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    8054 results match your criteria Catheterization and Cardiovascular Interventions[Journal]

    1 OF 162

    Comparison of treatment strategies for femoro-popliteal disease: A network meta-analysis.
    Catheter Cardiovasc Interv 2018 Jan 14. Epub 2018 Jan 14.
    Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
    Objectives: We sought to compare treatment strategies in a Bayesian network meta-analysis of randomized controlled trials.

    Background: Peripheral artery disease (PAD) is a prevalent morbidity that is treated with various strategies.

    Methods: We performed a MEDLINE search for randomized studies comparing at least 2 treatment strategies, including bypass surgery, percutaneous transluminal angioplasty (PTA) balloons, stents, covered stents, drug-eluting stents (DES), and drug-coated balloons (DCB), in patients with native femoro-popliteal disease. Read More

    Transcatheter closure of patent foramen ovale for secondary prevention of ischemic stroke: Quantitative synthesis of pooled randomized trial data.
    Catheter Cardiovasc Interv 2018 Jan 14. Epub 2018 Jan 14.
    Florida Hospital, Pepin Heart Institute, Tampa, Florida.
    Objectives: To evaluate the safety and efficacy of percutaneous device closure of patent foramen ovale (PFO) for secondary prevention of ischemic stroke BACKGROUND: Stroke remains the leading cause of serious long-term disability in the United States. The effectiveness of a percutaneous PFO closure in the prevention of recurrent cryptogenic strokes has not been established.

    Methods: We performed a literature search using PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Google Scholar, and Internet-based sources from January 2003 to September 2017. Read More

    Scaffold thrombosis following implantation of the ABSORB BVS in routine clinical practice: Insight into possible mechanisms from optical coherence tomography.
    Catheter Cardiovasc Interv 2018 Jan 14. Epub 2018 Jan 14.
    AMC Heartcenter, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
    Objectives: To identify potential underlying mechanisms of early and (very) late scaffold thrombosis (ScT) by optical coherence tomography (OCT), in a frame-by-frame analysis.

    Background: The absorb scaffold is associated with an increased risk of ScT compared with metallic stents. Several potential causes of bioresorbable ScT have been identified, however the precise etiology still remains unclear. Read More

    Predictive value of neutrophil to lymphocyte ratio in long-term outcomes of left main and/or three-vessel disease in patients with acute myocardial infarction.
    Catheter Cardiovasc Interv 2018 Jan 13. Epub 2018 Jan 13.
    State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beilishi Road No. 167, Xicheng District, Beijing, 100037, People's Republic of China.
    Objectives: We sought to evaluate the independent predictive value of left main disease (LMD) and/or three-vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients.

    Background: Patients with acute coronary syndrome resulting from LMD and/or three-vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined. Read More

    Retrograde transmitral paravalvular leak closure through an antegrade transseptal approach: A novel technique.
    Catheter Cardiovasc Interv 2018 Jan 13. Epub 2018 Jan 13.
    Department of Cardiology, Cleveland Clinic Florida, Weston, Florida.
    Mitral paravalvular leak (PVL) remains a well-known complication after mitral valve replacement. Since the first report over 25 years ago, several catheter-based PVL closure techniques have been described. Most of these comprise of either an antegrade transseptal approach, or a retrograde transaortic or transapical approach. Read More

    Randomized comparison of novel biodegradable polymer and durable polymer-coated cobalt-chromium sirolimus-eluting stents: Three-Year Outcomes of the I-LOVE-IT 2 Trial.
    Catheter Cardiovasc Interv 2018 Jan 11. Epub 2018 Jan 11.
    Department of Cardiology, General Hospital of Shenyang Military Region, Shenyang, China.
    Objectives: We aimed to compare the long-term outcomes of the novel biodegradable polymer cobalt-chromium sirolimus-eluting stent (BP-SES) versus the durable polymer sirolimus-eluting stent (DP-SES) in the I-LOVE-IT2 trial.

    Backgrounds: Comparisons of the long-term safety and efficiency of the BP-DES versus the DP-DES are limited.

