors: Guido E. Pieles, Victor Ofoe, Gareth J. Morgan Tags: Case Report Source Type: research

Long-Term Outcomes After Invasive Management for Older Patients With Non-ST-Segment Elevation Myocardial Infarction [Original Articles]
Conclusions— Older patients with non–ST-segment elevation MI with significant coronary disease face high long-term risks for mortality and nonfatal cardiovascular outcomes after early catheterization that differ by type of revascularization procedure performed. These findings can help guide the design of studies evaluating long-term therapies among elderly post-MI patients. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 21, 2013 Category: Cardiology Authors: Roe, M. T., Li, S., Thomas, L., Wang, T. Y., Alexander, K. P., Ohman, E. M., Peterson, E. D. Tags: Catheter-based coronary interventions: stents, Acute coronary syndromes, Acute myocardial infarction Original Articles Source Type: research

Yield and Diagnostic Value of Stress Myocardial Perfusion Imaging in Patients Without Known Coronary Artery Disease Presenting With Syncope [Original Articles]
Conclusions— Stress MPI for evaluation of syncope in patients without known coronary artery disease has a low-diagnostic yield among all risk categories; thus, reaffirmation and revision of the appropriateness criteria should be considered. (Source: Circulation: Cardiovascular Imaging)
Source: Circulation: Cardiovascular Imaging - May 21, 2013 Category: Radiology Authors: AlJaroudi, W. A., Alraies, M. C., Wazni, O., Cerqueira, M. D., Jaber, W. A. Tags: Nuclear cardiology and PET, PET and SPECT Original Articles Source Type: research

Intrapulmonary shunt confirmed by intracardic echocardiography in the diagnosis of hepatopulmonary syndrome
We describe the case of a 59‐year‐old man with cirrhosis and hypoxemia whose clinical picture was suspicious for hepatopulmonary syndrome. A transthoracic echocardiogram saline contrast bubble study was unable to decipher between intracardiac and intrapulmonary shunting. Transesophageal echocardiogram could not be done due to esophageal varices. The presence of intrapulmonary shunting was proven by right heart catheterization with direct injection of agitated saline into the pulmonary artery. Bubbles were detected entering the left atrium by intracardiac echocardiogram, thus confirming the diagnosis of hepatopulmonary ...
Source: Hepatology - May 20, 2013 Category: Internal Medicine Authors: Joseph E. Khabbaza, Richard A. Krasuski, Adriano R. Tonelli Tags: Clinical Observations in Hepatology Source Type: research

Multiple anomalous left pulmonary venous connections detected with transthoracic echocardiography
We present the case of a 26-year-old female with new onset dyspnea on exertion who was diagnosed with the left superior and inferior pulmonary veins draining into the innominate vein via a vertical vein by two and three-dimensional transthoracic echocardiography and multidetector computed tomographic angiography. (Source: Journal of Cardiothoracic Surgery)
Source: Journal of Cardiothoracic Surgery - May 17, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Tzu-Lin WangHuei-Fong HungChang- LinMing-Chon HsiungJeng Wei Source Type: research

Accidental guide-wire loss during central venous catheterization: A report of two life-threatening cases
Tanmoy Ghatak, Afzal Azim, Arvind K Baronia, Neelima K GhatakIndian Journal of Critical Care Medicine 2013 17(1):53-54 (Source: Indian Journal of Critical Care Medicine)
Source: Indian Journal of Critical Care Medicine - May 17, 2013 Category: Intensive Care Authors: Tanmoy GhatakAfzal AzimArvind K BaroniaNeelima K Ghatak Source Type: research

Physiologic and molecular characterization of a murine model of right ventricular volume overload
We describe the physiologic and molecular characteristics of the first murine model of RV volume overload. PI was created by entrapping the pulmonary valve leaflets with sutures. Imaging, catheterization, and exercise testing were performed at 1, 3, and 6 mo and compared with sham controls. RNA from the RV free wall was hybridized to Agilent whole genome oligonucleotide microarrays. Volume overload resulted in RV enlargement, decreased RV outflow tract shortening fraction at 1 mo followed by normalization at 3 and 6 mo (39 ± 2, 44 ± 2, and 41 ± 2 vs. 46 ± 3% in sham), early reversal of early and...
Source: AJP: Heart and Circulatory Physiology - May 15, 2013 Category: Cardiology Authors: Reddy, S., Zhao, M., Hu, D.-Q., Fajardo, G., Katznelson, E., Punn, R., Spin, J. M., Chan, F. P., Bernstein, D. Tags: SIGNALING AND STRESS RESPONSE Source Type: research

