Volume 15 - Issue 9 - September, 2003
Editor's Message (July 2003)
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Dear Readers,
This issue of the Journal of Invasive Cardiology marks the beginning of a new home for the journal and for the editor-in-chief. Management of the journal will now be coordinated from the office of the Joint Cardiac Program of Sutter Health System in San Francisco. The Joint Cardiac Program includes California Pacific Medical Center and St. Luke’s Hospital in San Francisco, Marin General Hospital in Greenbrae and Novato Community Hospital in Novato, Sutter Medical Center in Santa Rosa and Mills-Peninsula Health Services in Burlingame, California. Editorial activities will con
The First Clinical Experience with a Peripheral, Self-Expanding Nitinol Stent in the Treatment of Saphenous Vein Graft Disease:
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Coronary artery bypass graft surgery (CABG) is an established form of revascularization, typically associated with improved survival. However, CABG has its own inherent deficiencies, including recurrent ischemia, venous graft failure and the need for repeat revascularization. The ideal treatment for degenerated vein grafts is controversial. Treatment options for saphenous vein graft (SVG) disease are repeat CABG and percutaneous coronary intervention (PCI) using balloon and non-balloon technologies. Currently, a number of non-balloon interventional devices are available for use in SVG disease.
A Unique Pacemaker Complication of Thrombus Formation in the Right Internal Jugular Vein Due to Unusual Migration of an Atrial P
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Common complications of permanent endocardial pacing systems include infection of the generator pocket, the wire track, increase in pacing threshold or complete exit block due to fibrosis at the myocardial contact site, dislocation or (rarely) intravascular migration of the electrode.1 Although phlebothrombosis of upper major veins, such as the superior vena cava and the subclavian vein, occasionally complicates placement of transvenous endocardial leads,2–4 clinical manifestation is uncommon or mild; it includes edema of the upper extremities or cervical venous engorge
Covered Stent: A Novel Percutaneous Treatment of Iatrogenic Aortic Dissection During Coronary Angioplasty
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Aortic dissection is a rare complication of percutaneous coronary intervention (PCI).1,9 It can be life-threatening and warrants immediate diagnosis and treatment, which may be conservative,1,3 surgical, or stenting.4–6,8,9 We describe a patient in whom retrograde aortic dissection appeared during PCI to the right coronary artery which was successfully treated by a covered stent implantation.
Case Report. A 74-year-old Caucasian male was admitted to the hospital because of unstable angina. Eleven years previously, this patient presented with stab
Successful Percutaneous Closure of Patent Foramen Ovale Seven Years After Surgical Closure
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Patent foramen ovale (PFO) is a common phenomenon, affecting approximately one-quarter of the normal healthy population. The prevalence of PFO in patients with ischemic stroke is significantly higher than in the normal population.1 Many patients with PFO who have had a stroke are initially treated therapeutically with aspirin, warfarin or clopidogrel, or a combination thereof. However, a percentage of these patients either fail or wish to discontinue medical therapy. In these patients, closure of PFO is an attractive goal.
With the emergence of percutaneous transcatheter closure, t
Percutaneous Occlusion of the Patent Ductus Arteriosus with the Amplatzer Device for Atrial Septal Defects
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Percutaneous occlusion of the patent ductus arteriosus (PDA) has been performed safely and effectively with different devices over the last years.1–6 Selection of the closure device is based on the anatomic configuration of the duct and its minimal diameter. The large and short (window-type) ductuses are generally associated with higher rates of incomplete occlusion, device embolization and abandoned procedure failures.2,3 Also, the procedure can be technically demanding in adults due to suboptimal visualization of the ductal anatomy on angiography, local calcification
Bivalirudin in Peripheral Vascular Interventions: A Single Center Experience
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Unfractionated heparin (UFH) is the current antithrombotic agent utilized during peripheral angioplasty procedures (PTA). UFH has an unpredictable anticoagulation response, is an indirect thrombin inhibitor, does not inhibit bound thrombin and activates platelets.1 We have recently reported our procedural complications rate (9.2%) during PTA with the use of UFH as a primary anticoagulant.2 Our experience was in concordance with multiple published reports showing a complication rate of 3.5–32.7%.3–9
Bivalirudin, a direct thrombin inhibitor, has been recent
Use of Multiple Stents to Seal Off an Epicardial Pseudoaneurysm
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Pseudoaneurysms of saphenous vein grafts are rare following coronary artery bypass surgery. They occur most often at the proximal anastomosis secondary to vessel layer disruption. Rarely do they occur distally. We report the case of a pseudoaneurysm involving the saphenous vein graft to a circumflex marginal branch at the distal anastomosis site.
Case Report. A 69-year-old male presented initially with shortness of breath and chest pain; an exercise stress echocardiogram was positive for inducible ischemia, and subsequent cardiac catheterization revealed triple-vessel disease. The
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