181 results match your criteria Interventional Cardiology [Journal]


TAVI for Pure Native Aortic Regurgitation: Are We There Yet?

Interv Cardiol 2019 Feb;14(1):26-30

Barts Heart Centre, St Bartholomew's Hospital London, UK.

Treatment of degenerative aortic stenosis has been transformed by transcatheter aortic valve implantation (TAVI) over the past 10-15 years. The success of various technologies has led operators to attempt to broaden the indications, and many patients with native valve aortic regurgitation have been treated 'off label' with similar techniques. However, the alterations in the structure of the valve complex in pure native aortic regurgitation are distinct to those in degenerative aortic stenosis, and there are unique challenges to be overcome by percutaneous valves. Read More

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http://dx.doi.org/10.15420/icr.2018.37.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406131PMC
February 2019
4 Reads

Erratum to: Common and Uncommon CTO complications.

Interv Cardiol 2019 Feb;14(1):48

Cardiology Department, Belfast Health & Social Care Trust, Belfast Northern Ireland, UK.

[This corrects the article DOI: 10.15420/icr.2018. Read More

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http://dx.doi.org/10.15420/icr.2018.35.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406125PMC
February 2019

Why Did COAPT Win While MITRA-FR Failed? Defining the Appropriate Patient Population for MitraClip.

Interv Cardiol 2019 Feb;14(1):45-47

Swedish Heart and Vascular Institute Seattle, WA, US.

In 2018, the world of functional mitral regurgitation changed with the presentation of two trials - Multicentre Study of Percutaneous Mitral Valve Repair MitraClip Device in Patients With Severe Secondary Mitral Regurgitation (MITRA-FR) and Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT). The trials, which seemed to point in two different directions, raised significant questions for the field. This article looks at the differences in effective regurgitant area, guideline-directed medical therapy, patient selection, technical clues and other reasons why the trials had similar aims but very different findings. Read More

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http://dx.doi.org/10.15420/icr.2018.40.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406127PMC
February 2019
1 Read

Device-Related Thrombus After Left Atrial Appendage Closure.

Interv Cardiol 2019 Feb;14(1):42-44

Hôpital Privé Jacques Cartier, Institut Cardiovasculaire Paris Sud - Ramsay Générale de Santé Massy, France.

Although left atrial appendage closure (LAAC) has proved non-inferior to oral anticoagulants in patients with AF, there has been recent concern about the occurrence of late complications, especially device-related thrombus (DRT), which was associated with increased risk of stroke. In this article, the incidence, risk factors and time course of DRT after LAAC are discussed, as well as the potential benefits of dedicated strategies in the management of DRT, which remain speculative, especially in patients with a contraindication to oral anticoagulants. In these patients, decision-making should be based on a multidisciplinary evaluation of the ischaemic/bleeding balance on an individual basis. Read More

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http://dx.doi.org/10.15420/icr.2018.21.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406133PMC
February 2019

Patent Foramen Ovale Closure in 2019.

Interv Cardiol 2019 Feb;14(1):34-41

Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust Cambridge, UK.

Patent foramen ovale (PFO) is a common abnormality affecting between 20% and 34% of the adult population. For most people it is a benign finding; however, in some the PFO can open widely, enabling a paradoxical embolus to transit from the venous to arterial circulation, which is associated with stroke and systemic embolisation. Percutaneous closure of PFO in patients with cryptogenic stroke has been undertaken for a number of years, and a number of purpose-specific septal occluders have been marketed. Read More

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http://dx.doi.org/10.15420/icr.2018.33.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406129PMC
February 2019
1 Read

How to Make the TAVI Pathway More Efficient.

Interv Cardiol 2019 Feb;14(1):31-33

Groupe Cardiovasculaire Interventionnel, Clinique Pasteur Toulouse, France.

Transcatheter aortic valve implantation (TAVI) has been in use for 16 years. As there has been a rapid expansion in its use, there is a need to optimise TAVI programmes to ensure efficiency. In this article, the authors discuss the reasons why clinicians need to make the TAVI pathway more efficient and describe the most important steps to take from screening to early discharge, including procedural optimisation. Read More

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http://dx.doi.org/10.15420/icr.2018.28.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406128PMC
February 2019

Cerebral Embolic Protection in TAVI: Friend or Foe.

Interv Cardiol 2019 Feb;14(1):22-25

London Health Sciences Centre London, Ontario, Canada.