Volume‐Outcomes relationship in the era of modern coronary intervention ‐ Results from the prospective multicenter German DES.DE registry ‐
Conclusions: In the era of modern coronary intervention technological advances such as DES have not offset the inverse relation between procedural volume and both in‐hospital and 1‐year outcomes after PCI. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 15, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Ibrahim Akin, Mathias Hochadel, Steffen Schneider, Mohamed Abdel‐Wahab, Ralf Zahn, Jochen Senges, Gert Richardt, Karl‐Heinz Kuck, Christoph A. Nienaber, Tags: Original Study Source Type: research

Single‐stent crossover technique from distal unprotected left main coronary artery to the left circumflex artery
ConclusionsTLR rate at the LCx‐ostium is high irrespective of LMCA‐LCx or LMCA‐LAD stenting. The former also seems to be associated with high TLR at the LAD‐ostium. It may therefore be important to evaluate alternative strategies for treating distal LMCA disease that extends into the LCx but not LAD. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 15, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Toru Naganuma, Alaide Chieffo, Sandeep Basavarajaiah, Kensuke Takagi, Charis Costopoulos, Azeem Latib, Mauro Carlino, Matteo Montorfano, Chiara Bernelli, Sunao Nakamura, Antonio Colombo Tags: Original Study Source Type: research

Transcatheter closure of perimembranous ventricular septal defects
Although effective, transcatheter closure of perimembranous ventricular septal defects (pmVSD) with the Amplatzer Membranous VSD Occluder (AGA Medical Corporation, MN) carries a substantial risk of complete heart block, prompting many to abandon this intervention. A newly designed Amplatzer device for pmVSD was modified, in part, to minimize this risk. After rigorous preclinical testing, we report the first human experience with the Amplatzer Membranous VSD Occluder 2 (AGA Medical Corporation) in two patients (a 5‐year old with a 12‐mm pmVSD and a 26‐year‐old male with a 8‐mm defect). Both procedures were success...
Source: Catheterization and Cardiovascular Interventions - May 15, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Daniel Velasco‐Sanchez, Apostolos Tzikas, Reda Ibrahim, Joaquim Miró Tags: Pediatric and Congenital Heart Disease Source Type: research

Acute outcome of stent therapy for coarctation of the aorta: Results of the coarctation of the aorta stent trial
ConclusionsStenting of CoA, using the NuMED Cheatham Platinum Stent, is acutely safe and effective for treatment of CoA. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 15, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Richard E. Ringel, Julie Vincent, Kathy J. Jenkins, Kimberlee Gauvreau, Heidi Moses, Kimberly Lofgren, Kudret Usmani Tags: Pediatric and Congenital Heart Disease Source Type: research

Abstract 1: The Association Between Patient Selection for Diagnostic Coronary Angiography and Hospital-Level PCI Appropriateness: Insights from the NCDR [Concurrent Session I Session A: Oral Abstract Presentations on Less is More]
Conclusions. In a national sample of hospitals performing invasive coronary procedures, the proportion of coronary angiograms performed in asymptomatic patients was associated with the proportion of inappropriate PCI. Further study to clarify factors related to practice variability in processes of patient selection prior to the cardiac catheterization laboratory may optimize the use of both diagnostic angiography and PCI. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bradley, S. M., Spertus, J. A., Nallamothu, B. K., Chan, P. S., Kennedy, K. F., Patel, M. R., Bryson, C. L., Malenka, D. J., Rumsfeld, J. S. Tags: Concurrent Session I Session A: Oral Abstract Presentations on Less is More Source Type: research

Abstract 28: Implementation of a Nationwide Health IT System for Cardiac Cath Labs in the VA Hospital System: the CART Program [Concurrent III Session A: Oral Abstract Presentations on EHS & Health IT]
Conclusions. The CART system was successfully implemented nationwide, achieving full use in the 75 VA cardiac cath labs. The final stage, full Clinical Use, took the longest and was most variable by site. These results reinforce that successful HIT implementation does not end with technical installation and training, and must support clinical use as part of routine care delivery. Our results also reinforce the importance of senior leadership support for HIT implementation to support clinical care. [[Unable to Display Character:  ]] (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Box, T. L., Maddox, T. M., Tsai, T. T., Gethoffer, H., Grunwald, G. K., Jesse, R. L., Fihn, S. D., Rumsfeld, J. S. Tags: Concurrent III Session A: Oral Abstract Presentations on EHS & amp; Health IT Source Type: research