    Methods: A total of 2,737 patients eligible for coronary stenting were randomized to the BP-SES or DP-SES group at a 2:1 ratio. Read More

    Validation of contemporary risk scores in predicting coronary thrombotic events and major bleeding in patients with acute coronary syndrome after drug-eluting stent implantations.
    Catheter Cardiovasc Interv 2018 Jan 11. Epub 2018 Jan 11.
    Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
    Objectives: We aimed to assess the prognostic ability of the ST score, DAPT score, and PARIS score in a Chinese population.

    Background: Recently, several risk scores predicting the long-term risk of coronary thrombotic events [CTE, defined as the composite of definite or probable stent thrombosis (ST) and myocardial infarction] and bleeding have been developed and initially validated in Western populations.

    Methods: A total of 6,088 consecutive patients with acute coronary syndrome (mean age 58. Read More

    Impact of pre-procedural hyponatremia on clinical outcomes after transcatheter aortic valve replacement: A propensity-matched analysis.
    Catheter Cardiovasc Interv 2018 Jan 11. Epub 2018 Jan 11.
    Department of cardiology, Keio University School of Medicine, Tokyo, Japan.
    Background: Hyponatremia is associated with the increased risk of early and late mortality in patients with cardiac disease. This study aimed to assess the prognostic value of hyponatremia in patients who had undergone transcatheter aortic valve replacement (TAVR).

    Methods: We investigated 1,215 consecutive patients (mean age: 84. Read More

    Stenting of the inter-atrial septum in infants and small children: Indications, techniques and outcomes.
    Catheter Cardiovasc Interv 2018 Jan 11. Epub 2018 Jan 11.
    Department of Paediatric Cardiology, Evelina London Children's Hospital, Guy's and St. Thomas' Hospital, London, United Kingdom.
    Objectives: To evaluate the procedural success and outcome of inter-atrial stenting.

    Background: Inter-atrial stenting has been shown to be an effective way to maintain inter-atrial blood flow, however it is considered a high risk procedure, usually performed urgently in patients with significant hemodynamic compromise.

    Methods: Between September 2004 and August 2016, inter-atrial stenting was attempted in 29 children. Read More

    Outcomes of intermediate-risk patients treated with transcatheter and surgical aortic valve replacement in the Veterans Affairs Healthcare System: A single center 20-year experience.
    Catheter Cardiovasc Interv 2018 Jan 9. Epub 2018 Jan 9.
    Division of Cardiology, Department of Medicine, Minneapolis VA Healthcare System, Minneapolis, Minnesota.
    Background: Transfemoral transcatheter aortic valve replacement (TAVR) was superior to surgical aortic valve replacement (SAVR) in the placement of aortic transcatheter valves (PARTNER) 2A trial (P2). The generalizability of the trial results to the broader population of patients with intermediate surgical risk remains unknown.

    Objective: To compare the outcomes of SAVR and TAVR among patients with intermediate surgical risk treated in the VA Healthcare System. Read More

    Use of a novel embolic filter in carotid artery stenting: 30-Day results from the EMBOLDEN Clinical Study.
    Catheter Cardiovasc Interv 2018 Jan 3. Epub 2018 Jan 3.
    Miriam Hospital, Providence, Rhode Island.
    Objectives: The EMBOLDEN study was conducted to test the safety and efficacy of a novel emboli protection filter design for use in carotid artery stenting (CAS) in patients with severe carotid stenosis who were at high risk of operative complications from carotid endarterectomy (CEA).

    Background: General considerations for filter design usually involve trade-offs between trackability/profile and wall apposition/capture efficiency. The GORE® Embolic Filter (GEF) is intended to address these design goals via a hybrid construction. Read More

    Venous access closure: From A to Z.
    Catheter Cardiovasc Interv 2018 Jan;91(1):113-114
    Fortis Escorts Heart Institute, New Delhi, India.
    Points to increasing need for achieving safe and secure closure of femoral venous access site after large caliber venous sheath for after structural interventions. Emphasizes the role of a simple, easy to learn "Z-stitch" for achieving femoral vein hemostasis leading to early ambulation. Cautions and advocates the use of multiple complimentary techniques for venous access closure after extreme large bore devices. Read More

