Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Nov 2014
Comparative Study Observational StudyLong-term outcome in patients with ST segment elevation myocardial infarction and multivessel disease treated with culprit-only, immediate, or staged multivessel percutaneous revascularization strategies: Insights from the REAL registry.
To examine the differences in cardiac outcomes for patients with ST-elevation myocardial infarction (STEMI) and multivessel disease (MVD) as a function of whether they underwent culprit-only primary percutaneous coronary intervention (PPCI) or multivessel PCI, either during PPCI or as a staged procedure. ⋯ Our findings support the current guidelines recommendation to perform culprit-only PPCI in STEMI patients with MVD without hemodynamic compromise, followed by a staged PCI of noninfarct-related significant lesions.
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Catheter Cardiovasc Interv · Nov 2014
Observational StudyTransfemoral implantation of Edwards Sapien XT aortic valve without previous valvuloplasty: role of 2D/3D transesophageal echocardiography.
Balloon valvuloplasty (BAV) has been considered a mandatory step before TAVI. However, it might be related to cerebrovascular microembolizations, atrioventricular conduction disturbances, and hemodynamic instability. The aim of this study is to describe transesophageal echocardiography characteristics of patients that could benefit from direct transfemoral transcatheter aortic valve implantation (TAVI) of Edwards SAPIEN XT, without previous BAV. ⋯ TAVI without previous BAV is feasible and safe. 2D/3D TEE is an essential tool to select the patients that could benefit from this technique.
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Catheter Cardiovasc Interv · Nov 2014
Single center TAVR experience with a focus on the prevention and management of catastrophic complications.
Transcatheter aortic valve replacement (TAVR) is an important treatment option for patients with severe symptomatic aortic stenosis (AS) who are inoperable or at high risk for complications with surgical aortic valve replacement. We report here our single-center data on consecutive patients undergoing transfemoral (TF) TAVR since the inception of our program, with a special focus on minimizing and managing complications. ⋯ TAVR can be accomplished with excellent safety in a tertiary center with a well-developed infrastructure for the management of serious complications. The data presented here provide support for TAVR as an important treatment option, and results from randomized trials of patients with lower surgical risk are eagerly awaited.
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Catheter Cardiovasc Interv · Nov 2014
Comparative StudyX-ray magnetic resonance fusion modality may reduce radiation exposure and contrast dose in diagnostic cardiac catheterization of congenital heart disease.
Radiation exposure in the pediatric population may increase the risk of future malignancy. Children with congenital heart disease who often undergo repeated catheterizations are at risk. One possible strategy to reduce radiation is to use X-ray Magnetic Resonance Fusion (XMRF) to facilitate cardiac catheterization. ⋯ Select diagnostic cardiac catheterization cases that utilized XMRF used less radiation and contrast than similar cases where XMRF was not used. Future work is needed to determine whether similar benefits can be extended to other types of diagnostic and complex interventional procedures.
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Catheter Cardiovasc Interv · Nov 2014
ReviewSCAI expert consensus statement for advanced training programs in pediatric and congenital interventional cardiac catheterization.
Pediatric and Congenital Interventional Cardiology is the practice of catheter-based techniques that improve cardiac physiology and circulation through the treatment of heart disease in children and adults with congenital or acquired heart defects. Over the last decade, and since last published training guidelines for pediatric cardiac catheterization and interventional cardiology were published in 2005 [1] the field of Pediatric and Congenital Cardiac Catheterization has evolved into a predominantly interventional discipline. ⋯ The statement puts forth recommendations for program infrastructure in terms of teaching, personnel, equipment, facilities, conferences, patient volume and trainee assessment. This is meant to set a standard for training programs as well as giving applicants a basis on which to judge and compare programs.