CLINICAL EVENTS CALENDAR
Non-Accredited Education
 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE On Demand Web ArchiveNon-Accredited Target Audience: Physicians, nurses, and technologists. This activity is supported by an educational grant from Terumo Medical Corporation. |
CASE REPORTS
Successful Percutaneous Closure of an Aortic Graft Pseudo- Aneurysm with a Patent Foramen Ovale Occluder Device
Case Report. A 22-year-old female presented to an outside hospital with back pain radiating to the epigastrum. The patient had a history of hypertension and Takayasu’s arteritis. At age 17 she underwent resection of an ascending aortic aneurysm via a median sternotomy with placement of a graft to the aortic arch and banding of the sino-tubular junction because of significant aortic regurgitation. Six weeks prior to her presentation with back pain, the patient underwent resection of a descending thoracic aortic aneurysm via a left posterior-lateral thoracotomy and placement of a 26 mm graft. This included resection of a portion of the aortic arch (hemi-arch) to the descending thoracic aorta just cranial to the diaphragm.
Stabilization of Renal Function, Improvement in Blood Pressure Control and Pulmonary Edema Symptoms after Opening a Totally Oc
Stenting has emerged as a procedure associated with low mortality and morbidity for symptomatic renovascular disease. Frequently responsible for uncontrollable hypertension, congestive heart failure and progressive renal failure leading to endstage renal disease, it is prevalent among elderly patients.1 Acute pulmonary edema is not an infrequent presentation of severe renovascular disease in the elderly,2 and carries high risk in patients will diminished cardiopulmonary reserve. In most cases, total occlusion of a renal artery supplying a small atrophied kidney has not be
Challenging Closure of a Patent Foramen Ovale via a Superior Approach
This case describes the closure of a patent foramen ovale (PFO) via the right internal jugular (IJ) vein in a young patient with an interrupted inferior vena cava (IVC) awaiting liver transplantation.
Case Report. A 25-year-old male with chronic liver failure due to Budd Chiari syndrome had a PFO discovered on contrast echocardiography as part of his transplantation workup. He was subsequently referred by the transplant team for PFO closure prior to liver transplantation to avoid the potential for intraoperative paradoxical embolism.
As the IVC was known to be
Percutaneous Mitral Commissurotomy in a Case of Mirror-Image Dextrocardia and Rheumatic Mitral Stenosis
Distorted cardiac anatomy offers technical difficulties during fluoroscopy-guided transcatheter procedures. This is even more the case with percutaneous transvenous mitral commissurotomy (PTMC), where the cardiac malpositions considerably increase the complications involved in interatrial septal puncture and left ventricular entry. Though it has been established as the procedure of choice in a selected subset of patients with rheumatic mitral stenosis (MS), there are only a few reports on successful PTMC in altered cardiac anatomy using the standard Inoue technique.1–6 Here
A Case of Acute Coronary Thrombosis in Diffuse Coronary Artery Ectasia
Case Report. A 75-year-old Afro-Caribbean male presented to our hospital with typical ischemic chest pain associat ed wi th a rai sed t roponin I l eve l of 3.5. His electrocardiogram (ECG) on admission showed anterolateral T-wave inversion. The diagnosis of non-ST-elevat ion myocardial infarction (NSTEMI) was made. He was treated with nitrates, low-molecular weight heparin, aspirin and clopidogrel. Past medical history included a previous non-Qwave inferior MI in 1994. He had no history of significant childhood fever.
Coronary angiography in 1994 showed
Percutaneous Coronary Revascularization of an Occluded Ostial Circumflex Artery Arising from the Right Coronary Cusp Utilizing
Approximately 30% of patients with significant coronary artery disease (CAD) have a chronically occluded vessel ( CTO).1 Due to frequent difficulty in crossing the CTO lesion by standard wire techniques, novel approaches have been created to improve success rates. One such innovative strategy is to cross the lesion in a retrograde approach utilizing collateral vessels.
This approach was born out of the peripheral angioplasty experience that frequently demonstrated success in crossing CTOs in a distal-to-proximal lesion progression, consistent with the histological realizati
Successful Recanalization of In-Stent Coronary Chronic Total Occlusion by Subintimal Tracking
Percutaneous treatment of coronary chronic total occlusions (CTO) remains one of the major challenges in interventional cardiology. Although CTO in the form of in-stent restenosis (ISR-CTO) is relatively rare, with an incidence of 1.6% of stent procedures, it is associated with significant morbidity.1 The paucity of published data on this rare population indicates that the low success rate of PCI is mostly due to difficulty in passing the guidewire across the occlusive stent lumen.1,2 Thus far, there is no consensus on the best method to overcome the failure of w
Collateral Circulation via a Rare, Anomalously Arising Right Ventricular Branch
Coronary collateral vessels are able to supply blood to a myocardial territory vascularized by severely stenosed or occluded epicardial arteries. They may contribute significantly to the limitation of ischemia and infarct size.1,2 Improvement in left ventricular function3,4 and prevention of left ventricular aneurysm formation5 also has been attributed to the presence of collateral vessels.
Variations in coronary anatomy are not uncommon. They are usually benign, but can be a cause of confusion to the angiographer and have no clinical significanc
Percutaneous Coronary Intervention in Neurosurgical Patients
The management of coronary disease in patients with spinal or intracranial disease may be challenging. In some cases, coronary lesions may require treatment before neurosurgery, while in others, myocardial ischemia or infarction may occur in the postoperative patient or simultaneously with stroke or intracranial hemorrhage. Patients with subarachnoid and intracranial hemorrhage have a high incidence of cardiovascular complications,1 and antiplatelet and anticoagulant medications normally used in coronary disease may further increase the risk of hemorrhage.2 Recent neur
Hemodynamics “Au Contraire” Despite Diastolic Flow Reversal and Angiographically Severe Aortic Regurgitation
Aortic regurgitation (AR) is characterized by inadequate aortic valve closure that results in the reflux of blood from the aorta into the left ventricle (LV) during diastole. Assessment of the degree of regurgitation is paramount to clinical decision-making in patients with AR, because patients with severe AR most often require surgical intervention. Semiquantitative grading of AR with color and spectral Doppler echocardiography or with angiography is widely used, but both techniques are hindered by significant limitations. Furthermore, quantitative parameters such as regurgitant volume and
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Press Release
— Bethlehem, Pennsylvania – Invatec received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in October to market its Mo.Ma Ultra Proximal Cerebral Protection Device for use during carotid artery stenting (CAS). The device effectively reduces and captures debris released during the stenting procedure to prevent it from traveling to the brain, where it has the potential to cause a stroke.
CME Showcase
 The Use of Remote Robotic Navigation in Complex Arrhythmias Complimentary Accredited Web Archive This activity is designed for electrophysiologists and EP allied professionals. Diagnosing Coronary Artery Disease: Advanced Cardiovascular Imaging Solutions  New Standards of Care for CRMD Antibiotic Protection Complimentary CME Accredited Webcast Dates: November 18, 2008 Time: 6:00 pm ET November 19, 2008 Time: 3:00 pm ET This activity is sponsored by the North American Center for Continuing Medical Education. |
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