Cerebrovascular accidents including stroke or transient ischaemic attack are one of the most feared complications after transcatheter aortic valve implantation. Transcatheter aortic valve implantation procedures have been consistently associated with silent ischaemic cerebral embolism as assessed by diffusion-weighted MRI. To reduce the risk of cerebrovascular accidents and silent emboli, cerebral embolic protection devices were developed with the aim of preventing procedural debris reaching the cerebral vasculature. Read More

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http://dx.doi.org/10.15420/icr.2018.32.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406126PMC
February 2019

Large-bore Vascular Closure: New Devices and Techniques.

Interv Cardiol 2019 Feb;14(1):17-21

Department of Cardiology, Thoraxcenter, Erasmus University Medical Center Rotterdam, the Netherlands.

Endovascular aneurysm repair, transcatheter aortic valve implantation and percutaneous mechanical circulatory support systems have become valuable alternatives to conventional surgery and even preferred strategies for a wide array of clinical entities. Their adoption in everyday practice is growing. These procedures require large-bore access into the femoral artery. Read More

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http://dx.doi.org/10.15420/icr.2018.36.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406132PMC
February 2019
1 Read

Contemporary Management of Stent Failure: Part One.

Interv Cardiol 2019 Feb;14(1):10-16

Dorset Heart Centre, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust Bournemouth, UK.

The occurrence of in-stent restenosis (ISR) still remains a daunting challenge in the current era, despite advancements in coronary intervention technology. The authors explore the underlying pathophysiology and mechanisms behind ISR, and describe how the use of different diagnostic tools helps to best elucidate these. They propose a simplistic algorithm to manage ISR, including a focus on how treatment strategies should be selected and a description of the contemporary technologies available. Read More

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http://dx.doi.org/10.15420/icr.2018.39.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406130PMC
February 2019

OCT-guided Percutaneous Coronary Intervention in Bifurcation Lesions.

Interv Cardiol 2019 Feb;14(1):5-9

Interventional Structural Cardiology Division, Department of Heart, Lung and Vessels, Careggi University Hospital Florence, Italy.

Coronary artery bifurcation lesions remain challenging despite significant advancements in stent technology and development of specific bifurcation stenting approaches. Optical coherence tomography (OCT) is the intracoronary imaging technique with the highest resolution and can generate automatically contoured lumen areas across the variable geometry of bifurcation lesions. Knowledge of plaque severity and composition facilitates planning of the best strategy for percutaneous coronary intervention (PCI) and stenting. Read More

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http://dx.doi.org/10.15420/icr.2018.17.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406124PMC
February 2019

Foreword.

Authors:
Simon Kennon

Interv Cardiol 2019 Feb;14(1)

Interventional Cardiologist and TAVI Operator at the Barts Heart Centre, St Bartholomew's Hospital, London. He trained at Manchester University, St Bartholomew's Hospital, the London Chest Hospital and St Vincent's Hospital, Melbourne. His research interests relate to aortic valve and coronary interventions.

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http://dx.doi.org/10.15420/icr.2019.14.1.FO1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406123PMC
February 2019

Alternate Access for TAVI: Stay Clear of the Chest.

Interv Cardiol 2018 Sep;13(3):145-150

Centre Hospitalier Regional et Universitaire de Lille Lille, France.

Transcatheter aortic valve implantation (TAVI) is currently performed through an alternative access in 15% of patients. The transapical access is progressively being abandoned as a result of its invasiveness and poor outcomes. Existing data does not allow TAVI operators to favour one access over another - between transcarotid, trans-subclavian and transaortic - because all have specific strengths and weaknesses. Read More

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http://dx.doi.org/10.15420/icr.2018.22.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234489PMC
September 2018
7 Reads

Annular Rupture During Transcatheter Aortic Valve Implantation: Predictors, Management and Outcomes.

Interv Cardiol 2018 Sep;13(3):140-144

University Hospital Limerick Dooradoyle, Co Limerick, Ireland.