Abstract 41: Broken Heart Syndrome-"Not so rare anymore" [Poster Session I]
Conclusions: TCM is becoming an increasing finding in the cardiac catheterization lab in patients presenting as an acute MI .Increasing awareness of this condition and performing a ventriculogram in these patients is necessary for diagnosis. Our study suggests that in ICU patients, a diagnosis of TCM portends a poor prognosis and TCM in the postoperative period may result in permanent cardiomyopathy. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Rajamanickam, A., Kansara, P., Fanari, Z., Rao, A. D., Hopkins, J., Rahman, E., Kostal, M., Stillabower, M., William, W. Tags: Poster Session I Source Type: research

Abstract 45: Hemodynamic and Clinical Determinants of Coronary Sinus Flow in Patients Referred for Cardiac Catheterization [Poster Session I]
Conclusions: Coronary sinus blood flow is determined by patient morbidities and central hemodynamic parameters. CSBF tends to be lower in patients with obstructive CAD, diabetes and/or HTN. Increased RA pressure and systemic HTN are associated with augmented CSBF. We speculate that effects of RA pressure on CSBF are reflective of preload and intrathoracic pressure parameters. Increased intrathoracic pressure may augment coronary blood flow by compression of the aorta and improved coronary perfusion gradient. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Saunders, J., Lyubarova, R., El-Hajjar, M., Torosoff, M. Tags: Poster Session I Source Type: research

Abstract 47: Presentation and Outcomes of Women Veterans with Suspected Ischemia and Nonobstructive Coronary Artery Disease: Insights from the VA Clinical Assessment Reporting and Tracking Program. [Poster Session I]
Conclusion: Between October 2007 and September 2011, 23% of women veterans undergoing catheterization for suspected ischemia had non-obstructive CAD. In contrast to non-VA studies, adverse clinical outcomes and re-hospitalization rates for chest pain were less frequent. These findings may represent systematic differences in treatment and follow-up care of women veterans between VA and non-VA healthcare systems. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Nkonde-Price, C., Plomondon, M., Maddox, T. M., Rumsfeld, J., Duvernoy, C. Tags: Poster Session I Source Type: research

Abstract 51: Can Wellens' Sign be used to Predict Significant Proximal Left Anterior Descending Artery Lesion? [Poster Session I]
Conclusion: Our results corroborated prior studies showing that WS predicts the presence of critical (90%) PLAD lesion. Unfortunately, the value of WS for detecting/predicting significant CAD in PLAD was weak. Our results indicated that we were not able to predict the presence of significant (70%) PLAD lesion using WS. However, in appropriate clinical settings such as Non-ST elevation MI (NSTEMI) or unstable angina, Wellens’ sign may indicate the need for a more aggressive treatment strategy with patients proceeding to the cardiac catheterization suite sooner than later. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Alderwish, E., Nassour, W., Costea, A., Smith, T., Carrazco, C., Usmani, S., Hussain, H., Viadan, S., Soroori Rad, B., Seeshore, J., Gilyadov, B., Chen, A., Simmons, B., Fernaine, G., Kalantari, H., Hassen, G. W. Tags: Poster Session I Source Type: research

Abstract 68: A Cardiologist-Directed, Selective Testing Approach to Emergency Department Chest Pain Patients is Safe and Efficient [Poster Session I]
Conclusion: A cardiologist-directed approach to CP patients in the ED was safe and resulted in lower testing utilization rates than standard protocol-driven management. Replacing a one-size-fits-all approach will likely result in more patient-centered, selective use of testing. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Panchal, P., Leighton, H., Kostela, J., Rizkalla, J., Balek, M., Heretis, K., Kerwin, T. Tags: Poster Session I Source Type: research

Abstract 104: Survey of Emergency Physician Cardiac Imaging Technology and Guideline Knowledge [Poster Session I]
Conclusions: Despite the frequency of chest pain patients presenting to the emergency department, access to imaging tools for evaluation of cardiac etiology is limited. Knowledge and use of AUC guidelines was also limited. These results question the current clinical paradigm which appears to limit the emergency physician knowledge and use of imaging technology to evaluate the chest pain patient despite the high frequency of presentation. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Martin, C., Lacey, M., Spalding, J., Essoi, B. Tags: Poster Session I Source Type: research

