Volume 21 - Issue 12 - December, 2009

Optimizing of Transcoronary Pacing in a Porcine Model

Konstantin M. Heinroth, MD, Justin M. Carter, MD, Michael Buerke, MD, *Dirk Mahnkopf, MD,
Karl Werdan, MD, §Roland Prondzinsky, MD

ABSTRACT: Background. Transcoronary pacing for the treatment of bradycardia during percutaneous coronary intervention (PCI) is not well established, but may be a useful technique in interventional cardiology. We developed a porcine model to examine the feasibility and efficacy of transcoronary pacing during PCI. Methods and Results. Eight pigs under general anesthesia underwent unipolar transcoronary pacing with a standard floppy guidewire in a coronary artery (as the cathode) and a skin patch electrode (as the anode). We examined the effect of skin-patch position (groin vs. anterior or poster...

A Regional System for Delivery of Primary Percutaneous Coronary Intervention (Full title below)

Richard Aplin, MD, Daniel Tiede, MD, Cheryl Lovitz, RN, Mark Gartner, RT(R)(CV), †David Robinson, PhD, †Hui Xu, PhD, Philip Martin, RN, BSN, Bernard Erickson, MD, Wade Schmidt, MD, Jamie Pelzel, MD,
David Wendt, AAS, John Mahowald, MD

A Regional System for Delivery of Primary Percutaneous Coronary Intervention in ST- Elevation Myocardial Infarction: STEMI-St. Cloud

ABSTRACT: Background. Strategies of emergency care in the treatment of ST-segment elevation myocardial infarction (STEMI) have evolved rapidly over the past two decades to include primary percutaneous coronary intervention (PPCI) when possible. Most U.S.-based transfer programs still use complicated protocols that include fibrinolytic therapy often resulting in transfer delays, inappropriately applied therapy (wrong diagnosis) and bleeding and strok...

Primary PCI for STEMI — Pushing the Limits

Robert J. Applegate, MD

The optimal management of patients with ST-elevation myocardial infarction (STEMI) has been the subject of ongoing clinical investigations for the past several decades. When it became apparent that primary angioplasty was not only feasible, but superior, to thrombolytic therapy in randomized clinical trials,1 there was universal adoption of primary percutaneous coronary intervention (PCI) for those centers that perform PCI. The belief that primary PCI was superior to thrombolytic therapy as the initial treatment of STEMI is so strong that many centers that previously administered thrombolytic ...

X-Ray Angiography and Magnetic Resonance Imaging to Distinguish Interarterial (Full title below)

Ravi V. Desai, MD,§* Ritesh Gupta, MD, MPH,§* Silvio H. Litovsky, MD,£ Hrudaya Nath, MD,∞
Himanshu Gupta, MD,§ Satinder P. Singh, MD,∞ William T. Evanochko, PhD,§ Johnnie E. Knobloch, RT,§
Steven G. Lloyd, MD, PhD§

X-Ray Angiography and Magnetic Resonance Imaging to Distinguish Interarterial from Septal Courses of Anomalous Left Coronary Artery: An Ex Vivo Heart Model

ABSTRACT: Objective. We sought to demonstrate the distinguishing features between interarterial and intraseptal courses of an anomalous left coronary artery from the right sinus of Valsalva (RSV) on X-ray angiography, using an ex vivo model. Background. An anomalous left main coronary artery (LMCA) arising from the RSV can take prepulmonary, retro-aortic, interarterial (IA) or intraseptal (IS) courses, of which only the IA cours...

Avoiding Intelligence Failures in the Cardiac Catheterization Laboratory (Full title below)

Jonathan D. Marmur, MD, Renee P. Bullock-Palmer, MD, Shyam Poludasu, MD, Erdal Cavusoglu, MD

Avoiding Intelligence Failures in the Cardiac Catheterization Laboratory: Strategies for the Safe and Rational Use of Dalteparin or Enoxaparin during Percutaneous Coronary Intervention

ABSTRACT: Low-molecular-weight heparin (LMWH) has been a mainstay for the management of acute coronary syndromes (ACS) for almost a decade. However, several recent developments have seriously threatened the prominence of this drug class: (i) the adoption of an early invasive strategy, frequently leading to percutaneous coronary intervention (PCI) where the dosing and monitoring of LMWH is unfamiliar ...

