Volume 18 - Issue 6 - June, 2006

Impact of Functional Testing Results on Prescription Patterns of Anti-Anginal Medication after Coronary Artery Bypass Graft Surg

Karen Wou, Hiep Nguyen, MD, Robert Duerr, MD, Michael Del Core, MD, Dominique Fourchy, MD, Thao Huynh, MD, Ellis Lader, MD, Felix J. Rogers, DO, Rashid Chaudhry, MD, Louise Pilote, MD, MPH, PhD, Mark J. Eisenberg, MD, MPH

Coronary artery bypass graft surgery (CABG) relieves anginal symptoms and decreases morbidity and mortality in patients suffering from coronary artery disease (CAD).1,2 Unless comorbid diseases are present, guidelines do not recommend the routine use of anti-anginal medication post-CABG.3,4 However, previous studies suggest that anti-anginal medication is not significantly reduced following CABG. It is also unclear whether functional testing results have an impact on post-CABG prescription patterns. Functional testing is often used to identify graft occlusion, native coro...

Cold Leg in Patient with High Coated Platelets: Possible Association with the Use of Rofecoxib

Abdul Rashid, MD, George Dale, MD, Thomas Hennebry, MD

Diagnostic coronary angiography in the current era is a remarkably safe procedure, yet major complications do occur. Many of these complications are related to vascular access. Although discomfort at the site of access is frequent and minor hematomas are common, one of the most potentially devastating complications is acute limb ischemia. This can relate to pre-existing atherosclerosis, prothrombotic state, catheter-induced dissection, local thrombus formation, or a combination of these factors. Prolonged use of external compression devices may also increase this risk. A new concern is whether...

Immediate- and Short-Term Outcome following Recanalization of Long Chronic Total Occlusions (> 50 mm) of Native Coronary Arteri

aAkil Loli, MD, aRex Liu, MD, bAshish Pershad, MD

Chronic total occlusion (CTO) is present in approximately 30% of diagnostic angiograms. Data suggest that 10-year survival of patients with CTO is improved if the CTO is successfully recanalized.1 Percutaneous coronary intervention (PCI) of a CTO now accounts for approximately 10% of patients undergoing PCI.2–4 However, the success of recanalization with conventional wires is about 50–60%,5–7 and the impact of the new technology on recanalization is unknown. We are presenting a single-center experience with one device, the Frontrunner™ catheter (LuMe...

Late In-Stent Thrombosis in a Patient with Systemic Lupus Erythematosus and Hyperhomocysteinemia while on Clopidogrel and Aspiri

Andre C. Olivier, MD and Jay L. Hollman, MD

Recent case reports of late stent thrombosis following the discontinuation of aspirin have raised the concern that drug-eluting stents might be more prone to this complication. McFadden et al reported on 4 patients, 2 who received a paclitaxel-eluting stent, and 2 who received a sirolimus-eluting stent. The time from stent implantation to stent thrombosis was 335 to 442 days. All patients had finished dual antiplatelet drugs and were being maintained on aspirin. The aspirin was discontinued for elective surgery 4 days to 2 weeks prior to stent thrombosis. Two patients received bare metal stent...

Left Main Coronary Embolism

Victor M. Mejia, MD, Y. Joseph Woo, MD, Howard C. Herrmann, MD

Case Presentation. A 58-year-old female was transferred from an outside hospital with impending cardiogenic shock and pericardial effusion. She had a history of mitral regurgitation due to myxomatous degeneraton and had undergone complex mitral valve repair with quadrangular resection of the second segment of the posterior leaflet and ring annuloplasty 7 weeks prior to presentation. There was also a history of paroxysmal atrial fibrillation for which she was treated with warfarin prior to admission, as well as after surgery. She was taken emergently to the operating room for a perica...

