The number of percutaneous coronary interventions (PCI) performed worldwide is increasing. With the improvement of technology and interventional tools, the number of procedures is expected to further increase. As the range of equipment available to the interventional cardiologist evolves, together with necessary operator expertise, not only will the number of procedures increase, but interventionists will be treating patients with complex disease and more challenging coronary anatomy.
Among the most dreadful complications seen during PCI are abrupt vessel closure and perforations. Improveme... continue reading about Coronary Perforation 2006 — Watch for the Wire
The primary goal of therapy for acute myocardial infarction (AMI) is rapid, complete and sustained restoration of infarct-related artery (IRA) blood flow and myocardial perfusion, with a consequent positive impact on the patient’s outcome. Both fibrinolytic and mechanical restoration of anterograde coronary blood flow in patients suffering AMI have shown to improve left ventricular function, reduce infarct size and reduce mortality.1–10 The benefits of myocardial reperfusion, including the prevention of infarct expansion and improvement of electrical stability, are amplified whe... continue reading about Rescue Percutaneous Coronary Intervention: A Review
A 42-year-old man presented with heavy chest pain of four hours’ duration. Physical examination was unremarkable. The ECG showed an acute septoapical infarction. Nitroglycerin, aspirin, clopidogrel and heparin were administered, and an emergency coronary angiography was performed from the right femoral artery (Figures 1 A and B). The left anterior descending artery was occluded distally. The left main trunk ostium was deeply intubated by a slightly too large Q4 6 French intervention catheter. There was, however, no damping or ventriculization of pressure. The occlusion was crossed with a ... continue reading about The “Zipper” Lesion: A Rare but Serious Guiding Catheter-Induced Complication of a PCI Procedure
The Fontan operation was first described for management of univentricular heart disease in 1971. Since it was first described, there have been several modifications to the original operation.1 In 1988, de Laval2 first proposed the concept of total cavopulmonary anastomosis (construction of an intra-atrial lateral tunnel to connect the inferior vena cava to the pulmonary artery together with a bidirectional cavopulmonary shunt) as an alternative to atriopulmonary connection. The extracardiac approach remains popular because it eliminates the need for aortic cross-clamping,... continue reading about Transcatheter Fenestration of Autologous Pericardial Extracardiac Fontan via the Transhepatic Approach