Transcatheter aortic valve implantation (TAVI) is the treatment of choice in patients with symptomatic severe aortic stenosis who are either inoperable or at high risk for conventional surgical aortic valve replacement. Recent data have also shown favourable outcomes in patients deemed to be at intermediate operative risk, which expands the application of this novel technology. Despite its success, TAVI has been associated with rare life-threatening complications. Read More

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https://www.icrjournal.com/articles/annular-rupture-TAVI
Publisher Site
http://dx.doi.org/10.15420/icr.2018.20.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234484PMC
September 2018
19 Reads

Delayed Coronary Occlusion After Transcatheter Aortic Valve Implantation: Implications for New Transcatheter Heart Valve Design and Patient Management.

Interv Cardiol 2018 Sep;13(3):137-139

EMO-GVM Centro Cuore Columbus Milan, Italy.

Transcatheter aortic valve implantation has revolutionised the treatment of patients with severe aortic stenosis and is the preferred treatment option for patients with elevated surgical risk. Outcomes have continually improved, but because of the nature of the procedure infrequent catastrophic complications, such as coronary obstruction, persist. Recently, data were published regarding delayed coronary obstruction (DCO), a phenomenon in which the obstruction occurs after the index procedure. Read More

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http://dx.doi.org/10.15420/icr.2018.24.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234488PMC
September 2018
7 Reads

ORBITA: What Goes Around, Comes Around… Or Does It?

Interv Cardiol 2018 Sep;13(3):135-136

Freeman Hospital, High Heaton Newcastle-Upon-Tyne, UK.

Current guidelines recommend percutaneous coronary intervention (PCI) in patients with ongoing stable angina symptoms despite optimal medical therapy (OMT), although trials have shown no reduction in death or myocardial infarction. The recently published ORBITA trial compared OMT + PCI with OMT + 'placebo' PCI in patients with angina and single-vessel coronary artery disease (CAD), and found no significant difference in treadmill exercise time between the two groups after six weeks. The trial concluded that invasive procedures can be assessed with placebo control while numerous editorials interpreted the trial as showing that PCI has no role in the management of stable angina. Read More

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http://dx.doi.org/10.15420/icr.2018.18.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234483PMC
September 2018
3 Reads

Culprit Vessel Only Versus Complete Revascularisation in Patients with ST-Segment Elevation Myocardial Infarction - Should we Stay or Stage?

Interv Cardiol 2018 Sep;13(3):129-134

2nd Medical Department with Cardiology and Intensive Care Medicine, KA Rudolfstiftung Vienna, Austria.

Multivessel coronary artery disease (MVCAD) is common in patients with ST-elevation myocardial infarction (STEMI), thereby negatively affecting mortality and outcome. Currently there is increasing evidence that complete revascularisation should be considered in haemodynamically stable patients. There are few larger randomised controlled trials available showing a lower risk of major adverse cardiac events after complete revascularisation, mainly driven by a reduction of repeat revascularisation. Read More

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http://dx.doi.org/10.15420/icr.2018.13.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234493PMC
September 2018
1 Read

FFR for Complex Coronary Artery Disease Treatment Planning: New Opportunities.

Interv Cardiol 2018 Sep;13(3):126-128

St Paul's Hospital & University of British Columbia, Vancouver, British Columbia Vancouver, Canada.

Coronary computed tomography (CT) is well established for the assessment of symptomatic patients with suspected but not yet confirmed coronary artery disease with high diagnostic accuracy and risk prediction. Until recently, coronary computed tomography angiography (CTA) has played a limited role in the management of complex coronary artery disease (CAD) and in planning revascularisation strategies. With the advent of FFR, enabling anatomy and physiology with a single study and the ability to adjudicate lesion specific pressure loss, the potential of combined coronary CT angiography (CCTA) and fractional flow reserve (FFR) computed from non-invasive CT angiography (FFR) to inform treatment decision-making and help guide revascularisation has been recognised. Read More

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https://www.icrjournal.com/articles/ffrct-complex-coronary-a
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http://dx.doi.org/10.15420/icr.2018.14.3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234481PMC
September 2018
13 Reads

Common and Uncommon CTO Complications.

Interv Cardiol 2018 Sep;13(3):121-125

Cardiology Department, Belfast Health & Social Care Trust Belfast, Northern Ireland, UK.

Despite the ongoing development of technical skills, increasing operator experience and improvements in medical devices, percutaneous coronary interventions (PCI) for chronic total occlusions (CTO) are still the most challenging procedures in interventional cardiology for coronary artery disease. Due to the complexity of the procedures, there is an increased complication rate compared with PCIs for the treatment of non-occlusive disease. This may significantly increase procedural morbidity and potentially mortality. Read More

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http://dx.doi.org/10.15420/icr.2018.10.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234482PMC
September 2018
13 Reads

Risk Stratification in Patients with Coronary Artery Disease: A Practical Walkthrough in the Landscape of Prognostic Risk Models.