Late-Acquired Stent Malapposition after Sirolimus-Eluting Stent Implantation (Full title below)

*Sudhir Rathore, MD, §Mitsuyasu Terashima, MD, §Takahiko Suzuki, MD

Late-Acquired Stent Malapposition after Sirolimus-Eluting Stent Implantation following Acute Coronary Syndrome: Angiographic, IVUS, OCT and Coronary Angioscopic Observation

ABSTRACT: Drug-eluting stents (DES) have been shown to significantly reduce the incidence of restenosis and target lesion revascularization in a wide variety of clinical situations. DES have also been shown to significantly reduce neointimal hyperplasia as compared to bare-metal stents. However, the antiproliferative properties of DES also delay vascular healing and have been associated with stent malapposition,...

Late Sequela of Kawasaki’s Disease: Optical Coherence Tomographic Finding

Jin-Man Cho, MD, Il-Suk Sohn, MD, †Ik-Kyung Jang, MD, PhD

Case Description. A 24-year-old male without coronary risk factors came to our office for recent-onset exertional angina associated with shortness of breath. His medical history was notable for Kawasaki’s disease at the age of two. A stress test showed anterior ischemia. Subsequently, he underwent computed tomography (Figure 1) and coronary angiography, which revealed a calcified tubular narrowing of the proximal left anterior descending (LAD) and chronic total occlusion in the proximal right coronary artery (RCA), with bridge collaterals (Figures 2A and B). Optical coherence tomography (OCT...

Retrograde Approach to Chronic Total Occlusions: Can Septal Vessels Be Used More Than Once?

Albert Alahmar, MD, Simon Redwood, MD, Anthony Gershlick, MD

From the Cardiovascular Intervention Department, University Hospitals of Leicester, United Kingdom.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted May 29, 2009, provisional acceptance given August 11, 2009, final version accepted September 8, 2009.

Address for correspondents: Albert E. Alahmar, MD, Cardiovascular Intervention Department, Leicester University Hospitals of Leicester Glenfield Hospital, Leicester, United Kingdom LE3 9QP. E-mail: ae.alahmar@gmail.com


Percutaneous Aortic Valve Implantation in Patients with Coronary Artery Disease: Review of Therapeutic Strategies

Danny Dvir, MD,† Abid Assali, MD,† Konstantinos Spargias, MD,‡ Ran Kornowski, MD†

From the †Department of Cardiology, Rabin Medical Center, Petach Tikva, and the 'Sackler' Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, ‡Onassis Cardiac Surgery Centre, 1st Cardiology Department, Athens, Greece.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted July 6, 2009, provisional acceptance given July 20. 2009, and final version accepted July 27, 2009.

Address for correspondence: Prof. R. Kornowski, Department of Cardiology, Rabin Medical Center, Petach Tikva 49100, Israel. E-mail: rkornowski@clalit.org...

Chinese “Firebird” Brand Sirolimus-eluting Stent Fracture

Wei Hu, MD, PhD, Da Dong Zhang, MD, Jun Gu, MD

From the Department of Cardiology, Shanghai Minhang District Central Hospital, Shanghai, China.

The authors report no conflicts of interest regarding the content herein.

Manuscript submitted May 4, 2009, provisional acceptance given June 23, 2009, final version accepted July 15, 2009.

Address for correspondence: Wei Hu, Department of Cardiology, Minhang District Central Hospital, 201100, Shanghai, China. E-mail: huwei0516@hotmail.com


ABSTRACT: Recently, a stent fracture (SF) was reported as...

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