Abstract 105: Normal Coronary Rates for Elective Angiography in the VA Health Care System: Insights from the VA CART Program [Poster Session I]
Conclusions. About 1 in 5 patients undergoing elective coronary angiography in the VA had normal coronaries. This rate is lower than prior published studies in other systems. However, the observed hospital-level variation in normal coronary rates suggests barriers to consistent patient selection for diagnostic coronary angiography despite an integrated care delivery system. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bradley, S. M., Maddox, T. M., Stanislawski, M. A., O'Donnell, C. I., Grunwald, G. K., Tsai, T. T., Ho, P. M., Peterson, E. D., Rumsfeld, J. S. Tags: Poster Session I Source Type: research

Abstract 113: Regional Variation In The Receipt Of Coronary Revascularization Following Diagnostic Catheterization In British Columbia [Poster Session I]
Conclusions: There was substantial regional variation in revascularization practice among hospitals in the province of British Columbia, Canada. Identification of subgroups where variation in practices were significant, such as use of PCI vs. CABG among STEMI patients, offer opportunities for follow-up and quality improvement. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ng, C. H., Pu, A., Ding, L., Zhang, R., Kmetic, A. Tags: Poster Session I Source Type: research

Abstract 119: Prospective Assessment Of The Risk-Treatment Paradox In The Use Of Radial Access For Cardiac Catheterization [Poster Session I]
Conclusions: This study demonstrates that one of the underlying reasons for the risk-treatment paradox in the use of TRA is related to the perception of its benefit. More education on the benefits of bleeding avoidance strategies like TRA may lead to wider application of TRA to patients most likely to benefit. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Gilchrist, I. C., Rao, S. V., Robinson, C. O., Pancholy, S. B., Nevins, P. H., Kearns, C. K. Tags: Poster Session I Source Type: research

Abstract 121: Statin Use For Secondary Prevention Of Coronary Artery Disease In Patients Undergoing Repeat Percutaneous Coronary Intervention: Real World Data [Poster Session I]
Conclusions: Real world data shows that we fail at adequate usage of statins or getting lipids to target goals. Interestingly around 90% of patients are prescribed statins on discharge from the cardiac catheterization lab. In practice statins are discontinued or higher doses to achieve target LDLs are avoided as they are generally less well tolerated due to side effects (muscle and liver toxicity). In this subset of patients, referral to lipid specialists and specialty centers and advent of newer lipid lowering drugs may prove to be beneficial. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Rajamanickam, A., Zhang, Y., Rao, A., Aguiar, R., Bradley, E., Weintraub, W., Goldenberg, E. Tags: Poster Session I Source Type: research

Abstract 126: Trends in Cardiac Rehabilitation Referral after Myocardial Infarction: Data from the National Cardiovascular Data Registry (NCDR(R)) [Poster Session I]
Conclusions: A significant increase in the proportion of post-MI patients referred to cardiac rehabilitation was observed after referral to cardiac rehabilitation was included in published performance measures. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Beatty, A. L., Li, S., Thomas, L., Amsterdam, E. A., Alexander, K. P., Whooley, M. A. Tags: Poster Session I Source Type: research

Abstract 130: Do Demographic Differences Persist in a Large Radial Artery Access Center for Cardiac Catheterization? [Poster Session I]
Conclusion: RA access is utilized more often in patients with younger age, diabetes, hypertension and obese BMIs. FA access is used more often in renal failure patients perhaps due to concern about contrast load. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Patel, A., Chaudhry, K., Kabadi, R., Cartwright, T., Patel, A., Iliadis, E. Tags: Poster Session I Source Type: research

Abstract 133: Perceived Barriers And Facilitators Of Adoption Of Radial PCI Among Participants In A Pilot Training Program [Poster Session I]
Discussion: By conducting interviews among participants in a pilot training program, we largely precluded lack of motivation and interest as barriers. However, even in this group, concerns emerged about lack of long term research on complications for patients, and radiation exposure for the cath team. These data were collected among participants in a VA rPCI pilot training program, and may not be representative of other cardiac catheterization laboratory staff. Nor do our findings speak to the prevalence or relative importance of these factors. Future research will develop and field a structured survey to assess these barr...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Helfrich, C., Tsai, T. T., Lemon, J., Bryson, C. L. Tags: Poster Session I Source Type: research