Addendum: Four Days of Percutaneous Cardiopulmonary Support and Sixteen Days of Percutaneous Left Atrium-Artery Bypass: A Case

Yoshiyuki Yamamoto, MD, Takashi Sueda, MD, Mitsunori Okamoto, MD

The online case report with brief review entitled Four Days of Percutaneous Cardiopulmonary Support and Sixteen Days of Percutaneous Left Atrium-Artery Bypass: A Case Report of Survival of Acute Myocardial Infarction with Cardiogenic Shock and Severe Rhabdomyolysis was incorrectly listed in the Table of Contents of the December 2005 issue of The Journal of Invasive Cardiology (the authors’s names were correct, but the title and abstract were not). We regret this error and have provided the correct information below:

Four Days of Percutaneous Cardiopulmonary Support and Si...

Addendum: The Safety of Autologous Intracoronary Stem Cell Injections in a Porcine Model of Chronic Myocardial Ischemia

Shyam Bhakta, MD, Nicholas J. Greco, PhD, Marcie R. Finney, Paul E. Scheid, Robert D. Hoffman, MD, PhD, Matthew E. Joseph, Jason J. Banks, Mary J. Laughlin, MD, Vincent J. Pompili, MD

The authors of the article cited below, published in the May 2006 issue of the Journal, wish to add the
name of Paul E. Scheid to their list of authors whom they inadvertently omitted from the original manuscript.

The Safety of Autologous Intracoronary Stem Cell Injections in a Porcine Model of Chronic Myocardial Ischemia

Shyam Bhakta, MD, Nicholas J. Greco, PhD, Marcie R. Finney, Paul E. Scheid, Robert D. Hoffman, MD, PhD,
Matthew E. Joseph, Jason J. Banks, Mary J. Laughlin, MD, Vincent J. Pompili, MD

J INVASIVE CARDIOL 2006;18:212–218 (May 2006)...

Percutaneous Stenting of the Left Main with Drug Eluting Stents for In-Stent Restenosis: Immediate- and Long-Term Results

Timothy Mixon, MD and Patrick Fitzsimmons, MD

Left main coronary artery stenosis occurs in 3–5% of patients undergoing coronary angiography. Percutaneous treatment has been limited by major adverse cardiovascular events during the follow-up period. Studies suggest bare metal stents have restenosis rates of 20–30%.1 Recent studies suggest de novo left main (LM) stenting in the drug-eluting stent (DES) era is safe and effective, with restenosis rates of 5–20%.2–4
Traditionally, treatment for LM in-stent restenosis has been coronary artery bypass surgery. There are limited data on percutaneous treatment ...

Percutaneous Coronary Intervention under the Rigid Restriction of Contrast Media Dose in Patients with Chronic Renal Insufficien

Eisei Yamamoto, MD, Hitoshi Takano, MD, Morimasa Takayama, MD

Exposure to contrast media occasionally induces acute renal disturbance, often called contrast-induced nephropathy (CIN).1–3 Although the impairment is transient and function spontaneously recovers in most cases, irreversible damage occurs in some patients, particularly in those with preexisting chronic renal insufficiency (CRI).3,4 The nephrotoxicity of contrast media causes serious limitations in treating coronary artery disease in patients with CRI. Prevention of CIN has been considered to be one of the most important issues for those patients, since this complicatio...

Safety of Percutaneous Left Heart Catheterization Directly Performed by Cardiology Fellows: A Cohort Analysis

Pierfrancesco Agostoni, MD, Maurizio Anselmi, MD, Gabriele Gasparini, MD, Giorgio Morando, MD, Paolo Tosi, MD, M. Luisa De Benedictis, MD, Silvia Quintarelli, MD, Gionata Molinari, MD, Piero Zardini, MD, Marco Turri, MD

Percutaneous left heart catheterization, including pressure measurements, left ventriculography, coronary angiography and percutaneous coronary interventions (PCI), is nowadays considered the gold standard for the diagnosis, evaluation and treatment of several cardiac diseases (coronary artery disease [CAD], valvular and congenital heart diseases, cardiomyopathies, status post-heart transplant).1 Although it has shown major benefits, left heart catheterization is not free of complications, as it is an invasive procedure.2 The most frequently observed complications are rel...

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