    Chronic total occlusion: Does anti-platelet choice impact outcomes?
    Catheter Cardiovasc Interv 2018 Jan;91(1):7-8
    Department of Cardiology, Texas Heart Institute, Houston, Texas.
    Chronic total occlusion (CTO) is associated with worse outcomes compared to non CTO percutaneous coronary intervention (PCI). CTO might be associated with vasomotor dysfunction Ticagrelor is a novel P2Y12 inhibitor that increases local adenosine The TIGER-BVS trial plans to assess the impact of using ticagrelor vs. clopidogrel on vasomotor activity and outcomes after successful CTO PCI. Read More

    Patient preference: An important emerging factor in operator access site selection.
    Catheter Cardiovasc Interv 2018 Jan;91(1):25-26
    Cardiovascular Division, University of Alabama at Birmingham, Birmingham, Alabama.
    Patient preference should emerge as a third component influencing radial versus femoral access for cardiac catheterization. Ideally dually experienced "switch-operators" will consider co-morbidities, technical procedural factors, and patient preferences to choose a tailored approach with each patient. A tailored and tempered three component approach to access selection which includes patient preferences will likely optimize patient-centered outcomes. Read More

    Percutaneous transaxillary access for TAVR: Another opportunity to stay out of the chest.
    Catheter Cardiovasc Interv 2018 Jan;91(1):157-158
    Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland.
    Axillary arteries are less calcified and tortuous than iliofemoral arteries Axillary artery minimal luminal diameters are usually >5.0 mm even in patients with iliofemoral artery diameters < 5.0 mm Axillary and transcaval access are the only non-surgical fully percutaneous options for large-bore arterial access for TAVR or mechanical circulatory support devices. Read More

    Good enough…isn't.
    Catheter Cardiovasc Interv 2018 Jan;91(1):148-149
    Lankenau Heart Institute, 100 Lancaster Avenue, Suite 356 MOB East Wynnewood, PA 19096.
    Mild PVR has been shown to increase all-cause and cardiovascular mortality after TAVR, especially in high surgical risk patients. Mechanistic and associative causes, as well imprecise ascertainment have been suggested as underlying etiologies of this association. Ongoing trials with newer valve technologies, broader patient inclusion and more systematic assessment of PVR may provide further insight into the prevalence, causality, and outcome of PVR. Read More

    Moving beyond Seldinger, a vascular access and closure smorgasbord, "safe zone" or not.
    Catheter Cardiovasc Interv 2018 Jan;91(1):33-34
    Division of Cardiology, Hackensack University Medical Center, and Department of Cardiology, Seton Hall Hackensack Meridian School of Medicine, Hackensack, New Jersey.
    This paper describes a quality improvement initiative featuring the adoption of multiple access and closure techniques to assess "real world" outcomes. Although the study does not provide a scientific evidence base, it does highlight the changing platforms being adopted. Radial, micropuncture, and image guided access will hopefully become near universal in the coming decade. Read More

    Long-term pacemaker dependency and impact of pacing on mortality following transcatheter aortic valve replacement with the LOTUS valve.
    Catheter Cardiovasc Interv 2018 Jan 4. Epub 2018 Jan 4.
    Monash Cardiovascular Research Centre, MonashHeart, Monash Medical Centre and Monash University, Melbourne, Australia.
    Objectives: To determine permanent pacemaker (PPM) dependency following transcatheter aortic valve replacement (TAVR) with the Lotus™ valve system (Boston Scientific), and the impact of PPM implantation on long-term morbidity and mortality.

    Background: Conduction abnormalities are among the most common complications following TAVR. Limited studies have assessed pacing dependency following TAVR. Read More

    Transubclavian approach: A competitive access for transcatheter aortic valve implantation as compared to transfemoral.
    Catheter Cardiovasc Interv 2018 Jan 3. Epub 2018 Jan 3.
    CIBER CV, Cardiology Department, Hospital Clínico Universitario, Valladolid, Spain.
    Aims: Empirically, transfemoral (TF) approach is the first choice for transcatheter aortic valve implantation (TAVI). We aimed to investigate whether transubclavian (TSc) and TF approaches present comparable major outcomes according to current evidence.