Interv Cardiol 2018 Sep;13(3):112-120

CAST, AOU. Policlinico-Vittorio Emanuele, University of Catania Catania, Italy.

Although a combination of multiple strategies to prevent and treat coronary artery disease (CAD) has led to a relative reduction in cardiovascular mortality over recent decades, CAD remains the greatest cause of morbidity and mortality worldwide. A variety of individual factors and circumstances other than clinical presentation and treatment type contribute to determining the outcome of CAD. It is increasingly understood that personalised medicine, by taking these factors into account, achieves better results than "one-size-fitsall" approaches. Read More

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http://dx.doi.org/10.15420/icr.2018.16.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234492PMC
September 2018
1 Read

'Primary' Microvascular Angina: Clinical Characteristics, Pathogenesis and Management.

Interv Cardiol 2018 Sep;13(3):108-111

Molecular and Clinical Sciences Research Institute, St George's, University of London London, UK.

Microvascular angina (MVA), i.e. angina caused by abnormalities of the coronary microcirculation, is increasingly recognised in clinical practice. Read More

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http://dx.doi.org/10.15420/icr.2018.15.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234490PMC
September 2018
1 Read

Foreword.

Authors:
Simon Kennon

Interv Cardiol 2018 Sep;13(3):106

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http://dx.doi.org/10.15420/icr.2018.13.3.FO1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6234491PMC
September 2018
1 Read

Non-vitamin K Antagonist Oral Anticoagulant After Acute Coronary Syndrome: Is There a Role?

Interv Cardiol 2018 May;13(2):93-98

Icahn School of Medicine, Mount Sinai Hospital, New York NY, USA.

Despite dual antiplatelet therapy (DAPT) including potent P2Y12 inhibitors, recurrent ischaemic events occur in a significant number of patients after acute coronary syndrome (ACS), warranting new antithrombotic strategies. Combinations of non-vitamin K antagonist oral anticoagulant (NOAC) with antiplatelet therapy have been tested in several large phases II and III randomised trials. Overall, current evidence suggests that the use of NOACs on top of DAPT after ACS reduces the rate of recurrent ischaemic events, albeit at the price of increased risk for major bleeding. Read More

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https://www.icrjournal.com/articles/non-vitamin-k-antagonist
Publisher Site
http://dx.doi.org/10.15420/icr.2018:5:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980653PMC
May 2018
7 Reads

Anticoagulant Therapy for Acute Coronary Syndromes.

Interv Cardiol 2018 May;13(2):87-92

Freeman Hospital and Newcastle University and Newcastle Upon Tyne Hospitals NHS Trust Newcastle, UK.

Anticoagulation in conjunction with antiplatelet therapy is central to the management of acute coronary syndromes (ACS). When used effectively it is associated with a reduction in recurrent ischaemic events including myocardial infarction and stent thrombosis as well as a reduction in death. Effective ischaemic risk reduction whilst balancing bleeding risk remains a clinical challenge. Read More

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http://dx.doi.org/10.15420/icr.2017:26:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980649PMC
May 2018
9 Reads

'Combat' Approach to Cardiogenic Shock.

Interv Cardiol 2018 May;13(2):81-86

INOVA Heart and Vascular Institute, Falls Church VA, USA.

The incidence of cardiogenic shock is rising, patient complexity is increasing and patient survival has plateaued. Mirroring organisational innovations of elite military units, our multidisciplinary medical specialists at the INOVA Heart and Vascular Institute aim to combine the adaptability, agility and cohesion of small teams across our large healthcare system. We advocate for widespread adoption of our 'combat' methodology focused on: increased disease awareness, early multidisciplinary shock team activation, group decision-making, rapid initiation of mechanical circulatory support (as appropriate), haemodynamic-guided management, strict protocol adherence, complete data capture and regular after action reviews, with a goal of ending preventable death from cardiogenic shock. Read More

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http://dx.doi.org/10.15420/icr.2017:35:3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980650PMC
May 2018
25 Reads

Transseptal Transcatheter Mitral Valve Replacement for Post-Surgical Mitral Failures.