Abstract 168: The Impact of Prehospital Care on STEMI Time to Treat [Poster Session II]
In this study, we analyzed the entire population of non-transfer STEMI patients that underwent primary percutaneous coronary intervention (PCI) in Dallas County Texas from October 1, 2010 through December 31, 2011. Emergency medical services data from 24 agencies and 15 receiving hospitals collected and shared common, de-identified patient data. To control for confounding factors, we developed a robust generalized linear regression and relied on estimated marginal means analyses to assess the impact of EMS transport (versus self-transport) on hospital door to balloon (D2B) and total treatment time, defined as symptom onset...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Langabeer, J. R., Henry, T. D., DelliFraine, J. L., Segrest, W., Dallas Caruth AHA Advisory Board Tags: Poster Session II Source Type: research

Abstract 187: Value of Percutaneous Coronary Intervention in the VHA Integrated Health Care Delivery System: Insights from the VA CART Program [Poster Session II]
Conclusion: There were overall low 1 year mortality rates following PCI and small variation across sites. In contrast, there was significantly greater variability in 1 year costs following PCI, suggesting opportunities to reduce the costs of longitudinal PCI care without compromising outcomes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Ho, M., O'Donnell, C., Bradley, S. M., Grunwald, G., Hlefrich, C., Chapko, M., Liu, C.-F., Maddox, T. M., Tsai, T. T., Jesse, R. L., Fihn, S. D., Rumsfeld, J. S. Tags: Poster Session II Source Type: research

Abstract 188: Bridging the Gap: Development of Cardiac Surgery and Cardiac Diagnostic Interventional Registries in Resource Limited Settings in the West Indies [Poster Session II]
BACKGROUND The value of establishing a regional West Indies Cardiac Surgery Registry for patients undergoing Open Heart Surgery was discussed in Trinidad in 2010. Collaboration among regional partners including Mr Roberto Casula of the Imperial College of London, other stake holders, database experts and the Doctors Inn Research group (DIRG) has sought to identify and manage key data entry fields for this Registry.The need for a Caribbean PCI Registry was introduced and presented at the Caribbean Cardiac Society (CCS) meeting in 2011 in Trinidad. Over the last year, eight countries in the Caribbean with Cardiac Catheteriza...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Henry, R., Rawlins, R., Dullum, M., Rahaman Ganga, N., Elliott, V., Griffith, K., Primus, E. Tags: Poster Session II Source Type: research

Abstract 224: Neurological Complications Following Cardiac Catheterization During Transition From Femoral Access To Radial And Femoral Access [Poster Session II]
Conclusion: Our single-center, retrospective study shows that during a period of transition to the radial artery access site for cardiac catheterization does not significantly change the rate of neurologic complications. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Patel, A., Chaudhry, K., Kabadi, R., Cole, R., Patel, A., Martin, F., Iliadis, E. Tags: Poster Session II Source Type: research

Abstract 316: Costs Of Contrast Induced Acute Kidney Injury [Poster Session III]
Conclusions: CI-AKI occurs commonly and is a very costly complication among patients undergoing cath or PCI. In this study it increased LOS by 7 days and added an incremental cost exceeding $10,000. Our study underscores the importance of preventing CI-AKI to reduce morbidity and save costs. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Amin, A. P., Shapiro, R., Novak, E., Olsen, M., Singh, J., Bach, R. G., Cohen, D. J. Tags: Poster Session III Source Type: research

Abstract 322: Optimizing Cardiac Catheterization Laboratory Utilization [Poster Session III]
Conclusions: The marked disparity in mean and median hours reflects a skewed distribution, with many inpatients delayed in going to the CCL. Both median and mean hours were prolonged on Mondays and Fridays along with median length of stay. Further drill down suggested hand-offs, inter-hospital transfer delays, high bed occupancy, and high patient volume contributed to delays on these days. Operator availability, procedure variance, and case mix also contributed to distortions in scheduling and the effective use of lab time. Mid week, Wednesday, was the most efficient day. Block scheduling has since been implemented to bett...
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Lawson, W. E., Wilbert, L., Sokoloff, L., Jeremias, A., Mani, A. Tags: Poster Session III Source Type: research

