Volume 24 - Issue 4 - April 2012

Contraction of the Amplatzer Vascular Plug I and II in Pulmonary Artery and Systemic Venous Collateral Vessels is Safe and of No Hemodynamic or Vascular Consequence in Short- and Mid-term Follow-up

Michael R. Recto, MD1, Matthew Stohs1, Thomas Yeh Jr, MD, PhD2

Abstract: Background. The Amplatzer Vascular Plug (AVP) I and AVP II have been used successfully to occlude moderate-large venous collateral vessels (VC) and pulmonary arteriovenous malformations (PAVM) in children and adults with congenital heart disease. Purpose. To report our experience in 4 patients who underwent device occlusion of systemic venous collaterals (3 patients) and device closure of pulmonary arteriovenous malformation (1 patient) that developed contraction of the AVP....

Good Efficacy of Drug-Eluting Balloons in a Mixed Population of Patients with Coronary Artery Disease

Florim Cuculi, MD1, Mabelle Young, MD1, Remo Beeler, MD1, Andreas W. Schoenenberger, MD2, Paul Erne, MD1

Abstract: Introduction. Drug-coated balloons (DCB) are being increasingly used in interventional cardiology and are established for the treatment of in-stent restenosis (ISR). It is unclear how effective they are in patients with de novo lesions. Methods. A prospective registry of patients treated with the In.Pact DCB at our institution was conducted....

Low-Dose Unfractionated Heparin Administration During Intravascular Ultrasound Studies is Safe Even Shortly After Endomyocardial Biopsy in Cardiac Transplant Patients

Reza Arsanjani, MD, Avinash Khitri, MD, Mehrnoosh Hashemzadeh, PhD, Mohammad Reza Movahed, MD

Abstract: Background. Full therapeutic heparin doses ranging from 5000-10,000 units or weight based (70-100 units/kg) have been recommended during percutaneous coronary interventions. However, there are currently no data available in regards to the appropriate dosing of unfractionated heparin during intravascular ultrasound (IVUS) studies without therapeutic coronary interventions....

Heparin Dose and Harm: Absence of Evidence or Evidence of Absence?

Herbert D. Aronow, MD, MPH

There has been tremendous evolution in drug and device therapy for percutaneous coronary intervention (PCI) since its inception more than 3 decades ago. Although direct thrombin inhibitors, and to a lesser extent low molecular weight heparin, have eaten into the previous market dominance of unfractionated heparin (UFH) in the United States, the latter is still employed in a sizeable minority of contemporary PCI procedures....

A Novel Method to Deliver the Filtrap Coronary Embolic Protection Filter Using a Manual Thrombectomy Catheter: In Vitro and In Vivo Comparison with the Conventional Method

Shin Watanabe, MD1, Naritatsu Saito, MD1, Akihiro Tokushige, MD1, Bao Bingyuan, MD1, Yoshiaki Kawase, MD2, Takeshi Kimura, MD1

Abstract: Background. Although several types of distal embolic protection devices have been developed, they are usually difficult to use because of their stiff and bulky characteristics. We present a novel method to deliver the coronary embolic protection filter via a manual thrombectomy catheter. Methods. We modified the Filtrap embolic protection filter (Nipro Corporation) to pass through the aspiration thrombectomy catheter....

Percutaneous Device Closure of Patent Foramen Ovale Using the Premere Occlusion Device: Initial Experience, Procedural, and Intermediate-Term Results

Nick J. Collins, FRACP1, Rachael Hatton, FRACP1, Kevin Ng, FRACP2, Rohan Bhagwandeen, FRACP1, John Attia, PhD3, Chris Oldmeadow, PhD3, Rohan Jayasinghe, PhD2

Abstract: Background. Percutaneous device closure is a therapeutic option in patients with presumed stroke complicating paradoxical emboli. Newer devices with lower profiles and potentially reduced thrombogenicity have emerged, such as the Premere PFO occlusion device (St Jude Medical, Inc.); there are limited data on the efficacy and procedural experience with this device....

Successful Transfemoral Antegrade Valve-in-Valve Implantation of a SAPIEN XT Valve into a Degenerated Mitral Valve Prosthesis

Raffi Bekeredjian, MD, Emmanuel Chorianopoulos, MD, Hugo A. Katus

Abstract: Transfemoral aortic valve implantation has become an important interventional technique for patients with severe aortic stenosis and high surgical risks. The mitral valve has been a much greater challenge for interventional procedures, and no percutaneous mitral valve implantation system has yet been developed and approved. ...

The Incidence of Transcatheter Aortic Valve Implantation-Related Heart Block in Self-Expandable Medtronic CoreValve and Balloon-Expandable Edwards Valves

Michael Liang, MBChB, FRACP1,2, Gerard Devlin, FRACP1, Sanjeevan Pasupati, MBChB, FRACP1    

Abstract: Background. Transcatheter aortic valve implantation (TAVI) has been performed at Waikato Hospital for high-risk severe symptomatic aortic stenosis patients who are considered unsuitable for conventional cardiac surgery for the last 3 years. The Medtronic CoreValve (MCV) is a self-expandable device, while the Edwards SAPIEN valve (EV) requires the use of a balloon to expand the device....

Management of Drug-Eluting Stent Restenosis

Kiyotake Ishikawa, MD1,2, Yutaka Aoyama, MD1, Haruo Hirayama, MD, PhD1

Abstract: In-stent restenosis has been a longstanding problem after percutaneous coronary intervention. The introduction of the drug-eluting stent (DES) successfully reduced the rate of restenosis; however, it is not completely diminished. Although restenosis occurs less frequently compared to the bare-metal stent (BMS), DES restenosis remains a familiar problem due to the increasing total number of implanted DESs as well as the targeting of more complex lesions....

Bilateral Arm Approach for Percutaneous Coronary Intervention of Unprotected Left Main Supported by a Modified Intra-Aortic Balloon Pump

Harsh Golwala, MD, Soni Zacharias, MD, Faisal Latif, MD

Abstract: Patients in whom femoral arterial access is not feasible pose a challenge in terms of hemodynamic support during high-risk percutaneous coronary intervention. Patient’s height adds another challenge given the fixed lengths of available intra-aortic balloon pumps, in terms of achieving an adequate infrasubclavian positioning in the descending thoracic aorta. ...

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