Interv Cardiol 2018 May;13(2):77-80

Center for Structural Heart Disease Henry Ford Hospital, Detroit, MI, USA.

Post-surgical deterioration of mitral valve repairs or replacements may present a clinical dilemma due to the high-risk nature of repeat surgery. Recent advances in transcatheter techniques and surgery have enabled the implantation of balloon-expandable valves in the mitral position when surgical rings and valves are present. Valves may be implanted either via transseptal or transapical access, with a reported success rate between 88-100 %. Read More

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http://dx.doi.org/10.15420/icr.2017:16:3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980652PMC
May 2018
1 Read

Coronary Revascularisation in Transcatheter Aortic Valve Implantation Candidates: Why, Who, When?

Interv Cardiol 2018 May;13(2):69-76

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan Italy.

Coronary artery disease (CAD) and aortic stenosis (AS) frequently coexist. The presence of CAD has been consistently associated with an impaired prognosis in patients undergoing surgical aortic valve replacement during short- and long-term follow-up. Accordingly, current guidelines recommend coronary revascularisation of all significant stenoses in patients undergoing surgical aortic valve replacement. Read More

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http://dx.doi.org/10.15420/icr.2018:2:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980648PMC
May 2018
3 Reads

Transcatheter Aortic Valve Implantation in Small Anatomy: Patient Selection and Technical Challenges.

Interv Cardiol 2018 May;13(2):66-68

Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan.

Transcatheter aortic valve implantation (TAVI) has become a standard treatment for severe aortic stenosis. Although this technique has reached relative maturity, further optimisation of patient selection and device implantation is essential to improve prognosis. Smaller body size is a predictor of a challenging TAVI procedure due to specific anatomical difficulty and adverse events including annulus rupture, acute coronary obstruction and vascular complications. Read More

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http://dx.doi.org/10.15420/icr.2017:28:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980651PMC
May 2018
9 Reads

Diagnosis and Outcomes of Transcatheter Aortic Valve Implantation in Bicuspid Aortic Valve Stenosis.

Interv Cardiol 2018 May;13(2):62-65

Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, CA, USA.

Bicuspid aortic valve is the most common congenital cardiac malformation. Aortic valve replacement is often required in older patients but the surgical risk is often extremely high. As Transcatheter aortic valve implantation (TAVI) is an established therapy for intermediate and high surgical risk patients with symptomatic severe aortic valve stenosis (AS). Read More

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http://dx.doi.org/10.15420/icr.2018:8:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980654PMC
May 2018
24 Reads

Foreword.

Authors:
Simon Kennon

Interv Cardiol 2018 May;13(2):58

Interventional Cardiologist and TAVI Operator at the Barts Heart Centre, St Bartholomew's Hospital, London. He trained at Manchester University, St Bartholomew's Hospital, the London Chest Hospital and St Vincent's Hospital, Melbourne. His research interests relate to aortic valve and coronary interventions.

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http://dx.doi.org/10.15420/icr.2018.13.2.FO1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980646PMC
May 2018
1 Read

Is Complete Revascularisation Mandated for all Patients with Multivessel Coronary Artery Disease?

Interv Cardiol 2018 01;13(1):45-50

Institute of Cardiology and Centre of Excellence on Ageing, "G. d'Annunzio" University of Chieti-Pescara,Chieti, Italy.

In multivessel coronary artery disease (MVCAD), myocardial revascularisation can be achieved by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), with complete revascularisation on all diseased coronary segments or with incomplete revascularisation on selectively targeted lesions. Complete revascularisation confers a long-term prognostic benefit, but is associated with a higher rate of periprocedural events compared with incomplete revascularisation. In most patients with MVCAD, the main advantage of CABG over PCI is conferred by the achievement of more extensive revascularisation. Read More

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http://dx.doi.org/10.15420/icr.2017:23:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872375PMC
January 2018
7 Reads

Challenges in Patients with Diabetes: Improving Clinical Outcomes After Percutaneous Coronary Intervention Through EVOlving Stent Technology.

Interv Cardiol 2018 Jan;13(1):40-44

San Raffaele HospitalMilan, Italy.