Abstract 340: Improved Patterns for Advanced Non-Invasive Diagnostic Testing Using a Personalized Gene Expression Score among Patients Presenting to Primary Care Clinicians with Symptoms of Suspected Obstructive Coronary Artery Disease: Results from the IMPACT-PCP (Investigation of a Molecular Personalized Coronary Gene Expression Test on Primary Care Practice Pattern) Trial [Poster Session III]
Conclusion: The GES was associated with a statistically significant and clinically relevant change in clinical decision making among pts evaluated for suspected symptomatic CAD. In conclusion, the addition of the GES showed clinical utility above and beyond conventional decision-making by optimizing the pt’s diagnostic evaluation, particularly around the reduction in the intensity of diagnostic testing among low GES patients. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Herman, L., Conlin, M., Watson, P., Froelich, J., Kanelos, D., St Amant, R., Yau, M., Rhees, B., Monane, M., McPherson, J. Tags: Poster Session III Source Type: research

Abstract 352: A Multimodal Radiation Reduction Intervention for Intra-procedural Radiation Exposure in Patients Undergoing Cardiac Catheterization in Veterans Affairs Hospitals [Poster Session III]
Conclusion: A three-tiered, multi-modal radiation reduction intervention was associated with reduced radiation exposure in a laboratory with high baseline radiation utilization. Similar reductions were not observed in a laboratory with low baseline radiation utilization. These findings suggest that radiation reduction interventions targeted at higher radiation use centers may result in meaningful decreases in patient radiation exposure. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Valle, J. A., Petrich, M., Carey, E. P., Bradley, S. M., Gurm, H. S., Varosy, P. D., Grossman, P. M., Maddox, T. M., Duvernoy, C. S., Nallamothu, B. K., Rumsfeld, J. S., Ho, P. M., Tsai, T. T. Tags: Poster Session III Source Type: research

Use of extracorporeal life support for emergency coronary artery bypass grafting
A 14-year old boy was admitted with an anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva, with an interarterial course of the narrow proximal segment. He underwent coronary ostial augmentation and main pulmonary artery translocation to the left pulmonary artery. In the post-cardiopulmonary bypass (CPB) period, he developed thrombotic occlusion of the RCA resulting in arrhythmia and ventricular dysfunction, requiring extracorporeal life support (ECLS) in the form of extracorporeal membrane oxygenation rather than CPB. After confirming this complication by cardiac catheterization, the right ...
Source: Interactive CardioVascular and Thoracic Surgery - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Panda, B. R., Prabhu, A., Provenzano, S., Karl, T. Tags: Congenital Source Type: research

Device closure of a pseudoaneurysm of the right ventricular outflow tract in an infant with right ventricle‐ to‐ pulmonary artery homograft
We describe a case of a RVOT pseudoaneurysm in a 5 kg patient that was palliated with interventional catheterization utilizing an Amplatzer Ductal Occluder (ADO) with four years follow‐up. Interventional catheterization can successfully manage this complication in small patients for the long term and thus avoids additional surgery and delays conduit replacement. © 2013 Wiley Periodicals, Inc. (Source: Catheterization and Cardiovascular Interventions)
Source: Catheterization and Cardiovascular Interventions - May 14, 2013 Category: Cardiovascular & Thoracic Surgery Authors: C Herbert, C Ikemba, A Nugent Tags: Case Report Source Type: research

Doubly Obstructive Hypertrophic Cardiomyopathy
A 40-year-old woman with hypertrophic cardiomyopathy presented with New York Heart Association functional class III dyspnea and angina despite optimal medical therapy. Left heart catheterization with a high-fidelity, micromanometer-tipped left ventricular (LV) catheter through a transseptal approach was performed to determine location and severity of obstruction. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 13, 2013 Category: Cardiology Source Type: research

Site-dependency of the E/e' ratio in predicting invasive left ventricular filling pressure in patients with suspected or ascertained coronary artery disease
Conclusions In patients with CAD, E/e'L is the most accurate parameter in predicting abnormally increased LVFP. (Source: European Journal of Echocardiography)
Source: European Journal of Echocardiography - May 13, 2013 Category: Cardiology Authors: Galderisi, M., Rapacciuolo, A., Esposito, R., Versiero, M., Schiano-Lomoriello, V., Santoro, C., Piscione, F., de Simone, G. Tags: CLINICAL/ORIGINAL PAPERS Source Type: research