Circulation. Cardiovascular interventions
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Circ Cardiovasc Interv · Dec 2012
Randomized Controlled TrialB-type natriuretic peptide and risk of contrast-induced acute kidney injury in acute ST-segment-elevation myocardial infarction: a substudy from the HORIZONS-AMI trial.
Contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention is associated with adverse short- and long-term outcomes. However, identification of patients at risk for CI-AKI is challenging. Using a large contemporary randomized trial database of patients with ST-segment-elevation myocardial infarction, we therefore sought to examine whether admission B-type natriuretic peptide (BNP) levels predict the development of CI-AKI. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT00433966.
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Circ Cardiovasc Interv · Dec 2012
Multicenter StudyMelody valve implant within failed bioprosthetic valves in the pulmonary position: a multicenter experience.
Transcatheter pulmonary valve implantation using the Melody valve has emerged as an important therapy for the treatment of postoperative right ventricular outflow tract dysfunction. Melody-in-bioprosthetic valves (BPV) is currently considered an off-label indication. We review the combined experience with transcatheter pulmonary valve implantation within BPVs from 8 centers in the United States and discuss technical aspects of the Melody-in-BPV procedure. ⋯ Transcatheter pulmonary valve implantation using the Melody valve within BPVs can be accomplished with a high rate of success, low procedure-related morbidity and mortality, and excellent short-term results. The findings of this preliminary multicenter experience suggest that the Melody valve is an effective transcatheter treatment option for failed BPVs.
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Circ Cardiovasc Interv · Dec 2012
Comparative StudyBivalirudin for primary percutaneous coronary interventions: outcome assessment in the Ottawa STEMI registry.
Data from randomized trials has demonstrated the superiority of bivalirudin to glycoprotein IIb/IIIa inhibitors plus heparin in patients undergoing primary percutaneous coronary intervention. Real-world performance of bivalirudin in primary percutaneous coronary intervention and the benefit of bivalirudin over heparin remain unknown in an era of routine dual antiplatelet therapy. ⋯ Bivalirudin use compared with glycoprotein IIb/IIIa inhibitors plus heparin as an antithrombotic strategy in primary percutaneous coronary intervention results in less major bleeding in contemporary practice. A benefit of bivalirudin over heparin could not be established with this registry and requires additional investigations to either confirm or refute.
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Circ Cardiovasc Interv · Dec 2012
Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension.
Although balloon pulmonary angioplasty (BPA) for inoperable patients with chronic thromboembolic pulmonary hypertension was first reported over a decade ago, its clinical application has been restricted because of limited efficacy and complications. We have refined the procedure of BPA to maximize its clinical efficacy. ⋯ Our refined BPA procedure improves clinical status and hemodynamics of inoperable patients with chronic thromboembolic pulmonary hypertension, with a low mortality. A refined BPA procedure could be considered as a therapeutic approach for patients with inoperable chronic thromboembolic pulmonary hypertension.
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Circ Cardiovasc Interv · Oct 2012
Randomized Controlled TrialMentored simulation training improves procedural skills in cardiac catheterization: a randomized, controlled pilot study.
Despite valuable supplemental training resources for surgical skill acquisition, utility of virtual reality simulators to improve skills relevant to performing cardiac catheterization has not been evaluated. ⋯ Skills required to perform cardiac catheterization can be learned via mentored simulation training and are transferable to actual procedures in the catheterization laboratory. Less proficient operators derive greater benefit from simulator training than more proficient operators.