    Methods: We systematically searched PubMed, EMBASE, and Cochrane database for studies with symptomatic aortic stenosis patients who underwent TAVI through TF or TSc/axillary access from January/2006 to January/2017. Read More

    Antegrade fenestration and re-entry: A new controlled subintimal technique for chronic total occlusion recanalization.
    Catheter Cardiovasc Interv 2018 Jan 4. Epub 2018 Jan 4.
    Division of Interventional Cardiology, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.
    Objectives: To describe and evaluate the efficacy of a novel antegrade dissection/re-entry (ADR) technique, called antegrade fenestration and re-entry (AFR), for chronic total occlusions (CTO) percutaneous coronary intervention (PCI).

    Background: The widespread adoption of ADR is limited by several technical, logistic, and financial factors. Therefore, novel ADR techniques are needed. Read More

    Subadventitial stenting around occluded stents: A bailout technique to recanalize in-stent chronic total occlusions.
    Catheter Cardiovasc Interv 2018 Jan 4. Epub 2018 Jan 4.
    Division of Cardiology and Angiology II, University Heart Center Freiburg Bad Krozingen, Bad Krozingen, Germany.
    Objectives: To evaluate the outcomes of subadventitial stenting (SS) around occluded stents for recanalizing in-stent chronic total occlusions (IS-CTOs).

    Background: There is little evidence on the outcomes of SS for IS-CTO.

    Methods: We examined the outcomes of SS for IS-CTO PCI at 14 centers between July 2011 and June 2017, and compared them to historical controls recanalized using within-stent stenting (WSS). Read More

    Robotic-assisted transradial diagnostic coronary angiography.
    Catheter Cardiovasc Interv 2018 Jan 4. Epub 2018 Jan 4.
    Durham VA Medical Center, 508 Fulton Street, Durham, North Carolina, 27705.
    Robotic percutaneous coronary interventions have recently been introduced in the cardiac catheterization laboratory. Robotics offers benefits of greater precision for stent placement and occupational hazard protection for operators and staff. First generation systems were able to advance and retract coronary wires, balloons, and stents, but did not have guide control functions. Read More

    Lost and found: Coronary stent retrieval and review of literature.
    Catheter Cardiovasc Interv 2018 Jan 4. Epub 2018 Jan 4.
    Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska.
    A 61-year-old man with a history of percutaneous coronary intervention (PCI) of the mid right coronary artery (RCA) with a drug eluting stent (DES), presented with non-ST segment elevation myocardial infarction. Coronary angiography demonstrated complex disease of the distal RCA as well as in-stent stenosis of the previously placed mid RCA stent. The patient underwent bifurcation PCI of the distal RCA followed by attempted intervention with a DES on the mid RCA lesion. Read More

    Predictors of patient radiation exposure during transcatheter aortic valve replacement.
    Catheter Cardiovasc Interv 2017 Dec 27. Epub 2017 Dec 27.
    Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
    Background: Transcatheter aortic valve replacement (TAVR) exposes patients to radiation.

    Objectives: We sought to identify factors associated with higher radiation exposure and to quantify their relative influence, which may inform reduction of this hazard.

    Methods: All TAVR procedures at Rhode Island Hospital between March 20, 2012 and February 12, 2017 were included. Read More

    Perforated balloon technique: A simple and handy technique to combat no-reflow phenomenon in coronary system.
    Catheter Cardiovasc Interv 2017 Dec 27. Epub 2017 Dec 27.
    Department of Cardiology, Mercy Hospital and Community Medical Center, Scranton, Pennsylvania.
    Objective: Examining the efficacy and outcomes of intracoronary (IC) instillation of adenosine using a novel perforated balloon technique (PBT) to combat no-reflow phenomenon during percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).

    Background: Occurrence of no-reflow during PCI is a serious adverse prognostic event and inability to re-establish better flow is associated with poor outcomes. Several pharmacological and non-pharmacological interventions have been used to treat this situation. Read More

    Ventricular arrhythmias immediately following transcatheter pulmonary valve implantation: A cause for concern?
    Catheter Cardiovasc Interv 2017 Dec 27. Epub 2017 Dec 27.
    Section of Pediatric Cardiology, Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut.
    Background: Transcatheter pulmonary valve implantation (TPVI) has revolutionized the care of patients with congenital disorders of the right ventricular outflow tract (RVOT) and is increasingly being used in patients with native outflow tracts. This is the first study to specifically report the occurrence of ventricular arrhythmias in the immediate post-TPVI period.