Patients with diabetes have poorer outcomes after percutaneous coronary intervention than patients without diabetes. The Cre8™ EVO drug-eluting stent (DES) has design features that aim to improve clinical outcomes in patients with diabetes. These include Abluminal Reservoir Technology - a proprietary polymer-free drug-release system consisting of reservoirs on the abluminal surface of the stent that control drug release and direct the drug exclusively towards the vessel wall - and the Amphilimus™ drug formulation, which enables enhanced drug-tissue permeation utilising fatty acid transport pathways. Read More

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http://dx.doi.org/10.15420/icr.2017:27:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872803PMC
January 2018
2 Reads

Assessing the Risk of Leaflet Motion Abnormality Following Transcatheter Aortic Valve Implantation.

Interv Cardiol 2018 Jan;13(1):37-39

San Raffaele Scientific InstituteMilan, Italy.

Leaflet motion abnormalities are a relatively new entity in the field of transcatheter aortic valve implantation and are associated with a range of different conditions, the extreme being prosthetic valve dysfunction with high gradients or central regurgitation and possibly early thrombotic degeneration. Another extreme condition is the incidental finding of leaflet thickening, but with normal transvalvular gradients. Transthoracic echocardiography is a useful screening tool for the detection of symptomatic thrombosis, but it has limited use in the detection of subclinical thrombosis and/or motion abnormalities alone. Read More

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http://dx.doi.org/10.15420/icr.2017:24:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872376PMC
January 2018
3 Reads

Oral Anticoagulant Therapy for Early Post-TAVI Thrombosis.

Authors:
Neil Ruparelia

Interv Cardiol 2018 Jan;13(1):33-36

Oxford Heart Centre, John Radcliffe Hospital, Oxford.

While transcatheter aortic valve implantation (TAVI) is now the accepted treatment option of choice for patients presenting with severe symptomatic aortic stenosis who are deemed to be inoperable or of high surgical risk, there have been concerns regarding the risk of early valve failure and durability. One potential limitation is the occurrence of early post-TAVI thrombosis. Whilst the incidence of obstructive transcatheter heart valve (THV) thrombosis is <1 %, with technological advances in imaging, it is increasingly apparent that the overall true incidence is likely to be much higher with between 7-40 % of patients observed to have appearances strongly suggestive of asymptomatic subclinical THV thrombosis. Read More

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http://dx.doi.org/10.15420/icr.2017:14:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872346PMC
January 2018
5 Reads

Understanding Neurologic Complications Following TAVR.

Interv Cardiol 2018 Jan;13(1):27-32

Yale School of Medicine, Section of Cardiovascular Medicine.

Transcatheter aortic valve replacement is a groundbreaking treatment modality for severe, symptomatic aortic stenosis. Despite the rapid progression in indications to include intermediate-risk patients, the risk of peri-procedural stroke remains, with a higher incidence rate than previously reported. Accurate assessment of peri-procedural stroke rates requires selection of careful and meaningful trial endpoints during evaluation of neuroprotective devices. Read More

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http://dx.doi.org/10.15420/icr.2017:25:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872371PMC
January 2018
4 Reads

Bioprosthetic Valve Fracture During Valve-in-valve TAVR: Bench to Bedside.

Interv Cardiol 2018 Jan;13(1):20-26

Saint Luke's Mid America Heart InstituteKansas City, MO, USA.

Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) has been established as a safe and effective means of treating failed surgical bioprosthetic valves (BPVs) in patients at high risk for complications related to reoperation. Patients who undergo VIV TAVR are at risk of patient-prosthesis mismatch, as the transcatheter heart valve (THV) is implanted within the ring of the existing BPV, limiting full expansion and reducing the maximum achievable effective orifice area of the THV. Importantly, patient-prosthesis mismatch and high residual transvalvular gradients are associated with reduced survival following VIV TAVR. Read More

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http://dx.doi.org/10.15420/icr.2017:29:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872348PMC
January 2018
3 Reads

Minimally Invasive Surgical Mitral Valve Repair: State of the Art Review.

Interv Cardiol 2018 01;13(1):14-19

German Heart CenterBerlin, Germany.

Minimally invasive surgical mitral valve repair (MVRepair) has become routine for the treatment of mitral valve regurgitation, and indications have been expanded to include reoperations. Current European Society of Cardiology/European Association for Cardio-Thoracic Surgery guidelines for the management of valvular heart disease recommended standards in terms of mitral valve disease differentiation, timing of intervention and surgical techniques to improve patient care. Numerous minimally invasive techniques to lessen the invasiveness have been described, such as the minimal-access J-sternotomy (ministernotomy), the parasternal incision, the port-access technique and the right minithoracotomy. Read More

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http://dx.doi.org/10.15420/icr.2017:30:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872370PMC
January 2018
8 Reads

Transcatheter Treatment of Functional Tricuspid Regurgitation Using the Trialign Device.

