Volume 13 - Issue 12 - December, 2001
Editor’s Message (December 2001)
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Dear Readers,
This issue of the Journal of Invasive Cardiology includes original research articles, commentaries, case reports, and articles from the Journal special sections "Clinical Decision Making" and "The Electrophysiology Corner".
The first research article, submitted by Dr. Deepak Bhatt and colleagues from the Departments of Cardiology and Neurology at the Cleveland Clinic Foundation in Cleveland, Ohio, presents their study of the impact of dual antiplatelet therapy on thrombotic events following use of stents for the treatment of carotid artery stenosis. Their study demonstrate
Percutaneous Coronary Intervention of the Left Main Trunk in Congenitally Anomalous Single Coronary Artery
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Anomalous origin of the coronary arteries is uncommon. Angiographic studies have found a prevalence of such a congenital anomaly in 0.6–1.3% of cases.1,2 Single coronary artery arising from the right sinus of Valsalva is even less common, occurring in 0.02–0.04% of patients undergoing coronary arteriography.2,3 Accordingly, few reports have described percutaneous coronary interventions (PCI) of a single anomalous coronary artery.4–7 This report is the first to illustrate PCI of an anomalous left main trunk (LMT) originating from the proximal right coronary artery (RCA). The importance of
Initial Clinical Experience with Implantable Loop Recorders
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Syncope is responsible for 5% of emergency department visits and 1% of hospital admissions.1 Syncopal episodes are often too infrequent and unpredictable for detection with conventional ambulatory monitoring techniques.
Electrophysiologic testing is performed when noninvasive tests and neurologic work-ups are negative. Nonetheless, electrophysiological testing is negative in 14–70% of patients.1–3 The purpose of this study was to review our initial experience of a university hospital with a first-generation implantable loop recorder (ILR) for diagnosis of recurrent unexplained syncope or
Residual Inferior Atrial Septal Defect After Surgical Repair: Closure Under Intracardiac Echocardiographic Guidance
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Case Description. A 41-year-old woman was admitted with the diagnosis of atrial flutter/fibrillation of two days for cardioversion. Her past medical history was remarkable for two operations to repair a secundum atrial septal defect (ASD) at the age of 9 years (initial operation) and 29 years (for residual shunt with significant symptoms); both operations were performed elsewhere and the operative notes were not available to us. Two years prior to this admission, she sustained a transient ischemic attack (TIA) with weakness in her right side and speech impairment. At that time, she u
Letting the Air Out of the Follow-up Balloon
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The paper by Traverso and colleagues in this issue of the Journal tries valiantly to extract meaningful data from their retrospective look at a subset of their mitral valvuloplasty population. This study is similar to a number of
See Traverso et al. on pages 795–799
reports on balloon mitral valvuloplasty purporting to show excellent initial results, data on long-term follow-up, and insights on the validity of the Wilkin’s scoring system. Unfortunately, this paper, in common with many of the others, provides little of the above, and casts no light on the fundamental unanswere
Negative Remodeling at the Ostium of the Left Circumflex Artery
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Recently, lower restenosis rates have been demonstrated by directional coronary atherectomy (DCA) followed by stenting compared to stenting alone.1 This strategy may be suitable for ostial lesions, which are associated with a high risk of acute complications and a high restenosis rate.2 Because DCA removes atherosclerotic plaque and elastic elements, which are abundant at the ostium, DCA followed by stenting may result in a larger final lumen size and less incidence of sidebranch compromise due to plaque shift compared to stenting alone.1,3 However, this strategy has a risk of coronary perfora
Percutaneous Mitral Balloon Valvotomy: Six-Year Follow-up
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Valvular stenosis due to rheumatic heart disease is still frequent in the country of Chile; when its course is not altered with adequate therapy, it usually carries a high morbidity and mortality rate.1–3 Rheumatic mitral stenosis primarily affects young women, invalidating them and diminishing life expectancy. The short- and long-term efficacy of surgical mitral commissurotomy has been well documented in different studies.4–6 Nevertheless, due to the inherent risks involved with cardiac surgery, the need to develop percutaneous techniques became evident almost 20 years ago. Since Inoue’
Treatment of Long, Diffuse, In-Stent Restenotic Lesions with Beta Radiation Using Strontium 90 and Sequential Positioning “Pullb
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Diffuse, in-stent restenosis, characterized by lesions greater than 10 mm in length, is associated with revascularization rates ranging from 34% to more than 80% following conventional percutaneous coronary intervention (PCI).1 Lesion lengths extending beyond 30 mm are especially problematic and constitute a group of patients that benefit most from vascular brachytherapy.2 Five randomized, placebo-controlled trials have established that beta- and gamma-based vascular brachytherapy reduce the incidence of restenosis and clinical event rates following PCI for the treatment of in-stent restenosis
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