Volume 21 - Issue 9 - September, 2009

Patient Satisfaction is Comparable to Early Discharge versus Overnight Observation after Elective PCI (see full title below)

ABSTRACT: Background. Previous investigation has suggested that early discharge after percutaneous coronary intervention (PCI) is feasible and safe, but these studies have utilized largely radial approaches or been conducted in non-U.S. cohorts. We sought to assess patient satisfaction, safety and cost of a strategy of selective early discharge in U.S. patients undergoing PCI via a femoral approach with contemporary adjunctive pharmacologic and hemostasis agents. Methods and Results. Patients with stable coronary artery disease undergoing elective PCI were prospectively recruited and randomize



Peripheral Chronic Total Occlusions Treated with Subintimal Angioplasty and a True Lumen Re-Entry Device

ABSTRACT: Objective. We sought to verify how effective the Pioneer catheter (Medtronic, Inc., Minneapolis, Minnesota) is in overcoming the complexity of re-entry during subintimal angioplasty and provide a case series describing the technique. Background. Subintimal angioplasty is effective in treating peripheral chronic total occlusions (CTO). However, this technique is often limited by the inability to re-enter the true lumen after subintimal crossing of the occluded segment. The Pioneer catheter was the first device to address this difficulty associated with subintimal angioplasty. Methods.



Effect of Radiographic Contrast Media on Markers of Complement Activation and Apoptosis (Full title below)

Effect of Radiographic Contrast Media on Markers of Complement Activation and Apoptosis in Patients with Chronic Coronary Artery Disease Undergoing Coronary Angiography

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ABSTRACT: The effects of radiographic contrast media on markers of complement activation and apoptosis in patients with chronic coronary artery disease (CAD) are unknown. The purpose of this study was to assess the comparative effects of ionic high-osmolar and non-ionic iso-osmolar radiographic contrast media on plasma markers of complement activation and apoptosis in patients with chro



Structural Heart Disease Interventions: An Emerging Discipline in Cardiovascular Medicine

ABSTRACT: Within the past decade, we have witnessed the exponential growth of novel percutaneous transcatheter therapies for the treatment of valvular and congenital heart disorders among others. Consequently, a new field has emerged in the world of adult cardiovascular medicine known as “structural heart disease interventions.” We herein provide a contemporary review highlighting many of the important historical landmarks that have set the stage for the development of this new and exciting subspecialty, and introduce a comprehensive overview of the structured training and challenges that



Post-Traumatic Ventricular Septal Defects — Review of the Literature and a Novel Technique for Percutaneous Closure

ABSTRACT: Post-traumatic ventricular septal defect (VSD) is infrequent, with clinical sequelae ranging from imminent death to complete spontaneous resolution. The most appropriate management strategy is unclear. Careful observation has been advocated in the management of these patients. We demonstrate this concept by reporting two different approaches in two patients with traumatic injuries to the chest and review the English-language literature of both spontaneous and percutaneous closure of these lesions. In our case of percutaneous closure, we report a novel technique involving a transsepta



Very Late Drug-Eluting Stent Thrombosis Related to Incomplete Stent Endothelialization: (Full title below)

Very Late Drug-Eluting Stent Thrombosis Related to Incomplete Stent Endothelialization: In-Vivo Demonstration by Optical Coherence Tomography

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ABSTRACT: Very late drug-eluting stent (DES) thrombosis is a rare but potentially life-threatening event that has become a major cause of concern. Delayed arterial healing with incomplete endothelialization is probably a pivotal factor related with DES thrombosis. Optical coherence tomography (OCT) is a new high-resolution intracoronary imaging technique that allows detailed evaluation of stent neointimal coverag



Physician-Hospital Alignment: Finding the Sweet Spot

Many group practices, specialists and primary-care physicians are having their practices assessed in order to determine whether the practice should: (a) remain independent; (b) merge with another practice; or (c) agree to become employed by a hospital.

We believe that these alternatives widely miss the mark. In order for a medical practice to navigate successfully in today’s economic mean streets, you have to reprogram your GPS: your “destination-goal” is no longer simply whether to stay independent, merge or seek hospital employment, since these are now just short-term decisions, and



Consistent Door-to-Balloon Times of Less Than 90 Minutes for STEMI Patients Transferred for Primary PCI

ABSTRACT: Background. Recent data from large national registries show that < 15% of patients with ST-elevation myocardial infarction (STEMI) transferred for primary percutaneous intervention (PCI) actually meet the door-to-balloon (D2B) goal of ≤ 90 minutes, and only one-third achieve D2B times of ≤ 120 minutes. We established a streamlined STEMI protocol to allow rapid transfer of STEMI patients for primary PCI to meet the ACC D2B goal of ≤ 90 minutes in at least 75% of the patients. Methods. From February 2007 to August 2008, 37 consecutive patients presenting with STEMI to a community



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