Interv Cardiol 2018 Jan;13(1):8-13

Department of Cardiology, University of Leipzig - Heart CenterLeipzig, Germany.

Functional tricuspid regurgitation (TR) represents an important unmet need in clinical cardiology given its prevalence, adverse prognostic impact and symptom burden associated with progressive right heart failure. Several transcatheter techniques are currently in early clinical testing to provide alternative treatment options for patients deemed unsuitable for tricuspid valve surgery. Amongst them, the TrialignTM device (Mitralign, Inc. Read More

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http://dx.doi.org/10.15420/icr.2017:21:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872345PMC
January 2018
2 Reads

2017 and all that.

Authors:
Simon Kennon

Interv Cardiol 2018 Jan;13(1)

Interventional Cardiologist and TAVI Operator at the Barts Heart Centre, St Bartholomew's Hospital, London. He trained at Manchester University, St Bartholomew's Hospital, the London Chest Hospital and St Vincent's Hospital, Melbourne. His research interests relate to aortic valve and coronary interventions.

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http://dx.doi.org/10.15420/icr.2018.13.1.FO1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872367PMC
January 2018
2 Reads

Expert Opinion: Guidelines for the Management of Patients with Aortic Stenosis Undergoing Non-cardiac Surgery: Out of Date and Overly Prescriptive.

Interv Cardiol 2017 Sep;12(2):133-136

Barts Heart Centre, St Bartholomew's Hospital, London, UK.

Patients with severe aortic stenosis who require non-cardiac surgery present a difficult clinical problem. The most recent clinical practice guidelines from the American College of Cardiology/American Heart Association and the European Society of Cardiology for the perioperative cardiovascular assessment and management of patients undergoing noncardiac surgery were both published in 2014. These guidelines are reviewed in the light of recently published randomised controlled trial data regarding the efficacy of transcatheter aortic valve implantation to treat aortic stenosis. Read More

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http://dx.doi.org/10.15420/icr.2017:20:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844010PMC
September 2017
2 Reads

Safety and Efficacy of Protected Cardiac Intervention: Clinical Evidence for Sentinel Cerebral Embolic Protection.

Authors:
Ulrich Schäfer

Interv Cardiol 2017 Sep;12(2):128-132

Department of General and Interventional Cardiology, University Hospital Eppendorf, Hamburg, Germany.

Stroke is a well-documented potential risk of structural cardiac interventions. As a result of the far-reaching burden of stroke on patients, caregivers and the healthcare system, new medical interventions and therapies are being developed to help mitigate this risk. One such intervention is the recently FDA-cleared Sentinel™ Cerebral Protection System (Sentinel; Claret Medical, Santa Rosa, CA, USA) designed to capture and remove debris dislodged during transcatheter aortic valve replacement procedures. Read More

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http://dx.doi.org/10.15420/icr.2017:19:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808684PMC
September 2017
2 Reads

Expert Opinion Will PARTNER 2 Change My Practice?

Interv Cardiol 2017 Sep;12(2):126-127

The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Transcatheter aortic valve implantation (TAVI) has become an established and increasingly-used technique to treat patients with severe aortic valve stenosis (AS) over the past decade. The clinical outcomes obtained with TAVI have been found to be equivalent to surgical aortic valve replacement (SAVR) in patients with a high-risk profile. Following the Placement of Aortic Transcatheter Valves (PARTNER) 1 trial, which demonstrated the utility of TAVI in inoperable and high-risk groups, the PARTNER 2 trial was implemented. Read More

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http://dx.doi.org/10.15420/icr.2016:29:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808494PMC
September 2017
5 Reads

Predilatation Prior to Transcatheter Aortic Valve Implantation: Is it Still a Prerequisite?

Interv Cardiol 2017 Sep;12(2):116-125

Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy.

Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications. Several real-world retrospective studies and one small randomised study have shown that direct TAVI (with both self-expanding and balloon-expandable prostheses) is feasible, safe and associated with outcomes similar to standard TAVI with pre-implantation balloon aortic valvuloplasty. Read More

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http://dx.doi.org/10.15420/icr.2017:17:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808664PMC
September 2017
10 Reads

The Proximal Optimisation Technique for Intervention of Coronary Bifurcations.

