Volume 18 - Issue 6 - June, 2006

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...

Fatal Delayed Thrombocytopenia following Abciximab Therapy

Roger B. McCorry, MRCP and Paul Johnston, MRCP

Case Report. A 43-year-old Caucasian male was admitted with prolonged central chest pain. His initial ECG demonstrated ST depression in leads II, III, aVf and V2–V6. He received aspirin 300 mg, a loading dose of clopidogrel 300 mg (followed by 75 mg daily), and weight-adjusted enoxaparin (40 mg subcutaneously twice daily for 72 hours). Symptoms and ECG changes persisted and urgent coronary angiography was performed. This revealed a proximally occluded left anterior descending artery (LAD) and a severely stenosed, dominant right coronary artery (RCA), which completely collateralized...

Alveolar Hemorrhage Associated with Platelet Glycoprotein IIb/IIIa Receptor Inhibitors

aRasih Atilla Ener, MD, bNichole Bruno, MD, bDaniel Dadourian, MD, aNelson Wolf, MD, aWilliam Van Decker, MD, aJames Burke, MD, bMichael Styler, MD, bDavid Topolsky, MD

Bleeding into the alveoli from disruption of the pulmonary capillary lining may cause alveolar hemorrhage and can result from different mechanisms:1–4
1. Damage secondary to immunologic mechanisms, often associated with a pulmonary capillaritis (i.e., Goodpasture’s syndrome, systemic lupus erythematosus, vasculitides);
2. Direct mechanism or toxic injury (toxin or chemical inhalation, i.e., trimellitic anhydride, isocyanate, phenytoin, penicillamine, hydralazine, mitomycin-C, crack/cocaine use, propylthiouracil);
3. Physical trauma (i.e., pulmonary c...

Use of Magnetic Navigation to Facilitate Transcatheter Alcohol Septal Ablation for Hypertrophic Obstructive Cardiomyopathy

Richard G. Bach, MD*, Christopher Leach, MD, Simon A. Milov, MD, Bruce D. Lindsay, MD*

Percutaneous transcatheter alcohol septal myocardial ablation (PTSMA) is an effective alternative to septal myectomy for symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM).1–6 While alleviating symptoms for most patients, the procedure may not be technically feasible in 5–10% of cases,7 potentially due to septal artery anatomy. In some cases, success may be limited by operator difficulty in cannulating septal branches due to the typical 90° or greater angulation of their origin. The Stereotaxis Niobe® magnetic navigation system (Stereotaxis,...

Aortic Stenosis Catheterization Revisited: A Long Sheath Single-Puncture Technique

aJanet Hays, MD, bMichael Lujan, bRobert Chilton, MD

Aortic stenosis is one of the most common forms of valvular heart disease seen in adults. Despite advances in echocardiography, the evaluation of aortic stenosis continues to be a frequent procedure in the cardiac catheterization laboratory. In order to calculate the aortic valve area using the Gorlin formula,1 the mean transvalvular pressure gradient across the aortic valve must be measured. To obtain this transvalvular gradient, simultaneous evaluation of the proximal aortic and left ventricular pressures yields the most accurate data. Classically, this has required placing one ar...

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