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. |
Clinical Images
Hypertrophic Obstructive Cardiomyopathy in the Era of Cardiac MRI
A 41-year-old Asian woman presented with symptoms of palpitations, shortness of breath and chest heaviness on exertion. Transthoracic echocardiogram revealed severe asymmetrical hypertrophy (posterior wall thickness of 2 cm) and a significant septal wall thickness measuring 3 cm. Mild to moderate mitral regurgitation with a peak outflow tract gradient of 56 mmHg and PA pressure was noted at 52 mmHg.
The patient was treated with transcatheter alcohol septal ablation and later with AICD for primary prevention of ventricular tachycardia.
Potential for Myocardial Salvage Utilizing Direct Intracoronary Infusion of Aqueous Oxygen
Clinical Presentation. A 52-year-old male with a history of tobacco use, hypertension and hypercholesterolemia presented to the emergency room with 6 hours of “chest pressure radiating to the neck and jaw.” Associated dyspnea, diaphoresis and nausea were noted at the time of presentation. Initial electrocardiogram (Figure 1a) demonstrated unequivocal evidence of an inferior myocardial injury pattern. He was triaged to urgent catheterization laboratory intervention.
Diagnostic coronary angiography (Figure 2a) revealed a total occlusion of the right coronary artery (RCA) in its
Unstable Angina Due to Stent Fracture
Case Report. A 78-year-old woman who had undergone coronary artery bypass grafting eight years earlier presented with unstable angina. At coronary angiography, an aorto-ostial lesion was found in a saphenous vein graft to the right posterior descending artery, and this lesion was successfully treated with a 3.5 mm x 13 mm BX Velocity stent (Cordis Corporation, Miami Lakes, Florida), with inflations up to 18 atm. The middle portion of the stent remained mildly under-expanded (Figure 1). She had complete resolution of her angina for approximately one month, but then the angina recurred
Utility of Intravascular Ultrasound in the Diagnosis of Ambiguous Calcific Left Main Stenoses
Case Report. A 42-year-old Aboriginal man was transferred from a peripheral hospital for coronary angiography. He presented a week earlier with a small anterolateral non-ST elevation myocardial infarction. He was treated with aspirin, clopidogrel, metoprolol, ramipril and a glyceryl trinitrate patch. His previous medical history included chronic renal failure for which he had been having peritoneal dialysis since 1994. His cardiovascular risk factors included continued cigarette smoking and hypertension.
His coronary angiogram, performed with a GE Medical Systems “flat panel” co
Unprotected Left Main “Kissing” Stent Implantation With a Percutaneous Ventricular Assist Device
Case Report. An 80-year-old man with severe chronic obstructive pulmonary disease, chronic renal insufficiency and significant carotid artery disease presented with a 4-day history of episodic severe substernal chest pressure at rest. Echocardiography showed severe left ventricular dysfunction (ejection fraction 10%), anterior wall akinesis and moderate mitral regurgitation. Cardiac catheterization revealed a 95% distal left main (LM) coronary artery stenosis that involved the ostia of both the left circumflex (LCx) artery and the left anterior descending (LAD) artery, which was also
Posterior Descending Artery as a Continuity from the Left Anterior Descending Artery
The patient was a 44-year-old woman who was admitted to the hospital due to chest pain at rest. Two days later, the patient underwent a coronary angiogram. The angiogram revealed a left anterior descending artery (LAD) following a normal course along the anterior interventricular groove and terminating as a posterior descending artery (PDA) into the posterior interventricular septum (Figure 1). The right coronary artery was a small artery, and the circumflex artery followed a normal course. There were no atherosclerotic lesions in any of the above-mentioned arteries.
The posterior descending
Balloon Alignment T-Stenting for Bifurcation Coronary Artery Disease Using the Sirolimus-Eluting Stent
Case Presentation. A 65-year-old gentleman, who works as a professional football referee, presented with progressive symptoms of angina. His job officiating games necessitated significant physical activity and endurance. He presented 10 days prior to the opening game of the season and was referred for subsequent noninvasive testing, which demonstrated a large area of ischemia in the anterior and anterolateral distribution.
Cardiac catheterization demonstrated high-grade bifurcation disease involving the left anterior descending artery (LAD), as well as the major diagonal branch. We
Identical Twins, Identical Coronary Disease
Background. A number of studies have examined the environmental and genetic basis contributing to the pathogenesis of various disease states. This has been studied in monozygotic twins and recently published. Recent reports have examined disease prevalence, mechanism of onset, and disease progression in large cohorts of twins as it pertains to insulin resistance states,1 congenital heart disease,2 Parkinson’s and other neurologic disease states,3 as well as gastroesophageal reflux disease,4 to name just a few. Although endocrine disease is t
The “Zipper” Lesion: A Rare but Serious Guiding Catheter-Induced Complication of a PCI Procedure
A 42-year-old man presented with heavy chest pain of four hours’ duration. Physical examination was unremarkable. The ECG showed an acute septoapical infarction. Nitroglycerin, aspirin, clopidogrel and heparin were administered, and an emergency coronary angiography was performed from the right femoral artery (Figures 1 A and B). The left anterior descending artery was occluded distally. The left main trunk ostium was deeply intubated by a slightly too large Q4 6 French intervention catheter. There was, however, no damping or ventriculization of pressure. The occlusion was crossed with a
Iron Heart
The medical history of a 59-year-old male, summarized by a selected frame of his most recent angiogram of the heart in a left anterior oblique projection (Figure 1), illustrates the contemporary device armamentarium to fight cardiac disease. Five years ago, the patient had presented to our hospital with dyspnea. The evaluation revealed severe mitral regurgitation caused by a prolapsing posterior leaflet and preserved left ventricular systolic function. Surgical mitral valve reconstruction was performed using a 32 mm annuloplasty ring (AR). In further evolution of his condition, the patient
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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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