Authors:
Angela Hoye

Interv Cardiol 2017 Sep;12(2):110-115

Department of Academic Cardiology, Hull York Medical School, Hull, UK.

The proximal optimisation technique (POT) has been proposed as a strategy to improve the results of stent scaffolding of bifurcation lesions. It is a straightforward technique whereby a short, appropriately-sized balloon is inflated in the main vessel just proximal to the carina. The technique has several advantages: it reduces the risk of side branch compromise related to shifting of the carina, it improves stent apposition in the proximal main vessel, and it facilitates side branch access after main vessel stent implantation. Read More

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http://dx.doi.org/10.15420/icr.2017:11:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808474PMC
September 2017
2 Reads

Performing and Interpreting Fractional Flow Reserve Measurements in Clinical Practice: An Expert Consensus Document.

Interv Cardiol 2017 Sep;12(2):97-109

Department of Cardiology, St Johannes Hospital, Dortmund, Germany.

Fractional flow reserve (FFR) measurements can determine the haemodynamic relevance of coronary artery stenoses. Current guidelines recommend their use in lesions in the absence of non-invasive proof of ischaemia. The prognostic impact of FFR has been evaluated in randomised trials, and it has been shown that revascularisation can be safely deferred if FFR is >0. Read More

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http://dx.doi.org/10.15420/icr.2017:13:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808579PMC
September 2017
8 Reads

Unprotected Left Main Coronary Artery Disease: Management in the Post NOBLE and EXCEL Era.

Interv Cardiol 2017 Sep;12(2):92-96

Division of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.

The optimal management of unprotected left main coronary artery (ULMCA) disease is currently a debated topic. Percutaneous coronary intervention (PCI) has seen an increased adoption for the management of ULMCA disease after numerous small-scale randomised trials and cohort studies showed equipoise with coronary artery bypass grafting (CABG) for low complexity lesions. The recently published NOBLE and EXCEL trials are two of the largest international randomised clinical trials comparing PCI and CABG in patients with ULMCA disease. Read More

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http://dx.doi.org/10.15420/icr.2017:18:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844008PMC
September 2017
4 Reads

Current State of the Art in Approaches to Saphenous Vein Graft Interventions.

Interv Cardiol 2017 Sep;12(2):85-91

UCLA Medical Center, Los Angeles, CA, USA.

Saphenous vein grafts (SVGs), used during coronary artery bypass graft surgery for severe coronary artery disease, are prone to degeneration and occlusion, leading to poor long-term patency compared with arterial grafts. Interventions used to treat SVG disease are susceptible to high rates of periprocedural MI and no-reflow. To minimise complications seen with these interventions, proper stents, embolic protection devices (EPDs) and pharmacological selection are crucial. Read More

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http://dx.doi.org/10.15420/icr.2017:4:2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808481PMC
September 2017
3 Reads

Expert Opinion: Optimising Stent Deployment in Contemporary Practice: The Role of Intracoronary Imaging and Non-compliant Balloons.

Interv Cardiol 2017 Sep;12(2):81-84

Fortis Escorts Heart Institute, New Delhi, India.

Final stent dimensions remain an important predictor of restenosis, target vessel revascularisation (TVR) and subacute stent thrombosis (ST), even in the drug-eluting stent (DES) era. Stent balloons are usually semi-compliant and thus even high-pressure inflation may not achieve uniform or optimal stent expansion. Post-dilatation with non-compliant (NC) balloons after stent deployment has been shown to enhance stent expansion and could reduce TVR and ST. Read More

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http://dx.doi.org/10.15420/icr.2017:12:1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808472PMC
September 2017
7 Reads

Foreword.

Authors:
Simon Kennon

Interv Cardiol 2017 Sep;12(2):78

Simon Kennon is an Interventional Cardiologist and TAVI Operator at the Barts Heart Centre, St Bartholomew's Hospital, London. He trained at Manchester University, St Bartholomew's Hospital, the London Chest Hospital and St Vincent's Hospital, Melbourne. His research interests relate to aortic valve and coronary interventions.

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http://dx.doi.org/10.15420/icr.2017.12.02.78DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5844016PMC
September 2017
2 Reads