Volume 16 - Issue 3 - March, 2004

Severe Intravascular Hemolysis Following Mitral Valve Repair

ABSTRACT: We report two cases of severe intravascular hemolysis (IVH) following mitral valve repair using a Cosgrove-Edwards ring. In both cases, the degree of mitral regurgitation (MR) seen postoperatively worsened significantly compared to intraoperative transesophageal echocardiogram. Both patients required reoperation with mitral valve replacement with immediate resolution of the hemolysis. We hypothesize that the mitral regurgitation in the setting of an inadequate mitral valve repair is responsible for the hemolysis and propose various mechanisms to explain this pathophysiology. A



Low-Molecular-Weight Heparins and Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes (Part II)

Continued from previous page

Several other recent studies have also examined the efficacy and safety of the combination of LMWHs and GP IIb/IIIa antagonists in the catheterization laboratory (Table 1). Kereiakes et al. reported the results of a pilot study comparing two doses of dalteparin (40 or 60 IU/kg) in combination with abciximab for anticoagulation during elective PCI in 107 patients.46 Randomized enrollment was halted because three acute thrombotic events occurred in the 40 IU/kg



March 2004

Dear Readers,

This issue of the Journal of Invasive Cardiology coincides with the annual scientific sessions of the American College of Cardiology and includes original research articles, commentaries, review articles, case reports and offerings from our journal special sections Acute Coronary Syndromes, Interventions in Peripheral Vascular Disease, Clinical Decision Making and Clinical Images.

The research articles in this issue cover a broad range of topics that touch on important aspects of patient care. The first resear



Low-Molecular-Weight Heparins and Glycoprotein IIb/IIIa Antagonists in Acute Coronary Syndromes (Part I)

ABSTRACT: Traditional antithrombotic regimens for the management of acute coronary syndromes are far from optimal. There is considerable opportunity for improvement of standard treatment with unfractionated heparin and aspirin. The introduction of new antithrombotic drugs, such as low-molecular-weight heparins (LMWH), and more potent antiplatelet drugs, such as glycoprotein (GP) IIb/IIIa antagonists, has the potential to significantly improve clinical outcomes. The complementary anticoagulant/antiplatelet modes of action of LMWHs and GP IIb/IIIa antagonists mean that combining these dru



Cutting Balloon Angioplasty to Treat Carotid In-Stent Restenosis

ABSTRACT: We describe a case of carotid artery restenosis following carotid artery stenting for treatment of post-endarterectomy stenosis. The goal is to highlight the risk of recurrent restenosis following endarterectomy. In this case report, we describe the use of cutting balloon therapy as a reasonable alternative to repeat surgical revascularization.

Key words: arteriosclerosis, cerebrovascular disorders, endarterectomy

With the recent presentation of the SAPPHIRE trial1 favoring carotid stenting with protection compared to carotid endarterectomy in



Simple Clinical Risk Stratification and the Safety of Ambulation Two Hours After 6 French Diagnostic Heart Catheterization

ABSTRACT: Heart catheterization is frequently applied in patients with coronary artery disease for diagnostic and therapeutic implications. Using the femoral approach, post-procedure bed rest of 4–6 hours is recommended to prevent groin complications. This extended strict bed rest is associated with patient discomfort and increased medical costs, and interferes with more efficient catheterization laboratory management of referred outpatients. Accordingly, we tested a simple clinical approach to identify low-risk patients who may benefit from ambulation within two hours after sheath re



Comparison of the Radial and Femoral Approaches in Left Main PCI: A Retrospective Study

ABSTRACT: Transradial percutaneous coronary intervention (PCI) is a safe and effective method of percutaneous revascularization. However, there are no data on the efficacy of the transradial approach in left main (LM) PCI. We studied 80 patients (pts) who underwent LM PCI between February 1994 and January 2002, and compared the radial (27 pts) and femoral (53 pts) approaches. Patients were considered free of restenosis if they were free of angina and had a negative treadmill or nuclear imaging study 6 months post-PCI. Mean follow-up time was 27.4 ± 23.0 months. Reason for PCI (stable a



Validation of 4 French Catheters for Quantitative Coronary Analysis: In Vivo Variability Assessment Using 6 French Guiding Cathe

ABSTRACT: Although numerous studies have established the utility of 4 French (Fr) catheters for routine coronary angiography, its adequacy for automatic quantitative coronary analysis has not been previously assessed. Methods. In 32 consecutive patients, coronary angiography was performed sequentially with 4 Fr diagnostic catheters and 6 Fr guiding catheters after intracoronary nitroglycerin. A total of 43 lesions were evaluated for quantitative analysis using both types of catheter as scaling devices. Possible differences in the reference diameter, minimal luminal diameter and p



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