    Methods And Results: Medical records of all adult and pediatric patients who underwent TPVI at our institution between May 1, 2011 and March 1, 2016, were reviewed for the presence of clinically significant ventricular arrhythmias occurring within 30 days of TPVI. Read More

    Repeat MitraClip for early recurrent mitral regurgitation.
    Catheter Cardiovasc Interv 2017 Dec 27. Epub 2017 Dec 27.
    Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.
    Treatment for recurrent mitral regurgitation (MR) after MitraClip therapy remains a challenging issue. This study reports the efficacy of repeat MitraClip therapy for recurrent MR during the early phase after the index MitraClip procedure. We present a case series of four consecutive patients who underwent repeat MitraClip procedures for severe recurrent MR during the early phase. Read More

    Nine-month results of the BIOHELIX-I clinical trial study: Evaluation of the PRO-Kinetic Energy cobalt chromium bare-metal stent system.
    Catheter Cardiovasc Interv 2017 Dec 22. Epub 2017 Dec 22.
    St Charles Hospital, Bend, Oregon.
    Objectives: To evaluate the safety and efficacy of the PRO-Kinetic Energy (PKE) Cobalt Chromium Coronary Stent System (BIOTRONIK AG, Switzerland).

    Background: Percutaneous coronary intervention is a mainstay treatment for symptomatic coronary artery disease (CAD). While drug-eluting stents constitute a majority of implants, bare-metal stents (BMS) remain important for a subset of patients. Read More

    Incidence, predicting factors, and clinical outcomes of periprocedural myocardial infarction after percutaneous coronary intervention for chronic total occlusion in the era of new-generation drug-eluting stents.
    Catheter Cardiovasc Interv 2017 Dec 20. Epub 2017 Dec 20.
    Department of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
    Objective: This study aimed to examine predictors and clinical outcomes of periprocedural myocardial infarction (PMI) after chronic total occlusion (CTO) intervention.

    Background: There are limited data on the clinical implications of PMI after CTO intervention in the new-generation drug-eluting stent (DES) era.

    Methods: We enrolled 337 patients who underwent CTO intervention and met the study criteria. Read More

    Stenting and overdilating small Gore-Tex vascular grafts in complex congenital heart disease.
    Catheter Cardiovasc Interv 2018 Jan 20;91(1):71-80. Epub 2017 Dec 20.
    Birmingham Children's Hospital, The Heart Unit, West Midlands, United Kingdom.
    Background: Gore-Tex® grafts are integral in the management of congenital heart disease. Issues of graft stenosis or somatic outgrowth may precipitate high-risk early surgery, and catheter intervention is a relatively under-reported management option.

    Objectives: To assess efficacy, safety, and outcomes of stenting and overdilating small Gore-Tex® vascular grafts with the aim of optimizing surgical timing. Read More

    Feasibility of early mechanical circulatory support in acute myocardial infarction complicated by cardiogenic shock: The Detroit cardiogenic shock initiative.
    Catheter Cardiovasc Interv 2017 Dec 20. Epub 2017 Dec 20.
    Department of Cardiology, Henry Ford Hospital, Detroit, Michigan.
    Objective: The 'Detroit Cardiogenic Shock Initiative' is a single-arm, multicenter study to assess the feasibility of early mechanical circulatory support (MCS) in patients who present with acute myocardial infarction complicated by cardiogenic shock (AMICS) who undergo percutaneous coronary intervention.

    Methods: Between July 2016 and February 2017, 4 metro Detroit sites participated in the study. The centers agreed to treat patients with AMICS using a mutually agreed-upon protocol emphasizing invasive hemodynamic monitoring and rapid initiation of MCS. Read More

    The "side-BASE technique": Combined side branch anchor balloon and balloon assisted sub-intimal entry to resolve ambiguous proximal cap chronic total occlusions.
    Catheter Cardiovasc Interv 2017 Dec 20. Epub 2017 Dec 20.
    Department of Cardiology, Forth Valley Royal Hospital, Larbert, United Kingdom.
    Failure to penetrate the proximal cap or cross with equipment remains the most frequent cause of procedural failure in CTO PCI. In the "BASE" technique concerns were raised over the risk of proximal side branch loss. We here describe the evolution of this technique and highlight examples where the sub-intimal space was accessed proximal to the occlusion by using the side branch. Read More

    First in human evaluation of the vascular biocompatibility and biomechanical performance of a novel ultra high molecular weight amorphous PLLA bioresorbable scaffold in the absence of anti-proliferative drugs: Two-year imaging results in humans.
    Catheter Cardiovasc Interv 2017 Dec 15. Epub 2017 Dec 15.
    CRF-Skirball Center for Innovation, New York, New York.
    Objectives: In this first-in-human study, we prospectively studied the vascular compatibility and mechanical performance of a novel bare ultra-high molecular weight amorphous PLLA bioresorbable scaffold (BRS, FORTITUDE®, Amaranth Medical, Mountain View, California) up to two years after implantation using multimodality imaging techniques.

    Background: The vascular biocompatibility of polymers used in BRS has not been fully characterized in the absence of anti-proliferative drugs.

    Methods: A total of 10 patients undergoing single scaffold implantation were included in the final analysis and were followed up using optical coherence tomography (OCT) at 2-years. Read More

    Insufficiency of a Damus-Kaye-Stansel anastomosis in a Fontan patient: Transfemoral implantation of an Edwards Sapien 3 valve.
    Catheter Cardiovasc Interv 2017 Dec 14. Epub 2017 Dec 14.
    Department for Cardiology and Pneumology, University Medical Center Goettingen, Robert-Koch-Str. 40, Goettingen, 37075, Germany.
    We present a 22-year-old patient with a univentricular heart who had already undergone five open heart surgeries including a Damus-Kaye-Stansel procedure, Fontan completion and tricuspid valve replacement. In addition, epimyocardial pacemaker implantation and repeated revisions had been necessary. He developed symptomatic free regurgitation of the pulmonary portion of his DKS anastomosis. Read More

    Double layered stents for carotid angioplasty: A meta-analysis of available clinical data.
    Catheter Cardiovasc Interv 2017 Dec 14. Epub 2017 Dec 14.
    Division of Cardiology, University of Naples "Federico II", Naples, Italy.
    Objectives: The objective of this meta-analysis is to evaluate clinical efficacy of double layered mesh covered carotid stent systems in the clinical practice.

    Background: The need for an increase plaque coverage to decrease the risk of debris dislodgement through the stent struts, following carotid artery stenting (CAS), has brought to the design of a new generation of double layered carotid stents. Several small sized clinical studies evaluating two different devices have been recently published, unfortunately these are not sufficiently powered to test for device related and clinical endpoints and no comparison, between the two available devices, has been reported yet. Read More

    Validating a prediction modeling tool for left ventricular outflow tract (LVOT) obstruction after transcatheter mitral valve replacement (TMVR).
    Catheter Cardiovasc Interv 2017 Dec 11. Epub 2017 Dec 11.
    Center for Structural Heart Disease, Division of Cardiology, Henry Ford Health System, Detroit, Michigan.
    Objective: Demonstrate proof-of-concept validation of a computed tomography (CT) computer-aided design prediction modeling tool to identify patients at risk for left ventricular outflow tract (LVOT) obstruction in transcatheter mitral valve replacement (TMVR).

    Background: LVOT obstruction is a significant and even fatal consequence of TMVR.

    Methods: From August 2013 to August 2017, 38 patients in 5 centers underwent TMVR with compassionate use of balloon-expandable valves for severe mitral valve dysfunction because of degenerative surgical mitral ring, bioprosthesis, or severe native mitral stenosis from to severe mitral annular calcification. Read More

    Sirens song or a bugle call to charge.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1105-1106
    Division of Interventional Cardiology, MS Hershey Medical Center, Penn State University, College of Medicine, Heart & Vascular Institute, Hershey, Pennsylvania.
    Radial access for catheterization is associated with reduced bleeding and mortality across a spectrum of clinical conditions compared to femoral. Transradial technique is associated with a higher rate of access site failure but this is in those most likely to have a femoral-based complication. Improved outcomes will come with further radial technique refinement and not with a retreat to legacy femoral approaches. Read More

    Ischemia-reperfusion injury and ischemic post-conditioning in acute myocardial infarction: Lost in translation.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1068-1069
    The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
    Ischemic post-conditioning (IPoC) has been proposed as a strategy to mitigate the risk of ischemia-reperfusion injury during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In this comprehensive and updated meta-analysis of randomized controlled trials, IPoC during primary PCI for STEMI had no significant effect on all-cause mortality, re-infarction, or new-onset heart failure compared with no post-conditioning. Further strategies need to be prospectively evaluated to improve outcomes in patients with STEMI undergoing primary PCI. Read More

    A cardiologist's nightmare: Coronary obstruction during transcatheter aortic valve implantation: How to identify patients at highest risk for this complication.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1198-1199
    Department of Cardiology, Texas Heart Institute, Houston, Texas.
    Transcatheter aortic valve implantation (TAVI) is associated with several complications including coronary obstruction (CO) CO occurs in ∼1% of patients and mostly in patients receiving the SAPIEN XT valve Possible predictors of CO include coronary height <10 mm and aortic sinus diameter of <30 mm. Read More

    Vulnerable plaques, more than meets the i.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1115-1116
    Division of Cardiology, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island.
    Intravascular imaging plays a key role in the identification of mechanisms of acute coronary syndromes Post processing IVUS algorithms (IMAP-IVUS and VH-IVUS) for tissue characterization have not been widely adopted due to current limitations Future development will allow easier, faster, and more accurate identification of vulnerable plaques, ultimately allowing prognostication of various interventions. Read More

    Power of gradients.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1183-1184
    Henry Ford Hospital, Detroit, Michigan.
    Patients with high baseline gradients benefit most after TAVR. In severe symptomatic aortic stenosis, every 10 mm Hg increase in mean gradient has 20% reduction in mortality after TAVR. Low gradient severe aortic stenosis continues to be a clinical cohort with variable benefit from TAVR. Read More

    Nitroglycerin and the enduring principles of coronary procedures.
    Catheter Cardiovasc Interv 2017 Dec;90(7):1091-1092
    Division of Cardiology, Charles George Veterans Affairs Medical center, Asheville, North Carolina.
    The benefits of nitroglycerin are numerous, from ensuring accurate interpretation of diagnostic angiograms to treatment of coronary spasm and support of PCIs in simple or complex lesion types. The founders of the field were convinced that no coronary arteriography should be considered complete unless a vasodilator is used at some point during the study. This recommendation is valid. Read More

    Optimizing hemodynamics of transcatheter aortic valve-in-valve implantation in 19-mm surgical aortic prostheses.
    Catheter Cardiovasc Interv 2017 Dec 11. Epub 2017 Dec 11.
    Heart & Vascular Institute, Cleveland Clinic.
    Objective: To demonstrate the feasibility of achieving good hemodynamic results with valve-in-valve transcatheter aortic valve replacement (ViV TAVR) for degenerated 19 mm surgical bioprosthetic valves.

    Background: Considerable controversy exists regarding ViV TAVR within 19mm surgical prostheses due to concerns of elevated valve gradients and mortality.

    Methods: Among all patient undergoing ViV TAVR between 7/2016 and 4/2017 for symptomatic severe bioprosthetic aortic stenosis (AS), five had a 19 mm surgical valve in place and were included in this publication. Read More

    First experience of the usage of a GORE CARDIOFORM Septal Occluder device for treatment of a significant residual commissural mitral regurgitation jet following a MitraClip procedure.
    Catheter Cardiovasc Interv 2017 Dec 8. Epub 2017 Dec 8.
    Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
    The MitraClip (Abbott Vascular, Santa Clara, CA) procedure has emerged as a safe and effective treatment option for treatment of selected patients with severe mitral regurgitation (MR) who are at high risk for surgery. Effective reduction of MR is important to ensure an optimal clinical outcome. We present here the first case report of a significant commissural leak after a MitraClip procedure treated with a GORE CARDIOFORM Septal Occluder device (WL Gore & Associates, Flagstaff, AZ). Read More

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